Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain ; Adolescent ; Ascites ; Blood Proteins ; Bone Marrow ; Capillaries ; Capillary Permeability ; Complement System Proteins ; Edema ; Endothelial Cells ; Endothelin-1 ; Humans ; Hypoalbuminemia ; Induction Chemotherapy* ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Edema ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vincristine

BACKGROUND: At the present time, more than 100 cases of squamous cell carcinoma (SCC) developing in neurotrophic ulcers of leprosy have been reported. But the histopathologic features and the differences between SCC in leprosy and de novo SCC was not described. OBJECTIVE: The purpose of this study was to evaluate the characteristics of SCC in leprosy and to investigate growth dynamics of SCC in ulcers in leprosy. METHODS: We reviewed the clinical features and the degree of histopathologic differentiation of 13 cases of SCC in ulcers of leprosy patients presenting at the KLCA from 1986 to 1998. And immunohistochemical staining with PCNA(proliferating cell nuclear antigen) and TUNEL staining were done in paraffin-embedded tissue sections from 18 sites of 13 cases of SCC in ulcers of leprosy. RESULTS: 1. The average duration of leprosy and of an ulcer prior to diagnosis of SCC was 43 years and 19 years, respectively. 2. Histopathologic grading of 13 cases was performed as follows:10 cases were well-differentiated and 3 cases were moderately-differentiated. 3. The PCNA LI(labelling index) was 47.26+/-7.38% in well-differentiated group and 48.86+/-9.39% in moderately -differentiated group. 4. The apoptotic index(AI) was 45.57+/-8.68% in well- differentiated group and 29.38+/-1.06% in moderately differentiated group. The AI in de novo SCC was 45.09+/-6.18%. CONCLUSION: (1) Malignant change in chronic ulcer in leprosy may be found more often if patients are examined with care. (2) Our leprosy case with SCC is a 63-year-old male with past history of lepromatous leprosy of 43 year duration having ulcer problems for 19 years before presenting with SCC on an average. (3) High-degrees of malignancy in SCC of leprosy patients might be caused by extended cell survival due to decreased apoptosis rather than increased cell proliferation.
Apoptosis ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Cell Survival ; Diagnosis ; Humans ; In Situ Nick-End Labeling ; Leprosy* ; Leprosy, Lepromatous ; Male ; Middle Aged ; Proliferating Cell Nuclear Antigen ; Ulcer*

No abstract available.
Disseminated Intravascular Coagulation* ; Plasma* ; Scrub Typhus*

As one of many cell-many cell-based cartilage repairing methods, transplantation of chondrocyte-embedded-collagen gels in cartilage defect was performed for more satisfactory regeneration of cartilage. The authors performed this study to investigate whether the TGF-beta1 treatment of chondrocytes can do some additional synergistic effect on the transplantation of chondrocyte-embedded-collagen gels for crtilage repair. Chondrocytes were isolated from the articular cartilage of newborn Sprague-Dawley rats. Chondrocytes cultured for 10 days in monolayer were embedded in the 0.45% type I collagen gel. Full-thickness cartilage defect was made in the patellar groove of adult Sprague-Dawley rats. Chondrocytes culdefect was made in the patellar groove of adult Sprague-Dawley rats. The cartilage defects were treated with the following methods in a total of 200 animals, which were assigned to 5 different groups of 40 rats. In the control group, the deffect was left without any treatment, in group I, the defect was filled with collagen gel only, in group II, with collagen gel coontaining 10 ng/ml concentration of TGF-beta1, in group III, with collagen gel containing chondrocytes, and in group IV, with collagen gel containing chondrocytes and TGF-beta1. At 1, 2, 4, 8, 12 weeks after the operation, eight rats of each group were sacrificed, and their distal femurs were harvested for the histologic and biomechanical tests. The section s were stained with hematoxilin and eosin. Alcian-blue, and Safranin-O. Regenerated cartilage was analyzed by the semiquantitative histological grading system. Point indentation test was performed as a biomechanical evaluation, and the stiffness was calculated. The results of the histological grading system revealed that the scores gradually increased with time in all groups, and the scores of group III and IV were higher than those of control, group I and II. The biomechanical study showed that the stiffness gradually increased to reach a plateau level in each group. In control, group I and II, the stiffness increased up to the eighth week and remained around the increased level at the twelfth week, and did not show any statistically significant difference between the groups. In group III and IV, the stiffness was higher than in control group, and increased markedly at the fourth week and the increased level was maintained onwards. The results of this study showed that the transplantation of chondrocyte-embedded-collagen gels enhanced the healing process, and the treatment of TGF-beta1 demonstrated at least partially significant improvement.
Adult ; Animals ; Cartilage ; Cartilage, Articular* ; Chondrocytes ; Collagen ; Collagen Type I ; Eosine Yellowish-(YS) ; Femur ; Gels ; Humans ; Infant, Newborn ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transforming Growth Factor beta1

PURPOSE: To identify the effects of artificial tear instillation on tear film changes using wavefront aberrations. METHODS: Artifical tear was instilled every 2 hours for 14 days into 20 normal eyes and 20 dry eyes. The changes in tear film using wavefront aberrations were analyzed 1 minute after the final instillation of artifical tear. RESULTS: In dry eyes, total wavefront aberration and total high order wavefront aberration decreased significantly (p<0.05). In normal eyes, total wavefront aberration and high order wavefront aberration did not decrease. CONCLUSIONS: Stabilization of the tear film after instillation of artificial tear may be responsible for the decrease of wavefront abberation in dry-eye patients.
Humans ; Tears*

PURPOSE: To report the results of preschool vision screening in South Korea in 2003. METHODS: Nation wide, population-based vision screening tests were conducted in preschool children over the age of 3 years from March to September 2003. The first step involved home-screening using picture cards. The children who did not pass the first test were sent to public health care centers, where their visual acuity was re-tested. After the re-tests, some children were referred to ophthalmologists. The referral criteria for visual acuity were: age 3, less than 0.5 visual acuity; age 4 or older, less than 0.63 visual acuity in at least one eye. RESULTS: Among 56,836 subjects who had been enrolled, 2,637 (4.6%) children were referred to ophthalmologists. Refractive error was found in 1,746 (66.2%) children. Amblyopia was discovered in 480 (18.2%) children. Anterior segment abnormalities were detected in 269 (10.2%) children, manifest strabismus was detected in 169 (6.4%) children, and fundus abnormalities were found in 17 (0.6%) children. Myopic astigmatism (31.0%) was the most common type of refractive error. Refractive error (87.9%) was the most common cause of amblyopia and exodeviation (63.9%) was the most common type of strabismus. CONCLUSIONS: From the results of the 2003 Preschool Vision Screening, we collected data about the ophthalmic abnormalities that can affect visual development in children. This information will foster improvement in the overall quality and design of preschool vision screening systems.
Amblyopia ; Astigmatism ; Child ; Child, Preschool ; Exotropia ; Humans ; Korea* ; Public Health ; Referral and Consultation ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity

No abstract available.
Angiokeratoma* ; Fabry Disease*

OBJECTIVE: To determine the feasibility and safety of performing laparoscopically assisted vaginal hysterectomy (LAVH) for uteri weighing 500 g or more and evaluate the advantages and complications of LAVH. METHODS: A subpopulation of 30 women with uteri weighing 500 g or more from group of 412 patients undergoing LAVH between Mar, 2003 to Feb, 2005. We reviewed medical records and analyzed these cases about age, parity, history of previous abdominal surgery, preoperative indications, postoperative pathologic diagnosis, mean operation times, weight of extracted uterus, change of hemoglobin, hospital stay, and complications. RESULTS: The mean age was 44.8+/-3.88 years. The mean parity was 1.78+/-0.76. Previous operation history was 16 cases (53.3%). The most common indication of operation was palpable abdominal mass. The most common pathologic diagnosis was leiomyoma. The mean operation time was 126.40+/-39.30 minutes. The mean weight of uterus was 621.23+/-107.28 g. The mean hemoglobin change was 1.57+/-1.14 g/dL. The mean hospital stay was 3.74+/-0.88 days. The only complication of operation was superficial trocar site bleeding (1 case). CONCLUSION: LAVH is a safe and effective alternative to total abdominal hysterectomy of the uteri weighing 500 g or more in selective groups.
Diagnosis ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Leiomyoma ; Length of Stay ; Medical Records ; Parity ; Surgical Instruments ; Uterus*

No abstract available.
Meningioma* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Histiocytoma, Malignant Fibrous* ; Lung*