The recurrent pterygium can be caused by repeating excisions for simple pterygium. The severe conjunctival cicatrization on the area of the medial rectus muscle limits abduction and results in diplopia and it is one of the causes of acquired retraction syndrome. We experienced two patients who have marked abducticn limitation and diplopia in all directions of gaze by recurrent pterygium. In order to eliminate these troblesome symptoms and signs with only one surgery, we performed conjunctival autograft transplantation in one patient and on the other patient with bilateral recurrent pterygium, the procedure was performed with resection of the lateral rectus using adjustable suture at one time. The limitation of ocular movement and diplopia were completely gone postoperatively.
Autografts ; Cicatrix ; Diplopia ; Duane Retraction Syndrome ; Esotropia* ; Humans ; Pterygium* ; Sutures

Cyclic esotropia is a rare condition, first mentioned by Burian in 1958, in which orthophoria is regularly followed by constant deviation on rhythmic pattern. The periodicity would suggest a biologial clock mechanism. Consecutive cyclic esotropia following strabismus surgery is extremely rare. Only three cases of consecutive cyclic esotropia following surgery for intermittent exotropia have been reported We report one case of consecutive cyclic esotropia in an 8-year-old girl who underwent surgery for intermittent exotropia. The periodic esodeviation was treated with bimedial rectus recession. We suggest the overcorrection after surgery for intermittent exotropia would cause the periodicity by biological clock mechanism when the biorhythm of the patient is in an unstable and dangerous state.
Biological Clocks ; Child ; Esotropia* ; Exotropia* ; Female ; Humans ; Periodicity ; Strabismus

Eosinophils are derived from hematopoietic stem cells. Peripheral blood eosinophilia is defined as an absolute eosinophil count of > or =0.5x10(9)/L. Eosinophilia is classified into primary or clonal eosinophilia, secondary eosinophilia, and idiopathic categories including idiopathic hypereosinophilic syndrome. Both hematopoietic and solid neoplasms may be associated with peripheral blood eosinophilia, but multiple myeloma is rarely associated with eosinophilia. We now report the case of a 31-year-old man with multiple myeloma associated with marked eosinophilia who developed multiple organ dysfunction with infiltration of eosinophils. He recovered after treatment with chemotherapy followed by autologous stem cell transplantation.
Adult ; Eosinophilia ; Eosinophils ; Hematopoietic Stem Cells ; Humans ; Hypereosinophilic Syndrome ; Multiple Myeloma ; Stem Cell Transplantation ; Stem Cells ; Transplantation, Autologous

Eosinophils are derived from hematopoietic stem cells. Peripheral blood eosinophilia is defined as an absolute eosinophil count of > or =0.5x10(9)/L. Eosinophilia is classified into primary or clonal eosinophilia, secondary eosinophilia, and idiopathic categories including idiopathic hypereosinophilic syndrome. Both hematopoietic and solid neoplasms may be associated with peripheral blood eosinophilia, but multiple myeloma is rarely associated with eosinophilia. We now report the case of a 31-year-old man with multiple myeloma associated with marked eosinophilia who developed multiple organ dysfunction with infiltration of eosinophils. He recovered after treatment with chemotherapy followed by autologous stem cell transplantation.
Adult ; Eosinophilia ; Eosinophils ; Hematopoietic Stem Cells ; Humans ; Hypereosinophilic Syndrome ; Multiple Myeloma ; Stem Cell Transplantation ; Stem Cells ; Transplantation, Autologous

OBJECTIVE: Diverse glomerular disorders leadsing to progressive glomerulosclerosis share the common features of increased mRNA expression for extra- cellular matrix protein and growth factors. The precise role of angiotensin II in contributing to these disturbances is currently unknown. ACE inhibitors have been proved to be beneficial in protecting against glomerular injury in animal models and many of human glomerular diseases. Type IV collagen is a main component of extracellular matrix in the mesangium : its increased accumulation is a common pathologic finding in the glomerulosclerosis. There are some evidences that the beneficial effect of ACE inhibitor does not solely depend on the hemodynamic effect, but may be mediated by other effect. The purpose of this study is to evaluate the effects of high glucose, angiotensin II and angiotensin converting enzyme inhibitor on the expression of PC alpha1(lV) in mesansial cells(MCs). METHODS: Human mesangial cells were cultured with standard method. To investigate the effect of each drug and high glucose condition, MCs were cultured in the normal-glucose medium(100mg/dl) and high-glucose medium(450mg/dl), respectively. An- giotensin II and angiotensin converting enzyme inhibitor(captopril) were added to culture medium at final concentration of 10 M which is the physiologic dose in vivo. MCs were cultured in each condition for 3days, when the maximal effect of high glucose on MCs, and harvested for mesurement of the expression of PC alpha1(IV) mRNA. To quantitate the PC alpha(1V) mRNA levels in each condition, semiquantitatine RT-PCR was done with co-amplification of house keeping gene. RESULTS: PCa1(IV) mRNA expression was significantly increased in high-glucose medium(30mM) compared to normal-glucose medium(5.5mM)(2.28+/-0.34 vs 0.96+/-0.08, p<0.05). Administration of angiotensin ll(10(-6)M) in culture media induced a further increment in the PC a >(IV) mRNA expression to 4.64+/-0.28(p<0.05). Angiotensin II in the normal-glucose medium increased the PC alpha1(lV) mHNA expression as 2.69+/-0.23 control(p<0.05). Addition of angiotensin converting enzyme inhibitor(Capopril, 10(-6)M) in high- glucose culture medium significantly suppressed the PC alpha1(IV) mRNA expression as 0.690.11(p<0.05). CONCLUSION: High glucose concentration in culture medium significantly increases the mRNA expression of procollagen alphal(IV) than normal glucose concentration. Angiotensin II increases the collagen mRNA expression directly and this effect was significantly prevented by ACE inhibitor. This result suggests that hyperglycemia in diabetic millieu can directly increase collagen production, and ACE inhibitor may inhibit progressive glomerulosclerosis by decreasing collagen production as well as reducing intraglomerular pressure.
Angiotensin II ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Collagen ; Collagen Type IV ; Culture Media ; Extracellular Matrix ; Glucose* ; Hemodynamics ; Humans* ; Hyperglycemia ; Intercellular Signaling Peptides and Proteins ; Mesangial Cells* ; Models, Animal ; Peptidyl-Dipeptidase A ; Procollagen ; RNA, Messenger*