A case of rare subcutaneous sparganosis in thigh treated by surgical excision is reported. In this 49year-old male with a palpable mass on the anteromedial aspect of mid-thigh (5x7x5cm sized) which was misdiagnosed with a soft tissue tumor initially, a sparganosis was suspected by a plain x-rays, bone scan and his past history which he frequently had raw snakes, frogs and raw fishes before but confirmed by MRI and surgical excision. This represents tor warning to some Koreans who have frequently comsumed raw fishes, snakes or frogs etc., and to some doctors because it is easily confused with a soft tissue tumor.
Fishes ; Humans ; Magnetic Resonance Imaging ; Male ; Snakes ; Sparganosis* ; Subcutaneous Tissue* ; Thigh*

Peroxisome proliferator-activated receptor-gamma (PPARgamma) has been implicated in the growth inhibition of a number of cancer cells. In the present study, we investigated the antitumor effect of the PPARgamma agonist rosiglitazone in U87MG human glioma cells. Rosiglitazone treatment in vitro reduced cell proliferation without induction of cell death in a dose- and time-dependent manner. Rosiglitazone decreased cell migration and mRNA level of MMP-9. Rosiglitazone treatment also induced marked changes in glioma cell morphology. Oral administration of rosiglitazone in animals with subcutaneous U87MG glioma cells reduced tumor volume. Subsequent tumor tissue analysis showed that rosiglitazone decreased the number of PCNA-positive staining cells and MMP-9 expression and induced apoptosis of tumor cells. These data suggest that rosiglitazone exerts antineoplastic effect in U87MG cells and may serve as potential therapeutic agent for malignant human gliomas.
Administration, Oral ; Animals ; Apoptosis ; Cell Death ; Cell Movement ; Cell Proliferation ; Glioma ; Humans ; Peroxisomes ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Tumor Burden

PURPOSE: To investigate the effect of unilateral medial rectus muscle resection for recurrent exotropia after bilateral lateral rectus muscle recession for intermittent exotropia METHODS: A retrospective analysis was made of thirtypatients who underwent unilateral medial rectus resection for recurrent exotropia. All had prior bilateral lateral rectus recession for intermittent exotropia. Data were collected for age, the preoperative deviation, the postoperative deviation at 2 weeks, 3 months, 6 months and the last visit, and the amount of medial rectus resection performed. RESULTS: The average preoperative deviation was 27.0+/-3.6 PD. After unilateral medial rectus resection, average deviation at distance was 2.8 PD at postoperative 2 weeks, 4.5 PD at 3 months, 5.1 PD at 6 months and 5.8 PD at last visit. The average deviation corrected per millimeter of medial rectus resection was 3.53+/-0.17 PD/mm. CONCLUSIONS: Considering that deviation angles of recurrent exotropia is smaller than those of primary surgery and the possibility of saving the other medial rectus muscle, unilateral rectus muscle resection could be effective surgical method for recurrent exotropia.
Child ; Exotropia/*surgery ; Female ; Humans ; Male ; Oculomotor Muscles/*surgery ; *Ophthalmologic Surgical Procedures ; Recurrence ; Refraction, Ocular ; Retrospective Studies

Ectopic pregnancy is a common medical problem that is difficult to diagnose and potentially may lead to significant mortality or morbidity. The incidence of ectopic pregnancy is definitely increasing due to the rise in pelvic inflammatory disease (PID), pelvic surgery, intrauterine device (IUD), and assisted reproductive technologies, such as in vitro fertilization and embryo transfer (IVF-ET). Combined ectopic gestations are much rare and their true incidence is unknown. Multiple ectopic gestations may occur in a variety of locations. The majority involve one or both fallopian tubes. We report a case of combined tubal and cervical pregnancies, and discuss their management.
Embryo Transfer ; Fallopian Tubes ; Female ; Fertilization in Vitro ; Incidence ; Intrauterine Devices ; Mortality ; Pelvic Inflammatory Disease ; Pregnancy* ; Pregnancy, Ectopic ; Reproductive Techniques, Assisted

PURPOSE: To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. METHODS: Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. RESULTS: Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (p<0.01). After occlusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). CONCLUSIONS: There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia.
*Accommodation, Ocular ; Adult ; Aged ; Amblyopia/*etiology/*physiopathology ; Esotropia/*physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Occlusive Dressings/adverse effects ; Retrospective Studies ; *Sensory Deprivation ; Treatment Outcome

Multiple endocrine neoplasia (MEN) 2B is charaterized by tumors of endocrine glands, consisting of medullary thyroid carcinoma (MTC), pheochromocytoma and mucosal neuromas of the tongue, lips and other sites. Especially, MTC is the main cause of death in patients who have not received early prophylactic treatment, and MTC in MEN 2B represents more aggressive progress than that of MEN 2A. We encountered two cases of multiple endocrine neoplasia type 2B. One was a 13 month old boy who had familial history of MEN 2B without any symptoms, and the other was a 6-year old boy who manifested multiple mucosal neuromas of the tongue which had been aggravated in four months. Their genetic analysis revealed a point mutation 918th cordon in the RET proto-oncogene. Both of them underwent an operation for prophylactic total thyroidectomy and the 6 year old boy's specimen turned out to be thyroid medullary carcinoma. We encountered two cases of MEN 2B with prophylactic thyroidectomy by early diagnosis of RET proto-oncogene, and report the cases with review of literature.

In obsterics and gynecology laparoscopic surgery is increasing in numbers and gaining wide popularity replacing classical laparotomy and is becoming new trend in surgical fields. Laparoscopic surgery is favoured over the classical laparotomy because of numerous advantages but it can cause complications by insuffulatory CO2 to induce artificial pneumoperitoneum. Therefore, wide knowledges and thorough understandings of anesthesiologist on the prevention of complications and their treatments are essential. Authors present one case that the patient developed subcutaneous emphysema and ateleciasis on right upper lobe, pulmonary edema in left side lung resulting from inadvertent one lung ventilation during laparoscopic hysterectomy under general anesthesia and on trendelenberg position.
Anesthesia, General* ; Gynecology ; Humans ; Hysterectomy* ; Laparoscopy ; Laparotomy ; Lung ; One-Lung Ventilation* ; Pneumoperitoneum, Artificial ; Pulmonary Edema ; Subcutaneous Emphysema*

Cisplatin treatment increases the excretion of inorganic phosphate in vivo. However, the mechanism by which cisplatin reduces phosphate uptake through renal proximal tubular cells has not yet been elucidated. We examined the effect of cisplatin on Na+-dependent phosphate uptake in opossum kidney (OK) cells, an established proximal tubular cell line. Cells were exposed to cisplatin for an appropriate time period and phosphate uptake was measured using [32P]-phosphate. Changes in the number of phosphate transporter in membranes were evaluated by kinetic analysis, [14C]phosphonoformic acid binding, and Western blot analysis. Cisplatin inhibited phosphate uptake in a time- and dose-dependent manner, and also the Na+-dependent uptake without altering Na+-independent uptake. The cisplatin inhibition was not affected by the hydrogen peroxide scavenger catalase, but completely prevented by the hydroxyl radical scavenger dimethylthiourea. Antioxidants were ineffective in preventing the cisplatin-induced inhibition of phosphate uptake. Kinetic analysis indicated that cisplatin decreased Vmax of Na+-dependent phosphate uptake without any change in the Km value. Na+-dependent phosphonoformic acid binding was decreased by cisplatin treatment. Western blot analysis showed that cisplatin caused degradation of Na+-dependent phosphate transporter protein. Taken together, these data suggest that cisplatin inhibits phosphate transport in renal proximal tubular cells through the reduction in the number of functional phosphate transport units. Such effects of cisplatin are mediated by production of hydroxyl radicals.
Antioxidants ; Blotting, Western ; Catalase ; Cell Line ; Cisplatin ; Epithelial Cells* ; Foscarnet ; Hydrogen Peroxide ; Hydroxyl Radical ; Kidney ; Kinetics ; Membranes ; Opossums ; Phosphate Transport Proteins

This study was undertaken to elucidate the underlying mechanisms of ATP depletion-induced membrane transport dysfunction and cell death in renal proximal tubular cells. ATP depletion was induced by incubating cells with 2.5 mM potassium cyanide (KCN)/0.1 mM iodoacetic acid (IAA), and membrane transport function and cell viability were evaluated by measuring Na+-dependent phosphate uptake and trypan blue exclusion, respectively. ATP depletion resulted in a decrease in Na+-dependent phosphate uptake and cell viability in a time-dependent manner. ATP depletion inhibited Na+-dependent phosphate uptake in cells, when treated with 2 mM ouabain, a Na+ pump-specific inhibitor, suggesting that ATP depletion impairs membrane transport functional integrity. Alterations in Na+-dependent phosphate uptake and cell viability induced by ATP depletion were prevented by the hydrogen peroxide scavenger such as catalase and the hydroxyl radical scavengers (dimethylthiourea and thiourea), and amino acids (glycine and alanine). ATP depletion caused arachidonic acid release and increased mRNA levels of cytosolic phospholipase A2 (cPLA2). The ATP depletion-dependent arachidonic acid release was inhibited by cPLA2 specific inhibitor AACOCF3. ATP depletion-induced alterations in Na+-dependent phosphate uptake and cell viability were prevented by AACOCF3. Inhibition of Na+-dependent phosphate uptake by ATP depletion was prevented by antipain and leupetin, serine/cysteine protease inhibitors, whereas ATP depletion-induced cell death was not altered by these agents. These results indicate that ATP depletion-induced alterations in membrane transport function and cell viability are due to reactive oxygen species generation and cPLA2 activation in renal proximal tubular cells. In addition, the present data suggest that serine/cysteine proteases play an important role in membrane transport dysfunction, but not cell death, induced by ATP depletion.
Adenosine Triphosphate ; Amino Acids ; Antipain ; Arachidonic Acid ; Arachidonic Acids ; Catalase ; Cell Death ; Cell Survival ; Cytosol ; Diminazene ; Hydrogen Peroxide ; Hydroxyl Radical ; Iodoacetic Acid ; Membranes ; Ouabain ; Peptide Hydrolases ; Phospholipases A2 ; Potassium Cyanide ; Protease Inhibitors ; Reactive Oxygen Species ; RNA, Messenger ; Trypan Blue

PURPOSE: The treatment of West syndrome is difficult since current antiepileptic drugs are rarely effective. The objective of this study is to evaluate the clinical efficacy of topiramate as add-on therapy in the refractory West Syndrome. METHODS: Nineteen children with refractory infantile spasms were included in this study. Topiramate was given as an initial dose of 25 mg per day in addition to the current antiepileptic drug (s). Dosage was increased by 25 mg every week until spasms were controlled, the maximal tolerable dose was reached, or the maximal dose of 25 mg/kg/day was achieved. RESULTS: Five (26.3%) subjects became seizure free and 7 (36.8%) achieved seizure frequency reduction more than 50%. No significant side effect of topiramate was noted. CONCLUSION: Topiramate could be a promising therapy in the treatment of refractory West syndrome.
Anticonvulsants ; Child ; Humans ; Infant ; Infant, Newborn ; Seizures ; Spasm ; Spasms, Infantile*