BACKGROUND: Bronchial asthma is an inflammatory disease of the airways that is associated with airway remodeling. The vascular endothelial growth factor (VEGF) is a potent, multifunctional cytokine that contributes to angiogenesis and inflammation. Matrix metalloproteinase-9 (MMP-9) is a major proteolytic enzyme that induces bronchial remodeling in asthma. However, there is no data available on the possible role of the VEGF or on the potential relationship between the VEGF and MMP-9 in acute asthma. Therefore, the VEGF was studied to determine whether or not it participates in airway inflammation during acute asthma. An additional aim of this study was to determine whether or not the VEGF levels correlated with the MMP-9 levels in the sputum of acute asthma patients. METHODS: Both the VEGF and MMP-9 levels were measured by an enzyme immunoassay and zymographic analysis in the sputum of patients with either stable asthma or with acute asthma. The VEGF and MMP-9 levels were also evaluated during a spontaneous asthma attack. RESULTS: The VEGF levels were significantly higher in the sputum of acute asthmatic patients than in either the stable patients the control subjects. The VEGF levels in the sputum during asthma exacerbation were significantly higher than those on the remission days, and those levels decreased after decreased after asthma therapy. In acute asthmatic patients, the VEGF levels in the sputum correlated with the number of neutrophils and eosinophils. In addition, a significant correlation was established between the VEGF and MMP-9 levels in the sputum. CONCLUSION: These results suggest that VEGF overproduction is associated with airway inflammation during acute asthma and is related to the MMP-9 function.
Airway Remodeling ; Asthma* ; Eosinophils ; Extracellular Matrix ; Humans ; Immunoenzyme Techniques ; Inflammation ; Matrix Metalloproteinase 9* ; Neutrophils ; Sputum ; Vascular Endothelial Growth Factor A*

The use of LASER in medicine has increased since the early 1960s. The advantages of LASER are clear cut, less bleeding, less post-operative edema and rapid wound healing. But the disadvantages are penetration of normal tissue, endotracheal of tube ignition or penetration and chronic exposure. Therefore, through managemnt of anesthesia is required in the usuage of the LASER for the laryngeal surgery. We have experienced anesthesia in 28 cases of ENT patients using CO2 LASER without specific problems except one patient, who had the complication of penetration of the endotracheal tube cuff by the LASER beam after the main procedure. The anesthetic management to avoid LASER complications and emergency treatment after the complication are discussed with references.

We measured the near point of accommodation in 59 patients (59 eyes), who were implanted with 3M diffractive multifocal intraocular lens, in order to evaluote the pseudoaccommodation Average amount of pseudoaccommodation were 3.65 diopter (standard deviation was 1.75) and it was greater than that of monofocal intraocular lens Far vision and age did not affect the pseudoaccommodation. Near visual acuity alone appeared to have a positive correlation with pseudoaccommodation.
Humans ; Lenses, Intraocular* ; Visual Acuity

A 12-year-old spayed female Pomeranian (weighing 2.4 kg) was referred with primary complaints of acute dyspnea, cough, and lethargy. Diagnostic imaging studies found degenerative mitral valve cusps, chordae tendinae rupture, severe mitral regurgitation (5.45 m/s of peak velocity), and marked left atrial and ventricular dilation. The dog was diagnosed as having degenerative mitral valve disease (DMVD) with ISACHC stage IIIa heart failure. Her clinical condition was stabilized after administration of cardiac medication (e.g. diuretics and pimobendan). Ten months later, the dog was referred back to the clinic due to a sudden worsening of clinical signs. Echocardiographic study found pulmonary hypertension in addition to DMVD. After medication was adjusted, clinical signs were stabilized in 2 weeks. The patient was returned after 4 months for cardiac recheck and there was no obvious worsening of clinical signs. Incidental finding of a left-to-right atrial septal defect from rupture of the atrial septum secondary to marked left atrial dilation by DMVD was noted by echocardiography. To diminish left atrial volume overload, the frequencies of both furosemide and pimobendan were increased (i.e. from q 12 hr to q 8 hr) in addition to adding spironolactone (1 mg/kg q 12 hr). Based on diagnostic findings, this case was re-diagnosed as acquired atrial septal defect secondary to rupture of the atrial septum with advanced stage DMVD. The dog was then stabilized and is currently being regularly monitored.
Animals ; Atrial Septum* ; Child ; Cough ; Diagnostic Imaging ; Diuretics ; Dogs* ; Dyspnea ; Echocardiography ; Female ; Furosemide ; Heart Failure ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Incidental Findings ; Lethargy ; Mitral Valve Insufficiency ; Mitral Valve* ; Rupture* ; Spironolactone

PURPOSE: To evaluate changes in anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). METHODS: Seventy-eight eyes of 69 patients had uneventful phacoemulsification and IOL implantation using a clear corneal incision. Anterior segment OCT images of nasal and temporal angle quadrants were obtained before and at one month after surgery. The angle-referenced (ACD1), pupil-referenced (ACD2), lens-referenced (ACD3) ACDs, crystalline lens rise (CLR), nasal and temporal iridocorneal angles, angle opening distance at 500 micrometer (AOD500), and trabecular iris surface area at 750 micrometer (TISA750) were measured. Preoperative and postoperative measurements were compared using paired sample t-tests. RESULTS: The mean ACD1 was 3.19+/-0.24 mm preoperatively and 3.22+/-0.21 mm at one month postoperatively (P=0.21); ACD2 was 2.99+/-0.40 mm preoperatively and 3.56+/-0.28 mm at one month postoperatively (P<0.05); ACD3 was 2.75+/-0.41 mm preoperatively and 4.00+/-0.27 mm at one month postoperatively (P<0.05). The mean iridocorneal angles, AOD500, and TISA750 for both nasal and temporal sides increased significantly at the postoperative examinations (P<0.05). CONCLUSIONS: Changes in anterior chamber angle after cataract surgery can be objectively quantified by anterior segment OCT. Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction were shown on AS-OCT.
Anterior Chamber ; Cataract ; Cataract Extraction ; Eye ; Humans ; Iris ; Lens Implantation, Intraocular ; Lens, Crystalline ; Phacoemulsification ; Tomography, Optical Coherence

No abstract available.
Pregnancy*

PURPOSE: To evaluate whether a combination of penetrating keratoplasty (PKP) or pars plana vitrectomy (PPV) and Ahmed glaucoma valve (AGV) implantation affords a level of success similar to that of AGV implantation alone. METHODS: Eighteen eyes underwent simultaneous PPV and AGV, 14 eyes with PKP and AGV and 30 eyes with AGV implantation alone were evaluated. Success was defined as attainment of an intraocular pressure (IOP) >5 and <22 mmHg, with or without use of anti-glaucoma medication. Kaplan-Meier survival analysis was performed to compare cumulative survival between the combined surgery groups and the AGV implantation-alone group. Cox proportional hazard regression analysis was conducted to identify factors predictive of success in each of the three groups. RESULTS: Mean (+/-standard deviation) preoperative IOP was 30.2 +/- 10.2 mmHg in the PKP + AGV, 35.2 +/- 9.8 mmHg in the PPV + AGV, and 36.2 +/- 10.1 mmHg in the AGV implantation-alone group. The cumulative success rate at 18 months was 66.9%, 73.2%, and 70.8% in the three groups, respectively. Neither combined surgery group differed significantly in terms of cumulative success rate compared with the AGV implantation-alone group (p = 0.556, p = 0.487, respectively). The mean number of preoperative anti-glaucoma medications prescribed was significantly associated with success in the PKP + AGV implantation group (hazard ratio, 2.942; p = 0.024). CONCLUSIONS: Either PKP or PPV performed in conjunction with AGV implantation afforded similar success rates compared to patients treated with AGV implantation alone. Therefore, in patients with refractory glaucoma who have underlying corneal or retinal pathology requiring treatment with PKP or PPV, AGV implantation can be performed simultaneously.
Female ; Follow-Up Studies ; Glaucoma/physiopathology/*surgery ; *Glaucoma Drainage Implants ; Humans ; *Intraocular Pressure ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Prosthesis Implantation/*methods ; Retrospective Studies ; Tonometry, Ocular ; Treatment Outcome ; Vitrectomy/*methods

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor that occurs among young women and typically presents as bilateral multiple nodules. In the present report, we describe an uncommon case of PEH presented as a single cavitary nodule in a 33-yr-old asymptomatic man. This is the first case of PEH presented as a single cavitary nodule in the English literature. Three years of the follow-up without treatment was performed. Overall histologic findings were accord with conventional PEH, but some atypical features such as, increased mitotic activity (mean; two per ten high power fields), necrosis, spindling, and pleural and vascular invasion were recognized. Immunohistochemically, the tumor cells were positive for CD34. This report may contribute to the data on clinical findings and natural history of this rare tumor.
Adult ; Antigens, CD34/biosynthesis ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology ; Human ; Immunohistochemistry ; Lung Neoplasms/*diagnosis/pathology ; Male ; Mitosis ; Necrosis ; Time Factors ; Tomography, X-Ray Computed

Gastric polyps are uncommon. The incidence of gastric polyps has been reported between 0.4% and 2.0%. Two histologically distinct forms of gastric polyps are hyperplastic polyps and adenomatous polyps. Hyperplastic polyps are multiple in up to a half of cases. When the polyps number is more than 50, the term "Hyperplastic polyposis" is applied and such cases are even more rare. Polypoid lesions of the stomach have heen reported in many of the polyposis syndromes, such as Familial polyposis coli, Gardners syndrome, Peutz-Jeghers syndrame, Juvenile polyposis and Cowdens disease. Only 1 case of gastric hyperplastic polyposis associated with colonic hyperplastic polyposis has been reported. The patient under study is not included in any polyposis syndrome and has no familial tendency, We report a case of gastric hyperplastic polyposis with colonic hyperplastic polyposis with literatures reviews.
Adenomatous Polyposis Coli ; Adenomatous Polyps ; Colon* ; Gardner Syndrome ; Hamartoma Syndrome, Multiple ; Humans ; Incidence ; Polyps ; Stomach

BACKGROUND/AIMS: Lamivudine is highly effective in suppressing hepatitis B virus replication and hepatitis B induced necroinflammatory activity. The objective of this study was to evaluate the virological and biochemical responses to lamivudine by patients with HBV associated chronic liver disease. In particular we stressed the importance of lamivudine therapy by patients with decompensated liver cirrhosis. METHODS: We conducted a one-year trial of lamivudine in 80 patients with HBV associated chronic liver disease (chronic hepatitis 44, cirrhosis 36). We classified these patients according to the severity of hepatic dysfunction as chronic B hepatitis (Group A) or liver cirrhosis (Group B). These patients were treated for 12 months with 100 mg daily doses of lamivudine. RESULTS: The seroconversion rate of HBeAg was 23.5% in group A patients and 26.7% in group B patients. The negative conversion of HBV-DNA was sustained for one year in 79.5% of patients in group A and 86.1% in group B. The normalization rates of serum ALT were 90.9% in group A and 88.9% in group B patients. No serious side effect after discontinuance of the treatment was found. There were 12 ALT breakthrough cases and all of them showed mutation of YMDD motif. However, they did not deteriorate clinically in spite of ALT elevation and HBV-DNA reappearance. The Child-Pugh scores improved even in patients with decompensated liver cirrhosis. CONCLUSION: One-year lamivudine treatment resulted in excellent virological and biochemical improvements and was well tolerated in the patients with HBV associated chronic liver disease, even in decompensated cirrhosis. We conclude that lamivudine is relatively safe in chronic hepatitis B and liver cirrhosis treatment.
Fibrosis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Liver Cirrhosis* ; Liver Diseases ; Liver*