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 examined the clinical results of silicone IOL[SI-30NB]for 3 years or more. A total of 50 eyes underwent phacoemulsification and foldable silicone posterior chamber lens implantation through 3.2 millimeter temporal clear corneal incision. Preoperative and post-operative intraocular pressure, visual acuity, corneal astigmatism and complications were evaluated. More than 94%of all cases showed best corrected visual acuity better than 20/40 and intraocular pressure was decreased for 2 months. At 1 day after operation, mean surgically induced astigmatism was minimal[0.64 +/-1.42]and recovered fast. Posterior capsular opacity was found in 26%;however, Nd-YAG laser capsulotomy was performed in 18%. In conclusion, foldable silicone lens implantation through 3.2 millimetertemporal clear corneal incision revealed a low incidence of complication, minimally induced astigmatism, and rapid visual rehabilitation.
Astigmatism ; Follow-Up Studies* ; Incidence ; Intraocular Pressure ; Lasers, Solid-State ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Rehabilitation ; Silicones ; Visual Acuity

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The authors analysed statically 420 Cases of the ocular trauma among 35,460 patients who visited to the emergency department, from Jul. 1995 to Jun. 1996. Ocular trauma is one of the commonest causes of eye diseases and blindness, but its patterns and incidences are variable according to the environment. A large number of patients can be readily treated in the emergency department. Prevention is, of course, the best management, but when an ocular injury occurs, proper emergency treatment can often prevent permanent damage.
Blindness ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Eye Diseases ; Humans ; Incidence

BACKGROUND: Production of nitric oxide (NO) radicals may contribute to neuronal injury. We examined that the inhibition of NO synthase (NOS) could improve postischemic neurologic outcome after spinal cord ischemia in rabbits. Also, we measured cGMP as a marker of NOS activation in control and experimental groups. METHODS: Spinal cord ischemia in rabbits was induced by aortic occlusion with aneurysm clip at the level just below branching of left renal artery. Five minutes before aortic occlusion, saline (control group, n=10) or a NOS inhibitor NG-nitro-L-arginine methyl ester (10 mg/kg, L-NAME group, n=10) was injected intravenously. After 15 min ischemia and 1 hour reperfusion, animals were sacrified and the spinal cords were extruded for the measurement of cGMP by enzymeimmunoassay. For neurologic examination, the same procedures of ischemia/reperfusion and drug injection were done, except that rabbits were perfused for 4 hours (control-4 and L-NAME-4, n=8 at each group) or 48 hours (control-48 and L-NAME-48, n=8 at each group) after aortic occlusion. RESULTS: L-NAME (10 mg/kg) increased mean systemic arterial pressure accompanied by bradycardia, and reduced cGMP significantly. Control-4 animals showed better neurologic function than L-NAME-4 animals (p<0.05), however, there was no significant difference of neurologic outcome between control-48 and L-NAME-48 groups. CONCLUSION: Intravenous administration of L-NAME prior to spinal cord ischemia/reperfusion diminishes the extent of postischemic neuronal spinal cord damage at the early postreperfusion period.
Administration, Intravenous ; Aneurysm ; Animals ; Arterial Pressure ; Bradycardia ; Ischemia ; Neurologic Examination ; Neurons ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroarginine* ; Rabbits* ; Renal Artery ; Reperfusion ; Spinal Cord Ischemia ; Spinal Cord*

BACKGROUND: Production of nitric oxide (NO) radicals may contribute to neuronal injury. We examined that the inhibition of NO synthase (NOS) could improve postischemic neurologic outcome after spinal cord ischemia in rabbits. Also, we measured cGMP as a marker of NOS activation in control and experimental groups. METHODS: Spinal cord ischemia in rabbits was induced by aortic occlusion with aneurysm clip at the level just below branching of left renal artery. Five minutes before aortic occlusion, saline (control group, n=10) or a NOS inhibitor NG-nitro-L-arginine methyl ester (10 mg/kg, L-NAME group, n=10) was injected intravenously. After 15 min ischemia and 1 hour reperfusion, animals were sacrified and the spinal cords were extruded for the measurement of cGMP by enzymeimmunoassay. For neurologic examination, the same procedures of ischemia/reperfusion and drug injection were done, except that rabbits were perfused for 4 hours (control-4 and L-NAME-4, n=8 at each group) or 48 hours (control-48 and L-NAME-48, n=8 at each group) after aortic occlusion. RESULTS: L-NAME (10 mg/kg) increased mean systemic arterial pressure accompanied by bradycardia, and reduced cGMP significantly. Control-4 animals showed better neurologic function than L-NAME-4 animals (p<0.05), however, there was no significant difference of neurologic outcome between control-48 and L-NAME-48 groups. CONCLUSION: Intravenous administration of L-NAME prior to spinal cord ischemia/reperfusion diminishes the extent of postischemic neuronal spinal cord damage at the early postreperfusion period.
Administration, Intravenous ; Aneurysm ; Animals ; Arterial Pressure ; Bradycardia ; Ischemia ; Neurologic Examination ; Neurons ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroarginine* ; Rabbits* ; Renal Artery ; Reperfusion ; Spinal Cord Ischemia ; Spinal Cord*

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