Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.
Adolescent ; Cerebrospinal Fluid ; Child ; Cytoplasm ; Endothelial Cells ; Europe ; Female ; Humans ; Meningitis* ; Meningitis, Aseptic ; Neck ; Neutrophils

Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.
Adolescent ; Cerebrospinal Fluid ; Child ; Cytoplasm ; Endothelial Cells ; Europe ; Female ; Humans ; Meningitis* ; Meningitis, Aseptic ; Neck ; Neutrophils

PURPOSE: We analyzed time series changes in cataract surgeries in Korea, and provide basic data to enhance the efficiency of medical services for cataract surgery. METHODS: Among cataract surgery statistics registered in the Korean National Health Insurance Cooperation from 2006 to 2012, we used data regarding the number of patients and operations and the number of patients and operations per 100,000 people. We analyzed various time series changes, including differences by sex and age. RESULTS: The total numbers of patients from 2006 to 2012 by year were 207,370; 228,170; 250,289; 268,548; 289,867; 308,111; and 302,182, respectively. The total numbers of operations from 2006 to 2012 by year were 272,920; 305,807; 338,332; 365,874; 398,338; 428,158; and 420,905, respectively. The number of patients and operations per 100,000 people were highest in men 80 to 84 years old and women 75 to 79 years old. Comparing the number of operations in 2006 and after, the patient age group with the highest increase rate changed from over 85 years old to 75–79 years old since 2010 in men and from over 85 years old to 50–54 years old since 2009 in women. For each year investigated, the number of operations performed was higher than the number of patients who received operations. CONCLUSIONS: Over the study period, the number of cataract surgeries increased, while the age of cataract patients decreased. Additionally, the number of cataract-related surgeries increased in relation to the number of patients.
Cataract Extraction ; Cataract* ; Epidemiology ; Female ; Humans ; Korea* ; Male ; National Health Programs

Objectives: ZZThe purpose of this study is to investigate the interest level, perception and attitude of suicide high-risk group towardthe media’s suicide report, and also to provide the fundamental data in order to strengthen both the standard and the recommendationof media coverage in Korea. Methods: ZZWe analyzed the data from the 2013 The Korea National Suicide Survey. The study included 1500 participants aged between19 and 75 years. The participants were selected through the regional multi-layer stratification method using the sampling frameof the 2010 Census. One-on-one face-to-face interviews investigated the interest level, opinions, and attitudes toward suicide reportsand collected data on past suicide history and demographic data. The collected data were evaluated using multiple logistic regressionanalysis. A probability level of p < 0.05 was considered statistically significant. Results: ZZThe suicide high risk groups with histories of suicidal ideations or attempts showed more interest in suicidal reports [suicidalthought odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.40–2.34 ; suicidal attempt OR = 3.21, 95% Cl = 1.52–6.78]. However,there was no difference among the groups in thought that suicide reports incite suicide (suicidal thought OR = 1.26, 95% Cl = 0.92–1.73 ; suicidal attempt OR = 0.96, 95% Cl = 0.44–2.09). The suicide high risk groups showed a positive attitude toward suicide reports,but it was not statistically significant (suicidal thought OR = 1.10, 95% Cl = 0.41–2.92 ; suicidal attempt OR = 1.10, 95% Cl = 0.76–1.59). Conclusions ZZWe suggest the need of careful attitude of media suicidal reports not to bring about copycat suicides. and also we offersuicide prevention campaign based on media leverage.

Objectives: ZZThe purpose of this study is to investigate the interest level, perception and attitude of suicide high-risk group towardthe media’s suicide report, and also to provide the fundamental data in order to strengthen both the standard and the recommendationof media coverage in Korea. Methods: ZZWe analyzed the data from the 2013 The Korea National Suicide Survey. The study included 1500 participants aged between19 and 75 years. The participants were selected through the regional multi-layer stratification method using the sampling frameof the 2010 Census. One-on-one face-to-face interviews investigated the interest level, opinions, and attitudes toward suicide reportsand collected data on past suicide history and demographic data. The collected data were evaluated using multiple logistic regressionanalysis. A probability level of p < 0.05 was considered statistically significant. Results: ZZThe suicide high risk groups with histories of suicidal ideations or attempts showed more interest in suicidal reports [suicidalthought odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.40–2.34 ; suicidal attempt OR = 3.21, 95% Cl = 1.52–6.78]. However,there was no difference among the groups in thought that suicide reports incite suicide (suicidal thought OR = 1.26, 95% Cl = 0.92–1.73 ; suicidal attempt OR = 0.96, 95% Cl = 0.44–2.09). The suicide high risk groups showed a positive attitude toward suicide reports,but it was not statistically significant (suicidal thought OR = 1.10, 95% Cl = 0.41–2.92 ; suicidal attempt OR = 1.10, 95% Cl = 0.76–1.59). Conclusions ZZWe suggest the need of careful attitude of media suicidal reports not to bring about copycat suicides. and also we offersuicide prevention campaign based on media leverage.

PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.
Acinetobacter baumannii ; Acinetobacter ; Anterior Chamber ; Ceftazidime ; Corneal Ulcer ; Cyclopentolate ; Doxycycline ; Eyelids ; Female ; Gentamicins ; Humans ; Hyperemia ; Inflammation ; Keratitis ; Middle Aged ; Ochrobactrum anthropi ; Ochrobactrum ; Pseudomonas aeruginosa ; Pseudomonas ; Republic of Korea ; Slit Lamp ; Ultrasonography ; Visual Acuity ; Voriconazole

PURPOSE: Most patients with thyroid cancer have a good prognosis. However, it has been difficult to study a large number of patients succumbing to thyroid carcinoma due to the low mortality rate and the long follow-up period associated with differentiated thyroid cancer. Therefore, we evaluated characteristics of metastasis and deaths, sites of metastasis, difference of survival from pathologic classification and treatments and the cause of deaths. METHODS: From June 1995 to December 2003, fifty-four patients who died due to distant metastasis and recurrence of thyroid cancer in Samsung Seoul Medical Center were analyzed. RESULTS: We analyzed cause of death in 55 fatal cases. Single fatal conditions could not be specified in 13 patients. In the remaining 42 patients, respiratory failure (57.1%) was the most common specific fatal condition, followed by airway obstruction (26.2%), renal failure (7.1%) and sepsis (7.1%). According to histologic subtype, overall survival and relapse survival were statistically significant (P<0.005). However, No significant difference in disease free survival was observed (P=0.09). CONCLUSION: Early diagnosis and suitable treatment were also important factors for thyroid cancer. There was shorter relapse survival length in papillary cancers than that of follicular cancers. Anaplastic cancers had a poorer survival. We couldn't find difference of relapse survival result from the treatments of metastatic thyroid cancer.
Airway Obstruction ; Cause of Death ; Classification ; Disease-Free Survival ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Renal Insufficiency ; Respiratory Insufficiency ; Seoul ; Sepsis ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: A sentinel lymph node biopsy (SLNB) has become the standard care for the staging of axilla in breast cancer and the increase in body weight with age has an inverse relationship to its success. Therefore, the characteristics of patients who underwent a SLNB, and the relationship of the influences of Body Mass Index (BMI) and age, were evaluated using lymphoscintigram visualization in a sentinel lymph node biopsy (SLNB) for breast cancer. METHODS: Between Sept. 1995 and Dec 2003, 238 patients underwent lymphoscintigraphy and SLNB (including full axillary node dissection with SLNB). 205 (86.1%) cases were able to be visualized by lymphoscintigraphy, But the remaining 33 (13.9%) were not. A combined technique (radioisotope and blue dye) was used to detect the SLNs. The BMI for each patient was calculated from height and weight data (kg/m2). RESULTS: A SLNB was attempted in all cases, but 5 failed. Of the 238 cases, the lymphoscintigraphy visualization was successful in 205 (86.1%) and failed in 33 (13.9%). The mean weight and BMI were significantly higher in the failure group. The success of a SLNB was inversely related to the BMI. When the subjects were divided into two group ac-coding to age (<50 year-old versus > or =50 year-old), this relationship was more pronounced in the > or =50 year-old group. CONCLUSION: The age and BMI of the patient influences the detection of the sentinel lymph node on a lymphoscintigram. There was no influence on the sentinel lymph node biopsy with increasing BMI and age. Therefore, increased age and/or BMI alone do not appear to be contraindication for a sentinel lymph node biopsy in older or overweight patients.
Axilla ; Body Mass Index* ; Body Weight ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Nodes* ; Lymphoscintigraphy* ; Overweight ; Sentinel Lymph Node Biopsy

PURPOSE: We report a case of rapid progression to proliferative diabetic after generalized edema occurrence in a non proliferative diabetic retinopathy patient. CASE SUMMARY: A 48-year-old man visited our hospital with both eyes visual disturbance which occurred 1 week ago. He was diagnosed with moderate non proliferative diabetic retinopathy 5 months ago and there was no significant interval change 3 weeks ago. Date of visit, diffuse macular edema and neovascularization were observed in both eyes. Accompanying visual disturbance, he had generalized edema and 10 kg of weight gain. We thought it was not common diabetic macular edema, we held ophthalmic treatment such as an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection and requested medical treatment to the department of nephrology. Diagnosed with aggravation of left ventricle heart failure and diabetic nephropathy, he took diuretics and low salt diet for 10 days. After 10 days, his visual acuity improved and macular edema disappeared. Since then, he received intravitreal anti-VEGF injection and panretinal photocoagulation for proliferative diabetic retinopathy treatment. Nevertheless, he underwent pars plana vitrectomy due to vitreous hemorrhage in right eye. CONCLUSIONS: We experienced a case of sudden diffuse macular edema and progression to proliferative diabetic retinopathy associated with generalized edema. We suggest that it is necessary to consider systemic changes in diabetic retinopathy.
Diabetic Nephropathies ; Diabetic Retinopathy* ; Diet ; Diuretics ; Edema* ; Endothelial Growth Factors ; Heart Failure ; Heart Ventricles ; Humans ; Light Coagulation ; Macular Edema ; Middle Aged ; Nephrology ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Weight Gain

PURPOSE: To determine the effect of intravitreal bevacizumab injection before panretinal photocoagulation (PRP) in clinically significant macular edema (CSME) patients. METHODS: A total of 91 eyes (70 patients) having severe nonproliferative diabetic retinopathy with CSME requiring PRP were enrolled in the present study; the medical records were retrospectively reviewed and analyzed. The eyes were divided into the regular PRP group (51 eyes) and PRP with preinjection of bevacizumab (1.25 mg) group (combination group, 40 eyes) and compared. Best corrected visual acuity (BCVA) and central macular thickness (CMT) at pretreatment and 1, 3, 6, and 12 months after PRP was evaluated. RESULTS: BCVA (logarithm of the minimum angle of resolution, Snellen visual acuity in parentheses) at pretreatment and 1, 3, 6, and 12 months after PRP was 0.24 (0.575), 0.27 (0.537), 0.28 (0.525), 0.28 (0.525), and 0.30 (0.501) (p = 0.13, 0.15, 0.56 and 0.79) in the regular PRP group and 0.32 (0.479), 0.25 (0.562), 0.26 (0.549), 0.27 (0.537), and 0.36 (0.436) (p = 0.02, 0.04, 0.02 and 0.13) in the combination group, respectively. CMT (microm) at pretreatment and 1, 3, 6, and 12 months after PRP was 257.66, 285.16, 282.21, 289.65, and 309.85 (p = 0.00, 0.00, 0.00 and 0.00) in the regular PRP group and 349.39, 312.17, 331.15. 353.30, and 333.55 (p = 0.04, 0.94, 0.79 and 0.06) in the combination group, respectively. CONCLUSIONS: Pretreatment of anti-vascular endothelial growth factor injection before PRP affected the decrease of macular thickness for 3 months after PRP and improved visual acuity for 6 months after PRP when compared with PRP alone in patients with CSME.
Diabetic Retinopathy ; Endothelial Growth Factors ; Humans ; Light Coagulation* ; Macular Edema* ; Medical Records ; Retrospective Studies ; Visual Acuity ; Bevacizumab