PURPOSE: We report two cases of retinal folds developing after pars plana vitrectomy in patients exhibiting rhegmatogenous retinal detachment. CASE SUMMARY: (Case 1) A healthy 52-year-old male visited our clinic complaining of blurred vision in his right eye. His visual acuity was 0.8 in that eye. Fundal examinations revealed upper retinal detachment and retinal tears at the 12 and 1 o'clock positions. He underwent pars plana vitrectomy with gas injection, and 1 week later, the retina was reattached. A retinal fold was detected at the 4 o'clock position; the fold extended for two disc diameters from the optic disc to the equator. The fold resolved spontaneously after 3 months. (Case 2) A 59-year-old male visited our clinic complaining of blurred vision in his right eye. His visual acuity was “counting fingers” in that eye. Fundal examination revealed a retinal tear at the 11 o'clock position and upper retinal detachment involving the macula. He underwent pars plana vitrectomy with gas injection. A retinal fold was detected in the temporal region of the disc running from the 7 o'clock position to the equator. Over 11 months of observation without treatment, optical coherence tomography (OCT) revealed that the retinal fold resolved. CONCLUSIONS: We report the first two Korean cases of spontaneous relief of retinal folds developing after vitrectomy, and the OCT patterns of the folds.
Humans ; Male ; Middle Aged ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Running ; Temporal Lobe ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

BACKGROUND: Treatment outcome with only chemotherapy for multi-drug resistant tuberculosis is usually considered not to be satisfactory. However, the combined therapy of chemotherapy with surgical treatment has been producing higher sputum AFB negative conversion and longer survival rates, and this treatment strategy is expected to be a set-up for the patients with multi-drug resistant tuberculosis. MATERIAL AND METHOD: A retrospective review was performed with the medical records and laboratory findings in 49 patients with multi-drug resistant tuberculosis of 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital. RESULT: A mean number of the resistant drugs was 4.5 with a mean age of 35 years. Cavitary lesions on plain chest x-ray were shown in 43 patients of 49(87.8%). Thirty one had positive sputum cultures preoperatively(63.3%). Operative techniques were as follows; 12 pneumonectomies, 28 lobectomies, 7 lobectomies with segmentectomies or wedge resections, one wedge resection and a cavernoplasty. Sputum AFB negative conversion rate was 93.5 % with continuous postoperative chemotherapy. There was no death after operation. Air leakage over a week, postoperative bleeding and wound disruption were developed as postoperative complications. CONCLUSION: We experienced the higher effectiveness of postoperative chemotherapy with pulmonary resection on multi-drug resistant tuberculosis. Although there are several different ideas about operative indications, postoperative drug regimens and length of postoperative medications, pulmonary resection should be considered actively as a effective combination measure with chemotherapy to give a treatment for multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Hemorrhage ; Hospitals, Chronic Disease ; Humans ; Mastectomy, Segmental ; Medical Records ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Sputum ; Survival Rate ; Thorax ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary ; Wounds and Injuries

BACKGROUND: Tools such as SCORE (Simple Calculated Osteoporosis Risk Estimation) and ORAI (Osteoporosis Risk Assessment Instrument) have been used for screening test of Osteoporosis, These tools include race, age, weight, BMI, previous treatment with HRT and so on, as confounding factor. Among those factors, it has been reported that body weight is more appropriate than BMI. But those study were based on Caucasian women and not based on Korean women. Therefore, comparison among Korean women needed to be assessed. METHODS: A total of 200 postmenopausal women in ages 50 and over were enrolled in health promotion center of one university hospital, BMD was checked by DXA of lumbar spine (L1-L4) from January 2002 to May, 2003. Women, who had previous history of endocrine disease or medications, early onset menopause, previous surgery of uterus and ovary, which all could influence BMD, were excluded. RESULTS: The average age was 58.01, the average weight 58.36 kg, the average BMI (kg/m2) 24.39, the average BMD (t-score) -1.00. Among the total 26 women (13%) recorded BMD (t-score)< or =-2.5 and 50 women (25%) recorded -2.5 Body Mass Index* ; Body Weight* ; Continental Population Groups ; Endocrine System Diseases ; Female ; Health Promotion ; Humans ; Logistic Models ; Mass Screening ; Menopause ; Osteoporosis* ; Ovary ; Risk Assessment ; Spine ; Uterus

Ulcerative colitis (UC) is an inflammatory disease primarily involving the colonic mucosa. The extension of classic UC is uniform and continuous with no intervening areas of normal mucosa. The rectum is usually involved and the inflammation extends proximally in a continuous fashion for a variable distance. However, as more patients get colonoscoped, it had been reported that there is a wide spectrum to what is called UC. There appear to be a few patients with otherwise typical UC but with rectal sparing. And also there are patients with classic distal UC who have an isolated area of cecal disease and segmental UC with skipped area. We have experienced a case of atypical UC initially presented as a isolated lesion around the appendiceal orifice with the segmental distribution of inflammatory change without an active inflammatory lesion in the rectum. It was considered that understanding of the significance of an isolated lesion in the appendix would contribute to the elucidation of the pathogenesis of UC.
Appendix ; Cecal Diseases ; Colitis, Ulcerative* ; Colon ; Humans ; Inflammation ; Mucous Membrane ; Rectum ; Ulcer*

Although endoscopic submucosal dissection (ESD) is widely accepted as a curative treatment method for early gastric cancer (EGC) worldwide, metachronous recurrence often occurs after ESD for EGC. However, there are insufficient data about the role of Helicobacter pylori (H. pylori) infection and other risk factors for recurrence. We aimed to compare the metachronous lesion in the H. pylori persistent group and the eradicated group, and to identify risk factors for metachronous lesion. We retrospectively analyzed 782 patients who underwent ESD between January 2008 and December 2013. We excluded patients with dysplasia or patients who were not tested for H. pylori infection. One hundred eighty-five patients were enrolled. We studied risk factors for recurrence, and used survival analysis to test. There were 24 patients with metachronous recurrence after ESD for EGC among the group. The incidence of metachronous gastric lesions after ESD for EGC developed more in the over 70-year-old group (P = 0.025) and more in the H. pylori persistent group (P = 0.008). In conclusion, H. pylori infection and old age are independent risk factors for metachronous gastric lesions after ESD in EGC.
Aged ; Helicobacter pylori ; Humans ; Incidence ; Methods ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Stomach Neoplasms*

Granulocytosis occurs in 40% of patients with lung and gastrointestinal cancers, 20% of patients with breast cancer, 30% of patients with brain tumor and ovarian cancer and 10% of patients with renal cell carcinoma. Granulocytosis occurs because of production of G-CSF, GM-CSF and IL-6. Uterine cervical carcinoma with granulocytosis as a paraneoplastic syndrome, however, has been rarely reported. We recently witnessed a case of invasive squamous cell carcinoma of the uterine cervix with granulocytosis. Leukocytosis developed up to 69, 000/micro L, and then normalized after chemo-radiotherapy. There was no evidence of infection, tumor necrosis, glucocorticoid administration, or myeloproliferative disease by examination of a bone marrow aspirate when granulocytosis appeared. This phenomenon was probably associated with the secretion of hematopoietic growth factors such as G-CSF, GM-CSF and IL-6 by the tumor. We suggest that, like some other solid tumors, cervical cancer can present with granulocytosis as a paraneoplastic syndrome.
Uterine Neoplasms/complications/*diagnosis ; Uterine Cervical Neoplasms/complications/*diagnosis/physiopathology ; Paraneoplastic Syndromes/*etiology ; Middle Aged ; Leukocytosis/*etiology ; Humans ; Granulocytes/*pathology ; Female

PURPOSE: Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. MATERIALS AND METHODS: Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. RESULTS: In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend <0.01, respectively), whereas nulliparous and premenopausal status were positively associated. Compared to women who had > or =2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). CONCLUSION: Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.
Alcohol Drinking ; Body Mass Index ; Breast ; Breast Neoplasms ; Child ; Cross-Sectional Studies ; Female ; Hormone Replacement Therapy ; Humans ; Information Systems ; Korea ; Logistic Models ; Mammography ; Menarche ; Menopause ; Parity ; Risk Factors

Pancreatic ductal adenocarcinoma is a lethal cancer type that is associated with multiple gene mutations in somatic cells. Genetically engineered mouse is hardly applicable for developing a pancreatic cancer model, and the xenograft model poses a limitation in the reflection of early stage pancreatic cancer. Thus, in vivo somatic cell gene engineering with clustered regularly interspaced short palindromic repeats is drawing increasing attention for generating an animal model of pancreatic cancer. In this study, we selectedKras, Trp53, Ink4a, Smad4, and Brca2 as target genes, and applied Campylobacter jejuni Cas9 (CjCas9) andStreptococcus pyogens Cas9 (SpCas9) for developing pancreatic cancer using adeno associated virus (AAV) transduction. After confirming multifocal and diffuse transduction of AAV2, we generated SpCas9 overexpression mice, which exhibited high double-strand DNA breakage (DSB) in target genes and pancreatic intraepithelial neoplasia (PanIN) lesions with two AAV transductions; however, wild-type (WT) mice with three AAV transductions did not develop PanIN. Furthermore, small-sized Cjcas9 was applied to WT mice with two AAV system, which, in addition, developed high extensive DSB and PanIN lesions. Histological changes and expression of cancer markers such as Ki67, cytokeratin, Mucin5a, alpha smooth muscle actin in duct and islet cells were observed. In addition, the study revealed several findings such as 1) multiple DSB potential of AAV-CjCas9, 2) peri-ductal lymphocyte infiltration, 3) multi-focal cancer marker expression, and 4) requirement of > 12 months for initiation of PanIN in AAV mediated targeting. In this study, we present a useful tool for in vivo cancer modeling that would be applicable for other disease models as well.

It has been reported that colitis may be associated with intrarectally administered drugs or chemicals. Colonotoxicity may results from conventional medical therapy, herbal or other illicit drugs, contrast materials, and detergents. Clues that a colitis may be due to an intrarectally administered agent include perianal excoriation, segmental distal colitis due to a concentration gradient from enema administration, and recent diagnostic or therapeutic administration of high risk solutions such as hypertonic contrast agents or detergent enemas. Barium is a highly viscous contrast agent that is insoluble in water. Barium enemas are usually very safe. Also, no case report of barium-induced chemical colitis has been reported yet. We report a case of chemical colitis with colonic stricture occurring after the barium enema for diagnostic purpose.
Barium Sulfate/*adverse effects ; Colitis/*chemically induced/pathology ; Contrast Media/*adverse effects ; *Enema ; Humans ; Male ; Middle Aged