It is known that the treatment of pseudomonas aeruginosa infection associated with scleral necrosis after pterygium excision is difficult. Pseudomonas scleritis were treated with systemic and topical antibiotics, debridement, scleral homograft,and conjunctival autograft in 3 cases of 4 cases. Another 1 case was transfered to other hospital with patient`s request after short medical treatment. The interval from pterygium operation to onset of pseudomonas scleritis ranged from 2 to 17 years with an average of 10 years. In all cases with operation, the graft was stabilized after mean time of 42 days (ranged 35 to 48 days) from operation. The complications were visual disturbance, endophthalmitis, complicated cataract, exudative retinal detachment, exotropia, and posterior synechia of iris. In 1 case, a corticosteroid which was used in the early of treatment induced exacerbation of disease.Because the complications of disease were so severe,early prophylactic operation will be necessary in noninfected scleral necrosis, and when infection is suspected, it should be necessary to do culture and sensitivity test with an intensive anti-pseudomonal therapy.
Anti-Bacterial Agents ; Autografts ; Cataract ; Debridement ; Endophthalmitis ; Exotropia ; Iris ; Necrosis ; Pseudomonas aeruginosa ; Pseudomonas* ; Pterygium* ; Retinal Detachment ; Scleritis* ; Transplants

OBJECTIVE: The purpose of this study was to determine no response rates of sensory nerve conduction studies and late responses in the lower limbs of healthy adults. METHOD: The subjects were 50 healthy adults (mean age, 45.6 years) without the clinical signs and symptoms of peripheral neuropathy. All subjects underwent electrodiagnostic evaluation of the following sensory nerves in lower limbs: superficial peroneal, sural, proximal sural, lateral dorsal cutaneous branch of sural nerve (LDSN), and medial plantar. Examined late responses included: tibial F-wave, peroneal F-wave, and H-reflex recorded from the soleus muscle. RESULT: No response rates of sensory nerve conduction studies such as superficial peroneal, sural, proximal sural, LDSN, and medial plantar nerves were 2%, 0%, 0%, 24%, and 18%, respectively. No response rates of late responses such as tibial F-wave, peroneal F-wave, and H-reflex were 0%, 2%, and 8%, respectively. And no response rates were significantly correlated with age (p<0.05). CONCLUSION: No response rate of sensory and late responses of lower limbs are relevant to age increments, the results should be considered for an early diagnosis of peripheral neuropathy in the lower limbs of old population.
Adult* ; Early Diagnosis ; H-Reflex ; Humans ; Lower Extremity* ; Muscle, Skeletal ; Neural Conduction* ; Peripheral Nervous System Diseases ; Sural Nerve ; Tibial Nerve

Laboratory diagnosis of respiratory viral infection has traditionally been based upon virus isolation and/or viral antigen identification. Recently, more sensitive and specific nucleic acid detection methods by reverse transcription- polymerase chain reaction (RT-PCR) have been developed, however, conventional RT-PCR can identify only a single suspected virus. To identify the causative agents which belong to Paramyxoviridae of respiratory virus infections, we have developed a single-tube multiplex RT-PCR using four primer sets which can amplify respiratory syncytial virus and parainfluenza virus type 1, 2 and 3 simultaneously. Assay sensitivity of single-tube multiplex RT-PCR allowed a detection in the range of 3~500 TCID50 and there were no cross amplification among other respiratory viral agents based on the test using reference virus stocks. The single-tube multiplex RT-PCR was able to directly detect viruses in respiratory specimens, with virus being detected 11 of 80 samples as compared to 9 of 80 samples detected by indirect immunofluorescence or antigen detection following shell vial culture. This result suggests that the single-tube multiplex RT-PCR can be established as a more sensitive and rapid diagnostic application than shell vial assay for the detection of respiratory infection of Paramyxoviridae.
Clinical Laboratory Techniques ; Fluorescent Antibody Technique, Indirect ; Humans* ; Parainfluenza Virus 1, Human* ; Paramyxoviridae ; Paramyxoviridae Infections* ; Polymerase Chain Reaction* ; Respiratory Syncytial Virus, Human* ; Respiratory Syncytial Viruses ; Reverse Transcription*

BACKGROUND: Psoriasis is an inflammatory skin disorder that is characterized by a marked proliferation of keratinocytes, vascular dilation and leukocyte infiltration. Cytokines play important roles in the pathogenesis of inflammatory disorders. An overexpression of proinflammatory cytokines was characterized in psoriasis plaque. Among these cytokines, IL-1beta is major pro-inflammatory cytokine synthesized during the infection and inflammatory process. The IL-1 receptor antagonist (IL-1Ra) competes for the same IL-1 receptor for IL-1alpha and -1beta, which prevents activation of the target cells. Three single nucleotide polymorphisms (SNPs) in the IL-1beta gene have been reported at position-31, -511 and +3954. Within the IL-1Ra gene (IL-1RN), there is a variable number of tandem repeats (VNTR) of an 86 bp length in intron 2. These polymorphisms related to cytokine production and associated with various diseases. METHODS: We investigated the polymorphisms of IL-1B (promoter -511 and +3954) and IL-1RN on 114 psoriasis patients and -311 healthy normal controls in Korean. We performed PCR-RFLP on single nucleotide polymorphisms (SNPs) of IL-1B (promoter -511 and +3954) and fragment analysis on IL-1RN 86 bp VNTR polymorphism. RESULTS: The frequency of IL-1B-511*1 allele (patients vs. controls; 50.0% vs. 42.3%, RR=1.4) was significantly increased and IL-1B -511*2 allele (patients vs. controls; 50.0% vs. 57.7%, RR=0.7) decreased in psoriasis patients compared to normal controls. We also analyzed the IL-1B -511 polymorphism according to patients' characters (age of onset, sex and family history). The IL-1B -511 alleles were significantly associated in patients with male and family history than health normal controls. There were no significant associations of IL-1B +3954 and IL-1RN polymorphisms with psoriasis patients. CONCLUSION: These results suggest that the polymorphism of IL-1B -511 could be genetic susceptibility to psoriasis in Koreans.
Alleles ; Cytokines ; Genetic Predisposition to Disease ; Humans ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Introns ; Keratinocytes ; Leukocytes ; Male ; Minisatellite Repeats ; Polymorphism, Single Nucleotide ; Psoriasis* ; Skin

INTRODUCTION: Perioperative irradiation is often combined with spine tumor surgery. Radiation is known to be detrimental to healing process of bone fusion. We tried to investigate bone fusion rate in spine tumor surgery cases with perioperative radiation therapy (RT) and to analyze significant factors affecting successful bone fusion. METHODS: Study cohort was 33 patients who underwent spinal tumor resection and bone graft surgery combined with perioperative RT. Their medical records and radiological data were analyzed retrospectively. The analyzed factors were surgical approach, location of bone graft (anterior vs. posterior), kind of graft (autologous graft vs. allograft), timing of RT (preoperative vs. postoperative), interval of RT from operation in cases of postoperative RT (within 1 month vs. after 1 month) radiation dose (above 38 Gy vs. below 38 Gy) and type of radiation therapy (conventional RT vs. stereotactic radiosurgery). The bone fusion was determined on computed tomography images. RESULT: Bone fusion was identified in 19 cases (57%). The only significant factors to affect bony fusion was the kind of graft (75% in autograft vs. 41 in allograft, p=0.049). Other factors proved to be insignificant relating to postoperative bone fusion. Regarding time interval of RT and operation in cases of postoperative RT, the time interval was not significant (p=0.101). CONCLUSION: Spinal fusion surgery which was combined with perioperative RT showed relatively low bone fusion rate (57%). For successful bone fusion, the selection of bone graft was the most important.
Allografts ; Autografts ; Cohort Studies ; Humans ; Medical Records ; Retrospective Studies ; Spinal Fusion ; Spine* ; Transplants

Severe hypoglycemia leading to permanent brain damage is rare in non-diabetic population. We present one case where chronic alcoholism combined with prolonged fasting lead to such a state. A 51-year-old male patient, a chronic alcoholic, was found unconscious and brought to the emergency room. At the time of hospitalization, consciousness was stupor and he had a blood glucose of 5 mg/dl and MRI of the brain showed high signal density of the inner temporal gyrus and both hippocampus in T2 weighted imaging. There was no history of diabetes. After two months of rehabilitation, improvements were showed to Rancho Los Amigos recognition scale IV, fair grade of muscular strength in upper and lower limbs, FIM score of 21, and dysphagia was improved and nutrition supply was intaken orally. An alcoholic for a long period of time without adequate nutrient supply was experienced to develop into hypoglycemic encephalopathy and therefore reported.

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disease characterized by telangiectasias of the skin, mucous membranes, and various organ system. HHT is not unusual in western countries but there were several reported cases of HHT in Korea. Recently we evaluated a 40-year-old postpartum female who had been suffering from recurrent epistaxis and peripartum dyspnea. The patient was diagnosed as a HHT complicated by high output heart failure caused by intrahepatic arteriovenous malformation. This case is reported with a review of relevant literature.
Adult ; Arteriovenous Malformations ; Dyspnea ; Epistaxis ; Female ; Heart Failure ; Humans ; Korea ; Mucous Membrane ; Peripartum Period ; Postpartum Period ; Skin ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

Gastrointestinal mucormycosis is an uncommon opportunistic fungal infection often presents in immunocompromised patients. Direct invasion of the intestinal walls by spores from ingested food is the main pathogenetic mechanism of this disease, which usually takes place in stomach and colon. Early diagnosis is critical, especially in vascular invasive types, due to its high mortality rate close to 100%. In the past when appropriate diagnostic tools were not available, mucormycosis were frequently found with autopsy. The advance in current endoscopic technology has increased diagnostic rate and made successful management available with appropriate treatments such as debridement of contaminated tissues. In this case report, we discussed a case of ileal mucormycosis diagnosed by colonoscopy and treated with anti-fungal agent successfully.
Amphotericin B/therapeutic use ; Antifungal Agents/therapeutic use ; Colonoscopy ; Humans ; Ileal Diseases/*diagnosis/microbiology/therapy ; Ileum/pathology ; Immunocompromised Host ; Leukemia, Myeloid, Acute/*complications/drug therapy ; Male ; Mucormycosis/*diagnosis/etiology/therapy ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: To evaluate the sensitivity and specificity of the DNA chip method in diagnosing patients with granular corneal dystrophy type II (GCD II) induced by mutation of the betaigh3 gene. METHODS: Two hundred twenty-seven patients who visited Severance Eye hospital, corneal dystrophy clinic, from 1 July 2006 to 30 September 2007 were included in this study after history taking and review of their medical records. All subjects were examined by slit lamp microscopy, and blood sampling was done. The sampled blood was used in DNA sequencing and the DNA chip method. RESULTS: Among 227 subjects, 125 (54.6%) patients had GCD II and 103 (45.4%) patients showed normal results according to the DNA sequencing method. The sensitivity and specificity of the DNA chip method were both 100%, while the sensitivity of the slit lamp method was 99.19% and the specificity was 100%. CONCLUSIONS: The DNA chip method for diagnosing GCD II is a more simple, time-saving, and accurate method than DNA sequencing method, and the sensitivity and specificity were both 100%.
DNA ; Eye ; Humans ; Medical Records ; Microscopy ; Oligonucleotide Array Sequence Analysis ; Sensitivity and Specificity ; Sequence Analysis, DNA

A 70-year old man presented with postprandial upper abdominal pain of two months duration, accompanied by indigestion, weight loss, and anorexia. There was no abnormality noted in the lab results. Abdominal CT showed a 3-cm round cystic mass in the tail of the pancreas. A distal pancreatectomy was done. The patient was discharged in 9 days. The cystic wall was composed of a keratinizing squamous epithelium surrounded by subepithelial, dense lymphoid tissue. Some clusters of the sebaceous gland were noted but there was no sweat gland or hair follicle. These findings were consistent with a lymphoepiethelial cyst with sebaceous differentiation. The patient was followed up for 12 months post operatively, and no recurrence was noted.
Abdominal Pain ; Aged ; Anorexia ; Dermoid Cyst* ; Dyspepsia ; Epithelium ; Hair Follicle ; Humans ; Lymphoid Tissue ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Recurrence ; Sebaceous Glands ; Sweat Glands ; Tomography, X-Ray Computed ; Weight Loss