No abstract available.

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

The importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.

PURPOSE: To determine the change of exoangle according to the measure distance and 1-hour occlusion of exotropic eye in intermittent exotropia. METHODS: We prospectively reviewed the records of 60 patients diagnosed with intermittent exotropia. The exoangle was measured at 6 m, 14 m, outdoor 30 m and at 6 m after occlusion of exotropic eye for 1 hour. Refractive error, stereoacuity and suppression were investigated in all subjects. RESULTS: The mean amount of exoangle was 28.2 +/- 5.64 PD at 6 m, 29.7 +/- 6.54 PD at 14 m and 30.3 +/- 2.84 PD at outdoor 30 m. The amounts of exoangle at 14 m and at outdoor 30 m were significantly increased compared with that at 6 m (p=0.009 and p=0.005, respectively). However, there was no significant difference between that at 14 m and at 30 m (p=0.08). The mean amount of exoangle after occlusion of exotropic eye for 1 hour was 29.3 +/- 5.48 PD, which was not statistically different from that at 14 m (p=0.44) and at 30 m (p=0.19). In 31 patients (51.7%) who had an increase of exoangle more than 3 PD at 14 m and 30 m compared to that at 6 m, mean exoangle at 6 m was 31.4 +/- 5.30 PD. In 29 patients (48.3%) who had an increase of exoangle less than 3PD, mean exoangle at 6 m was 26.2 +/- 5.72 PD. Increase of exoangle was prominent in patients with exoangle more than 30 PD at 6 m. There was no correlation in the amount of exoangle according to refractive error, stereoacuity and the presence of suppression (p=0.17, p=0.47, p=1.0, respectively). CONCLUSIONS: The exoangle increased at distances longer than 6 m and after 1-hour occlusion of exotropic eye in intermittent exotropia. The increment of exoangle according to distance was prominent in patients with exoangle more than 30 PD at 6 m.
Exotropia* ; Humans ; Prospective Studies ; Refractive Errors

No abstract available.
Rhinoplasty*

Glioblastoma multiforme (GBM) is a brain tumor notorious for its malignancy. The key reason for the limited efficacy of standard treatment is the high recurrence rate of GBM, even after surgical resection. Hence, intensive postsurgical chemical therapies, such as the systemic delivery of various drugs and/ or drug combinations, are typically followed after surgery. However, overcoming the blood-brain barrier by systemic administration to efficiently deliver drugs to the brain tumor remains a daunting goal. Therefore, various local drug delivery methods showing potential for improved therapeutic efficacy have been proposed. In particular, the recent application of electronic devices for the controlled delivery of chemotherapy drugs to GBM tissue has attracted attention. We herein review the recent progress of local drug delivery strategies, including electronics-assisted strategies, at the research and commercial level. We also present a brief discussion of the unsolved challenges and future research direction of localized chemotherapy methods for GBM.

PURPOSE:We performed this study to evaluate the clinical significance and temporal changes of pleural effusion developed after the resection of hepatoma. MATERIALS AND METHODS: We reviewed retrospectively follow-up chest radiographs of 97 patients who had undergone operation for hepatoma and had no radiologically demonstrable postoperative complications. The duration of pleural effusion was classified into five groups and the amount of pleural effusion at one week after operation was graded into four groups. Statistical significance of the relationship between the duration, amount of pleural effusion and five factors, which are location and size of tumor, age of the patients, methods of operation, and preoperative liver function, was studied respectively. RESULTS:Pleural effusion was developed in 63.9% (62/97) and the mean duration was 2.5 weeks. In 92% (52/56), pleural effusion disappeared spontaneously within four weeks. Patients who had hepatoma in upper portion of the right lobe developed more frequent pleural effusion which persisted longer, and was larger in amount at one week after operation(p<0.05). There were no statistically significant differences between pleural effusion and the other four factors. CONCLUSION:Pleural effusion following hepatoma surgery should not be regarded as a sign of post-operative complication, as it invariably disappears spontaneously within four weeks. Development of pleural effusion is considered to be caused by local irritation and disturbance of lymphatic flow at the diaphragm.
Carcinoma, Hepatocellular* ; Diaphragm ; Follow-Up Studies ; Humans ; Incidence* ; Liver ; Pleural Effusion* ; Postoperative Complications ; Radiography, Thoracic ; Retrospective Studies

We report a rare case of severe hypoglycemia after sunitinib treatment for pancreatic neuroendocrine carcinoma. We describe the initial clinical presentation, laboratory results, pathologic findings, and managment in a patient with a nonfunctioning pancreatic neuroendocrine carcinoma with liver metastases who developed life threatening hypoglycemia after 2 months of sunitinib therapy. A 46-year-old woman presented to the emergency department with loss of consciousness from hypoglycemia. Serum C-peptide and insulin levels at fasting state revealed that the hypoglycemia resulted from endogenous hyperinsulinemia. She had been diagnosed with nonfunctioning pancreatic neuroendocrine carcinoma based on a biopsy of metastatic cervical lymph node and was being treated with sunitinib, a small molecule tyrosine kinase inhibitor. Immunohistochemical stain of the metastatic liver mass demonstrated that the initially nonfunctioning neuroendocrine carcinoma cells had changed into insulin-producing cells after sunitinib therapy. Transarterial chemoembolization of the liver masses and systemic chemotherapy with streptozotocin/adriamycin relieved the hypoglycemia. A nonfunctioning pancreatic neuroendocrine carcinoma was transformed into an insulin-producing tumor after treatment with sunitinib, causing endogenous hyperinsulinemia and severe hypoglycemia.
Biopsy ; C-Peptide ; Carcinoma, Neuroendocrine ; Emergencies ; Fasting ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia ; Indoles ; Insulin ; Insulinoma ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Pyrroles ; Unconsciousness

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

The optimum timing of surgery for ruptured intracranial aneurysms still remains controversial. In order to compare the total management outcome between early and late surgery a retrospective analysis was carried out. Of 159 patients, 97 patients were selected according to the entry criteria and were divided into two groups ; group I(46pts.) was early surgery planned patients and group II(51 pts.) was late surgery planned patients. The results obtained are as follows ; 1) The incidence of a good recovery for the early surgery planned group was 74%, and that of the late surgery planned group was 67%, but there was no statistically significant difference between two groups. 2) The incidence of a delayed ischemic deficit was 24% for the early surgery planned group, and 29% for the late surgery planned group, with no statistically significant difference. But, the incidence of rebleeding was 2% for the early surgery group, and 14% for the late surgery planned group, so there was a statistically significant difference here. 3) The total management outcome of the early and late surgery planned group was similar, but early surgery was advantageous for the prevention of rebleeding.
Aneurysm, Ruptured ; Humans ; Incidence ; Intracranial Aneurysm* ; Retrospective Studies ; Subarachnoid Hemorrhage