PURPOSE: The purpose of the experiment with the rabbit was to evaluate the effect of human amniotic membrane transplantation in the extraocular muscle surgery area after the operation. METHODS: Five millimeters resection of both superior rectus muscles was performed in eight rabbits. The left eye was served as a control, and the right eye was covered with human amniotic membrane at the site where the operation was performed. Each rabbit was graded according to the degree of adhesion. A histological comparison was done after enucleation. RESULTS: At one week after the operation, it was discovered that the inflammation of the human amniotic membrane transplantation site was suppressed, but at two weeks the human amniotic membrane transplantation site was significantly inflamed. However, the inflammation decreased at six weeks. CONCLUSIONS: This study shows that strabismus surgery with transplantation of human amniotic membrane may reduce postoperative inflammation and adhesion in strabismus surgery after one week. However, after two weeks the inflammation will increase and produce more postoperative adhesion. After six weeks there was no significant inflammation in comparison to the control group.
Amnion* ; Humans ; Inflammation ; Muscles ; Rabbits* ; Strabismus* ; Tissue Adhesions*

Gastrointestinal involvement has been reported to occur in about 5 to l0% of patients with lymphoma. The most common gastrointestinal site for a lymphoma is the stomach, followed by the small intestine and ileocecal region. When lymphoma is found in the esap us, generally it is with contiguous involvement of the gastric fundus, the cervical node, secondary to mediastinal lymph node compression, or a late manifestation of advanced desease. Such cases cannot be labeled as primary esophageal lymphoma. A search of the literature reveals that there have been about 20 or more published cases classified as esophageal lymphoma. However, more than ten cases are indistingishable from the case of distal esophageal involvement by gastric lymphoma. In 1935, Chiolero described a case of midesophageal stricture, which at autopsy was consistent with Hodgkin's disease for the first time. Berman reported an authentic case of primary histiocytic lymphoma confined to the lower esophagus. Only six or more cases were reported in literature until the present time. Here, a 30-year-old man with substernal discomfort was shown to have a mass lesion on the esophagus. The mass was proved to be malignant lymphoma on the histologic examination. This may be the first report dealing with spontaneous regression of maligant lymphoma of the esophagus possibly associated with the use of cimetidine.
Adult ; Autopsy ; Cimetidine ; Constriction, Pathologic ; Esophagus* ; Gastric Fundus ; Hodgkin Disease ; Humans ; Intestine, Small ; Lymph Nodes ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Stomach

The majority of lung cancers associated with hyperamylasemia are adenocarcinomas. Here we report an unusual case of a 54-year-old male patient who complained of dyspnea, anterior chest wall discomfort and facial edema for one month, presenting with a huge mediastinal mass and hyperamylasemia complicated by pericardial effusion Histological evaluation of mediastinal mass revealed small cell carcinoma and pericardium showed nonspecific inflammation with fibrosis. The serum amylase had an electrophoretic mobility similar to that of salivary gland enzyme. There were no evidence of a salivary or pancreatic causes of hyperamylasemia. After chemotherapy, parenchymal lung lesions improved and hyperamylasemia disappeared. For the mannagement of peracardial effusion a pericardial window was forms(i. We concluded that the striking increase in serum amylase was due to the ectopic production of this enzyme by the tumor.
Adenocarcinoma ; Amylases* ; Carcinoma, Small Cell ; Drug Therapy ; Dyspnea ; Edema ; Fibrosis ; Humans ; Hyperamylasemia ; Inflammation ; Lung ; Lung Neoplasms ; Male ; Middle Aged ; Pericardial Effusion ; Pericardium ; Salivary Glands ; Small Cell Lung Carcinoma* ; Strikes, Employee ; Thoracic Wall

Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.
Communication Aids for Disabled ; Cranial Nerves ; Eye ; Eyelids ; Humans ; Mutism ; Paralysis ; Quadriplegia ; Stroke

No abstract available.
Diagnosis* ; Postpartum Period* ; Pregnancy* ; Thyroid Diseases*

Herpes simplex virus (HSV) infection of the lower respiratory tract occurs rarely in neonate and immunocompromised host. The need for a timely and specific diagnosis of viral infections is becoming greater with development of antiviral chemotherapy. Herein, we report a case of herpes simplex virus pneumonia diagnosed by cytologic examination of the bronchoalveolar lavage (BAL) sample of respiratory epithelial cells in a tracheal adenoid cystic carcinoma patient. A 65-year-old woman presented with dyspnea and cough for one month. Bronchoscopy showed a mass arising from the posterior wall of upper trachea, and she underwent tracheal sleeve resection with cricotracheal anastomosis. The pathologic examination revealed adenoid cystic carcinoma. Corticosteroids were used for prevention of stenosis and swelling on the anastomosis site. On 28th postoperative day, pneumonia developed and it was aggravated despite of antibiotic therapy. The cytologic examination of the BAL fluid showed the eosinophilic nuclear inclusion along with the positive result of immunocytochemistry using monoclonal antibody to HSV. Despite of immediate therapy with acyclovir the pneumonia progressed to the acute respiratory distress syndrome and the patient eventual died.
Acyclovir ; Adenoids* ; Adrenal Cortex Hormones ; Aged ; Bronchoalveolar Lavage ; Bronchoscopy ; Carcinoma, Adenoid Cystic* ; Constriction, Pathologic ; Cough ; Diagnosis ; Drug Therapy ; Dyspnea ; Eosinophils ; Epithelial Cells ; Female ; Herpes Simplex* ; Humans ; Immunocompromised Host ; Immunohistochemistry ; Infant, Newborn ; Intranuclear Inclusion Bodies ; Pneumonia ; Pneumonia, Viral* ; Respiratory Distress Syndrome, Adult ; Respiratory System ; Simplexvirus ; Trachea

Pure red cell aplasia (PRCA) is characterized by severe anemia with reticulocytopenia and absence of erythroblast from the bone marrow. Sinus histiocytosis with massive lymphadenopathy (SHML : Rosai-Dorfman disease) is rare systemic disease characterized by painless cervical, axillary, inguinal and mediastinal lymphadenopathy and frequent extranodal invasion. Histologically, lymph node sinuses are expanded by numerous distinctive histiocytes which contains well preserved lymphocytes. We report a case of sinus histiocytosis with massive lymphadenopathy in inguinal lymph node biopsy with polyclonal gammopathy and pure red cell aplasia in bone marrow biopsy who was infected by Epstein-Barr virus.
Anemia ; Biopsy ; Bone Marrow ; Erythroblasts ; Herpesvirus 4, Human ; Histiocytes ; Histiocytosis, Sinus* ; Lymph Nodes ; Lymphatic Diseases* ; Lymphocytes ; Red-Cell Aplasia, Pure*

BACKGROUND: Aortic stiffness and intima-media thickness (IMT) are known to be associated with ischemic stroke. The aim of the present study was to investigate the differences of aortic stiffness and IMT between cerebral infarction (CI) and transient ischemic attack (TIA). METHODS: A total of 500 patients with acute stroke were divided into 2 groups: the TIA group (n = 230, 62.4 +/- 12 years, 144 males) versus CI group (n = 270, 63.4 +/- 11 years, 181 males). Aortic stiffness index and IMT, as well as conventional cardiovascular risk factors, were compared. RESULTS: The prevalence of hypertension, diabetes, and dyslipidemia were significantly higher, and left atrial volume and E/E' were significantly elevated in the CI group than in the TIA group. Carotid IMT was significantly thicker in the CI group than in the TIA group. Aortic stiffness index beta was significantly higher (7.99 +/- 2.70 vs. 7.02 +/- 4.30, p = 0.043) and aortic IMT was significantly thicker (1.53 +/- 0.41 vs. 1.45 +/- 0.39 mm, p = 0.040) in the CI group than in the TIA group. Aortic stiffness index beta was significantly correlated with the IMT of the aorta (r = 0.279, p = 0.014), right (r = 412, p < 0.001) and left carotid artery (r = 441, p < 0.001). CONCLUSION: Aortic stiffness index beta and IMT were significantly higher in patients with CI than TIA. The result of the present study suggested that CI is associated with more advanced degree of atherosclerotic and arteriosclerotic process than TIA.
Aorta ; Carotid Arteries ; Cerebral Infarction ; Dyslipidemias ; Humans ; Hypertension ; Ischemic Attack, Transient ; Prevalence ; Risk Factors ; Stroke ; Vascular Stiffness

BACKGROUND: The glucose uptake rate is the limiting step in glucose utilization and storage. The failure of insulin to stimulate glucose uptake in muscle appears to be a primary defect of insulin resistance. This study was undertaken to examine the effect of physiological hyperinsulinemia on the phosphorylation of the insulin receptor (IR-beta), insulin receptor substrate (IRS), Akt kinase and GSK-3 in isolated skeletal muscle, in people with type 2 diabetes (n=9) and control subjects (n=11). METHODS: 75g OGTT and euglycemic hyperinsulinemic clamp test were done. And vastus lateralis muscle was obtained before and 30 min into the euglycemic clamp. Western blots were performed for tyrosine phosphorylation of insulin receptor substrate (IRS) and phosphorylation of the insulin receptor(IR-beta), Akt and GSK-3. RESULT: There were no statistical differences in the mean age, BMI and body fat between the control subjects and diabetic patients. The fasting blood sugar and HbA1c in controls and diabetic patients were 98.+/-1.3 and 208.1+/-16.5 ng/dl, and 5.4+/-0.5 and 9.2+/-0.6%, and 1.4+/-0.2 in the control subjects, and 72.2+/-52.3% (p<0.01) and 10.2+/-6.3 (p<0.01) in the diabetic patients, respectively. The insulin resistance from the euglycemic hyperinsulinemic clamp tests were 8.2+/-0.6 mg/kg/min and 3.7+/-1.1 ng/kg/min in the control subjects and in the diabetic patients, respectively (p<0.01). Compared with the normal controls, insulin-stimulated IR phosphorylation was no different to that in the diabetic patients. However, insulin-stimulated IRS phosphorylation, insulin-stimulated Akt phosphorylation and insulin-stimulated GSK-3 phosphorylation were reduced in the diabetic patients compared with the normal controls by 24, 43 and 25%, respectively (p<0.05). CONCLUSION: In korean type 2 diabetic patients, the insulin resistance may be due to the impairment of the upstream insulin signal molecular network. Further studies will focus on determining whether these signaling defects are the cause of the development of insulin resistance, or secondary to the altered metabolic state, associated with type 2 diabetes mellitus
Adipose Tissue ; Blood Glucose ; Blotting, Western ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Glucose Clamp Technique ; Glucose Tolerance Test ; Glycogen Synthase Kinase 3 ; Humans ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Muscle, Skeletal* ; Phosphorylation ; Phosphotransferases ; Quadriceps Muscle ; Receptor, Insulin ; Signal Transduction* ; Tyrosine

OBJECTIVE: The purpose of this study is to evaluate the clinical and hematological effects of tocilizumab in active rheumatoid arthritis (RA) patients. METHODS: Fourteen patients with active RA were enrolled in this study. The patients received tocilizumab 8 mg/kg intravenously every four weeks for 6 months. Disease activity, anemia-related factors including serum hepcidin-25, and hematological parameters were monitored at baseline and at 1, 3, and 6 months after the initiation of treatment. RESULTS: Significant reductions in tender joint count, swollen joint count, visual analogue scale, erythrocyte sedimentation rate (ESR), and C-reactive (CRP) protein plus reductions in a 28-joint disease activity score were observed within one month after the first tocilizumab treatment. These effects lasted throughout the six-month study period. In addition, significant improvements in anemia-related factors such as hepcidin-25, ferritin, iron, hemoglobin, red blood cell counts and mean corpuscular volume were observed during the treatment period. Hematological parameters were improved with reductions in counts for leukocytes, monocytes, neutrophils, and platelets. The lymphocyte counts and their subset numbers were unchanged. Changes in hepcidin levels showed significant correlation with changes in CRP, ESR, ferritin, hemoglobin and counts for red blood cells, leukocytes, and neutrophils during the treatment period. CONCLUSION: This study demonstrates that tocilizumab significantly and meaningfully reduces disease burden in patients with active RA. In addition, tocilizumab diminishes the levels of inflammatory anemia by inhibiting hepcidin production. These clinical data provide evidence of a favorable outcome from tocilizumab in RA.
Anemia* ; Arthritis, Rheumatoid* ; Blood Sedimentation ; Erythrocyte Count ; Erythrocyte Indices ; Erythrocytes ; Ferritins ; Hepcidins* ; Humans ; Iron ; Joints ; Leukocytes ; Lymphocyte Count ; Monocytes ; Neutrophils