A case of optic nerve glioma is presented. This 11 years old Korean boy was seen because of proto nasion of the risht eye ball of 2 months duration. Vision of the right eye was reduced to 20/30 and optic disc showed blurring of the margin with some venous engorgement. Visual field showed enlarged blind spot of Mariotte and contraction of temporal field of vision in the right eye. Radiograpic study of the optic foramina was normal. There was no cafe-au-lait spot. On April 19. 1967. the orbit was exposed through anterior approach because of the tumor possibly invading the intraocular pertion. On operating procedure it was easy to remove the tumor and optic nerve by aspiration of 3 cc. of vitreous using 19 gauge needle. We confirmed a diagnosis of astrocytoma of the optic nerve in pathologic study. A year later the removal of the tumor, the patient was in good health and there had been no recurrence. A review of the literature of recent years related to glioma of the optic nerve, particularly its signs, symptoms, diagnosis and treatment was added.
Astrocytoma ; Cafe-au-Lait Spots ; Child ; Diagnosis ; Glioma ; Humans ; Hyperemia ; Male ; Needles ; Optic Disk ; Optic Nerve Glioma* ; Optic Nerve* ; Orbit ; Recurrence ; Visual Fields

Authors presented two cases of typical Groenblad-Strandberg's syndrome and reviewed concerning pathogenesis, histology, heredity and its related conditions. Followings are to be considered in these cases. 1. Pseudoxanthoma elasticum, generally considered; mainly appears from 25 to 50 years of life, but we met in case 2 that he was eleven years old. 2. In ocular complications Case 1 showed disciform macular degeneration of the left eye and macular hemorrhages in superficial layers of retina of the right eye. The other case was several retinal exudates of the left eye without any amcular complications. 3. Case 2 had suggestive signs of Paget's disease in radiograms of the skull and pelvic bone. Routine laboratery studies including serum calcium, phosphorus and alkaline phosphatase were normal. 4. Suspicious heroditary occurrence was noted in case 2. 5. There were no significant abnormalities in blood and cardiovascular system.
Alkaline Phosphatase ; Calcium ; Cardiovascular System ; Exudates and Transudates ; Hemorrhage ; Heredity ; Macular Degeneration ; Pelvic Bones ; Phosphorus ; Pseudoxanthoma Elasticum ; Retina ; Retinaldehyde ; Skull

Hydrogen peroxide solution is commonly used for irrigating and cleaning wounds. When it is applied to tissues, catalase causes its rapid molecular degeneration with the release of oxygen bubbles. We present case report illustrating two hazards ; chemical colitis and oxygen embolus. A 29-year-old previously healthy woman presented to the bloody diarrhea and anal pain after hydrogen peroxide enema. In the colonoscopic examination, severe mucosal edema and ulceration with bleeding was noted from anus to sigmoid colon. With use of anal endosonography, multiple high level echo were noted in the internal and external anal sphincter of the upper anal canal. Microscopically, mononuclear cells were infiltrated in lamina propria and congestion. She had treatment with IV fluid, IV antibiotics and NPO. At 3rd hospital day, anal pain was disappeared. Bloody stool was disappeared next day. At 8th hospital day, mucosal edema and ulceration were disappeared on colonoscopic examination. Recovery was full and the patient was discharged at nine days after the episode.
Adult ; Anal Canal ; Anti-Bacterial Agents ; Catalase ; Colitis* ; Colon, Sigmoid ; Diarrhea ; Edema ; Embolism ; Endosonography ; Enema* ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Mucous Membrane ; Oxygen ; Ulcer ; Wounds and Injuries

OBJECTIVES: This study was designed to investigate the distribution of Helicobacter pylori(HP), the relationship between HP colonization and gastritis scores graded according to the Sydney system, epithelial damage, and lymphoid follicles, and to assess the effect of eradication of HP infection on the different histological parameters. METHODS: Gastritis scores, epithelial damage, and lymphoid follicles were assessed in gastric antral, body, and fundic biopsy specimens before and 4 weeks after antiHP triple therapy in 32 patients with HP-related gastritis. RESULTS: The mean initial scores of all histological parameters were higher in the antrum compared with the body and fundus. A significant, positive correlation was noted between HP score and the score for inflammation, for activity, and for mucus depletion. After eradication of HP infection, significant improvement in activity, chronic inflammation, and mucus depletion was detected in responders with a successful HP eradication ; the activity return to normal in follow-up, and chronic inflammation and mucus depletion was decreased significally in severity in responders(p<0.05). No significant reduction in severity of gastritis and mucus depletion was detected in the non-responders with persistent HP infection following anti-HP triple therapy. CONCLUSIONS: The eradication of HP results in a rapid, significant histopathological improvement in the gastritis scores and epithelial damage in gastric mucosa.
Biopsy ; Colon ; Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Helicobacter ; Helicobacter pylori ; Humans ; Inflammation ; Mucus

Agranulocytosis is a rare adverse effect associated with prolonged vancomycin therapy, and is potentially serious, especially in end stage renal disease (ESRD) patients. We describe a continuous ambulatory peritoneal dialysis (CAPD) patient that developed vancomycin-induced agranulocytosis during treatment for methicillin-resistant Staphylococcus aureus (MRSA) -associated external cuff infection and pneumonia. The agranulocytosis was rapidly resolved by granulocyte colony-stimulating factor (G-CSF) therapy and by the discontinuation of vancomycin.
Aged ; Agranulocytosis/*chemically induced/drug therapy ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Catheters, Indwelling/microbiology ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Human ; Kidney Failure, Chronic/complications/therapy ; Male ; Peritoneal Dialysis, Continuous Ambulatory ; Staphylococcal Infections/drug therapy ; Vancomycin/*adverse effects/therapeutic use

OBJECTIVES: To investigate the role of annexin-I in human cervical cancer, we evaluated the expression of annexin-I and the relation with the proliferation of cancer cells. Methods: By immunohistochemical analysis and the western blotting of annexin-I , we investigated the extent and distribution of the expression of annexin-I in cervical cancer tissues. After treating the human cancer cell lines ( SiHa and HeLa cell lines ) with tamoxifen, estradiol, and retinoic acid for 5 days to make the cells proliferate and antiproliferate, we measured the proliferation simultaneously with 3-(4,5- dimethyl thiazol- 2-yl)-2,5-diphenyl-tetr -azolium bromide (MTT) colorimetric assay and the expression level of annexin-I with flowcytometry. RESULTS: In the immunohistochemical stains, a granular staining pattern involving the entire cytoplasm was more heavily observed in malignant lesions than in normals. In the western blotting, the antibodies against 35-kDa annexin-I appeared to react more strongly with the lysates of cancer tissues than normal and benign tissues. In SiHa and HeLa cell lines with tamoxifen and beta- estradiol treatment, increased expressions of annexin-I were noted with correlated increased proliferation of cells, and with the treatments of all trans retinoic acid, decreased expressions of annexin-I were noted with correlated decreased proliferation of cells. CONCLUSIONS: The results suggest that the expression of annexin-I might correlate with cervical cancer than normal and the proliferation of cancer cells.
Antibodies ; Blotting, Western ; Cell Line ; Cell Proliferation* ; Coloring Agents ; Cytoplasm ; Estradiol ; HeLa Cells ; Humans ; Tamoxifen ; Tretinoin ; Uterine Cervical Neoplasms*

Diabetic ketoacidosis is an acute complication of diabetic mellitus. The most common triggering factors are infection, insulin therapy omission and the onset of the disease, but if these are excluded, other less frequent etiologic factors must be ruled out. We report a case of 22-year-old woman with Graves' disease presented as diabetic ketoacidosis. She was diagnosed type 1 diabetes mellitus at 13 years old and continually has been treated with insulin therapy until now. She typically showed tachycardia at rest in spite of correction of metabolic acidosis. Hyperthyroidism worsens glycemic control in diabetic patients and may precipitate diabetic ketoacidosis. Hyperthyroidism always should be investigated in diabetic patients presenting diabetic ketoacidosis without obvious triggering factors.
Acidosis ; Adolescent ; Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis* ; Female ; Graves Disease ; Humans ; Hyperthyroidism* ; Insulin ; Ketosis ; Tachycardia ; Young Adult

The potential role and determinants of response to a cisplatin-based regimen of neoadju-vant chemotherapy in women with a histologically confirmed first diagnosis of stage IB-III cervical cancer were analyzed. From 1993 to 1996, 92 patients with bulky(designated as more than 3X3 cm2 size) mass were treated with cisplatin 60 mg/m2 and etoposide 100 mg/m2, admi-nistered intravenously at 7 day intervals. Seventy cases of radical hysterectomy with pelvic lymph node dissection and 22 cases of radiation therapy were performed 2 to 3 weeks after chemotherapy. At the end of the cycles, the overall clinical response rate of portio was 83.7 %(34.8 % with a complete response and 48.9 % with a partial response). The older ages, lower stages, and squamous cell types correlated favorably with the clinical response of the portio, but neither with the parametrium nor with the vagina. After the operation, we found the diff-erences in histologic responses, with the following parameters : lymphovascular space invasion, 3 mm below stromal invasion and lymph node metastasis. Theses parameters correlated with the clinical responses, and the down-staging of cases were 70 %. In comparison with radiolog-ical findings of pretreatment and postoperative tissue pathology, we could find a decrease in pelvic LN metastasis. The tumor-free survival rate calculated by the Kaplan-Meier product limit method was 75 % but it was 86.1 % for cases without the occurrence of persistent disease after the completion of the treatments. All patients suffered from nausea and vomiting, but grade 4 toxicity was not detected after the routine use of antiemetics. There were no events that delayed the next step in the treatment or caused difficulty during the operation. The results of this study suggest that the neoadjuvant chemotherapy should be accepted as a routine tool in treating high risk cervical cancer in order to improve the likelihood of favorable outcomes.
Antiemetics ; Cisplatin ; Diagnosis ; Drug Therapy ; Etoposide ; Female ; Humans ; Hysterectomy ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymph Nodes ; Nausea ; Neoplasm Metastasis ; Pathology ; Survival Rate ; Uterine Cervical Neoplasms* ; Vagina ; Vomiting

BACKGROUND/AIMS: Gastric atrophy can be diagnosed by serum pesinogen I/II ratio. The aim of this study was to investigate whether the changes of serum pepsinogen I/II ratio can be predicted by gastroscopy. MATERIALS AND METHODS: Sixty healthy subjects who underwent screening for serum pepsinogen I/II levels, serum Helicobacter pylori (H. pylori) antibody, and gastroscopy for two sequential years were included. Endoscopic findings were classified into four different categories according to the degree of chronic atrophic gastritis; none, mild, moderate, and severe. Changes of the serum pepsinogen I/II ratio, body mass index, H. pylori antibody, and endoscopic findings were analyzed after a year. RESULTS: The serum pepsinogen I/II ratio showed a tendency to decrease after a year in subjects with H. pylori infection (P=0.013) and those with moderate to severe atrophic gastritis (P=0.004), whereas it increased in subjects without H. pylori infection and those with none to mild atrophic gastritis. On multivariate analysis, the degree of atrophic gastritis was the only factor that was related to the changing trends of the serum pepsinogen I/II ratio (odds ratio=5.385, P=0.023). CONCLUSIONS: The degree of atrophic gastritis on endoscopic findings can predict the changes of the serum pepsinogen I/II ratio after a year. Regardless of the current status of H. pylori infection, the serum pepsinogen I/II ratio decreases after a year in subjects with moderate to severe atrophic gastritis.
Atrophy ; Body Mass Index ; Gastritis, Atrophic ; Gastroscopy ; Helicobacter pylori ; Mass Screening ; Multivariate Analysis ; Pepsinogen A

BACKGROUND: It has been hypothesized that early atherosclerosis may be related to the pathogenesis of coronary vasospasm. This study was designed to investigate the relationship between early atherosclersosis and coronary vasospasm or vasoconstriction in response to axetylcholine utilizing intravascular ultrasonography. METHOD: Total 43 segments were analyzed from subjects who were composed of 10 patients with and 7 patients without coronary vasospasm in response to intra coronary acetylcholine infusion. Spasm segment(Sp) was defined as total or subtotal occlusion, constriction segment(C) as diameter decrease>/=10%, and normal segment(N) as diameter decrease<10% compared to baseline coronary angiogram. Atherosclerotic plaque thickness was defined as the sum of thickness of intimal leading edge and sonolucent zone. Atherosclerosis was defined as atherosclerotic plaque thickness > 0.5mm. RESULTS: The atherosclerotic plaques of spasm segments were significantly thicker than those of normal and constriction segments(spasm segments : 1.19+/-0.21mm, constrict segments : 0.58+/-0.11mm, normal segment : 0.37+/-0.11, p<0.05). Atherosclerosis was present in 90% of spasm segments. Among normal of constriction segments, atherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm, although it was statistically insignificant(patients with vasospasm : 0.65+/-0.51mm, patients without vasospasm 0.36+/-0.39mm, p=0.07). Frequency of atherosclerosis in normal or constriction segments was significantly higher in patients with vasospasm than patients without vasospasm(patients with vasospasm 47%, patients without vasospasm : 11%, p<0.05). CONCLUSION: Atherosclerosis is present at segments of vasospasm in response to intracoronary acetylcholine. Even among normal or constriction segments, the artherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm which may indicates that coronary vasospasm is a diffuse early atherosclerotic disease.
Acetylcholine ; Atherosclerosis ; Constriction ; Coronary Vasospasm* ; Humans ; Plaque, Atherosclerotic ; Spasm ; Ultrasonography* ; Ultrasonography, Interventional ; Vasoconstriction*