A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.
Aged ; Atrioventricular Block ; Female ; Hemoptysis ; Humans ; Neck ; Radiotherapy* ; Thorax ; Thyroid Neoplasms

The purpose of this study was to evaluate the relation between ocular discomfort and ocular Demodex infestation, and therapeutic effects of tea tree oil (TTO) in Demodex blepharitis patients. Three hundred and thirty-five patients with ocular discomfort were evaluated for ocular Demodex infestation and subjective symptoms with ocular surface discomfort index (OSDI) score. Among them, Demodex-infested patients were randomized to receive either eyelid scrubbing with TTO (TTO group,106 patients) or without TTO (Control group, 54 patients) for 1 month. Demodex were found in 84% of patients with ocular discomfort. The number of Demodex was significantly correlated with age (P = 0.04) and OSDI score (P = 0.024). After eyelid scrub treatment, Demodex count was reduced from 4.0 +/- 2.5 to 3.2 +/- 2.3 in the TTO group (P = 0.004) and from 4.3 +/- 2.7 to 4.2 +/- 2.5 in the control group (P = 0.27). Also, OSDI score was reduced from 34.5 +/- 10.7 to 24.1 +/- 11.9 in the TTO group (P = 0.001) and from 35.3 +/- 11.6 to 27.5 +/- 12.8 in the control group (P = 0.04). In conclusion, Demodex number showed a significant positive correlation with age and subjective ocular discomfort. The tea tree oil eyelid scrub treatment is effective for eliminating ocular Demodex and improving subjective ocular symptoms.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Anti-Infective Agents, Local/pharmacology/therapeutic use ; Blepharitis/*drug therapy/pathology ; Eye Infections, Parasitic/*drug therapy/parasitology/pathology ; Eyelids/parasitology/pathology ; Female ; Humans ; Male ; Middle Aged ; Mite Infestations/*drug therapy/parasitology/pathology ; Mites/drug effects ; Phytotherapy ; Tea Tree Oil/pharmacology/*therapeutic use ; Young Adult

Mycobacterium is an uncommon cause of peritonitis in patients receiving peritoneal dialysis (PD), and the incidence of nontuberculous mycobacterium (NTM) peritonitis is even rarer since the majority of mycobacterial peritonitis cases are caused by Mycobacterium tuberculosis. However, NTM peritonitis has been known to result in a high mortality rate with delayed diagnosis and treatment. In this study, we report a case of Mycobacterium abscessus peritonitis in a 52-year-old male under continuous ambulatory peritoneal dialysis (CAPD).
Delayed Diagnosis ; Humans ; Incidence ; Male ; Mycobacterium ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis

PURPOSE: To investigate changes in intraocular pressure (IOP) after corneal refractive surgery and determine risk factors associated with increased IOP (IIOP). METHODS: This retrospective observational study was comprised of 450 eyes of 225 patients, each of whom had corneal refractive surgery in Seoul National University Hospital between January 2004 and January 2008, and were followed for more than one month. IIOP was defined as IOP above 130% of the predicted IOP, adjusted according to corneal thickness and repeated more than twice after postoperative 1 week or after anti-glaucoma medication was needed. Correlation and stratified regression analyses were performed for eyes with myopia and IIOP. Logistic regression analysis was performed to assess risk factors of IIOP and need for medication. RESULTS: IIOP was detected in 22.2%, and anti-glaucoma medication was required in 12.0%, of eyes. The mean IIOP of the medication group was 5.6 +/- 3.4 mmHg. Stratified regression analysis showed that the proportion of IIOP did not differ significantly by the degree of myopia. Logistic regression analysis revealed that statistically significant risk factors of IIOP were female gender, preoperative low IOP, and thicker cornea. The statistically significant risk factor of need for medication was the corneal thickness. CONCLUSIONS: Thick corneal thickness was found to be a significant risk factor of IIOP after corneal refractive surgery was performed, and IIOP was not affected by the degree of myopia.
Cornea ; Eye ; Female ; Humans ; Intraocular Pressure ; Logistic Models ; Myopia ; Ocular Hypertension ; Refractive Surgical Procedures ; Retrospective Studies ; Risk Factors

PURPOSE: To evaluate the short-term clinical outcome of cataract surgery using torsional mode phacoemulsification for patients with low endothelial cell density. METHODS: Fifty-seven eyes of 52 patients who underwent torsional phacoemulsification and intraocular lens insertion were included in the present study. Patients were divided into groups according to endothelial cell density (ECD). The control group was comprised of patients with more than 2500/mm2 of ECD and was compared with the low ECD group (LECD) comprised of patients with less than 1600/mm2 of ECD. The LECD group was further divided into a very low ECD group (VLECD) comprised of patients with less than 1000/mm2 of ECD, and a PK-VLECD group comprised of patients with less than 1000/mm2 of ECD after penetrating keratoplasty. Measurement of ECD, cell-size variation coefficient, hexagonality, and central corneal thickness were performed preoperatively and 1 month after surgery. RESULTS: The only one patient who had undergone penetrating keratoplasty with remaining low endothelial density and grade 4 nuclear sclerosis developed overt corneal edema after cataract surgery. No statistically significant differences in the change of endothelial cell characteristics and central corneal thickness before and after surgery were observed between the control and LECD group and between the VLECD and PK-VLECD group. CONCLUSIONS: Even in patients with low ECD, torsional phacoemulsification appears to have a similar effect on the short-term change of endothelial cells, suggesting cataract surgery can be conducted with a staged approach when the density of nucleus is moderate or less dense.
Cataract ; Corneal Edema ; Endothelial Cells ; Eye ; Humans ; Keratoplasty, Penetrating ; Lenses, Intraocular ; Phacoemulsification ; Sclerosis

Listeria grayi is a catalase-positive, non-spore forming, and glucose-fermenting Gram-positive rod. L. grayi is widely distributed in environments such as soil, water and fresh food. Human infection by L. grayi is very rare, and there have been no cases reported in Korea, and only two cases worldwide. Dermabacter hominis is a relatively new species belonging to the coryneform bacteria and is a component of the normal human skin flora. D. hominis is a non-motile, glucose-fermenting, Gram-positive rod that has similar biochemical characteristics to L. grayi. The authors of the present study report a case initially misidentified as L. grayi via a traditional morphological and biochemical identification method but that was subsequently confirmed as D. hominis using sequence analysis of 16S rRNA.
Bacteria ; Humans ; Korea ; Listeria ; Sequence Analysis ; Skin ; Soil

PURPOSE: To examine the changes in meibomian glands associated with aging in a normal Korean population and to estimate the differences between the upper and lower eyelid in each age group. METHODS: We performed meibography on adult subjects using an infrared charge-coupled device (CCD) camera. Each eyelid was scored based on the loss of meibomian glands, and the meiboscores of the upper and lower eyelids were summed to obtain a score for each eye. Meiboscores were evaluated according to age, sex, and upper and lower eyelid meiboscores in each age group. RESULTS: One hundred seventeen eyes of 117 people were enrolled in this study. The study subjects had an average age of 50.4 +/- 19.1 years (range, 20-92; male, 56; female, 61). There was a significant positive correlation between age and total meiboscore, upper and lower eyelid meiboscore (r = 0.578, p < 0.001; r = 0.550, p < 0.001; r = 0.524, p < 0.001). There were no significant differences in the meiboscores of the upper and lower eyelids in any age group, though meiboscores were significantly higher since 40 year-old group than 20 year-old group (p < 0.001, p < 0.001, p < 0.001, p < 0.001). CONCLUSIONS: Based on noncontact meibography in normal adult eyes, the authors concluded that prevalence of changes in the meibomian glands was about 60% and changes in meibomian glands increase with age.
Adult ; Aging ; Eyelids ; Female ; Humans ; Male ; Meibomian Glands* ; Prevalence

PURPOSE: To compare oxidative stress status in the aqueous humor of highly myopic eyes and control eyes. METHODS: Aqueous humor samples were collected from 15 highly myopic eyes (high myopia group) and 23 cataractous eyes (control group) during cataract surgery. Central corneal thickness, corneal endothelial cell density, hexagonality of corneal endothelial cells, and cell area of corneal endothelial cells were measured using specular microscopy. Axial length was measured using ultrasound biometry. 8-Hydroxydeoxyguanosine (8-OHdG) and malondialdehyde levels were measured using enzyme-linked immunosorbent assay. RESULTS: 8-OHdG level was lower in the aqueous humor of myopic patients than in that of control group (p = 0.014) and was positively correlated with central corneal thickness and negatively correlated with axial length (r = 0.511, p = 0.02; r = -0.382, p < 0.001). There was no correlation between 8-OHdG level and corneal endothelial cell density, hexagonality, or cell area. Malondialdehyde level did not show any correlation with any parameters evaluated. CONCLUSIONS: 8-OHdG might be a sensitive biomarker for evaluating oxidative stress status in the eye. Oxidative stress level was lower in the aqueous humor of highly myopic eyes compared to that in control eyes, which indicates lower metabolic activity in these eyes.
Aged ; Aqueous Humor/*metabolism ; Deoxyguanosine/*analogs & derivatives/metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Malondialdehyde/*metabolism ; Middle Aged ; Myopia/*metabolism/physiopathology ; *Oxidative Stress ; Refraction, Ocular/*physiology ; Severity of Illness Index

PURPOSE: To assess the feasibility and effectiveness of transperineal ultrasonography (TPUS) for the evaluation of perianal Crohn disease (PCD) in pediatric patients. METHODS: Between September 2010 and August 2013, 64 TPUS examinations were performed in 43 patients (34 males and 9 females; mean age+/-standard deviation, 13.3+/-2.4 years; age range, 6 to 17 years) to evaluate PCD. The pain severity, location, and activity of perianal fistula, the presence of an abscess, and anal canal hyperemia were retrospectively evaluated. Spearman rank correlation analysis was performed to assess the relationship between the severity of the pain and the fistula activity, the presence of an abscess, and anal canal hyperemia. RESULTS: All examinations were successfully performed. Thirty-nine examinations (60.9%) were performed without any pain experienced by the patient, 19 examinations (29.7%) with mild pain, five examinations (7.8%) with moderate pain, and one examination (1.6%) with severe pain. The pain severity was correlated with the fistula activity (P<0.01). An anterior fistula location was more common than a posterior location. Active fistulas and abscesses were identified during 30 examinations (46.9%) and 12 examinations (18.8%), respectively. Anal canal hyperemia was identified in 31 examinations (48.4%). CONCLUSION: TPUS with a color Doppler study is useful for visualizing a perianal fistula or abscess and for assessing its inflammatory activity in pediatric Crohn patients.
Abscess* ; Anal Canal ; Crohn Disease* ; Female ; Fistula* ; Humans ; Hyperemia ; Male ; Pediatrics ; Perineum ; Retrospective Studies ; Ultrasonography*

BACKGROUND: Immunoglobulin heavy chain (IgH) gene rearrangement has been known to be a useful marker for determining the clonality as well as detecting minimal residual disease in B cell malignancies. This study was performed to establish single polymerase chain reaction (PCR) methods for the detection of IgH gene rearrangements in formalin-fixed, paraffin-embedded tissue of patients with B cell lymphoma and determine the type of JH segments used. METHODS: We obtained formalin-fixed, paraffin-embedded tissue sections of 44 patients diagnosed with B cell lymphoma at Ajou University Hospital from January 2005 to January 2007 and reviewed medical records retrospectively. After the extraction of DNA, PCR was performed using VH3 and JHPST primers to detect the third complementarity determining region (CDR3) gene of IgH. Sequence analysis of the PCR products was also done in 23 patients. RESULTS: The CDR3 gene rearrangements were detected in 26 (59%) out of 44 patients with B cell lymphoma. Sequence analysis of the amplified CDR3 gene was successful in 16 (70%) of 23 patients. JH3, JH4, JH5, and JH6 segments were used for CDR3 gene rearrangements in 3 (25%), 4 (33%), 1 (8%), and 4 (33%) patients with diffuse large B cell lymphoma, respectively. CONCLUSION: Although there are some limitations due to a low sensitivity less than 60%, single PCR using consensus primers could be an effective tool for the detection of CDR3 gene rearrangements in routine laboratory settings. Furthermore, sequence analysis of the CDR3 PCR products will provide basic information necessary for further studies.
Complementarity Determining Regions ; Consensus ; DNA ; Formaldehyde* ; Gene Rearrangement* ; Humans ; Immunoglobulin Heavy Chains* ; Immunoglobulins* ; Lymphoma, B-Cell* ; Medical Records ; Neoplasm, Residual ; Polymerase Chain Reaction* ; Retrospective Studies ; Sequence Analysis