Actinomycosis is a chronic suppurative and granulomatous bacterial infection characterized by contiguous spread, abscess formation and sinus tract formation. There are four clinical forms according to the lesional site, as 1) cervicofacial, 2) thoracic, 3) abdominal, and 4) disseminated form. Recently, we experienced a case of 54 year-old patient with left mandibular actinomycosis. The pathognomonic findings of actinomycosis is sulfur granule with multiple filaments in Gram-stain and the treatment of actinomycosis is surgical excision of mass or sinus tract with massive antibiotics (esp. Penicillin) therapy for 6 to 12 months.
Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Bacterial Infections ; Humans ; Penicillins ; Sulfur

PURPOSE: To report the results of managing dislocated posterior chamber intraocular lenses (PC IOLs) by externalizing both haptics alternately through a single clear corneal incision. METHODS: The study included 10 eyes of 10 patients in which a dislocated PC IOL was managed with pars plana vitrectomy. With our modified method, both haptics were alternately externalized through a single clear corneal incision for suture knot placement and then reinserted. RESULTS: The dislocated PC IOLs were repositioned successfully in all 10 eyes, and the corrected visual acuity improved postoperatively in 9 eyes at a minimum follow-up of six months. Abnormal IOL position, IOL capture by the iris, or posterior synechia was not observed. Hypotony maculopathy occurred in one eye, but the macular folding disappeared and the visual acuity improved after adding one-bite suture. CONCLUSIONS: The technique we describe in this study is a simple and effective procedure for repositioning posteriorly dislocated PC IOLs with minimal intraocular manipulations and complications.
Dislocations ; Eye ; Follow-Up Studies ; Humans ; Iris ; Lenses, Intraocular ; Sutures ; Visual Acuity ; Vitrectomy

PURPOSE: To report a case of bilateral optic neuropathy related with idiopathic hypertropic pachymeningitis. CASE SUMMARY: A 66-year old woman presented with acute visual loss that developed 6 days previously in the right eye and 3 days prior in the left eye. During the initial evaluation, her visual acuity was light perception in the right eye and counting fingers at 30 cm in the left eye. A relative afferent papillary defect (RAPD) was noted in the patient's right eye. On brain MRI, the duramater was thickened and enhanced by contrast. The erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) level were increased and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) as positive. Other neurological and medical abnormalities were not found. Under the suspicion of bilateral optic neuropathy due to idiopathic hypertrophic pachymeningitis, the patient was treated with methylprednisolone pulse therapy. Two days after the treatment, the visual acuity was hand movements at 20 cm in the right eye and 0.6 in the left eye. Three months after the treatment, the visual acuity was counting fingers at 20 cm in the right eye, and 0.7 in the left eye. The right eye showed optic disc pallor and diffuse retinal nerve fiber layer (RNFL) defect. The left eye showed a suspicious RNFL defect, and was otherwise normal. CONCLUSIONS: The authors report a rare case of optic neuropathy related with idiopathic hypertrophic pachymeningitis. Idiopathic hypertrophic pachymeningitis should be considered as one of the various causes of optic neuropathy.
Blood Sedimentation ; Brain ; C-Reactive Protein ; Cytoplasm ; Eye ; Female ; Fingers ; Hand ; Humans ; Light ; Meningitis ; Methylprednisolone ; Nerve Fibers ; Optic Nerve Diseases ; Pallor ; Patient Rights ; Retinaldehyde ; Visual Acuity

Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
Angiography ; Atrial Fibrillation ; Catheters ; Cough ; Echocardiography ; Embolectomy ; Embolism* ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Young Adult

There has not been reported that the tardy ulnar nerve palsy could be developed as a sequelae of the olecranon fracture. The purpose of this paper is to report our experience of diagnosis and treatment of tardy ulnar nerve palsy, developed in three patients who had managed for non-union and malunion of olecranon fractutre, with a review of the literature.
Diagnosis ; Elbow ; Humans ; Olecranon Process* ; Ulnar Nerve* ; Ulnar Neuropathies*

The authors investigated the effect of single intraoperative exposure of mitomycin C(MMC), 5-fluorouracil(5-FU), and cyclosporine A(Cs A) on the glaucoma filtering surgery. Human Tenon's fibroblasts were cultured and exposed to various concentrations of each drug for 5 minutes. Cell viability was measured using MTT assay, and cell proliferation was studied by 3H-thymidine uptake test. None of MMC(up to 0.04%), 5-FU(up to 40mg/ml), Cs A(up to 20micro gram/ml) was cytocidal. However, both MMC and 5-FU inhibited proliferation of fibroblasts significantly, but not Cs A. We concluded that MMC and 5-FU improve the results of filtering surgery not by direct cytocidal effect, but by the inhibition of proliferation. As for Cs A, longer exposure time and higher concentrations were needed to have similar effect on cellular viability and proliferation.
Cell Proliferation ; Cell Survival ; Cyclosporine ; Fibroblasts ; Filtering Surgery ; Fluorouracil ; Glaucoma ; Humans ; Mitomycin

PURPOSE: To report a case of central retinal vein occlusion caused by iron deficiency anemia in a healthy young adult. CASE SUMMARY: A 23-year-old female was referred to the department of ophthalmology after 4 days of acute onset of decreased vision in her left eye. The best corrected visual acuity was 20/20 in the right eye and 10/20 in the left eye. There was no ocular pain, afferent pupillary defect or other ocular symptoms. Results of the anterior segment examination were normal. Fundus examination showed mild optic disc swelling, flame-shaped retinal hemorrhages around the optic disc, and vascular tortuosity with dilatation. The fluorescein angiography showed tortuous peripapillary veins, multiple blocked fluorescences due to retinal hemorrhages, and delayed arteriovenous transit time. All medical examinations and laboratory tests for the risk factors of central retinal vein occlusion were within normal limits, except for iron deficiency anemia. The patient was subsequently treated with oral iron. Three months after the first visit, the best corrected visual acuity was 20/20 in the patient's left eye with nearly normal fundus appearances and no iron deficiency anemia detected in laboratory tests. CONCLUSIONS: In cases of CRVO in young adults without other systemic diseases and risk factors, evaluation of the hematologic state may be necessary.
Anemia, Iron-Deficiency ; Dilatation ; Eye ; Female ; Fluorescein Angiography ; Humans ; Iron ; Ophthalmology ; Pupil Disorders ; Retinal Hemorrhage ; Retinal Vein ; Risk Factors ; Veins ; Vision, Ocular ; Visual Acuity ; Young Adult

BACKGROUND AND OBJECTIVES: Exposure to noise results in pertubations of cochlear microcirculation. There is evidence that these events are mediated, in part, by the calcium channel. The subsequent decrease in cochlear blood flow may lead to hypoxia and predispose to the formation of free oxygen radicals. Saponin extracted from Korean red ginseng is generally known to enhance blood flow and scavenge for free oxygen radicals. MATERIALS AND METHODS: We investigated the effect of saponin (100 mg/kg) on the cochlear damage induced by noise exposure (1500 Hz narrow band noise, 115 dB, 12hours) in guinea pigs through auditory brainstem response (ABR) and with scanning electron microscopy (SEM), RESULTS: After noise exposure, the saponin pre-treated group showed a significant decrease in the ARR threshold compared with the saponin non- treated group. Also, SEM findings of the cochlea showed that there was a minimal structural change in the outer hair cells in the saponin pre-treated group. CONCLUSION: Saponin extracted from Korean red ginseng can attenuate noise induced cochlear damage in guinea pigs.
Animals ; Anoxia ; Calcium Channels ; Cochlea ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs ; Hair ; Hearing Loss ; Microcirculation ; Microscopy ; Microscopy, Electron, Scanning ; Noise* ; Panax* ; Reactive Oxygen Species ; Saponins*

To investigate the role of angiogenesis in multiple myeloma (MM), bone marrow biopsy from 75 adults with newly diagnosed, untreated MM were evaluated. Microvessels were scored in at least 3 areas ( x 200 fields) of the highest microvessel density in representative sections of each bone marrow specimen using immunohistochemistry for CD34. Prognostic variables were also evaluated for the overall survival. Microvessel counts were significantly higher in patients with MM (n=69.42+/-9.67), compared with control (n=26.81+/-2.85). Microvessel density had a weak correlation with percentage of bone marrow plasma cells. By univariate analysis, age, beta2-microglobulin, serum albumin, serum creatinine, serum calcium, hemoglobin, platelet count, and bone marrow plasma cell percentage were correlated with survival. By multivariate analysis, age, serum albumin, serum creatinine, hemoglobin, platelet count and bone marrow plasma cell percentage were correlated with overall survival, whereas microvessel density was not. In summary, microvessel density in bone marrow of MM is significantly increased compared to control, but was not correlated with overall survival. Further studies regarding angiogeneic molecules are needed to determine the functional role of angiogenesis in MM.
Adult ; Aged ; Aged, 80 and over ; Bone Marrow/blood supply ; Endothelial Growth Factors/physiology ; Female ; Hematopoietic Stem Cell Transplantation ; Human ; Lymphokines/physiology ; Male ; Microcirculation ; Middle Age ; Multiple Myeloma/therapy ; Multiple Myeloma/mortality ; Multiple Myeloma/blood supply* ; Neovascularization, Pathologic/physiopathology* ; Survival Rate

BACKGROUND: Idiopathic pulmonary fibrosis(IPF) is a devastating illness for which there is little effective treatment. The key cytokines currently implicated in the fibrotic process are the transforming growth factor-β1(TGF-β1), tumor necrosis factor-α(TNF-α), endothelin-1(ET-1) and interferon-γ(IFN-γ). The rat model for paraquat-induced pulmonary fibrosis was chosen to investigate the role of ET-1 in this disease. Both ET-1 and TGF-β1 expression in lung lesions were examined using immunohistochemical staining. After Bosentan® administration, an orally active ET-1A and ET-1B receptor antagonist, the degree of pulmonary fibrosis and ET-1 and TGF-β1 expression were analyzed. METHOD: Sprague-Dawley rats were divided into three groups, the control group, the fibrosis group, and the fibrosis-Bosentan®-treated group. The animals were sacrificed periodically at 1, 3, 5, 7, 10, 14 days after administering saline or paraquat. The effects between groups were compared with the results of light microscopy and immunohistochemical staining for ET-1 and TGF-β1. The degree of fibrosis was evaluated by H&E and Masson's trichrome staining, which were graded by a computerized image analyzer. The degree of immunohistochemical staining was categorized by a semi-quantitative analysis method. RESULTS: The lung collagen content had increased in the paraquat instillated animals by day 3, and continued to increase up to day 14. A daily treatment by gavage with Bosentan®(100mg/kg) did not prevent the increase in collagen deposition on the lung that was induced by paraquat instillation. There were increased imunohistochemical stains of ET-1 on the exudate, macrophages, vascular endothelial cells and pneumocytes in the paraquat instillated group. Furthermore, TGF-β1 expression was higher on the exudate, macrophages, some infalmmatory cells, pneumocytes(type I, and II), vascular endothelium and the respiratory epithelial cells around the fibrotic area. After Bosentan treatment, there were no definite changes in ET-1 and TGF-β1 expression. CONCLUSION: Fibrosis of the Paraquat instillated group was more advanced when compared with the control group. In addition, there was increased ET-1 and TGF-β1 expression around the fibrotic area. ET-1 is associated with lung fibrosis but there was little effect of the ET-1 receptor blocker(Bosentan®) on antifibrosis.
Animals ; Collagen ; Coloring Agents ; Cytokines ; Endothelial Cells ; Endothelin-1* ; Endothelium, Vascular ; Epithelial Cells ; Exudates and Transudates ; Fibrosis ; Lung ; Macrophages ; Microscopy ; Models, Animal ; Necrosis ; Paraquat* ; Pneumocytes ; Pulmonary Fibrosis* ; Rats* ; Rats, Sprague-Dawley ; Receptor, Endothelin A*