Idiopathic central serous chorioretinopathy is localized detachment of the neurosensory retina in the macula which is commonly seen. However extensive sensory retinal detachment of the posterior role and multiple leaking points are rare characteristics of idiopathic central serous chorioretinopathy. Idiopathic central serous chorioretinopathy with bullous retinal detachment is frequently misdiagnosed and treated improperly. The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal detachment and multiple Ieaking points in the both eyes.
Central Serous Chorioretinopathy* ; Retina ; Retinal Detachment* ; Retinaldehyde*

PURPOSE: Exercise-induced bronchospasm (EIB) is widely prevalent in asthmatic patients. Recently, eosinophilic airway inflammation and atopy (defined as skin sensitivity to common aeroallergens) are considered to be a important factors in the pathogenesis of asthma. Thus we studied to find out the effect of atopy and airway eosinophilic inflammation on exercise- induced bronchospasm. METHODS: We followed up the cases of 132 mild asthmatics for 2 years. On their first visit, skin prick tests, with 29 common allergens including dust mites antigen, and sputum induction were performed. And 3 days later, methacholine challenge was done. 24 hours after methacholine challenge, treadmill test was performed and the positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise. RESULTS: EIB was observed in 54 (40.9%) of 132 asthmatic subjects. There was no significant difference in atopy between EIB positive and EIB negative asthmatics. Eosinophil and eosinophil cationic protein in induced sputum were significantly higher in EIB positive asthmatics. We also found the significant correlation between bronchial responsiveness (BR) index and maximal % fall in FEV1. CONCLUSION: The severity of bronchospasm evoked by exercise was more closely related to eosinophilic airway inflammation and airway hyperresponsiveness to methacholine than atopy.
Allergens ; Asthma ; Asthma, Exercise-Induced* ; Bronchial Spasm ; Dust ; Eosinophil Cationic Protein ; Eosinophils* ; Exercise Test ; Humans ; Inflammation* ; Methacholine Chloride ; Mites ; Skin ; Sputum

PURPOSE: Atopic dermatitis is the most common chronic inflammatory skin disease in children. However, the role of allergy in the pathogenesis of atopic dermatitis is still controversial. The purpose of this study is to investigate the effects of antigen sensitization and development of respiratory allergy disease on severity of atopic dermatitis. METHODS: 211 children with atopic dermatitis were monitored for 2-3 years and classified into three groups: mild, moderate, severe. The severity of atopic dermatitis was compared with antigen sensitization identified by MAST CLA Korea Panel and development of respiratory allergy disease; such as asthma and allergic rhinitis. RESULTS: The frequency of mild, moderate, severe atopic dermatitis was respectively, 38.4%, 33.6%, 28.0%. Food sensitization was significantly higher in patients under 4 years old and aeroallergen sensitization was higher in patients above 5 years old. There was a good correlation between the severity of atopic dermatitis and food sensitization but not in aeroallergen. There was no significant association the severity of atopic dermatitis and development of respiratory allergy disease. CONCLUSION: This result suggests that the sensitization to food allergen is associated with the severity of atopic dermatitis, but sensitization to aeroallergen and development of respiratory allergy disease are not correlated. The restriction of sensitized diets might be helpful in management of atopic dermatitis.
Asthma ; Child ; Child, Preschool ; Dermatitis, Atopic* ; Diet ; Humans ; Hypersensitivity* ; Korea ; Rhinitis ; Skin Diseases

PURPOSE: The authors investigated the process of endochondral ossification quantitatively and objectively in respect to proliferation and apoptosis. MATERIALS AND METHODS: Fractures were made on the left tibiae of 72 male Sprague-Dawley rats. The fracture callus was harvested at the 5th, 7th, 9th, 11th, 14th, and the 21st day after fracture. Cellular DNA content was analyzed with image cytometry, and proliferative index was determined from the data. The Ki-67 antigen expression was semiquantitatively measured by the immunohisto-chemical method. TUNEL was used for in situ localization of apoptotic cells. The expression of cell cycle inhibitors, P21 and P27, was investigated with Northern blotting. RESULTS: The proliferation index was highest on the 5th day, then gradually decreased until the 11th day. The expression of Ki-67 antigen gradually decreased with time. Apoptotic cells increased in accordance with enhanced bone formation within chondroid callus. The expression of p21 and p27 was highest on the 11th and the 14th day. CONCLUSIONS: These findings show that proliferative activity decreased with the reduction of mesenchymal tissue and the appearance of mature chondroid tissue. The apoptosis of hypertrophic chondrocytes occurred in accordance with enhanced bone formation. P21 and P27 had a certain role in the differentiation of chondrocytes.
Apoptosis* ; Blotting, Northern ; Bony Callus ; Cell Cycle ; Cell Proliferation* ; Chondrocytes ; DNA ; Fracture Healing* ; Humans ; Image Cytometry ; In Situ Nick-End Labeling ; Ki-67 Antigen ; Male ; Osteogenesis ; Rats, Sprague-Dawley ; Tibia

PURPOSE: Activation of T helper(Th) cells and secretion of cytokines play a pivotal role in the pathogenesis of asthma. Th2 cells secrete IL-4 and IL-5. IL-4 stimulates IgE production and IL-5 is related with hematopoiesis, chemotaxis and activation of eosinophils. IFN-gamma produced by Th1 cells and IL-12 produced by antigen presenting cells have an inhibitory action on IgE production. We examined the cytokine production by peripheral blood mononuclear cells(PBMCs) of atopic asthmatic children and its relation with clinical findings. METHODS: We measured IL-4, IFN-gamma, IL-5, IL-12 in serum and supernatants of stimulated PBMCs cultures in 32 children with moderate stable asthma and 17 healthy controls. They were compared with number of skin test positive allergens, serum total IgE, peak expiratory flow rate(PEFR), methacholine PD20, sputum eosinophils and eosinophil cationic protein(ECP). RESULTS: No difference in serum cytokines was found between patients and controls, except IL-5. In supernatants of stimulated PBMCs cultures, the concentration of IL-4, IL-5 was significantly increased and IFN-gamma, IL-12 was significantly decreased in patients compared with controls. IL-4 was related with total serum IgE and numbers of skin test positive allergens. IL-5 was related with sputum eosinophils and ECP. The serum total IgE was inversely and PEFR was directly related with IFN-gamma. CONCLUSION: In atopic asthmatics, Th1 cytokines were increased and Th2 were decreased in stimulated PBMCs cultures. IL-4 was related with atopy, IFN-gamma with lung function and IL-5 with airway inflammation.
Allergens ; Antigen-Presenting Cells ; Asthma* ; Chemotaxis ; Child ; Cytokines ; Eosinophils ; Hematopoiesis ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-12* ; Interleukin-4* ; Interleukin-5* ; Lung ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin Tests ; Sputum ; Th1 Cells ; Th2 Cells

Auriculotemporal neuropathy is a rare aetiology of orofacial pain. A 66-year old female patientpresented with severe, throbbing pain around the right ear after herpes zoster. The pain was consistentwith post-herpetic neuropathy and was not relieved by oral medications. To alleviate neuropathicpain, ultrasound-guided auriculotemporal nerve block was done. The pain was relieved completelyand the patient remained symptom-free until the last follow up at eight months after treatment. Withunderstanding of the anatomy and related symptoms of auriculotemporal nerve, auriculotemporalneuropathy can be controlled by ultrasound-guided auriculotemporal nerve block.

Background and Objectives: Claudin-1 (CLDN-1) is the major component of tight junctions and functions in controlling cell to cell adhesion. Certain claudins were expressed aberrantly and proved to have prognostic significance in various human cancers. However, its clinical significance has been poorly understood in head and neck squamous cell carcinoma (HNSCC). The aim of this study was to investigate the relationship between CLDN-1 expression and clinicopathologic parameters in HNSCC.Subjects and Method The surgical specimens of primary HNSCCs from a consecutive cohort of 91 patients were retrospectively collected. Immunohistochemical staining for CLDN-1 was performed blindly by two pathologists. CLDN-1 staining intensity was scored semi-quantitatively on a scale of 0 to 3 (0: negative; 1: weak; 2: moderate; 3: strong). For the statistical analysis, the expression levels were classified as low (negative and weak) and high (moderate and strong). Next, the association between CLDN-1 expression and clinicopathological features & clinical outcomes was analyzed. Results: The increased CLDN-1 expression was significantly associated with lymphatic invasion (p=0.019). The expression level of CLDN-1 was not associated with pathological T stage, lymph node metastasis or recurrence. Kaplan-Meier analysis found that 3-year overall survival (OS) rate was 53% in patients with high level CLDN-1 expression and 74% in patients with low level CLDN-1 expression. It also found that 5-year OS rate was 49% in patients with high level CLDN-1 expression and 68% in patients with low level CLDN-1 expression. A significantly poor OS rate was recorded in patients with high level of CLDN-1 expression compared to patients with low level CLDN-1 expression (p=0.022). Conclusion CLDN-1 may serve as useful prognostic marker in patients with HNSCCs.

BACKGROUND: Embryonic lethal abnormal vision (ELAV)-like protein HuR is known to stabilize mRNA through binding AU-rich elements in the 3'-untranslated region. Recent studies show that HuR expression is associated with the expression of several genes including cyclooxygenase-2 (COX-2). HuR exists predominantly in the nucleus, but cytoplasmic translocation of HuR is thought to be more important for its activity. COX-2 is a well-known enzyme that promotes tumor growth. METHODS: To evaluate the correlation of HuR and COX-2 expression, we analyzed expression of HuR and COX-2 in 91 cases of breast cancer using immunohistochemistry. RESULTS: Nuclear and cytoplasmic expression of HuR was seen in 76 (83.5%) and 19 (20.9%) of 91 cases respectively. COX-2 immunoreactivity was seen in 54 (59.4%) cases. Cytoplasmic HuR expression showed significant correlation with COX-2 expression (p=0.001). Nuclear HuR showed no correlation with COX-2 expression or other clinicopathological parameters. COX-2 expression is significantly associated with tumor grade (p=0.028). COX-2 (p=0.092) and cytoplasmic (p=0.569) and nuclear HuR (p=0.247) expression showed no correlation with survival. CONCLUSIONS: These results suggest that cytoplasmic HuR expression is associated with COX-2 expression in breast cancer and cytoplasmic location of HuR might contribute to the stabilization of COX-2 mRNA.
Breast Neoplasms

PURPOSE: Previous epidemiologic studies have demonstrated that nonsteroidal anti-inflammatory drugs can reduce the risk of breast cancer, and this possibly happens via cyclooxygenase (COX) inhibition. Moreover, growth factor-inducible COX-2, which is overexpressed in neoplastic tissue, is an attractive therapeutic target. Thus, we evaluated the expression of COX-2 in breast cancer tissues, and we assessed the association between COX-2 expression and HER-2/neu expression and also with several clinicopathological features. MATERIALS AND METHODS: We analyzed the surgical specimens from 112 women with breast cancer who had undergone lumpectomy or mastectomy. The expressions of COX-2, HER-2/neu, MMP-2 and TIMP-2 were determined immunohistochemically. The correlations between COX-2 expression and several variables, including clinicopathological factors, HER-2/neu expression, MMP-2 expression and TIMP-2 expression were analyzed. Survival analysis was also performed with respect to COX-2 overexpression. RESULTS: The overexpression of COX-2 protein was observed in 28.6% of the breast cancer tissues. Tumors with lymph node metastasis more frequently showed COX-2 overexpression than did those tumors without metastasis (p=0.039), and the increased COX-2 expression correlated positively with HER-2/neu overexpression (p=0.000). No significant differences were found for the MMP-2 or TIMP-2 expression rates in the COX-2 positive and negative groups. The survival analysis revealed no significant differences according to the COX-2 expression. CONCLUSION: This study results suggest that increased COX-2 expression is related with the progression of breast cancer, e.g., with lymph node invasion. COX-2 overexpression found to be related with HER-2/neu overexpression, but not with MMP-2 or TIMP-2 expression. These results support the potential use of selective agents that inhibit COX-2 or HER-2/neu for the management of breast cancer.
Breast Neoplasms* ; Breast* ; Cyclooxygenase 2* ; Epidemiologic Studies ; Female ; Humans* ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Neoplasm Metastasis ; Prostaglandin-Endoperoxide Synthases ; Tissue Inhibitor of Metalloproteinase-2

Radiation therapy is one of the cardial therapeutic modality on breast cancer. Three decades ago, the heart was considered to be radioresistant, but now it is generally recognized that the heart is also radiosensitive. The most common clinical syndromes after irradiation are pericarditis in acute and chronic forms, cardiomyopathy, valvular disease and, to a lesser degree, complete atrioventricular block. However, lesions of coronary vessels had been considered exceptionally rare and even questionable. And then there have been a few case reports for acute myocardial infartion after irradiation for left sided breast cancer and it may be considered that radiation therpy can injure endothelium of coronary artery and cause ischemic coronary artery disease. We report the case of a 38 years old women who developed acute anterior wall myocardial infarction after irradiation for left sided breast cancer.
Adult ; Anterior Wall Myocardial Infarction ; Atrioventricular Block ; Breast Neoplasms* ; Breast* ; Cardiomyopathies ; Coronary Artery Disease ; Coronary Vessels ; Endothelium ; Female ; Heart ; Humans ; Myocardial Infarction* ; Pericarditis