The auther has presented recently treated 2 cases of squamous cell cancer, which are found in the lower lid in 25 years old male, and a tumd arising from the lacrimal sac in 47 years old female. It was reviewed clinically with the literature.
Adult ; Carcinoma, Squamous Cell* ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Squamous Cell

Although this vascular anomaly, angiomatosis retinae, was initially observed over 85 years ago, and although excellent clinical description of the lesion exist in the literature, treatments for the angiomatosis retinae is difficult and unless the condition is in its early stages, impossible but available symptomatic therapy. Two cases of the angiomatosis retinae, the first, 11 year old girl, von Hippel disease, early stage of vascular dilatation and angiomatous formation, and the second, 15 year old boy, von Hippel-Lindau disease, the final stage of glaucoma and destruction of the eye, are reported. Intravenous fluorescein angiography has been demonstrated, the retinal vascular malformations in von Hippel-Lindau disease are distributed focally and not diffusely, The retinal veins showing greater changes than the arteries are disclosed. This paper presents the fluorscein angiographic findings of von Hippel-Lindau disease and discusses the treatments and the pathologic findings of angiomatosis retinae with literatures related to von Hippel-Lindau disease.
Adolescent ; Arteries ; Child ; Dilatation ; Female ; Fluorescein Angiography ; Glaucoma ; Humans ; Male ; Retinal Vein ; Retinaldehyde ; Vascular Malformations ; von Hippel-Lindau Disease*

Authors experienced a case of acute optic neuritis, 12 years old female patient, following scarlet fever which is rare among bacterial origin in ophthalmological aspects. On the first day of admission, the visual acuities of 0.04(N.C.) in right eye and 0.2 (N.C.) in left eye, blurring of disc margins (OU), central scotoma (OD), and high antistreptolysin O titer (A.S.T.O.) were noted. After bed rest and medical treatment with corticosteroid, penicillin, and vitamin B12 for two and a half months, the visual acuities and antistreptolysin O titer were recovered completely.
Antistreptolysin ; Bed Rest ; Child ; Female ; Humans ; Optic Neuritis* ; Penicillins ; Scarlet Fever* ; Scotoma ; Visual Acuity ; Vitamin B 12

Authors experienced a case of acute optic neuritis, 12 years old female patient, following scarlet fever which is rare among bacterial origin in ophthalmological aspects. On the first day of admission, the visual acuities of 0.04(N.C.) in right eye and 0.2 (N.C.) in left eye, blurring of disc margins (OU), central scotoma (OD), and high antistreptolysin O titer (A.S.T.O.) were noted. After bed rest and medical treatment with corticosteroid, penicillin, and vitamin B12 for two and a half months, the visual acuities and antistreptolysin O titer were recovered completely.
Antistreptolysin ; Bed Rest ; Child ; Female ; Humans ; Optic Neuritis* ; Penicillins ; Scarlet Fever* ; Scotoma ; Visual Acuity ; Vitamin B 12

BACKGROUND: Most current reseatch using prognostic scoring systems in critically ill patients have focused o prediction using the first intensive care unit(ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. METHODS: 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the 1st and 7th APACHE III scores and the mortality risk. RESULTS: 1) The mean length of stay in the ICU was 10.3±13.8 days. 2) The mean 1st and 7th day APACHE III scores were 59.7±30.9 and 37.9±27.7. 3) The mean 1st day APACHE III scores was significantly lower in survivors than in non- survivors(49.9±23.8 vs 86.3±32.3 P<0.0001). 4) The mean 7th day APACHE III scores was significantly lower in survivors than in non- survivors(30.1±18.5 vs 80.1±30.4, P<0.0001). 5) The odds ratios among the 1st and 7th day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. CONCLUSION: These results suggest that the seventh day APACHE III scores is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the 1st and 7th day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the 7th day APACHE III score is useful for predicting the clinical outcome.
APACHE* ; Critical Illness ; Humans ; Intensive Care Units* ; Critical Care* ; Korea ; Length of Stay ; Logistic Models ; Mortality ; Odds Ratio ; Prognosis ; Survivors ; Western World

BACKGROUND: Ulinastatin has anti-inflammatory properties and protects organs from ischemia/reperfusion-induced injury. The aim of this study was to investigate whether ulinastatin provides a protective effect on a regional myocardial ischemia/reperfusion injury in an in vivo rat heart model and to determine whether the anti-inflammatory response is related to its myocardial protective effect. METHODS: Rats were randomized to two groups. One group is received ulinastatin (50,000 U/kg or 100,000 U/kg) diluted in normal saline and the other group is received normal saline, which was administered intraperitoneally 30 min before the ischemic insult. Reperfusion after 30 min of ischemia of the left coronary artery territory was applied. Hemodynamic measurements were recorded serially during 6 h after reperfusion. After the 6 h reperfusion, myocardial infarct size, cardiac enzymes, myeloperoxidase activity, and inflammatory cytokine levels were compared between the ulinastatin treated and untreated groups. RESULTS: Ulinastatin improved cardiac function and reduced infarct size after regional ischemia/reperfusion injury. Ulinastatin significantly attenuated tumor necrosis factor-alpha expression and reduced myeloperoxidase activity. CONCLUSIONS: Ulinastatin showed a myocardial protective effect after regional ischemia/reperfusion injury in an in vivo rat heart model. This protective effect of ulinastatin might be related in part to ulinastatin's ability to inhibit myeloperoxidase activity and decrease expression of tumor necrosis factor-alpha.
Animals ; Coronary Vessels ; Glycoproteins ; Heart ; Hemodynamics ; Inflammation ; Ischemia ; Myocardial Reperfusion ; Myocardium ; Peroxidase ; Rats ; Reperfusion ; Tumor Necrosis Factor-alpha

BACKGROUND: Rhinovirus is an important precipitating factor in acute exacerbation of asthma and COPD. Rhinovirus has short incubation period, causing transient inflammatory process and then has spontaneous resolution. We hypothesized that alterations in anti-inflammatory cytokines are present at sites of rhinoviral infection and these alterations contribute to the transient nature of rhinovirus-induced inflammation and symptomatology. To test this hypothesis, we characterized time-sequenced alterations in anti-inflammatory cytokines elaboration from human bronchial epithelial cells (HBEC). METHODS: We compared the ability of rhinovirus-infected HBEC to produce anti-inflammatory cytokines with controls. We infected HBEC, BEAS-2B with rhinovirus 14 obtained from American Type Culture Collection. We harvested the supernatants from rhinovirus infected BEAS-2B cells and the controls at 2hr, 4hr, 8hr, 12hr, 24hr, 48hr from inoculation time. We measured the concentration of interleukin(IL)-1 Ra(receptor antagonist), IL-1 sRII(soluble receptor type II), IL-4, transforming growth factor(TGF)-beta by ELISA kits. RESULTS: Rhinovirus-infected BEAS-2B cells increased the production of IL-1 Ra, IL-1 sRII from 24hr and produced outstandingly compared with the controls at 48hrs. However, the production of IL-4 and TGF-beta was so minimal that there was no significant difference between the rhinovirus-infected BEAS-2B cells and the controls. CONCLUSIONS: Our results demonstrate that rhinovirus elaborates the IL-1 Ra and IL-1 sRII but not TGF-beta, IL-4. At the beginning of rhinoviral infection, the elaboration of IL-1 Ra, IL-1 sRII was so minimal but notably increased at 48hrs. with slower kinetics. These results suggest the possibility of rhinovirus- induced IL-1 Ra, IL-1 sRII to contribute to the spontaneous resolution.
Asthma ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Humans* ; Inflammation ; Interleukin-1 ; Interleukin-4 ; Kinetics ; Precipitating Factors ; Pulmonary Disease, Chronic Obstructive ; Rhinovirus* ; Transforming Growth Factor beta

BACKGROUND: Rhinovirus (RV) or smoking are one of the most important precipitating factors in acute exacerbation of COPD and bronchial asthma. We hypothesized that alterations in interleukin (IL)-8 elaboration are present at sites of RV infection and cigarette smoke stimulation and also there is an additive effect if both agents are present in bronchial epithelial cells. To test this hypothesis, we characterized time-sequenced alterations in IL-8 elaboration from human bronchial epithelial cells in vitro under the stimuli of RV and cigarette smoke extract (CSE). METHODS: We compared the ability of RV-infected and/or CSE-stimulated bronchial epithelial cells, BEAS-2B (from American Type Culture Collection) cells to produce the IL-8 with controls. We stimulated BEAS-2B cells with RV 14 and/or CSE. We harvest the supernatants from RV and/or CSE- stimulated BEAS-2B cells and the controls at 2 hr, 4 hr, 6 hr, 12 hr, 24 hr, 48 hr from inoculation time. We measured the concentration of IL-8 by ELISA kits from supernatants and analysed IL-8 mRNA transcript semiquantitatively by RT-PCR. RESULTS: RV-infected and/or CSE-stimulated BEAS-2B cells increased the production of IL-8 from 24hr and produced outstandingly compared with the controls at 48 hr and there were an additive effects when both agents were present, especially in the combinations of RV and CSE stimuli. CONCLUSIONS: Our results demonstrate that RV infection and components of cigarette smoke elicit inflammatory responses in bronchial epithelial cells and RV and CSE could be more harmful to respiratory tract in combination.
Asthma ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Humans* ; Interleukin-8* ; Interleukins ; Precipitating Factors ; Pulmonary Disease, Chronic Obstructive ; Respiratory System ; Rhinovirus* ; RNA, Messenger ; Smoke* ; Smoking ; Tobacco Products*

BACKGROUND: Endobronchial tuberculosis is a serious complication of pulmonary tuberculosis and may result from rupture of an infected lymph node through the bronchial wall or from lymphatic spread to the mucosal surface of the bronchial tree. It is a major cause of morbidity, as it frequently heals with concentric scarring, resulting in bronchial stenosis, atelectasis, and secondary pneumonia. The clinical and bronchoscopic features of endobronchial tuberculosis in 280 patients were retrospectively investigated and compared to clinical and bronchoscopic features of 121 patients with endobronchial tuberculosis from 1982 to 1990. METHODS: A total of 280 patients with endobronchial tuberculosis out of 1,639 subjects, who had a flexible fiberoptic bronchoscopic examination at the Department of Respiratory Medicine of Hanyang University Hospital during the period between the beginning of January 1990 and the end of June 2001 were included in this study. The diagnostic criteria used for endobronchial tuberculosis included those patients with certain endobronchial lesions present on bronchoscpy, patients with tuberculosis proven by culture of sputum or bronchial brush and washing and patients with positive AFB or bronchoscopic biopsy specimens. Clinical information was retrospectively gathered from all available medical records. RESULTS: The peak incidence of endobronchial tuberculosis occurred in the third decades, with 2.3 times higher incidence noted in female than in male subjects. A barking cough (73.9%) with sputum (55.7%) was the most common chief complaint. The barking cough was not responsive to antitussive medication over a 3~4 week period but it did respond well to steroids in combination with antituberculosis combination therapy. Pulmonary function tests showed a normal pattern in 47.4% of patients, a restrictive pattern in 27.9% and an obstructive pattern in 16.2%. Parenchymal infiltration and/or consolidation was the most common roentgenographic finding of the chest (61.7%). Caseating necrosis was the most common bronchoscopic finding (31.4%). By bronchoscopic examination, the right upper bronchi and left upper bronchi were the most frequently involved in 42.2%. The positive rate of AFB smear and culture from bronchoscopic washing and/or brushing samples 46.4% and 30.5%, respectively. The positive rate of tuberculosis PCR was 51.3%(40/78). CONCLUSION: The incidence of endobronchial tuberculosis did not decrease compared to the clinical features of 1982~1990. Thus, young female patients presenting with a barking cough not responsive to antitussives over a 3~4 week period, endobronchial tuberculosis should be considered as an etiology.
Antitussive Agents ; Biopsy ; Bronchi ; Bronchoscopy ; Cicatrix ; Constriction, Pathologic ; Cough ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Medical Records ; Necrosis ; Pneumonia ; Polymerase Chain Reaction ; Pulmonary Atelectasis ; Pulmonary Medicine ; Respiratory Function Tests ; Retrospective Studies ; Rupture ; Sputum ; Steroids ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

Amyloidosis limited to the tracheobronchial respiratory tract is a relatively rare condition. Fewer than 100 cases of tracheobronchial amyloidosis are reported. It is characterized by deposits of amyloid in airway walls. Bronchoscopy, although carrying a risk of bleeding, is the procedure of choice diagnostically and therapeutically. 49-year old man suffered from cough and exertional dyspnea over 20s years and recently hemoptysis, atelectasis of right middle lobe and postobstructive pneumonia. He was diagnosed as amyloidosis and treated by bronchoscopy with Nd : YAG laser. We discussed this case with review of literatures.
Amyloid ; Amyloidosis* ; Bronchoscopy ; Cough ; Dyspnea ; Hemoptysis ; Hemorrhage ; Humans ; Laser Therapy* ; Lasers, Solid-State ; Middle Aged ; Pneumonia ; Pulmonary Atelectasis ; Respiratory System