PURPOSE: To determine the frequency and potential causes of segmentation errors in spectral domain optical coherence tomography (SD-OCT) imaging of retinal nerve fiber layer (RNFL) scans. METHODS: Segmentation errors for the RNFL thickness analysis were recorded during a retrospective chart review of 214 eye scans from 132 consecutive patients with glaucoma or glaucoma suspect who underwent a complete eye exam using Spectralis™ OCT scanning from August 2014 to November 2014. Segmentation errors were classified as inner, outer, inner and outer segmentation errors, and degraded images. The risk factors including age, sex, intraocular pressure, spherical equivalents, severity of glaucoma, and associated ocular disorders were evaluated using logistic regression analysis. RESULTS: A total of 71 eye scans included segmentation errors. Risk factors of inner segmentation error (8.9%) were age, epiretinal membrane, and degenerative myopia. Risk factors of outer segmentation error (29.9%) were age, peripapillary atrophy, posterior vitreous detachment, and severity of glaucoma. Risk factors of inner and outer segmentation errors (6.1%) were age and degenerative myopia. The single risk factor of degraded image (2.3%) was degenerative myopia. CONCLUSIONS: Segmentation errors for SD-OCT RNFL scans in glaucoma patients are common. Clinicians should carefully review the scans for segmentation errors when using SD-OCT images in glaucoma diagnosis or during patient follow-up.
Artifacts ; Atrophy ; Diagnosis ; Epiretinal Membrane ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Logistic Models ; Myopia, Degenerative ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Risk Factors ; Tomography, Optical Coherence* ; Vitreous Detachment

PURPOSE: To report a case of persistent shallow anterior chamber after silicone tube intubation, recovered by fibrin glue in glaucoma drainage device implantation (GDI). CASE SUMMARY: A 42-year-old female, diagnosed with neovascular glaucoma at a local clinic visited our clinic for uncontrolled intraocular pressure (IOP) in her right eye. We performed GDI on her right eye. Scleral flap and paracentesis of the anterior chamber were performed. Then, a silicone tube was inserted into the anterior chamber. Despite repetitive infusion of balanced salt solution (BSS), the anterior chamber became persistently shallow due to peritubular leakage. After dropping the fibrin glue in the peritubular space and beneath the scleral flap, attachment occurred. No additional leakage was observed near the scleral flap and after infusion of BSS, a deep anterior chamber was maintained. One day after surgery, IOP in the right eye was 3 mm Hg, deep anterior chamber was maintained, and no leakage of aqueous humor into the conjunctiva occurred. Two months after surgery, IOP was 16 mm Hg and a deep anterior chamber was maintained. CONCLUSIONS: In cases of persistent shallow anterior chamber after silicone tube intubation in intraoperative GDI, the best methods to maintain the anterior chamber is by suture ligation of the peritubular loosened site or infusion of viscoelastic agent to anterior chamber. In the present case, applying the fibrin glue beneath the scleral flap apparently obstructed the peritubular infiltration.
Adult ; Ambulatory Care ; Anterior Chamber* ; Aqueous Humor ; Conjunctiva ; Drainage* ; Female ; Fibrin Tissue Adhesive* ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Intubation ; Ligation ; Paracentesis ; Silicones ; Sutures

PURPOSE: Isolated oculomotor nerve palsy in preeclampsia patients have not been reported in Korea. Herein, we report 1 case of a patient in her 32nd week of gestation diagnosed with preeclampsia experiencing oculomotor nerve palsy in the left eye which improved after delivery. CASE SUMMARY: 28-year-old pregnant woman in her 32nd week of gestation with no underlying diseases visited our clinic with the chief complaint of diplopia and left eye ptosis. The patient suffered headache symptoms 1 week prior and did not undergo any exams. The visual acuity, anterior segment, and, fundus showed no abnormal signs and the pupil light reflex was normal, but the patient showed left eye ptosis with +2 mm/-2 mm on the marginal reflex distance (MRD) exam, 25 prism exotropia and 6 prism hypotropia, supraduction and adduction limitation -2 and, infraduction limitation -1. To exclude other systemic disorders and brain lesions, laboratory tests and brain magnetic resonance imaging (MRI) was performed, and preeclampsia was diagnosed based on high blood pressure (150/110 mm Hg) and mild proteinuria. Imaging and labatory tests showed other disorders thus the patient was treated conservatively. Two weeks after the ocular symptoms appeared, the left ptosis and ocular movement restriction worsened, but systemic signs and tests shown no aggravation, thus we maintained conservative therapy and after delivery at 37-weeks, the symptoms slowly improved and recovered completely after 2 months. CONCLUSIONS: Full systemic examination including MRI and laboratory tests must be performed in pregnant women who suddenly experience ocular symptoms and are diagnosed as oculomotor motor nerve palsy. If diagnosis and treatment are appropriate, good prognosis can be expected in this disease.
Adult ; Brain ; Diagnosis ; Diplopia ; Exotropia ; Female ; Headache ; Humans ; Hypertension ; Korea ; Magnetic Resonance Imaging ; Oculomotor Nerve Diseases* ; Paralysis ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Prognosis ; Proteinuria ; Pupil ; Reflex ; Visual Acuity

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999) RESULTS: Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066). CONCLUSION: Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.
Colon ; Cross Infection ; Delivery of Health Care ; Furosemide* ; Fusidic Acid* ; Humans ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcal Infections ; Staphylococcus aureus

A functional single lung caused by lung diseases or pneumonectomy can result in anatomic and physiologic changes that may interfere with the conduct of subsequent coronary artery bypass surgery. Since this type of case is extremely rare, there has not been any report on this in Korea. A 71-year-old female with a history of a destroyed left lung from pulmonary tuberculosis 13 years ago was admitted for evaluation of her increasing chest pain that she'd experienced for 2 weeks. Since coronary angiographies demonstrated 80% stenosis of the left main os, 90~95% stenosis of the p-LAD, 90% stenosis of the m-LCx and 90% stenosis of the RCA, coronary artery bypass surgery (CABG) was planned. Off-pump CABG with vein grafts through a median sternotomy was performed and the patient recovered the same as other CABG patients without complications.
Aged ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Female ; Humans ; Korea ; Lung ; Lung Diseases ; Pneumonectomy ; Sternotomy ; Transplants ; Tuberculosis, Pulmonary ; Veins

It has been shown that QGC isolated and purified from Rumecis folium found protective effects of gastritis and esophagitis which EXT is an ethanol extract of it. We examined acute toxicity and the general pharmacological action of QGC EXT to search for any side effects of it in rats, mice, guinea pigs, and cats. In a single dose toxicity study, QGC EXT didn't show toxicological effects in rats and mice, and the LD50 was over 5 g/kg in both animals, and there were also no changes in weight, feed and water intake during these toxicological experimental periods. We examined the general pharmacological action on central controlled behavior responses, and peripheral organs including blood pressure, heart rate, respiration and gastrointestinal system, We found that there were no significant changes in body temperature, locomotors activity, stereotyped behaviors, sleeping time, and convulsion. In other studies, writhing reaction, normal body temperature, there did not appear to be any changes. The large intestine movement and electrical field stimulation-induced contraction was not changes by its EXT. In addition, the influences on blood pressure, heart rates, and respiration by QGC EXT were not found. These results indicate that QGC EXT may be very safe as a new drug, since its LD50 was very high over 5 g/kg and any side effects were not found.
Animals ; Blood Pressure ; Body Temperature ; Cats ; Contracts ; Drinking ; Esophagitis ; Ethanol ; Gastritis ; Guinea Pigs ; Heart Rate ; Intestine, Large ; Lethal Dose 50 ; Mice ; Rats ; Respiration ; Seizures ; Stereotyped Behavior

Sequence type (ST) 33 of Shiga toxin-producing Escherichia coli (STEC) strain O91:H14 has been proposed as a potential domestic clone of STEC in Korea because of its high prevalence among human patients with mild diarrhea or asymptomatic carriers. Herein, the clonal diversity of 17 STEC O91:H14 isolates of ST33 during 2003 to 2014 was analyzed by pulsed-field gel electrophoresis, including 14 isolates from human patients and 3 from retail meats. Their virulence characteristics, acid resistance, and antimicrobial susceptibility were also determined. Our results showed that all isolates were clustered mainly into three different pulsotypes and were likely low pathogenic without antimicrobial resistance.
Clone Cells ; Diarrhea ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli ; Humans ; Korea ; Meat ; Molecular Epidemiology ; Prevalence ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli ; Virulence

Hereditary fructose intolerance(HFI) is an autosomal recessive disease caused by catalytic deficiency of aldolase B in which affected homozygotes develop hypoglycemia and abdominal symptoms after taking foods containing fructose. Chronic exposure to fructose may lead to progressive hepatic injury, renal injury, growth retardation, and ultimately to liver and kidney failure. Herein, we report a case of HFI with presentation of episodic vomiting, diarrhea, cold sweating, abnormal liver function and failure to thrive after 12 months of her age. She developed an aversion to fruits and sweet-tasting foods. When she was admitted to hospital at the age of 30 months, hepatomegaly, and dysfunction of proximal renal tubule with renal tubular acidosis were noted. We confirmed the diagnosis via enzyme assay on biopsied liver and intestine. A fructose restrictied diet was recommended. The patient has been symptom free with normal liver functions since then.
Acidosis, Renal Tubular ; Diagnosis ; Diarrhea ; Diet ; Enzyme Assays ; Failure to Thrive ; Fructose ; Fructose Intolerance* ; Fructose-Bisphosphate Aldolase ; Fruit ; Hepatomegaly ; Homozygote ; Humans ; Hypoglycemia ; Intestines ; Kidney Tubules, Proximal ; Liver ; Renal Insufficiency ; Sweat ; Sweating ; Vomiting

Herein, we report the pathogenic and phylogenetic characteristics of seven Shiga toxin (Stx)-producing Escherichia coli (STEC) isolates from 434 retail meats collected in Korea during 2006 to 2012. The experimental analyses revealed that all isolates (i) were identified as non-O157 STEC, including O91:H14 (3 isolates), O121:H10 (2 isolates), O91:H21 (1 isolate), and O18:H20 (1 isolate), (ii) carried diverse Stx subtype genes (stx₁, stx(2c), stx(2e), or stx₁ + stx(2b)) whose expression levels varied strain by strain, and (iii) lacked the locus of enterocyte effacement (LEE) pathogenicity island, a major virulence factor of STEC, but they possessed one or more alternative virulence genes encoding cytotoxins (Cdt and SubAB) and/or adhesins (Saa, Iha, and EcpA). Notably, a significant heterogeneity in glutamate-induced acid resistance was observed among the STEC isolates (p < 0.05). In addition, phylogenetic analyses demonstrated that all three STEC O91:H14 isolates were categorized into sequence type (ST) 33, of which two beef isolates were identical in their pulsotypes. Similar results were observed with two O121:H10 pork isolates (ST641; 88.2% similarity). Interestingly, 96.0% of the 100 human STEC isolates collected in Korea during 2003 to 2014 were serotyped as O91:H14, and the ST33 lineage was confirmed in approximately 72.2% (13/18 isolates) of human STEC O91:H14 isolates from diarrheal patients.
Cytotoxins ; Enterocytes ; Escherichia coli ; Genomic Islands ; Humans ; Korea ; Meat ; Population Characteristics ; Red Meat ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli ; Virulence ; Virulence Factors

Characteristics of stroke cases, acute stroke care, and outcomes after stroke differ according to geographical and cultural background. To provide epidemiological and clinical data on stroke care in South Korea, we analyzed a prospective multicenter clinical stroke registry, the Clinical Research Center for Stroke-Fifth Division (CRCS-5). Patients were 58% male with a mean age of 67.2+/-12.9 years and median National Institutes of Health Stroke Scale score of 3 [1-8] points. Over the 6 years of operation, temporal trends were documented including increasing utilization of recanalization treatment with shorter onset-to-arrival delay and decremental length of stay. Acute recanalization treatment was performed in 12.7% of cases with endovascular treatment utilized in 36%, but the proportion of endovascular recanalization varied across centers. Door-to-IV alteplase delay had a median of 45 [33-68] min. The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases. Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes. The proportion of mRS scores of 0-1 was 42% on discharge, 50% at 3 months, and 55% at 1 year after the index stroke. Recurrent stroke up to 1 year occurred in 4.5% of patients; the rate was higher among older individuals and those with neurologically severe deficits. The above findings will be compared with other Asian and US registry data in this article.
Asian Continental Ancestry Group ; Humans ; Korea ; Length of Stay ; Male ; National Institutes of Health (U.S.) ; Stroke ; Tissue Plasminogen Activator