We studied retrospectively 46 patients of primary malignant eyelid tumors who were histologically diagnosed in Korea Cancer Center Hospital from May, 1987 to December, 1994 and followed for 6 months or longer. 46 patients consist of, 22 cases of basal cell carcinoma(47.8%), 10 cases of squamous cell carcinoma(21.7%), 9 cases of sebaceous gland carcinoma(19.6%), and 5 cases of malignant melanoma(10.9%). Our modalities of treatment for eyelid malignancy included excision under frozen-section control, radiotherapy and cryotherapy. In case of regional lymph node metastasis we performed radiation treatment with or without excision of primary tumor and regional lymph node dissection. A case with distant metastasis underwent radiotherapy combined with chemotherapy. Following initial treatment, 4 cases showed recurrence and 3 cases developed regional or distant metastasis. In this study, we emphasize that suspected eyelid malignancy should be histologically diagnosed with biopsy and treated adequately at an early stage to reduce recurrence or metastasis.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cryotherapy ; Drug Therapy ; Eyelids* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Sebaceous Glands

BACKGROUND AND OBJECTIVES: An increase in intracellular calcium concentration due to loss of Ca2+ homeostasis triggers arrhythmia or cardiac cell death in the heart. Paracrine factors released from stem cells have beneficial cardioprotective effects. However, the mechanism of modulation of Ca2+ homeostasis by paracrine factors in ischemic myocardium remains unclear. MATERIALS AND METHODS: We isolated rat bone marrow-derived mesenchymal stem cells (MSCs), and prepared paracrine media (PM) from MSCs under hypoxic or normoxic conditions (hypoxic PM and normoxic PM). We induced rat myocardial infarction by left anterior descending ligation for 1 hour, and treated PM into the border region of infarcted myocardium (n=6/group) to identify the alteration in calcium-regulated proteins. We isolated and stained the heart tissue with specific calcium-related antibodies after 11 days. RESULTS: The hypoxic PM treatment increased Ca2+-related proteins such as L-type Ca2+ channel, sarcoplasmic reticulum Ca2+ ATPase, Na+/K+ ATPase, and calmodulin, whereas the normoxic PM treatment increased those proteins only slightly. The sodium-calcium exchanger was significantly reduced by hypoxic PM treatment, compared to moderate suppression by the normoxic PM treatment. CONCLUSION: Our results suggest that hypoxic PM was significantly associated with the positive regulation of Ca2+ homeostasis in infarcted myocardium.
Adenosine Triphosphatases ; Animals ; Antibodies ; Arrhythmias, Cardiac ; Calcium ; Calcium-Transporting ATPases ; Calmodulin ; Cell Death ; Heart ; Homeostasis ; Ligation ; Mesenchymal Stromal Cells ; Myocardial Infarction ; Myocardium* ; Paracrine Communication ; Rats* ; Sarcoplasmic Reticulum ; Sodium-Calcium Exchanger ; Stem Cells

Periampullary diverticulum is commonly found during endoscopy and can occur at any age although its prevalence increases with age. Periampullary diverticular bleeding is a rare and difficult to diagnose during clinical practice because of its unique appearance and location. This often can lead to massive bleeding and interfere with adequate bleeding control. Endoscopic management on duodenal diverticular bleeding is limited compared to colonic diverticular bleeding due to lack of experience. Herein, we report a case of active bleeding from a periampullary diverticulum during bile duct stone extraction diagnosed by side-viewing endoscope and successfully controlled using hemoclips without any complications.
Aged ; Ampulla of Vater/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Diverticulum/*diagnosis/surgery ; Gastrointestinal Hemorrhage/etiology/*therapy ; Humans ; Male ; Surgical Instruments ; Tomography, X-Ray Computed

OBJECTIVE: There are few reports on the clinical outcomes of the percutaneous endoscopic lumbar discectomy(PELD) with laser for the treatment of far lateral lumbar disc herniation. The objective of this study is to assess the safety and efficacy of the PELD with laser for the treatment of far lateral lumbar disc herniation. METHODS: The clinical records of 42 patients who had far lateral lumbar disc herniation and underwent PELD with laser between January 1996 and August 2002 were analyzed retrospectively. There were 24(57.1%) males and 18(42.9%) females, with a mean age of 53(range, 26-73) years. The surgical procedure was performed via a posterolateral approach after induction of a local anesthesis. The clinical outcomes were measured with MacNabO s criteria. The mean follow-up period was 38(range, 5-77) months. RESULTS: Clinical outcomes were revealed as follows: excellent in 28 patients(66.7%); good in 11(26.2%); fair in 2(4.7%); and poor in 1(2.4%). Therefore, the percentage of successful(excellent and good) outcomes was 92.9%. There was no statistically significant variation in the success rates according to age and operation level(p>0.05). Before the introduction of the high resolution endoscope, the success rate was 90.3% but after upgrading to the high resolution endoscope, the success rate was 100%, and there was a statistically significant variation in the success rate(p<0.05). In all cases, there was no complication or recurrence. CONCLUSION: As a minimally invasive surgery, PELD with laser is a safe and efficacious procedure for the treatment of far lateral disc herniation.
Diskectomy* ; Endoscopes ; Female ; Follow-Up Studies ; Humans ; Male ; Recurrence ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

Fibrovascular polyps are rare benign intraluminal tumors that usually arise from the cervical esophagus. These often present as very large sized pedunculated polyps and cause symptoms including dysphagia and respiratory distress. Generally, large polyps are surgically excised, while endoscopic resection is limited to smaller polyps. Herein, we present a giant fibrovascular polyp of the esophagus treated successfully by endoscopic resection.
Deglutition Disorders ; Esophagus* ; Polyps*

Reflex gasping when hanging leads to passive and vigorous vomiting, the mechanical force of which causes gastric mucosa laceration. Mallory-Weiss syndrome is a tear in the gastro-esophageal junction or its adjacent mucosa, and this can occur due to nausea or vomiting that is caused by various etiologic factors. Gastric fundus is the most common site of gastric mucosa lacerations. We report a case of a 41-year-old man, who tried to hang himself and, as a result, caused multiple gastric mucosa lacerations that were treated by an endoscopic hemostatic procedure in the emergency room.
Adult ; Emergencies ; Gastric Fundus ; Gastric Mucosa ; Humans ; Lacerations ; Mallory-Weiss Syndrome ; Mucous Membrane ; Nausea ; Reflex ; Vomiting

BACKGROUND AND OBJECTIVES: Vascular perturbation induced by advanced glycation end-products (AGEs) leads to progression of atherosclerosis, plaque instability, and vascular inflammation, which results in a higher risk of neointimal proliferation. Here we investigated the inhibitory effect of alagebrium chloride (ALT-711), a breaker of AGE-based cross links, on neointimal proliferation in a carotid artery balloon injury model in diabetic rats induced by streptozotocin (STZ). MATERIALS AND METHODS: Rat aortic vascular smooth muscle cells (RASMCs) were treated with 1-100 microM of alagebrium added 24 hours before the addition of AGEs. This in vivo study was done using 8-week-old male rats that were injected intraperitoneally with 80 mg/kg STZ. Sixteen weeks later, the diabetic rats were treated with 10 mg/kg alagebrium for 4 weeks, after which carotid artery balloon injury was induced. After 4 weeks, the animals were sacrificed for histological analysis. RESULTS: Proliferation of RASMCs was significantly inhibited in alagebrium-treated cells. Alagebrium dose-dependently inhibited AGE-mediated formation of reactive oxygen species (ROS), extracellular signal-regulated kinase phosphorylation, and cyclooxygenase-2 expression. The cellular mechanisms of AGE-induced connective tissue and extracellular matrix expression were decreased in the alagebrium-treated group. This in vivo study shows that expression of AGE receptors and neointima hyperplasia are significantly suppressed in balloon-injured rats treated with alagebrium. CONCLUSION: Alagebrium treatment in diabetic rats significantly inhibits neointimal hyperplasia after carotid balloon injury due to its inhibition of intracellular ROS synthesis, which results in inhibition of RASMCs proliferation.
Animals ; Atherosclerosis ; Carotid Arteries ; Connective Tissue ; Cyclooxygenase 2 ; Extracellular Matrix ; Humans ; Hyperplasia ; Inflammation ; Male ; Muscle, Smooth, Vascular ; Neointima ; Phosphorylation ; Phosphotransferases ; Rats ; Reactive Oxygen Species ; Streptozocin ; Thiazoles

BACKGROUND: Body fat distribution, rather than the level of obesity per se, appears to be a strong predictor of abnormalities in metabolic complication. Visceral fat accumulation is significantly correlated with glucose intolerance and constitutes as an independent risk factor for the diabetes mellitus. METHODS: We investigated the impact of body fat distribution on the glucose, lipid metabolism and growth hormone secretion in obese subjects with varying glucose tolerance and lean controls matched with sex and age. 69 obese Koreans (34 men, 35 women; 43.8 yrs) and 21 lean Koreans (10 men, 11 women; 40.8 yrs) were recruited. Anthropometric measurement and impedence for measurement of total body fat, and computed tomography for visceral and subcutaneous fat area at umbilicus level were performed. All subjects underwent a standard oral glucose tolerance test and GH stimulation test by L-dopa. RESULTS: The results are summarized as follows. 1. Obese patients had greater ideal body weight (%, IBW) and lean body mass (LBM) than lean controls. But no significant differences were found in IBW and LBM between 3 obese groups. 2. The 25 obese NIDDM had the highest FFA-AUC during OGTI and the lowest GH-AUC to L-Dopa stimulation test. The insulin-AUC during OGTT was the highest in 24 obese subjects with normal glucose tolerance. 3. All male groups have VSR of more than 0.4, which has been designated visceral fat obesity. In contrast all female groups have VSR of lesser than 0.4 but obese DM subjects have the highest VSR. Visceral fat area per body weight ratio(VWR) showed increasing tendency in obese, IGT, and DM group. 4. Waist circumference and VWR showed strong correlation with metabolic parameters among anthropometric parameters. They were positively correlated with FFA-AUC during OGTT and negatively correlated with GH-AUC to L-dopa stimulation. CONCLUSION: Visceral fat accumulation are associated with insulin resistance, dyslipidemia and impairment of growth hormone secretion via increase of free fatty acid. The simple waist circumference may provide a more practical indicator that correlated with aMominal fat distribution and metabolic complications associated with obesity.
Adipose Tissue* ; Body Fat Distribution ; Body Weight ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Glucose Intolerance ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Humans ; Ideal Body Weight ; Insulin Resistance ; Intra-Abdominal Fat ; Levodopa ; Lipid Metabolism* ; Male ; Obesity* ; Risk Factors ; Subcutaneous Fat ; Umbilicus ; Waist Circumference

Pulmonary artery pseudoaneurysm (PAP) is a rare complication of septic pneumonia. It is potentially fatal because of the risk of massive hemoptysis. Treatment of PAP involving massive hemoptysis is by embolization or surgery. However, the progression of PAP after embolization has not been reported. A 59-year-old male who was recovering from septic pneumonia experienced massive hemoptysis. Computed tomography (CT) revealed PAP of the right pulmonary artery with surrounding consolidation, suggesting active hemorrhage. The patient was successfully treated with embolization of the right pulmonary artery. During outpatient follow-up, the amount of radiopaque embolized material gradually decreased on chest radiography. At 14 months after embolization, both the PAP and embolized material had disappeared on chest CT.
Aneurysm, False ; Follow-Up Studies ; Hemoptysis ; Hemorrhage ; Humans ; Male ; Middle Aged ; Outpatients ; Pneumonia ; Pulmonary Artery ; Thorax

PURPOSE: Thiazolidinediones (TZDs) are known to inhibit the proliferation of vascular smooth muscle cell (VSMC) by increasing the activity of p27(Kip1) and retinoblastoma protein (RB). However, the upstream signaling mechanisms associated with this pathway have not been elucidated. The Akt-mTOR-P70S6 kinase pathway is the central regulator of cell growth and proliferation, and increases cell proliferation by inhibiting the activities of p27(Kip1) and retinoblastoma protein (RB). Therefore, we hypothesized in this study that rosiglitazone inhibits VSMC proliferation through the inhibition of the Akt-TOR-P70S6K signaling pathway. MATERIALS and METHODS: Rat aortic smooth muscle cells (RAoSMCs) were treated with 10microM of rosiglitazone 24 hours before the addition of insulin as a mitogenic stimulus. Western blot analysis was performed to determine the inhibitory effect of rosiglitazone treatment on the Akt-mTOR-P70S6K signaling pathway. Carotid balloon injury was also performed in Otsuka Long-Evans Tokushima Fatty (OLETF) diabetic rats that were pretreated with 3 mg/kg of rosiglitazone. RESULTS: Western blot analysis demonstrated significant inhibition of activation of p-Akt, p-m-TOR, and p-p70S6K in cells treated with rosiglitazone. The inhibition of the activation of the p-mTOR-p-p70S6K pathway seemed to be mediated by both the upstream PI3K pathway and MEK-ERK complex. CONCLUSION: The inhibitory effect of rosiglitazone on RAoSMC proliferation in vitro and in vivo is mediated by the inhibition of the Akt-mTOR-P70S6K pathway.
Animals ; Cell Proliferation/drug effects ; Cells, Cultured ; Cytoprotection/drug effects ; Enzyme Activation/drug effects ; Insulin/*pharmacology ; Male ; Mitogen-Activated Protein Kinase Kinases/antagonists & inhibitors/metabolism ; Muscle, Smooth, Vascular/drug effects/*metabolism ; Myocytes, Smooth Muscle/drug effects/*metabolism ; Phosphorylation ; Protein Kinase Inhibitors/pharmacology ; Protein Kinases/*metabolism ; Proto-Oncogene Proteins c-akt/antagonists & inhibitors/*metabolism ; Rats ; Ribosomal Protein S6 Kinases, 70-kDa/*metabolism ; Signal Transduction/drug effects ; Thiazolidinediones/*pharmacology