PURPOSE: Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small sized arteries throughout the vascular system, including ocular tissues. We report a case of orbital polyarteritis nodosa complicated with retinal vasculitis and exophthalmos. METHODS: A 51-year-old woman complained of swelling and hard mass in periorbital region for 3 months. The left eye was anophthalmos after enucleation secondary to corneal infection. The patient has treated marginal ulcer of the cornea and keratomalacia. Posterior synechia and motility disturbance of lateral rectus muscle were also revealed. Fundus examination showed focal retinal hemorrhage, macular hard exudate, and soft exudate, which may mean retinal vasculitis. Both eyes gradually developed exophthalmos. Orbital CT scan revealed homogenous infiltration in the orbit, ethmoid bone, and nasal cavity and perforation of the nasal septum. The pathologic examination for the biopsy specimen from the orbital tissue demonstrated a nongranulomatous vasculitis, diagnosing the polyarteritis nodosa. RESULTS: The authors present ocular manifestations, including marginal corneal ulcer, keratomalacia, dysfunction of the extraocular muscles, posterior synechia, retinal hemorrhage, soft exudate, hard exdate in the macula, and exophthalmos, in this patient with the polyarteritis nodosa.
Anophthalmos ; Arteries ; Biopsy ; Cornea ; Corneal Ulcer ; Ethmoid Bone ; Exophthalmos* ; Exudates and Transudates ; Female ; Humans ; Middle Aged ; Muscles ; Nasal Cavity ; Nasal Septum ; Orbit* ; Peptic Ulcer ; Polyarteritis Nodosa* ; Retinal Hemorrhage ; Retinal Vasculitis* ; Retinaldehyde* ; Tomography, X-Ray Computed ; Vasculitis

No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*

Retinoic acid plays an important role in embryogenesis, by regulating morphogenesis, cell proliferation, differentiation, and extracellular matrix production. Also retinoic acid is a potent teratogen and induces a variety of limb and craniofacial malformations including cleft palate, that is the most common congenital malformation. Fibroblast growth factor 2 (FGF2) and fibroblast growth factor receptor 2 (FGFR2) are an important role in the secondary induction for the epithelial-mesenchymal transformation during development. Mutations in them, produce a congenital malformation in the skeletal system and the craniofacial tissue. It was of interest to explore the hypothesis of an inhibitory effect exerted by retinoic acid on the cell proliferating activity and the expression of FGF2 and FGFR2 in the developing palate in vivo. In the present study, author observed the expression of PCNA as a marker for the cell proliferating activity, FGF2 and FGFR2 to compare with developmental stages and locations in normal and retinoic acid-induced cleft palate. Retinoic acid was administered orally at gestational day (GD) 10 to ICR mice. The pregnant mice were sacrificed on GD 12, 13, 14, 15 to obtain the fetuses. Scanning electron microscope and immunohistochemistry was performed. In the retinoic acid-treated fetuses, palatal shelves did not elevate and cleft palate was induced. On GD 12, 13 in the palatal mesenchyme of the retinoic acid treated-fetuses, expression of the PCNA decreased. On GD 12 in the palatal epithelium of the retinoic acid-treated fetuses, expression of FGFR2 decreased, but after GD 13, the patterns of expression of FGFR2 were not affected. On GD 12, 13 in the palatal epithelium and mesenchyme of the retinoic acid-treated fetuses, expression of FGF2 decreased dramatically, but after GD 14, it was similar to that in the normal fetal palate. These results suggest that retinoic acid inhibits the cell proliferating activity and the expression of FGF2, FGFR2 in the palatal mesenchyme on GD 12, 13, which is critical in the developing palate, and elevation of palatal shelves is delayed and impaired. Moreover, it seems that retinoic acid inhibits the epithelial-mesenchymal transformation of epithelium. Finally, cleft palate is induced.
Animals ; Cell Proliferation ; Cleft Palate ; Embryonic Development ; Epithelial-Mesenchymal Transition ; Epithelium ; Extracellular Matrix ; Extremities ; Female ; Fetus ; Fibroblast Growth Factor 2* ; Fibroblast Growth Factors* ; Fibroblasts* ; Immunohistochemistry ; Mesoderm ; Mice* ; Mice, Inbred ICR ; Morphogenesis ; Palate ; Pregnancy ; Proliferating Cell Nuclear Antigen ; Receptor, Fibroblast Growth Factor, Type 2 ; Tretinoin*

PURPOSE: The purpose of this study was to evaluate the characteristics of patients who received primary androgen deprivation therapy (PADT) for clinically localized prostate cancer and the clinical efficacy of this treatment. MATERIALS AND METHODS: Between January 1998 and August 2007, patients who underwent PADT for clinically localized prostate adenocarcinoma were analyzed. The patients studied could not receive definitive therapy owing to old age or medical comorbidities. All patients' Gleason score, pretreatment prostate-specific antigen (PSA) value, time to PSA progression, and D'Amico's risk criteria were analyzed. RESULTS: A total of 72 patients were analyzed. The patients' mean age was 75.29 years (range, 57-92 years) and their median pretreatment PSA was 13.52 ng/ml (range, 1.27-74.82 ng/ml). The median follow-up duration was 39 months (range, 18-115 months). Thirteen patients (18.57%) had PSA progression after reaching a PSA nadir. The mean time to PSA progression was 14 months (range, 7-55 months). Among these 13 patients, 2 patients had low-risk prostate cancer and 11 patients had high-risk prostate cancer by D'Amico's risk criteria. Three of the 13 patients are now receiving chemotherapy, 2 patients died from cancer progression, 3 patients died of a non-cancer cause, and 5 patients are now being conservatively managed. Of the total 72 patients, 70.83% of the patients are still receiving PADT. A total of 11 patients died; however, only 2 deaths were caused by prostate cancer. CONCLUSIONS: In patients with localized prostate cancer who could not receive definitive therapy for several reasons, the cancer-caused death rate was very low, even in patients with PSA progression. PADT is an effective therapeutic option in patients with localized prostate cancer.
Adenocarcinoma ; Androgens ; Comorbidity ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

PURPOSE: To evaluate the changes in the leg length discrepancy in idiopathic hemihypertrophy as a function of time. MATERIALS AND METHODS: A lower extremity scannogram was performed on 33 patients (16 boys and 17 girls) who were clinically diagnosed with idiopathic hemihypertrophy from September, 1985 to December, 1996. The leg length discrepancy was compared every 6 months. The mean age of the patients on the first visit was 1.6 years (range, 1 to 5 years) and the average follow up period was 9.1 years (range, 8 to 15 years). RESULTS: Not all the discrepancies continued to increase at a constant rate with time. The developmental discrepancy patterns identified were classified as follows: type I, increasing pattern; type II, increasing-plateau pattern; type III, plateau pattern; type IV, increasing-decreasing pattern; type V, decreasing pattern. Twenty five patients (75%) had types I and II discrepancy patterns. CONCLUSION: A continual periodic follow up of the leg length is important in idiopathic hemihypertrophy patients because the developmental patterns of a discrepancy in the length of a lower extremity can vary.
Follow-Up Studies ; Humans ; Leg* ; Lower Extremity

BACKGROUND: Conventional visual assessment of coronary arteriogram is fraught with large interobserver variance and disagreement with pathologic findings. Thus quantitative coronary angiography had been recently developed to meet the requirement of more reproducible measurement of severity of coronary artery disease. This study was designed to evaluate the interobserver variability of quantitative coronary angiography and its usefulness in clinical application. METHODS: Three independent observers analysed coronary angiogram of 31 consecutive patients by visual assessment and quantitative measurement using computer based algorithm. RESULTS: 1) There was considerable disagreement between 3 observers in the identification of significant coronary stenosis. Complete agreement was achieved in only 29/61 (47%) coronary lesion and agreement of more than 2 observers in 41/61(67%) lesion. 2) In visual assessment, the largest interobserver variance was found in acute marginal artery and distal circumflex artery, whereas the least variance was observed in proximal right coronary artery. 3) The average interobserver variance was 13.1% in visual assessment, 14.9% in geometric analysis, and 10.5% in video densitometric analysis. There was no significant difference between these values. 4) Visual assessment was noted to overestimate the severity of stenotic lesion, by 5.6% compared to geometric analysis and by 11.8% compared to video-densitometric analysis. CONCLUSION: These findings suggest that identifying significant lesion is major source of interobserve variability in both visual and quantitative analysis of coronary arteriogram. In addition, suboptimal image quality was responsible for the inability of quantitative analysis to reduce the variance. These factors seem to be major limitation of quantitative coronary arterirogam.
Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Observer Variation*

Microinvasive carcinoma of the uterine cervix(FIGO stage IA) has been reported as highly curable disease even with conservative surgery such as conization and simple hysterectomy. Nevertheless, the surgical management for microinvasive carcinomas has been proposed varying from conservative surgery to radical hysterectomy with pelvic nodes dissection according to different diagnostic criterias for microinvasive carcinoma. We reviewed 512 patients who had been diagnosed as microinvasive carcinoma of the uterine cervix at the Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center from Jan. 1988 to Dec. 1995. Among them, 376 patients were included in this study satisfying guided criterias such as proper management and follow up more than at least one year, and they were analyzed retrospectively based on the clinicopathologic characteristics, pattern of surgical management and postoperative status. (continue)
Cervix Uteri* ; Conization ; Delivery of Health Care ; Diagnosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies

BACKGROUND AND OBJECTIVES: It's not clear whether the serum lipid level is associated with the individual carotid arterial wall thickness for patients suffering with coronary atherosclerosis, although hypercholesterolemia is associated with an increased carotid IMT. We sought to evaluate the association between the serum lipid level and the individual carotid arterial wall thickness (intimal thickness (IT) and medial thickness (MT)) as well as the carotid intima-media thickness (IMT) for patients with coronary atherosclerosis. SUBJECTS AND METHODS: The carotid arterial wall thickness was measured using high-resolution B-mode ultrasound in 139 consecutive patients (58+/-11 years old, 75 males) with coronary atherosclerosis by performing coronary angiography. RESULTS: Measurement of the individual arterial wall thickness was possible in 126 patients (90.6%) out of all the study subjects. The carotid IMT was correlated with the total cholesterol (r=0.207, p=0.015) and low-density lipoprotein (LDL) cholesterol (r=0.237, p=0.006). The carotid IT was correlated with the total cholesterol (r=0.210, p=0.020), triglyceride (r=0.212, p=0.018), and LDL-cholesterol (r=0.246, p=0.006), whereas the MT did not show any significant correlation with the serum lipid level. Multivariate analysis disclosed that the serum LDL cholesterol level was associated with the carotid IMT and IT for the patients with coronary atherosclerosis, but it was not correlated with the MT. CONCLUSION: This study suggests that the serum LDL cholesterol level is more closely associated with the carotid IT than the IMT for patients with coronary atherosclerosis, and each carotid arterial wall has a different response to the serum lipid level.
Carotid Arteries* ; Carotid Intima-Media Thickness ; Cholesterol ; Cholesterol, LDL ; Coronary Angiography ; Coronary Artery Disease* ; Humans ; Hypercholesterolemia ; Lipoproteins ; Multivariate Analysis ; Triglycerides ; Ultrasonography

OBJECTIVES: Multiple lung cancers and/or precancerous lesions can be developed because many bronchi are exposed to carcinogens simultaneously according to the concept of 'Field Cancerization'. We had performed a careful bronchoscopic examination and analysed the patients of double bronchial lesions who received the separate pathologic evaluation. METHODS: We studied 21 patients of double bronchial lesions among 1855 patients of bronchoscopic examination from April 1990 to December 1993 in Korea Cancer Center Hospital. We classified the patients into three groups(double malignancies of different histology, double malignancies of same histology, and combination of malignant and benign lesions) and analysed the histologic type, location, radiologic findings, and clinical parameters. RESULTS: Among 21 patients, six patients had double malignancies of different histology, eight had double malignancies of same histology, and seven had combination of malignant and benign lesions. Out of 14 double malignant cases, 11 cases are considered as synchronous multiple primary lung cancers. Combination of squamous cell carcinomas was found in 5 cases, combination of small cell carcinoma and squamous cell carcinoma was found in 4 cases. Combination of adenocarcinoma and squamous cell carcinoma and combination of squamous cell carcinoma and poorly differentiated carcinoma were found in 1 case respectively. All patients of synchronous multiple primary lung cancers were male and had long smoking history(average 40 pack years). Among 21 cases of double bronchial lesions, only one lesion could be detected by prebronchoscopic radiologic examination including chest CT in 15 cases. CONCLUSIONS: The presence of double bronchial lesions including multiple primary lung cancers and the limitation of radiologic examination to detect early bronchial lesions encourage us to examine the whole bronchi carefully and to perform pathologic evaluations.
Adenocarcinoma ; Bronchi ; Bronchoscopy ; Carcinogens ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Humans ; Korea ; Lung Neoplasms ; Male ; Smoke ; Smoking ; Tomography, X-Ray Computed

No abstract available.
Cisapride* ; Gastric Emptying* ; Humans ; Kidney Failure, Chronic*