Authors analysed the clinical characteristics and the surgical results of rhegmatogenous retinal detachment in 70 patients(71 eyes) who were operated GNUH from Feb. 1990 to Feb. 1992. The clinical characteristics of rhegmatogenous retinal detachment were as follows. The result was myopia(39.4%) as the most common associated ocular finding, one break(57.7%) as the number of break, two quadrants(33.8%) as the extent of retinal detachmenthole(53.5%) as the type of break and superior temporal portion(56.3%) and anterior portion including equator(83.1%) as the location of break. The success rate of first operation was 87.3% and the overall success rate of rhegmatogenous retinal detachment maintained anatomical attachment above 6 months and exeluded 3 cases of refused reoperation was 92.3%. The type of break extent of detachment and duration of detachment were not influenced to surgical success rate statistically(P>0.05). The most common cause of first operative failure was proliferative vitreoretinopathy(57%).
Reoperation ; Retinal Detachment* ; Retinaldehyde*

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.
Duodenal Ulcer ; Emergencies ; Endoscopy ; Epinephrine* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Mallory-Weiss Syndrome ; Peptic Ulcer ; Prospective Studies ; Sodium Chloride ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer ; Upper Gastrointestinal Tract*

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)
Esophageal and Gastric Varices* ; Esophagus ; Hemorrhage ; Hemostasis ; Ligation* ; Sclerotherapy* ; Varicose Veins

A substantial proportion of adrenal incidentalomas demonstrates subtle hormonal hypersecretion; however, adenomas that cosecrete aldosterone and cortisol are rare. We here report a case of an adrenal mass that was incidentally detected on a computed tomography scan in a 57-year-old man. The patient had a 10-year history of diabetes mellitus and a 5-year history of hypertension. Evaluation revealed hyperaldosteronemia with an elevated plasma aldosterone-to-renin ratio, hypokalemia, unsuppressed cortisol after dexamethasone administration, and elevated urinary free cortisol concentration. The appearance of the right adrenalectomy specimen indicated adrenal adenoma. Postoperatively, the blood glucose and blood pressure control improved and the urinary cortisol and aldosterone-to-renin ratio normalized. A complete endocrine evaluation in patients with incidentally discovered adrenal masses should be performed, even if the patient has a long-standing history of hypertension and diabetes, to avoid any postoperative adrenal crises.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Aldosterone* ; Blood Glucose ; Blood Pressure ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone* ; Hyperaldosteronism ; Hypertension ; Hypokalemia ; Middle Aged ; Plasma

Cervical carcinoma is the second leading cause of death from cancer in women worldwide. It is well known that human papillomaviruses (HPVs) is the etiologic agent of cervical neoplasia and cervical cancer. Zinc has been shown to inhibit the growth of malignant cell lines by inducing apoptosis and cell cycle arrest. Recently it was reported that zinc-citrate compound (CIZAR(R)) has a cytotoxic effect on choriocarcinoma cell line and ovarian adenocarcinoma cell line and suppresses its proliferation inducing apoptosis. CIZAR(R) prevents the proliferation by inactivation of m-aconitase activity and induces apoptosis by increasing Bax expression and reducing Bcl-2 expression and inactivation of telomerase. We report one patient of cervical adenocarcinoma with HPV infection, who desires to continue pregnancy, treated by daily topical application of SeLava(R) which contains zinc-citrate compound (CIZAR(R)). We followed up the cytologic, pathologic and coloposcopic changes of healing process.
Adenocarcinoma* ; Apoptosis ; Cause of Death ; Cell Cycle Checkpoints ; Cell Line ; Choriocarcinoma ; Female ; Humans ; Pregnancy* ; Telomerase ; Uterine Cervical Neoplasms ; Zinc

OBJECTIVE: Epithelial ovarian cancer is the most common cause of death due to gynecologic malignancies in adults, but is rare in children and adolescents. This is a report of series of such patients under 20 years of age documenting their presentation, histologic type, stage of disease, treatment, and outcome. METHODS: We collected data on 21 patients with epithelial ovarian cancer under 20 years of age between January 1990 and December 2005. Patient records and pathology were reviewed. RESULTS: Epithelial ovarian cancer under 20 years of age was 2.2% in overall ovarian cancer. Epithelial ovarian cancer was 42.0% among 50 patients under 20 years of age and the most common histologic type was germ cell tumors (54%). The median age at the time of diagnosis was 17.6 years (range, 13-20 years), and the median follow-up was 87 months (range, 4-175 months). There were seventeen (81.0%) mucinous tumors, four (19.0%) serous tumors. About thirty-eight percent were low malignant potential or borderline tumors. About Eighty-five percent (18 patients) of tumors were stage I disease and about fourteen percent (3 patients) were stage III disease at the time of diagnosis. Surgical treatment included conservative surgery in 18 patients (85.7%), total abdominal hysterectomy and bilateral salpingo- oophorectomy in 3 patients (14.3%). CONCLUSION: Epithelial ovarian cancers are rare in patients in children and adolescents. The majority of ovarian cancers in this age group are mucinous tumors, stage I at diagnosis and borderline ovarian tumor. Conservative management is feasible to achieve preservation of fertility.
Adolescent ; Adult ; Cause of Death ; Child ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Ovariectomy

Pulpitis (toothache) is a painful inflammation of the dental pulp and is a prevalent problem throughout the world. This pulpal inflammation occurs in the cells inside the dental pulp, which have host defense mechanisms to combat oral microorganisms invading the pulp space of exposed teeth.This innate immunity has been well studied, with a focus on Toll-like receptors (TLRs). The function of TLR4, activated by Gram-negative bacteria, has been demonstrated in trigeminal ganglion (TG) neurons for dental pain. Although Gram-positive bacteria predominate in the teeth of patients with caries and pulpitis, the role of TLR2, which is activated by Gram-positive bacteria, is poorly understood in dental primary afferent (DPA) neurons that densely innervate the dental pulp. Using Fura-2 based Ca2+ imaging, we observed reproducible intracellular Ca2+ responses induced by Pam3 CSK 4 and Pam2 CSK 4 (TLR2-specific agonists) in TG neurons of adult wild-type (WT) mice. The response was completely abolished in TLR2 knock-out (KO) mice. Single-cell RT-PCR detected Tlr2 mRNA in DPA neurons labeled with fluorescent retrograde tracers from the upper molars. Using the mouse pulpitis model, real-time RT-PCR revealed that Tlr2 and inflammatory-related molecules were upregulated in injured TG, compared to non-injured TG, from WT mice, but not from TLR2 KO mice. TLR2 protein expression was also upregulated in injured DPA neurons, and the change was corresponded with a significant increase in calcitonin gene-related peptide (CGRP) expression. Our results provide a better molecular understanding of pulpitis by revealing the potential contribution of TLR2 to pulpal inflammatory pain.

Carcinosarcoma is an uncommon pulmonary malignancy characterized by carcinomatous parenchyma and sarcomatous stroma. Pulmonary carcinosarcoma represented about 1% of the resected lung tumors. The predominant clinical features are productive cough, chest pain, dyspnea, hemoptysis, bronchiectasis, and atelectasis, but alternate atelectasis is rare. We report a case of pulmonary carcinosarcoma associated with alternate atelectasis of the right upper and lower lobe.
Bronchiectasis ; Carcinosarcoma* ; Chest Pain ; Cough ; Dyspnea ; Hemoptysis ; Lung ; Pulmonary Atelectasis*

Angiotensin II(ANG II) has been known to induce systemic and glomerular hypertension, which leads to renal tissue injury and progressive fibrosis of kidney. Some effects of ANG II may be mediated by its effect on the cytokine synthesis. In the present study, we investigated the effect of ANG II inhibition on the expression of various cytokines implicated in the pathogenesis and progression of the kidney disease. Blood samples of 11 patients with glomerulonephritis were obtained before the ACE inhibitor therapy and then while they were taking ACE inhibitors. Using peripheral blood mononuclear cells(PBMC) harvested from the samples, RT-PCR was performed to evaluate the changes in mRNA expression of TGF-beta1, IL-6, TNF-alpha and IL-10. The ratios of target cytokines and beta-actin were calculated. TGF-beta1 mRNA expression was decreased in five pat ients after ANG II inhibition with ACE inhibitors, while it was increased in the remaining six patients. ACE inhibitors consistently decreased IL-6 mRNA expression in all 11 patients. IL-10 expression was decreased in 4 patients, and increased in 3 patients after ANG II inhibition. It was not expressed in 4 patients. TNF-alpha expression was increased in 8 patients, and decreased in only 1 patient. In two patients, it was not changed while on ACE inhibitors. Conclusion: ACE inhibitors attenuate IL-6 expression consistently in all 11 patients. This is the first-time demonstration of the in vivo inhibitory effect of ACE inhibitors on IL-6 mRNA expression in humans. The lack of significant suppression of TGF-beta1 in PBMC suggests that the in vivo attenuating effect of ACE inhibitors on TGF-beta1 may be derived from renal hemodynamic changes. The tendency of heightened expression of TNF-alpha confirms the previous investigations in which IL-6 was shown to down regulate TNF-alpha expression
Actins ; Angiotensin II ; Angiotensin-Converting Enzyme Inhibitors* ; Angiotensins ; Cytokines* ; Fibrosis ; Gene Expression* ; Glomerulonephritis ; Hemodynamics ; Humans ; Hypertension ; Interleukin-10* ; Interleukin-6* ; Kidney ; Kidney Diseases ; RNA, Messenger ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha*