A disease may be closely related to the change of season, as metabolism in human body may variously change with the season and the weather. Especially in the field of ophthalmology, several diseases have close relationship to the season in its incidence. In Korea, however, there has not been a report on seasonal distribution and incidence of eye diseases. The author made investigation upon seasonal, sex and age incidence of several eye diseases in the patients who were seen at Woo-Sok Hospital and two other eye clinics during the past five years. The results were as follows: 1. Among a total of 35, 157 patients, the seasonal, sex and age incidence of hordeolum, chalazion, phlyctenular kerato-conjunctivitis, uveitis, herpetic keratitis and central serous retinopathy were investigated. 2. Hordeolum shows the highest incidence in the winter season, and higher incidence particularly in the patients with blepharitis. 3. Chalazion has the highest incidence in the third decade, but no remarkable seasonal variation. 4. Phlyctenular kerato-conjunctivitis has the highest incidence in the spring season. 5. Uveitis has the highest incidence in the winter, especially in the fourth decade. 6. Herpetic keratitis is frequently developed in the spring and autumn, especially in the male of fourth decade. 7. Central serous retinopathy has the highest incidence in the winter season in healthy young adult male.
Blepharitis ; Central Serous Chorioretinopathy ; Chalazion ; Eye Diseases* ; Hordeolum ; Human Body ; Humans ; Incidence ; Keratitis, Herpetic ; Korea ; Male ; Metabolism ; Ophthalmology ; Seasons* ; Uveitis ; Weather ; Young Adult

The authors present two cases of granular dystrophy of the cornea developed in 47-year-old house wife and her 27-year-old son respectively. The mother first noticed diminished vision at 23 years of age and was diagnosed as corneal dystrophy at the age 28. Her son was diagnosed as corneal dystrophy at his age 16. The disease has run a slow, torpid course, progressing without dramatic incident and inflammatory symptoms, but attack of slight epiphora and photophobia occurred as age advanced. The corneal change was characterized by the presence of miliary sized milk-white spots in the stroma mainly at the central area of the cornea. The visual acuity was progressively deteriorated over the year but not gravely reduced allowing useful activities.
Adult ; Cornea* ; Humans ; Lacrimal Apparatus Diseases ; Middle Aged ; Mothers ; Photophobia ; Spouses ; Vision, Low ; Visual Acuity

The authors have recently experienced a case of conjunctival papilloma which was developed on whole conjunctiva. The 6-year-old girl has soft, pinkish and pedunculated culated growth with delicate finger like processes in the right eye. The processes are scattered all over the mucous membrane of the bulbar and palpebral conjunctiva in considerable numbers. It is probable that many of these pedunculated types are of viral origin and that their spreads are due to contact infection. The papilloma of viral origin has no evidence of distant metastasis or malignant changes. The treatment was performed by electric cauterization with hyfricator and the result has been excellent up to date, 6 months after cauterization.
Cautery ; Child ; Conjunctiva ; Female ; Fingers ; Humans ; Mucous Membrane ; Neoplasm Metastasis ; Papilloma*

In Korea, careinoma of the cervix is the most common malignancy in women annually affecting 25 per every 100,000 female. The widespread use of the Papanicolaou smear has resulted in earlier detection of the tumor and a reduction in the number of patients with advanced disease, but the incidence of cervix. carcinoma is still the fifth most common malignancy in the world. Cervical carcinoma spreads to the small bowel primarily by direct extension from involved lymph nodes, most commonly from peraaortic or mesenteric nodes to the serosa of the bowel. But, the involvement of small bowel by cervical carcinoma is so rare, and shows a maximum incidence of small bowel involvement of less than 1.5%. We report a patient with squamous cell carcinoma of the cervix metastases to the second portion of the duodenum in whom the diagnosis was made by endoscopic biopsy of the lesion.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Duodenum* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Papanicolaou Test ; Serous Membrane ; Stomach*

BACKGROUND/AIMS: Hedgehog protein is an essential molecule for gastrointestinal tract development, and disruption of hedgehog signaling pathway is linked to some gastrointestinal tumorigenesis. Here, we performed hedgehog immunostaining in periampullary cancer to evaluate the differences according to the location type of cancer and the differentiation of adenocarcinoma. METHODS: We retrieved surgical specimens from 43 periampullary cancer patients (15 ampulla of Vater cancer, 12 distal common bile duct cancer, 13 pancreatic head cancer, and 3 combined ampulla of Vater/bile duct cancer). Immunohistochemical stain was performed in both normal and cancerous tissue portions of each case using Sonic hedgehog (H-160) rabbit polyclonal antibody. Immunohistochemical stain results were grouped into three groups according to the percentage of positive cytoplasmic stain in tumor volume (unstained: <5%, weakly stained: 5-50%, and strongly stained: >50%). RESULTS: All of the normal tissue revealed negative immunohistochemical stain while cancerous tissue revealed positivity in 95.3% (41/43 cases). Strongly stained cases were more frequently seen in ampulla of Vater cancers (13/15) and in combined ampulla of Vater/bile duct cancers (3/3) than in distal common bile duct cancers (4/12) and in pancreatic head cancers (3/13) (p=0.002). In addition, strongly stained cases were more frequently seen in well-differentiated adenocarcinoma than the others (p<0.001). CONCLUSIONS: Most of the periampullary cancers show hedgehog protein expression. In addition, hedgehog protein immunostainings shows stronger expression in ampulla of Vater cancers and in well-differentiated adenocarcinoma.
Adenocarcinoma/metabolism ; Aged ; *Ampulla of Vater ; Common Bile Duct Neoplasms/*metabolism ; English Abstract ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Neoplasms/*metabolism ; Trans-Activators/*metabolism

Bone Morphogenetic Protein 1 ; Carrier Proteins ; Cell Count ; Cell Cycle ; DNA, Complementary ; Fibroblasts ; Gingival Hyperplasia ; Glutaminase ; Humans ; Keratin-7 ; Oligonucleotide Array Sequence Analysis ; Organ Transplantation ; Protein Kinases ; Protein Phosphatase 1 ; Receptor, Epidermal Growth Factor ; Ribosomal Proteins ; Transcription Factors ; Transplants

Atlantoaxial subluxation causing spinal cord compression at the craniovertebral junction may develop in patients with rheumatoid or psoriatic arthritis. There have been only a few reports of atlantoaxial subluxation in patients with psoriatic arthritis in the world. The authors report a case of psoriatic arthritis with atlantoaxial subluxation accompaning periodontoid pannus formation. This 53-year-old man with a 3-year history of psoriatic skin lesion presented with nuchal pain and myelopathy. We performed decompression by C1 total laminectomy with transarticular screw fixation and obtained remarkable improvement in motor function and immediate postoperative stability.
Arthritis, Psoriatic* ; Decompression ; Humans ; Laminectomy ; Middle Aged ; Skin ; Spinal Cord Compression ; Spinal Cord Diseases

BACKGROUND/AIMS: The purpose of this study was to evaluate the diagnostic usefulness of PET/CT for pancreatic malignancy. METHODS: We retrospectively analyzed medical records of 115 patients with pathologically diagnosed pancreatic cancer between January 2003 to August 2008 who underwent abdominal CT and PET/CT examination before histological confirmation. CT and PET/CT images were reviewed in single-blinded status and diagnostic ability on primary pancreatic lesion, regional lymph node metastasis, and distant metastasis was evaluated. RESULTS: 99 patients (86%) had malignant diseases including 91 cases of adenocarcinoma, and 16 patients (14%) benign diseases. Only CA 19-9 value and SUV were significantly different between PET/CT positive and negative groups (p=0.001, p<0.001). Sensitivity, specificity and positive predictive values (PPV) of both modality for pancreatic lesion were same (94%, 62%, and 95%, respectively), and negative predictive values (NPV) were 67% on CT and 57% on PET/CT. PET/CT correctly diagnosed 8 cases (6.9%) of falsely diagnosed pancreatic lesion on CT. Nine cases (15.7%) of misdiagnosed lymph node metastasis on CT were correctly diagnosed on PET/CT. But, there was no significant difference in the diagnosis of regional lymph node metastasis. 3 out of 29 cases of distant metastasis, except 2 cases of supraclavicular lymph node metastasis, were additionally diagnosed by PET/CT. But, overall sensitivity of distant metastasis was significantly higher in CT (83% vs 69%, p=0.045). CONCLUSIONS: Although PET/CT provided additional correct diagnoses in many cases, it showed fair diagnostic power for primary pancreatic lesion and lymph node metastasis, and lower sensitivity for distant metastasis. Therefore, PET/CT should be used as an supplementary modality of CT in diagnosing pancreatic malignancy.
Adult ; Aged ; Aged, 80 and over ; CA-19-9 Antigen/analysis ; Diagnostic Errors ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Pancreatic Neoplasms/*diagnosis/pathology ; *Positron-Emission Tomography ; Retrospective Studies ; *Tomography, X-Ray Computed

BACKGROUND/AIMS: Early detection of gallbladder (GB) cancer is essential for better survival rates. Most cases of GB cancer are diagnosed incidentally via pathology of the cholecystectomy specimen. Data on the clinical characteristics of early GB cancer are lacking. The aim of the current study was to investigate the clinical characteristics of early GB cancer to aid earlier diagnosis. METHODS: Sixty-four patients who were diagnosed with early GB cancer after surgical resection at the Samsung Medical Center were enrolled in this study. Clinical characteristics, preoperative diagnoses, preoperative tumor size, laboratory findings including carbohydrate antigen 19-9 (CA19-9) levels, imaging features, and survival rate were investigated. RESULTS: Clinical symptoms and serum tumor markers such as carcinoembryonic antigen and CA19-9 levels were not helpful indicators of early GB cancer. Radiologic modalities showed abnormal findings in every case of early GB cancer; a polypoid mass was the most common feature. Less common features included GB wall thickening, cholecystitis, and GB stones. The clinical outcome of early GB cancer was excellent. CONCLUSIONS: Screening with imaging modalities such as computed tomography (CT) or ultrasonography (US) is helpful in detecting early GB cancer. Even in the presence of GB wall thickening, cholecystitis, or GB stones on the CT or US, any abnormal findings should prompt careful examination and intensive follow up, considering the possibility of occult gallbladder cancer.
Carcinoembryonic Antigen ; Cholecystectomy ; Cholecystitis ; Diagnosis ; Gallbladder ; Gallbladder Neoplasms* ; Humans ; Mass Screening ; Pathology ; Survival Rate ; Biomarkers, Tumor ; Ultrasonography

BACKGROUND/AIMS: Xanthogranulomatous cholecystitis (XGC) mimics early-stage gallbladder (GB) cancer with wall thickening on computed tomography (CT), both clinically and radiologically. Preoperative differentiation of XGC from early-stage GB cancer is important for selecting the most appropriate surgical management. Therefore, we evaluated the clinical features and multidetector CT (MDCT) findings of XGC to determine whether it can be distinguished from early-stage GB cancer. METHODS: We retrospectively evaluated 25 patients with XGC and 56 patients with the wall-thickening type of T1- and T2-stage GB cancer, where all of the diagnoses were pathologically confirmed by surgical treatment. All of the patients underwent preoperative MDCT. The clinical symptoms, laboratory findings, and CT findings were compared. RESULTS: Abdominal pain, fever, and jaundice were noted more frequently in the patients with XGC. Serum aspartate aminotransferase and alanine aminotransferase levels were more elevated in patients with XGC, whereas carbohydrate antigen (CA 19-9) was higher in the patients with GB cancer. When the T-category cancer staging of XGC and early-stage GB cancer were compared, diffuse GB wall thickening, intramural hypoattenuated nodule, gallstone, and pericholecystic infiltration were consistent significant findings associated with XGC, regardless of the cancer staging. CONCLUSIONS: MDCT findings such as diffuse GB wall thickening, intramural hypoattenuated nodule, gallstone, and pericholecystic infiltration together with the clinical symptoms, can provide clues for physicians to differentiate XGC from early-stage GB cancer with wall thickening on CT.
Abdominal Pain ; Alanine Transaminase ; Aspartate Aminotransferases ; Cholecystitis ; Fever ; Gallbladder ; Gallbladder Neoplasms ; Gallstones ; Granuloma ; Humans ; Jaundice ; Multidetector Computed Tomography ; Neoplasm Staging ; Retrospective Studies ; Xanthomatosis