Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. Before the use of intravitreal antibiotics, endophthalmitis almost always resulted in the loss of vision in the affected eye. The introduction of intravitreal injection of antibiotics had been a major advancement because it has resulted in a marked improvement in visual outcome. Current therapy is to administer broad-spectrum antibiotic agents covering both gram-positive and gram-negative organisms. Typically, vancomycin hydrochloride and aminoglycoside, such as amikacin sulfate, are administered as separate intrvitreal injections on an empiric basis. We experienced a case of culture-proven Pseudomonas aeruginosa endophthalmitis treated with intravitreal ceftazidime injection. We present it with a review of literature.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime* ; Decision Making ; Diagnosis ; Emergencies ; Endophthalmitis* ; Intravitreal Injections ; Pseudomonas aeruginosa* ; Pseudomonas* ; Vancomycin

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

We performed comprehensive ophthalmic examinations for 127 children at 4 and 5-year-old referred from primary(for 3315 subjects) and secondary(for 1441 subjects) vision screening. Although it may be duplicated, the 112 children(3.4%) had ametropic eyes, 49(1.5%) amblyopia, and 8(0.2%) strabismus. The mixed astigmatism took possession of 40% of ametropia, and 93.2% of ametropia had astigmatism on the whole. Among strabismic children, the case of exotropia was equal to that of esotropia by 4. The Titmus and TNO stereoacuity were not adequate to detect amblyopia. The early detection of eye problems for preschool children is important to prevent the permanent visual disability. It is necessary to make institutional devices for preschool vision screening.
Amblyopia ; Astigmatism ; Child* ; Child, Preschool* ; Esotropia ; Exotropia ; Humans ; Refractive Errors ; Strabismus ; Vision Screening*

We analyzed a total of 41 eyes with rhegmatogenous retinal detachment treated with scleral buckling to evaluate factors elated to anatomical and functional success rate. 22 patients (55 %) were wemen. The most common age group was third decade(27.5%). Among the associated ocular findings, the most common finding was high-degree myopia (14 eyes, 34.1%) and the next was lattice degeneration. The most common postoperative complication was temporary elevation of intraocular pressure (14 eyes, 34.1 %). The overall anatomical success rate was 87.8 % and functional success rate was 68.3%. Important factors related to anatomical and functional success were duration of retinal detachment(less than 1 month), location of tears(at or anterior to the equator) and the difference of intraocular pressure between affected and unaffected eyes(less than 10 mmHg). The macular status was highly related to the functional success. The sex, age , preoperative visual acutiy, preoperative refractive error and surgical method had no statistically significant relationship with success rate.
Humans ; Intraocular Pressure ; Myopia ; Postoperative Complications ; Refractive Errors ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling*

Renal cell carcinoma takes up 85 per cent of primary malignant renal tumors. It frequently metastasizes to the adrenal gland, lung, bone, liver and nephrectomy site but rarely to the head and neck area. When metastasizes to head and neck area, it involves the gingiva, tongue, palate, parotid gland, uvula, mandible, and lip. When tumors are found in the salivary gland consisting of clear cells, it is impartant to carry out differential diagnosis of various primary tumors with clear cell and metastatic renal cell carcinoma. Patients' medical history, review of system, and pathologic findings would be helpful factors in the differential diagnosis. In this paper, we report on a case of renal cell carcinoma which had metastasized to the psubmandibular gland after a radical nephrectomy.
Adrenal Glands ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Gingiva ; Head ; Lip ; Liver ; Lung ; Mandible ; Neck ; Nephrectomy ; Palate ; Parotid Gland ; Salivary Glands ; Submandibular Gland* ; Tongue ; Uvula

BACKGROUND: Calcineurin plays a crucial role in T cell activation, cell growth, apoptosis, and angiogenesis, and its over-expression has been implicated in the pathogenesis of cardiomyopathy and stroke. However, the expression and function of calcineurin in the pathologic lesion of chronic inflammatory diseases, like rheumatoid synovium, remain to be defined. This study was aimed to determine the role of calcineurin in inflammatory arthritis and investigate the expression and function of calcineurin in the rheumatoid synovium and synoviocytes, the actual site of chronic inflammation. METHODS: Immunohistochemical staining using specific antibody to calcineurin was perfomed in the synovium of rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients were isolated from RA and OA patients, and cultured with IL-1beta and TNF-alpha in the presence or absence of cyclosporin A, a calcineurin inhibitor. The calcineurin expression was assessed by phosphatase assay and Western blotting analysis. IL-6, -10, -17, matrix metalloproteinase (MMP)-1, -2, -3, and -9 released into the culture supernatants were measured by ELISA. After transfection with GFP-Cabin 1 gene into synoviocytes, the levels of IL-6 and MMPs were measured by ELISA. RESULTS: Calcineurin was highly expressed in the lining layer of synovium and cultured synoviocytes of RA patients. The elevated calcineurin activity in the rheumatoid synoviocytes was triggered by proinflammatory cytokines such as IL-1beta and TNF-alpha. In contrast, IL-10, an anti-inflammatory cytokine, failed to increase the calcineurin activity. The targeted inhibition of calcineurin by the over-expression of Cabin 1, a natural calcineurin antagonist, inhibited the production of IL-6 and MMP-2 by rheumatoid synoviocytes in a similar manner to the calcineurin inhibitor, cyclosporin A. CONCLUSION: These data suggest that abnormal activation of calcineurin in the synoviocytes may contribute to the pathogenesis of chronic arthritis, and thus provide a potential target for controlling inflammatory arthritis.
Apoptosis ; Arthritis* ; Arthritis, Rheumatoid ; Blotting, Western ; Calcineurin* ; Cardiomyopathies ; Cyclosporine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Matrix Metalloproteinases ; Osteoarthritis ; Stroke ; Synovial Membrane ; Transfection ; Tumor Necrosis Factor-alpha

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

PURPOSE: Behcet's disease is a chronic, recurrent, multisystemic disorder, which visual prognosis is poor. The clinical and epidemiological characteristics of Behcet's disease in Korean were evaluated. METHODS: The clinical records on 3,175 patients with Behcet's disease diagnosed at Behcet's disease clinic in Severance Hospital between November 1983 and December 1999 were reviewed. RESULTS: Among all 3,175 patients, the men/women ratio of Behcet's disease was 1:1.6. The age of disease onset was the highest in the thirties (33.8%). The most frequent major and minor symptom was oral ulcer (97.7%) and arthritis (32.8%) respectively, and the proportion of ocular symptom was 19.3%. The most frequent initial symptom was oral ulcer (77.4%). The ratio of men/women with ocular symptom was 1:0.98. The mean interval between the initial symptom and ocular symptom was 34 months, and the most common ocular symptom was iritis (79.0%). The most frequent systemic drug administered in patients with ocular involvement was colchicines (35%). Visual acuity was worsened in 56% of the eyes followed for over 24 months. CONCLUSIONS: The authors notice the characteristics of Behcet's disease in Korean and suggest that the continuous and nationwide survey is further necessary.
Arthritis ; Humans ; Iritis ; Oral Ulcer ; Prognosis ; Visual Acuity

Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is usually associated with disruption of the continuity of the skull after head and facial trauma, neuro or otorhinolaryngologic surgery, and rarely, spontaneously. But a case of pneumo-hydrocephlus, a special subtype of pneumocephalus, has been rarely reported. This is a case of a 26-year-old quadriplegic patient who traumatic brain injury with left frontoparietal skull bone fracture and epidural hemorrhage with developed of pneumo-hydrocepahlus in the ventricle 6 months after injury. The mechanism of this case can be explained by the "inverted bottle" hypothesis. Clinical observation suggests that the leakage of cerebrospinal fluid through the ventricle-peritoneal shunt tube caused negative pressure gradient differences resulting in the inflow of outside air into the ventricle through fissures created by concealed fracture of the skull base.
Adult ; Brain Injuries ; Fractures, Bone ; Head ; Hemorrhage ; Humans ; Pneumocephalus ; Skull ; Skull Base ; Ventriculoperitoneal Shunt