PURPOSE: To report an experience of improving symptoms through treatment with electrocauterization and subconjunctival bevacizumab injection in two patients with keratitis accompanied by corneal neovascularization and opacity. CASE SUMMARY: (Case 1) A 20-year-old woman visited our institution complaining of binocular blurred vision and congestion for the previous 3 years. Her best corrected visual acuity (BCVA) was 0.07 in the right eye and 0.4 in the left eye (Han Chun-suk visual acuity chart, decimal). The diagnosis was bilateral rosacea keratitis. Antibiotics, steroid eye drops and oral antibiotics were administered, but no improvement was observed. Electrocauterization was performed at the origin of the neovascularization of the cornea and bevacizumab was injected at the peripheral subconjunctiva in the right eye. Thereafter the corneal neovascularization did not recur, corneal opacity was reduced, and BCVA improved to 0.5. (Case 2) A 19-year-old woman visited complaining of left eye congestion for the previous 3 years. Her BCVA was 1.0 in the right eye and 0.08 in the left eye.The diagnosis was phlyctenular keratitis of the left eye. Antibiotics, steroid eye drops and oral antibiotics were administered, but no improvement was observed. Therefore, electrocauterization and subconjunctival bevacizumab injection were performed in the cornea of the left eye, after which corneal neovascularization and opacity decreased. CONCLUSIONS: In these cases, we report improvement of symptoms after treatment with electrocauterization and subconjunctival bevacizumab injection after failed treatment of palpebral sanitation, antibiotic and steroid.
Anti-Bacterial Agents ; Bevacizumab* ; Cornea ; Corneal Neovascularization* ; Corneal Opacity ; Diagnosis ; Electrocoagulation ; Estrogens, Conjugated (USP) ; Female ; Humans ; Keratitis ; Ophthalmic Solutions ; Rosacea ; Sanitation ; Telescopes ; Visual Acuity ; Young Adult

This study was performed to observe the elementary body and initial body in the cultured conjuntival epithelial cell, which was co-cultures with Chlamydia trachomatis serotype-D. Following 3 weeks of cultivation of the rabbit conjuntival epithelial cell, Chlamydia trachomatis seretype-D was inoculated into the epithelial cells and co-cultured for 24, 48, and 96 hours respectively. The infected conjunctival epithelial cells was stained with fluorescence-conjugated chlamydial antibody and iodine staining. Regardless of the duration of the cocultivation time, the cultured conjunctival cells showed the positive reaction to immunofluorescent staining and iodine staining. These results indicate that Chlamydia trachomatis can be cultured in the cultured conjuntival epothelial cell of rabbit and iodine staining is a good alternative to the immunofluorescent method.
Chlamydia trachomatis* ; Chlamydia* ; Coculture Techniques ; Epithelial Cells ; Fluorescent Antibody Technique ; Inclusion Bodies ; Iodine

PURPOSE: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. METHODS: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. RESULTS: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. CONCLUSION: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.
Adult ; Ascites ; Bile ; Chungcheongnam-do ; Diagnosis ; Hemolytic-Uremic Syndrome ; Humans ; Hyperglycemia ; Hypocalcemia ; Pancreatic Ducts ; Pancreatitis* ; Pancreatitis, Chronic ; Pleural Effusion ; Sewage

PURPOSE: The aim of this study was to review the clinical characteristics and treatment outcome of pancreatitis developed in 19 children with leukemia and lymphoma in Asan Medical Center. METHODS: Hospital and outpatient records of 19 children either with leukemia or lymphoma who developed acute pancreatitis were reviewed. Clinical characteristics of these patients along with serologic data were analysed. RESULTS: 1. Median age at diagnosis of pancreatitis in 19 patients was 11 years of age. 2. Patients had acute lymphocytic leukemia (12 cases; 53%), acute myelocytic leukemia (4 cases; 21%), non-Hodgkins lymphoma (3 cases; 16%). 3. The etiologies of pancreatitis were L-asparaginase (16 cases) therapy, continuous Ara-C therapy (2 cases) and gallbladder stone (1 case). 5. L-asparaginase realated pancreatitis developed during the course of CCG 1882 induction (7 cases), CCG 1901 onsolidation (4 cases), CCG 1901 induction (1 case), and ADCOMP induction (1 case). 6. All patients experienced abdomial pain. Nausea, fever, vomiting, abdominal distention and diarrhea were also manifested clinically. 7. Hypocalcemia, sepsis, ascites, hyperglycemia, diabetic ketoacidosis, pancreatic pseudocysts and fistula were complicating events. 8. 6 patients were dead. The causes of death were from progression of lymphoma/ leukemia itself in 5 cases. One patient died of regimen related toxicity. The period of follow-up ranged from 2 months to 6.6 years with median follow-up of 28 months. CONCLUSION: 1. It is neccessary to monitor the level of serum amylase and lipase or to perform radiologic evaluation in patients who develop abdominal pain during L-asparaginase and Ara-C therapy especially in the course of CCG 1882 induction and CCG 1901 consolidation. 2. The outcome of chemotherapy induced pancreatitis is favorable in most instances but in some patients chronic pancreatitis may remain. The delay of chemotherapy due to pancreatitis may be responsible for the relapse of cancer. Therefore, prompt diagnosis and aggressive supportive therapy are important.
Abdominal Pain ; Amylases ; Ascites ; Cause of Death ; Child* ; Chungcheongnam-do ; Cytarabine ; Diabetic Ketoacidosis ; Diagnosis ; Diarrhea ; Drug Therapy ; Fever ; Fistula ; Follow-Up Studies ; Gallbladder ; Humans ; Hyperglycemia ; Hypocalcemia ; Leukemia* ; Leukemia, Myeloid, Acute ; Lipase ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Nausea ; Outpatients ; Pancreatic Pseudocyst ; Pancreatitis* ; Pancreatitis, Chronic ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; Sepsis ; Treatment Outcome ; Vomiting

PURPOSE: To evaluate the mammographic and clinical features of bilateral breast cancer. MATERIALS AND METHODS: We retrospectively reviewed clinical records (n=23) and mammograms (n=15) of 23 patients with bilateral breast cancer. Patients' age, location of the tumor and pathologic staging were determined from clinical records. Mammographic features were classified as spiculated mass, nonspiculated mass, mass with microcalcification, microcalcification only, asymmetric density, and normal. RESULTS: Of the 23 cases of bilateral breast cancer, 8 (34.8%) were synchronous and 15 (65.2%) were metachronous. Age at diagnosis of cancer in the first breast was between 27 and 59 (mean 43) years; there was no statistically significant difference in mean age between patients with synchronous and metachronous cancer. The mean interval between the diagnosis of each lesion of themetachronous pairs was 9.1 years. In 11 of 23 cases (48%), tumors were located in the same quadrant, and in the other 12 cases (52%), they were in different quadrant. At mammography, five of 15 metachronous cancers (33%) were similar in appearance and 10 pairs (67%) were different. In 4 of 23 cases (17%), cancer in the first breast was at stage 0 and stage 1, and in 13 of 23 (57%), cancer in the second breast was at this same stage. CONCLUSION: In bilateral breast cancer, the two breasts frequently show different mammographic features. Cancer of the second breast was at an early stage; this suggest that regular examination and mammography are important and can allow early detection of contralateral breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis ; Humans ; Mammography ; Retrospective Studies

PURPOSE: To analyze the differences in mammographic and pathologic findings between palpable and non-palpable breast carcinoma. MATERIALS AND METHODS: Among 362 patients with surgically proven breast carcinoma, 317, whose chief com-plaint during preoperative evaluation was a palpable mass, Comprised group I, and 45 with no masses com-prised group II. We compared mammographic and pathologic findings between the two groups. RESULTS: As regards the pattern of mammographic presentation, mass alone accounted for 51.4 % of group I and 33.3 % of group II, while calcification alone was seen in 7.6 % of group I and 24.4 % of group II(p<0.05). In group I, 48.6 % of masses were of irregular shape, and in group II, 46.2 % were round. According to ACR-BIRADS, 47.6 % of group I was classified as category 5, and 51.1 % of group II as category 4 (p<0.05). On the other hand, the margin of the mass showed no statistical difference. Among the 362 patients, the mean age of group I was 48.1(range, 28 -79) years, while that of group II was 51. 7(range, 30 -73) years (p<0.05). Histologically, infiltrative ductal carcinoma was seen in 84.9% of group I, and DCIS in 8.5%, while for group II the respective figures were 62.2% and 28.9 % (p<0.05). For group I, mean lesional size was 3.01cm, with 4 7 .9 % lymph node metastasis in the axilla, while for group II the corresponding figures were 1.93 c m ( p < 0 . 0 5 ) and 28.2%(p<0.05). Differences were statistically significant. Under the TMN system, 30% of group I were at stage II, while 35.6 % of group II were at stage I (p<0.05). CONCLUSION: Palpable and non-palpable cancers showed statistically significant differences in mammographic findings such as mass shape and category, but not in the margin of the mass. There were also statistically sig-nificant differences with regard to age, histology, lesion size, axillary lymph node metastasis, and staging.
Axilla ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Hand ; Humans ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Lycopene, a carotenoid with anti-oxidant properties, occurs naturally in tomatoes and pink grapefruit. Although the beneficial effects of lycopene on various disorders have been established, little attention has been paid to the possible anti-diabetic effects of lycopene focusing on β-cells. Therefore, this study investigated the potential of lycopene to protect β-cells against apoptosis induced by a cytokine mixture. METHODS: For toxicity experiments, the cells were treated with 0.1 ~ 10 nM of lycopene, and the cell viability in INS-1 cells (a rat β-cell line) was measured using a MTT assay. To induce cytokine toxicity, the cells were treated with a cytokine mixture (20 ng/mL of TNFα+20 ng/mL of IL-1β) for 24 h, and the effects of lycopene (0.1 nM) on the cytokine toxicity were measured using the MTT assay. The expression levels of the apoptotic proteins were analyzed by Western blotting, and the level of intracellular reactive oxidative stress (ROS) was monitored using a DCFDA fluorescent probe. The intracellular ATP levels were determined using a luminescence kit, and mRNA expression of the genes coding for anti-oxidative stress response and mitochondrial function were analyzed by quantitative reverse-transcriptase PCR. RESULTS: Exposure of INS-1 cells to 0.1 nM of lycopene increased the cell viability significantly, and protected the cells from cytokine-induced death. Lycopene upregulated the mRNA and protein expression of B-cell lymphoma-2 (Bcl-2) and reduced the expression of the Bcl-2 associated X (Bax) protein. Lycopene inhibited apoptotic signaling via a reduction of the ROS, and this effect correlated with the upregulation of anti-oxidative stress response genes, such as GCLC, NQO1, and HO-1. Lycopene increased the mRNA expression of mitochondrial function-related genes and increased the cellular ATP level. CONCLUSION: These results suggest that lycopene reduces the level of oxidative stress and improves the mitochondrial function, contributing to the prevention of cytokine-induced β-cell apoptosis. Therefore, lycopene could potentially serve as a preventive and therapeutic agent for the treatment of type 2 diabetes.
Adenosine Triphosphate ; Animals ; Apoptosis* ; B-Lymphocytes ; Blotting, Western ; Cell Survival ; Citrus paradisi ; Clinical Coding ; Luminescence ; Lycopersicon esculentum ; Oxidative Stress ; Polymerase Chain Reaction ; Rats ; RNA, Messenger ; Up-Regulation

PURPOSE: The purpose of this study was to explore the current status of education for nursing management in Korea. METHODS: A descriptive study was done using a questionnaire developed by the investigators. The data were collected by survey from 96 out of 129 nursing schools, between December 2010 and February 2011. RESULTS: For 22.9% of nursing schools, there was no faculty for nursing management. The credits and subjects included in nursing management varied among the nursing schools. Lectures in subjects related to nursing management were given not only by nursing management faculty but also by faculty with other majors. There were more faculty and credits for nursing management courses in 4-year nursing schools than in 3-year schools. CONCLUSION: To improve the quality of education in nursing management, there is a need to standardized courses and provide nursing faculty who have majored in nursing management.
Faculty, Nursing ; Humans ; Lectures ; Surveys and Questionnaires ; Research Personnel ; Schools, Nursing

RESULTS: The administration of ADLE to HFD-induced diabetic mice reduced the hyperplasia, 4-hydroxynonenal levels, and the number of apoptotic cells while improving the insulin levels compared to the HFD group. Treatment of INS-1 cells with palmitate reduced insulin secretion, which was attenuated by the ADLE treatment. Furthermore, the ADLE treatment prevented palmitate-induced cell death in INS-1 cells and isolated islets by reducing the apoptotic signaling molecules, including cleaved caspase-3 and PARP, and the Bax/Bcl2 ratio. ADLE also reduced the levels of reactive oxygen species generation, lipid accumulation, and nitrite production in palmitate-treated INS-1 cells while increasing the ATP levels. This effect corresponded to the decreased expression of inducible nitric oxide synthase (iNOS) mRNA and protein. CONCLUSIONS ADLE helps prevent lipotoxic beta-cell death in INS-1 cells and HFD-diabetic mice, suggesting that ADLE can be used to prevent or treat beta-cell damage in glucose intolerance during the development of diabetes.

RESULTS: The administration of ADLE to HFD-induced diabetic mice reduced the hyperplasia, 4-hydroxynonenal levels, and the number of apoptotic cells while improving the insulin levels compared to the HFD group. Treatment of INS-1 cells with palmitate reduced insulin secretion, which was attenuated by the ADLE treatment. Furthermore, the ADLE treatment prevented palmitate-induced cell death in INS-1 cells and isolated islets by reducing the apoptotic signaling molecules, including cleaved caspase-3 and PARP, and the Bax/Bcl2 ratio. ADLE also reduced the levels of reactive oxygen species generation, lipid accumulation, and nitrite production in palmitate-treated INS-1 cells while increasing the ATP levels. This effect corresponded to the decreased expression of inducible nitric oxide synthase (iNOS) mRNA and protein. CONCLUSIONS ADLE helps prevent lipotoxic beta-cell death in INS-1 cells and HFD-diabetic mice, suggesting that ADLE can be used to prevent or treat beta-cell damage in glucose intolerance during the development of diabetes.