PURPOSE: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. CASE SUMMARY: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow's tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.
Achromobacter ; Achromobacter denitrificans ; Aged ; Animals ; Aza Compounds ; Ceftazidime ; Corneal Ulcer ; Eye ; Feces ; Humans ; Keratitis ; Ophthalmic Solutions ; Quinolines ; Soil ; Tail

PURPOSE: We compared the outcomes of laser iridotomy and primary phacoemulsification when treating acute angle-closure glaucoma. METHODS: This study was conducted with 61 patients diagnosed with acute angle closure glaucoma from January, 2005 to January, 2015. The patients received either laser iridotomy or primary phacoemulsification. The age and gender of each patient, differences of intraocular pressure (IOP) before and after treatment, visual acuity, need for IOP lowering agents and complications were analyzed retrospectively at 1-day, 1-month, 6-month and 12-month after the treatment. Patients who received laser iridotomy with phacoemulsification or trabeculectomy were excluded from this study. Additionally, we included only cases in which treatments were given within 3 days after the onset of symptom. RESULTS: Among the 61 patients, 45 patients received laser iridotomy and 16 patients received primary phacoemulsification. One day after the treatment the laser iridotomy group showed better outcome in their visual acuity (log MAR 0.62 +/- 0.51; p = 0.048). At 6-month postoperatively, the primary phacoemulsification group showed better visual acuity (log MAR 0.07 +/- 0.15; p = 0.013). However, at 12-month postoperatively, the visual acuities were not significantly different between the 2 groups. Regarding IOP, at postoperative 1-month, the group of primary phacoemulsification shows significantly lower IOP (9.5 +/- 1.3 mm Hg), compared with the group of laser iridotomy. A significant difference was observed in the number of IOP lowering agents that patients at 12 month after the treatment. There were no severe complications in either group. CONCLUSIONS: Following the initial treatment of acute angle-closure glaucoma, the primary phacoemulsification showed no significant differences in postoperative visual acuity, IOP and complications compared to the outcomes of laser iridotomy. Additionally, the need for IOP lowering agents was less in the primary phacoemulsification groups at 1 year after the operation.
Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Phacoemulsification* ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

PURPOSE: To analyze and compare the clinical characteristics of patients with herpes zoster ophthalmicus (HZO) by age groups on the basis of the age of 60. METHODS: Medical records of patients with HZO who visited Chonbuk National University Hospital from February 1, 2002 to February 28, 2011 were reviewed. The patients with follow-up of three months or more were divided into two groups: patients under 60 and patients with 60 years old and over. The clinical characteristics between two groups were examined through the analysis of their medical records. RESULTS: Among a total of 63 patients, 29 patients (46%) were under 60 years old, and 34 patients (54%) were 60 years old and over. Incidence of HZO highest in the sixties. The sex and intrusion of each group showed no difference. Younger patients had a higher incidence of pseudodendrite by HZO (86.2% vs. 58.8%, p = 0.014) compared with older patients who showed a higher incidence of post herpetic neuralgia (13.8% vs. 35.3%, p = 0.046). As patients showed Hutchinson's sign, they often had more ocular complications such as pseudodendrite (100% vs. 64.7%, p < 0.05), uveitis (41.7% vs. 7.8%, p = 0.04), and conjunctivitis (100% vs. 90.2%, p = 0.02). CONCLUSIONS: Herpes zoster ophthalmicus shows different clinical characteristics according to patients' age and requires appropriate treatment. Especially elderly patients showing Hutchinson's sign should be treated early and aggressively enough.
Aged ; Conjunctivitis ; Follow-Up Studies ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Incidence ; Medical Records ; Neuralgia ; Neuralgia, Postherpetic ; Uveitis

PURPOSE: To evaluate the long term effectiveness of double silicone tube intubation in the treatment of acquired nasolacrimal duct (NLD) obstruction. METHODS: The authors treated 68 eyes of 40 patients with acquired NLD obstruction. The resolution of preoperative symptoms and signs of NLD obstruction was evaluated 18 months after the operation. RESULTS: The mean age of patients was 64.7 years and the mean follow-up period was 24.91 months. The symptoms and signs of NLD obstruction were improved in 85.29% of the patients. The partially obstructed group showed a higher success rate (89.29%) than the completely obstructed group (50.0%). A prolapse of silicone tubes to the ocular side was observed in 2 eyes, and 2 eyes had inflammatory signs after the procedure. CONCLUSIONS: Double silicone tube intubation is an effective primary therapy with NLD obstruction, especially for patiensts with simple partially obstructed NLD instead of dacryocystorhinostomy.
Dacryocystorhinostomy ; Eye ; Follow-Up Studies ; Humans ; Intubation ; Nasolacrimal Duct ; Prolapse ; Silicones

BACKGROUND: The purpose of the study was to evaluate the effect of postural change on hemodynamics using thoracic eletrical bioimpedance (TEB) device during general anesthesia with enflurane-N2O-O2 and lumbar epidural anesthesia. The TEB device is safe, reliable and non-invasive way to measure hemodynmic values continuously. METHODS: General anesthesia (twenty patients) was induced by administration of pentotal sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously, and was maintained with 1 vol% of enflurane, N2O-O2 (2 l/min-2 l/min) and vecuronium 0.1 mg/kg. Epidural anesthesia (twenty patients) was performed at the level of L3-4 epidural space using 20 ml of 2% xylocaine mixed with epinephrine (5 microgram/ml). Hemodynamic changes were measured before induction, 1 and 5 minutes after intubation or epidural injection, 1, 5, 10, 20, 30 minutes after head- down tilt and 1, 5, 10 minutes after returning to the supine position. RESULTS: HR and LVSWI were minimaly affected in group E with epidural anesthesia compared to group G with general anesthesia. BP (SBP, DBP, MAP) and SVRI were remarkably increased in group G compared to group E. BP and SVRI showed rapid increse 1 minutes after head-down tilt in group G (p<0.01) and decreased gradually thereafter. SI and CI were decreased significantly in group G compared to group E (p<0.001). SI was unchanged but CI was decreasd significantly after head-down tilt in group E (p<0.05). EDI and ACI showed lower values decreased in general significantly in group G compared to group E (p<0.05). CONCLUSIONS: All hemodynamic changes were more predictable, gradual, less variable, and stable in the group with epidural anesthesia compared to the group with general anesthesia for hysterectomy.
Anesthesia, Epidural* ; Anesthesia, General ; Enflurane ; Epidural Space ; Epinephrine ; Head-Down Tilt ; Hemodynamics* ; Humans ; Hysterectomy* ; Injections, Epidural ; Intubation ; Lidocaine ; Mortuary Practice* ; Sodium ; Succinylcholine ; Supine Position ; Vecuronium Bromide

Dermatomyositis is a distinctive entity that is identified by a characteristic rash that accompanies or more often precedes proximal muscle weakness. There is a well recognized association between dermatomyositis and several cancers, such as ovarian cancer, lung cancer, pancreas cancer, stomach cancer and colorectal cancers and non-Hodgkin Lymphoma. But dermatomyositis associated with intrahepatic cholangiocarcinoma has not yet been reported in Korea. We experienced a case of dermatomyositis associated with infiltrative intrahepatic cholangiocarcinoma and we report on this unusual case along with reviewing the related literature.
Cholangiocarcinoma ; Colorectal Neoplasms ; Dermatomyositis ; Exanthema ; Korea ; Liver Neoplasms ; Lung Neoplasms ; Lymphoma, Non-Hodgkin ; Muscle Weakness ; Ovarian Neoplasms ; Pancreatic Neoplasms ; Stomach Neoplasms

PURPOSE: Non-intraocular pressure (IOP) factors such as vascular factors have been identified as contributing to normal tension glaucoma. However, there is not an established range of haemorheological factors considered normal, nor are there standardized tests. In this study, we investigated differences in blood viscosity and haemorheological parameters between patients with normal tension glaucoma (NTG) and normal controls using a new instrument called the BVD-RO1 (BIO-VISCO. Inc., Jeonju, Korea). METHODS: Twenty patients with NTG and 20 age-matched normal controls were included in the study. Haemorheological parameters of the venous blood samples, including blood viscosity at the shear rates of 300 (high shear rate) and 1 (low shear rate) s-1 were measured using an automated scanning capillary tube viscometer. RESULTS: More hematocrit concentration was detected in the NTG group than in the control group (p < 0.05). Furthermore, higher blood viscosities at the high (p < 0.01) and low (p < 0.01) shear rates were found in the NTG group. CONCLUSIONS: The NTG patients differed in blood viscosity with the control group. This may signify the importance of hemodynamic factors in the pathogenesis of NTG.
Blood Viscosity* ; Capillaries ; Hematocrit ; Hemodynamics ; Humans ; Jeollabuk-do ; Low Tension Glaucoma*

OBJECTIVES: We aimed to evaluate discrepancies between self-awareness of memory functions and actual memory functions in the elderly community. METHODS: A total of 369 individuals aged over 65 years from four elderly community centers completed clinical evaluation, neuropsychological batteries of the Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K), the Geriatric Depression Scale (GDS), the Instrumental Activities of Daily Living (IADL), and the Hachinski Ischemic Score. RESULTS: Among the elderly particpants, 26.3% showed incorrect awareness regarding their memory function. Those with subjective memory complaints included 73.5% with no memory impairment, while those without memory complaints included 11.3% of those with amnestic mild cognitive impairment (aMCI) and 4.3% of those with Alzheimer's disease (AD). Subjective memory complaints were significantly associated with depression. Among the elderly with no memory complaints, incorrect awareness was associated with 'no previous education' (OR 3.6, 95% CI 1.3-9.8), 'age over 80' (OR 2.4, 95% CI 1.1-5.4), and 'male' (OR 2.3, 95% CI 1.0-5.2) ; however, it was not significantly associated with depression. CONCLUSION: Incorrect awareness of memory impairment is prevalent among the elderly. Further, elderly individuals of an advanced age with no education may have memory impairment without memory complaints.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Depression ; Humans ; Memory ; Mild Cognitive Impairment

OBJECTIVE: The aim of this study is as follows; First, to assess knowledge regarding cervical cancer, HPV and the acceptance of HPV vaccination among girls in their late teens in Seoul, Korea. Second, to find out factors affecting the acceptance of HPV vaccination. METHOD: From November to December 2006, we surveyed Ewha Womans University freshmen and third year female students of Keumran High school affiliated with Ewha Womans University. A written questionnaire was sent to 310 students and 275 students responded. The questionnaire was divided into three sections that sought information about the followings : (1) Demographic characteristics; (2) Knowledge regarding cervical Pap smear testing and cervical cancer; (3) Knowledge regarding HPV and HPV vaccines. We scored the questionnaire giving one point for each correct answer. We summed up scores of knowledge on each section and compared the scores according to the acceptance of HPV vaccination in target group. RESULTS: The mean score of knowledge regarding cervical Pap smear testing and cervical cancer, HPV and HPV vaccines were 5.31+/-1.48 and 3.11+/-2.09, respectively. None of the demographic characteristics influenced the acceptance of HPV vaccine. The level of knowledge regarding HPV and HPV vaccines significantly affected the acceptance of HPV vaccine, however, knowledge regarding cervical Pap smear testing and cervical cancer did not. CONCLUSION: This study emphasize the need for further education regarding HPV infection and HPV vaccination for improvement in HPV vaccine acceptance.
Adolescent* ; Education ; Female* ; Humans* ; Korea* ; Papillomavirus Vaccines ; Surveys and Questionnaire ; Seoul ; Uterine Cervical Neoplasms* ; Vaccination*