The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula fistula without atresia is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6 kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5 cm in diameter, 0.5 cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostals space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed no extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.
Adult ; Cough ; Diagnosis ; Endoscopy ; Esophagus* ; Fistula ; Humans ; Male ; Silk ; Spine ; Sutures ; Tracheoesophageal Fistula* ; Weight Loss ; Young Adult

The pulmonary cytology has reached a high level of accuracy. By the examination of the sputum and/or bronchial brushings, it is now possible to make a diagnosis in 70% to 90% of patients with cancer. Primary melanoma of the lung is very rare and there have been reported about 20 cases in the world literature. We present a case of primary malignant melanoma of the lung in a 61-year-old male diagnosed by cytologic examination of sputum, bronchial brushing and aspirated pleural fluid. Histologic examination of bronchoscopic biopsy and examination of the skin and other primary sites confirmed the diagnosis.
Male ; Humans ; Biopsy

BACKGROUND: CYFRA 21-1 is a tumor marker which measures a fragment of cytokeratin 19 expressed by epithelial cells in bronchus. It is known that cytokeratin 19 is abundant in squamous epithelial cell cancer of the lung. However, if the incidence of elevated serum CYFRA 21-1 level in patients with benign lung diseases or pulmonary tuberculosis with severe parenchymal damage is high the specificity of CYFRA 21-1 could be decreased. The purpose of this study is to investigate the changes of serum CYFRA 21-1 according to the degree of parenchymal damage and the usefulness of CYFRA 21-1 for diagnosing possibly combined lung cancer in patients with pulmonary tuberculosis. METHOD: We studied the changes of serum CYFRA 21-1 according to the sputum AFB stain, radiologic manifestation and history of treatment in 81 patients with pulmonary tuberculosis, and 20 healthy persons, 25 patients with lung cancer, as a control group. CYFRA 21-1 concentration in serum was quantified by the immunoradiometry assay(Centocor (R)) RESULT: The results were as follow; Serum CYFRA 21-1 level was significantly lower in patients with pulmonary tuberculosis(1.54+/-1.19ng/mL, p<0.01) as compared to patients with lung cancer( 12.25+/-15.97ng/mL), and was slightly higher than the level in heathy persons(0.90+/-0.49ng/mL) but there was no significant difference. Serum CYFRA 21-1 level was below the cut-off value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis but it was above the cut-off value in 64 percent of patients with lung cancer. Serum CYFRA 21-1 level was significantly higher in the initial treatment group(1.91+/-1.55ng/mL, p<0.05) as compared to the treatment failure group (0.92+/-0.30ng/mL). According to the sputum AFB smear, serum CYFRA 21-1 level in patients with negative result was slightly higher than the level in patients with positive result but there was no significant difference. According to the radiologic manifestation, serum CYFRA 21-1 level was significantly higher in patients with infiltrative lesion (2.15+/-1.63ng/mL, p<0.01) as compared to patients with destructive lesion (1.04+/-0.54ng/mL). As the size of cavity or destructive lesion was larger, the level was significantly lower(p<0.05). CONCLUSION: As serum CYFRA 21-1 level was significantly higher in the initial treatment group and patients with infiltrative lesion, it suppose to be closely related with the degree of parenchymal damage of the lung of the pulmonary tuberculosis. However CYFRA 21-1 could be useful method for diagnosing lung cancer even in patients with pulmonary tuberculosis combined with lung cancer because of the fact that it was below the cutoff value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis.
Bronchi ; Epithelial Cells ; Humans ; Incidence ; Keratin-19 ; Lung ; Lung Diseases ; Lung Neoplasms ; Sensitivity and Specificity* ; Sputum ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

OBJECTIVE: We studied the possibility that addition of Tyrphostin AG 1478 which is selective epidermal growth factor inhibitor, would enhance the effect of radiation on human cervical cancer cell lines, HeLa and CaSki. METHODS: Tyrphostin was added to the cells which were irradiated. The ratio of dead cells was estimated by trypan blue dye examination, and survived cell fractions were estimated by clonogenic assays. The presence and degree of apoptosis were examined by DNA electrophoresis and nuclear dye using propium iodide. RESULTS: The growth was completely inhibited in both cell lines, but the addition of tyrphostin resulted in different effects on the radiation induced cell death and apoptosis in each cell line. However, the percentage of dead cells and apoptotic cells was decreased in HeLa cell line compared with CaSki cell line. The ultimate survived cell fractions determined by clonogenic assays were decreased in both cell lines and the size of colony was also decreased. CONCLUSION: These data suggest that the addition of Tyrphostin is able to increase the radiotherapeutic effects on human cervical cancer cells, and this synergistic effect may result from effective blocking of radiation-induced accelerated repopulation of cancer cells by tyrphostin.
Apoptosis ; Cell Death ; Cell Line* ; DNA ; Electrophoresis ; Epidermal Growth Factor ; HeLa Cells ; Humans* ; Trypan Blue ; Uterine Cervical Neoplasms*

We compared the clinical results of lens extraction with or without intraocular lens (IOL) for 41 eyes of 24 high myopic patients (axial length: >26mm, diopter: <-10) to those of laser in situ keratomileusis (LASIK) for 54 eyes of 29 patients. After operation,uncorrected visual acuity and best corrected visual acuity were improved in both patient groups. They gained visual improvement of 2 or more lines in 73% and 11%, respectively. Predictability was significantly higher in lens extraction group than LASIK group, while postoperative near vision was vise versa. The postoperative intraocular pressure was measured significantly low in LASIK group, while the number of corneal endothelium was significantly decreased in lens extraction group. In the point of postoperative complications, the incidence of posterior capsular opacity was 9.8% in lens extraction group and that of corneal ectasia was 5.3%in LASIK group. Conclusively, for precision and quality of vision, lens extraction with or without IOL implantation would be superior to LASIK for correction of high myopia. However, corneal endothelial cell loss, near vision impair-ment, and developememt of after-cataract might be problems in the procedure of lens extraction.
Corneal Endothelial Cell Loss ; Dilatation, Pathologic ; Endothelium, Corneal ; Humans ; Incidence ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Lenses, Intraocular ; Myopia* ; Postoperative Complications ; Visual Acuity

Cortical dysplasia(CD) represents a spectrum of neuropathologic changes reflecting a derangement of the normal process of neocortical development. We have presented 32 patients who underwent cortical recectiom for intractable seizures and demonstrated the neuropathologic features, which could be explained by a disturbance in the process of neural development in the farm. It could be characterized by light microscopic features: cortical laminar disorganization, neurons in the molecular layer, subpial re=ants of granule calls, remnants of marginal glioneuronal heterotopia, neuronal heterotopia in the white matter, polymicrogyria, neuronal cytomegaly and balloon cell change. Even though cortical dyslamimtion was the consistent finding of all the cases, the neuronal cytomegaly and balloon cell change were diagnostic hallmarks in the study. The cytomegatic neurons were strongly reactive to silver impregration and to immunohistochemical marrkers of neurons, such as neurofilament protein (NF, 68 and 200 kDa) and neuron-specific enolase(NSE). They showed hypertrophic endoplmmic reticul= and increased number of mitochondria in their cytoplasm and incomplete synapses in electron microscopic study. The balloon cells were positively stained by glial fibrillary acidic protein, NSE and vimentin and were filled with intermediate filaments in their cytoplasm. These results indicated that both cytomegalic neurons and balloon cells are produced by faulty cell differentiation involving neuroblast in the former, and both neuronal and glial stem cell lines in the latter.
Cell Differentiation ; Cytoplasm ; Glial Fibrillary Acidic Protein ; Humans ; Intermediate Filaments ; Malformations of Cortical Development* ; Mitochondria ; Neurons ; Seizures ; Silver ; Stem Cells ; Synapses ; Vimentin

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

A case of left parietal pleomorphic xanthoastrocytoma that occurred in a 58-year-old woman is reported clinicopathologically. Histopathologic diagnosis of pleomorphic xanthoastrocytoma was made because of the unique pleomorphic histologic features, positive glial fibrillary acidic protein in immunohistochemical staining. The flow cytometric analysis reveals DNA aneuploidy and relatively high S-phase fraction. The pleomorphic xanthoastrocytoma is considered as a special subgroup of glioma on the basis of superficial cortical location, GFAP expression, marked cellular atypia, xanthomatous cells, and relatively favorable prognosis.
Female ; Humans

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

The authors tried to evaluate the effect of the growth factors on cell proliferation in the human retina astrocyte culture. Each growth factor, EGF, bFGF, GGF, IGF-1 or PDGF, together with BrdU was added to astrocytes-enriched cultures in the serum-free media. The proliferating effect of each growth factor was evaluated by a double immunofluo- rescenece labelling for GFAP and BrdU. By and addition of each growth factor, the number of retinal astrocytes at the synthetic stage significantly increased than those of control group (p<0.01). In comparision, PDGF was more potent than IGF-1 (p<0.01). Above data extended the concept of astrocytic proliferation caused by several growth factors in human retinal injury.
Astrocytes ; Bromodeoxyuridine ; Cell Proliferation ; Culture Media, Serum-Free ; Epidermal Growth Factor ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Neuroglia* ; Retina ; Retinaldehyde*