PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy after bilateral selective neck dissection. CASE SUMMARY: A 48-year-old man presented with a visual field defect in his right eye 11 days after bilateral selective neck dissection. His corrected visual acuity in the right eye was 20/20; fundus photographs revealed a segmental optic disc swelling in the superior half of the right eye, and the Humphrey visual field test showed an inferior altitudinal defect in the right eye, corresponding to the disc swelling. The fluorescein angiography revealed a delayed filling on the superior half of the optic disc in the right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Orbital and brain MRIs showed an increase in caliber of the right optic nerve, but no other mass or enhanced lesion was noted. After 3 months, the patient's visual acuity and visual field were maintained, but segmental atrophy developed on the superior half of the right optic disc. CONCLUSIONS: With the risk factors of ischemic optic neuropathy, the possibility of postoperative visual impairment or field defect should be considered after a selective head and neck surgery.
Atrophy ; Brain ; Eye ; Fluorescein Angiography ; Head ; Humans ; Middle Aged ; Neck ; Neck Dissection ; Optic Nerve ; Optic Neuropathy, Ischemic ; Orbit ; Risk Factors ; Vision Disorders ; Visual Acuity ; Visual Field Tests ; Visual Fields

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Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon (222Rn) is a natural gas produced from radium (226Ra) in the decay series of uranium (238U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers. Case–control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case–control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose–response relationship between indoor radon and lung cancer risk. Further refined case–control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case–control studies.
Lung Neoplasms* ; Lung* ; Natural Gas ; Radium ; Radon* ; Risk Factors* ; Sample Size ; Smoke ; Smoking ; Uranium

Spontaneous myometrial contraction (SMC) in pregnant uterus is greatly related with gestational age and growing in frequency and amplitude toward the end of gestation to initiate labor. But, an accurate mechanism has not been elucidated. In human and rat uterus, all TRPCs except TRPC2 are expressed in pregnant myometrium and among them, TRPC4 are predominant throughout gestation, suggesting a possible role in regulation of SMC. Therefore, we investigated whether the TRP channel may be involved SMC evoked by mechanical stretch in pregnant myometrial strips of rat using isometric tension measurement and patch-clamp technique. In the present results, hypoosmotic cell swelling activated a potent outward rectifying current in G protein-dependent manner in rat pregnant myocyte. The current was significantly potentiated by 1microM lanthanides (a potent TRPC4/5 stimulator) and suppressed by 10microM 2-APB (TRPC4-7 inhibitor). In addition, in isometric tension experiment, SMC which was evoked by passive stretch was greatly potentiated by lanthanide (1microM) and suppressed by 2-APB (10microM), suggesting a possible involvement of TRPC4/5 channel in regulation of SMC in pregnant myometrium. These results provide a possible cellular mechanism for regulation of SMC during pregnancy and provide basic information for developing a new agent for treatment of premature labor.
Animals ; Female ; Gestational Age ; Humans ; Lanthanoid Series Elements ; Mice ; Muscle Cells ; Myometrium ; Obstetric Labor, Premature ; Osmotic Pressure ; Patch-Clamp Techniques ; Pregnancy ; Rats* ; Uterine Contraction* ; Uterus

Protease-activated receptor (PAR)-2 is expressed in endothelial cells and vascular smooth muscle cells. It plays a crucial role in regulating blood pressure via the modulation of peripheral vascular tone. Although some reports have suggested involvement of a neurogenic mechanism in PAR-2-induced hypotension, the accurate mechanism remains to be elucidated. To examine this possibility, we investigated the effect of PAR-2 activation on smooth muscle contraction evoked by electrical field stimulation (EFS) in the superior mesenteric artery. In the present study, PAR-2 agonists suppressed neurogenic contractions evoked by EFS in endothelium-denuded superior mesenteric arterial strips but did not affect contraction elicited by the external application of noradrenaline (NA). However, thrombin, a potent PAR-1 agonist, had no effect on EFS-evoked contraction. Additionally, omega-conotoxin GVIA (CgTx), a selective N-type Ca2+ channel (I(Ca-N)) blocker, significantly inhibited EFS-evoked contraction, and this blockade almost completely occluded the suppression of EFS-evoked contraction by PAR-2 agonists. Finally, PAR-2 agonists suppressed the EFS-evoked overflow of NA in endothelium-denuded rat superior mesenteric arterial strips and this suppression was nearly completely occluded by omega-CgTx. These results suggest that activation of PAR-2 may suppress peripheral sympathetic outflow by modulating activity of I(Ca-N) which are located in peripheral sympathetic nerve terminals, which results in PAR-2-induced hypotension.
Animals ; Blood Pressure ; Endothelial Cells ; Hypotension* ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Norepinephrine ; omega-Conotoxin GVIA ; Rats ; Receptor, PAR-2 ; Thrombin

Kaposi's sarcoma is one of the most serious complications associated with immune suppression treatment after kidney transplantation. Because it usually manifestations as skin lesions or lymphadenopathies, its clinical suspicion and tissue diagnosis is relatively easy. However, Kaposi's sarcoma presented as multiple pulmonary nodules without skin manifestations is not easily detected early and usually has a deadly prognosis. We present the case of a 36-year-old male who underwent kidney transplantation 13 months ago and has been on tacrolimus and mycophenolate mofetil (MMF)-based immune suppression presented dry cough, blood tinged sputum, and multiple pulmonary nodules without any skin lesions. Both bronchoscopic washing cytology and fine needle aspiration cytology of peripheral lung tissues were performed but failed due to low cellular yields. A video-assisted thoracoscopic biopsy subsequently revealed Kaposi's sarcoma. Following the diagnosis, we changed the immune suppression from a tacrolimus and MMF-based regimen to a sirolimus-based regimen. Respiratory symptoms gradually disappeared and we found complete remission on follow-up radiologic evaluations. Thus sirolimus may be the preferred method of treatment for patients with immune suppression after kidney transplantation.
Biopsy ; Biopsy, Fine-Needle ; Cough ; Follow-Up Studies ; Humans ; Kidney ; Kidney Transplantation ; Lung ; Male ; Multiple Pulmonary Nodules ; Mycophenolic Acid ; Prognosis ; Sarcoma, Kaposi ; Sirolimus ; Skin ; Skin Manifestations ; Sputum ; Tacrolimus ; Tolnaftate

PURPOSE: The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer. MATERIALS AND METHODS: A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion. RESULTS: Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p=0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726). CONCLUSIONS: PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.
Biopsy ; Humans ; Multivariate Analysis ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Invasiveness ; Peripheral Nerves ; Prognosis ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies