At the present time, lidocaine is commonly used in ophthalmic surgery as a local anesthetic. Although it is safer than general anesthesia, visionthreatening and even life-threatening side effect can occur rarely. We report one case of visual loss combined with severe neurologic damage after local injection of lidocaine. Fifty-year-old male patient underwent phacoemulsification and IOL transscleral implantation with unplanned anterior vitrectomy after Nadbath-Ellis akinesia and retrobulbar anesthesia with lidocaine with 1:100,000 epinephrine. After operation, the patient had visual loss, facial palsy, total ophthalmoplegia, severe proptosis and submandibular swelling. There were no evidences of eyeball perforation, retrobulbar hemorrhage, and direct nerve injury. Although the mechanism of nerve injury is not well explainable, we suggest lidocaine toxic reaction. To our knowledge, This is the first reported case in the literature. We report this case with available literature review.
Anesthesia ; Anesthesia, General ; Blindness* ; Cataract* ; Epinephrine ; Exophthalmos ; Facial Paralysis ; Humans ; Lidocaine* ; Male ; Ophthalmoplegia ; Phacoemulsification ; Retrobulbar Hemorrhage ; Vitrectomy

The purpose of this study was comparing the effectiveness in the topical applications of cyclosporine with that of steroid, the conventional and standard drug in the treatment of oral lichen planus. 21 patients with oral lichen planus were treated with cyclosporine (n=11) or steroid (n=10) by random allocations. They were recalled 2 weeks, 4 weeks, and 8 weeks after initial treatments. In each recall, the lesion size, clinical symptoms like pain or burning sensation, and side effects were evaluated. The differences of these measurements were compared and the effects of each drug were checked. In reticulation types, steroid showed higher effectivity than cyclosporine and this difference was significant statistically. But in erythema type lesions, either drug showed no significant recovery, statistically. However, the effect of cyclosporine was thought to be more effective. The pain of the lesions was significantly decreased by cyclosporine but not by steroid. The decrease of burning sensation was more dependant upon steroid than cyclosporine, but no statistical relationship could be found. There were no clinical side effects. There was limitation to draw in conclusion due to small pool of this study group. But with the results, this suggestion could be proposed that either drug might be superior to another in effectivity in a specific lesion type or patient symptom, so selection and usage of one drug in a specific case could be better than universal application of one drug in all cases.
Burns ; Cyclosporine* ; Erythema ; Humans ; Lichen Planus, Oral* ; Sensation

Primary pulmonary diffuse alveolar amyloidosis is a rare form among the pulmonary amyloidosis. Especially in primary form diffuse alveolar type is much more rare disease. the patient was checked simple chest X-ray for the purpose of routine screening test, he had no respiratory symptoms and signs and he had no complaint of other organ symptoms, while in chest roentgenogram it was found bilateral diffuse interstitial infiltration of the lung, but any other organs which commonly involved in amyloidosis were not involved in laboratory and other specific diagnostic procedures. We report a case of pulmonry diffuse alveolar amyloidosis only localized in lung which was confirmed by transbronchial lung biopsy.
Amyloidosis* ; Biopsy ; Humans ; Lung* ; Mass Screening ; Rare Diseases ; Thorax

Acute compartment syndrome is usually caused by local vascular and traumatic involvement. Thyroid disease is not a common cause of compartment syndrome and only two cases of spontaneous compartment syndrome associated with hypothyroid myopathy have been reported. Diabetic muscular infarction is a rare microvascular complication usually occured in type 1 diabetes patients under pjoor diabetic control and intramuscular volume expansion caused by muscle necrosis and increased tissue fluid can iduce compartment syndrome. We report a case of atypical bilateral anterior tibial compartment syndrome and foot drop in a 51-year-old patient with type 2 diabetes in hypothyroid state.
Compartment Syndromes* ; Diabetes Mellitus ; Foot ; Humans ; Hypothyroidism ; Infarction* ; Middle Aged ; Muscular Diseases ; Necrosis ; Thyroid Diseases

BACKGROUND: We evaluated the posttreatment response to chloroquine among 81 patients with vivax malaria who were residents in Northern area of Kyunggi province in 1996. The result of chloroquine therapy was followed 28 days after treatment. Material and METHODS: Diagnosis of malaria was made by microscopic examination of Giemsa stain of peripheral blood. Parasitemia levels from each patient were counted before treatment, 3, 14 and 28 days after treatment. RESULTS: Eight-one patients successfully completed the therapy. All patients were army soldiers, who were residing in northern area of Kyunggi province. The 14-day cumulative incidence of therapeutic failure for P. vivax was 2.5% (n=2) and 0% (n=81) at 28th day. One patient had a recurrence eight months after completion of antimalarial treatment. CONCLUSION: The results suggest that recent resurgent malaria in Korea need more careful therapy. Antimalarial treatment should not be completed without microscopic confirmation.
Azure Stains ; Chloroquine ; Diagnosis ; Gyeonggi-do ; Humans ; Incidence ; Korea* ; Malaria ; Malaria, Vivax* ; Military Personnel ; Parasitemia ; Plasmodium vivax ; Primaquine ; Recurrence

Candida is the most common etiologic agent causing endogenous endophthalmitis resulting due to hematogenous spread from a remote primary focus. Risk factors for the infection include intravenous drug use, hyperalimentation, surgery, malignancy, diabetes, neutropenia, and the use of broad- spectrum antibiotics and immunosuppressive agents, especially corticosteroids. The outcome of candida endophthalmitis is disappointing. One main problem in the management of this infection is that early diagnosis is difficult. Thus, treatment may be delayed and this which often leads to a poor outcome. Candida endophthalmitis, particularly candida guilliermondii endophthalmitis, is extremely rare, although it is becoming more common as the number of chronically debilitated patients and the use of invasive procedures increase. It is an ophthalmologic emergency and commonly takes a tragic course. Therefore, early suspicion and aggressive management are imperative to prevent visual loss. The authors report a case of candida endophthalmitis caused by Candida guilliermondii in a 65-year-old man with mixed gastrointestinal stromal tumor(GIST) and stomach adenocarcinoma.
Adenocarcinoma* ; Adrenal Cortex Hormones ; Aged ; Anti-Bacterial Agents ; Candida* ; Early Diagnosis ; Emergencies ; Endophthalmitis* ; Gastrointestinal Stromal Tumors* ; Humans ; Immunosuppressive Agents ; Neutropenia ; Risk Factors ; Stomach*

Candida is the most common etiologic agent causing endogenous endophthalmitis resulting due to hematogenous spread from a remote primary focus. Risk factors for the infection include intravenous drug use, hyperalimentation, surgery, malignancy, diabetes, neutropenia, and the use of broad- spectrum antibiotics and immunosuppressive agents, especially corticosteroids. The outcome of candida endophthalmitis is disappointing. One main problem in the management of this infection is that early diagnosis is difficult. Thus, treatment may be delayed and this which often leads to a poor outcome. Candida endophthalmitis, particularly candida guilliermondii endophthalmitis, is extremely rare, although it is becoming more common as the number of chronically debilitated patients and the use of invasive procedures increase. It is an ophthalmologic emergency and commonly takes a tragic course. Therefore, early suspicion and aggressive management are imperative to prevent visual loss. The authors report a case of candida endophthalmitis caused by Candida guilliermondii in a 65-year-old man with mixed gastrointestinal stromal tumor(GIST) and stomach adenocarcinoma.
Adenocarcinoma* ; Adrenal Cortex Hormones ; Aged ; Anti-Bacterial Agents ; Candida* ; Early Diagnosis ; Emergencies ; Endophthalmitis* ; Gastrointestinal Stromal Tumors* ; Humans ; Immunosuppressive Agents ; Neutropenia ; Risk Factors ; Stomach*

OBJECTIVE: To investigate the relationship between autonomic neuropathy and peripheral neuropathy through analysis of heart rate variability (HRV) in diabetic patients, and ultimately to investigate usefulness for HRV analysis for quantitative evaluation and prediction of diabetic autonomic neuropathy. METHOD: We performed nerve conduction study (NCS), H- reflex, and HRV test with 42 diabetic patients. We classified patients by presence of peripheral neuropathy and abnormality of H-reflex, respectively. By comparing standard deviation of RR interval (SDNN), high frequency (HF), low frequency (LF), very low frequency (VLF), and total power (whole level of frequency, TP) of HRV, we analyzed the relationship between these parameters and duration of diabetes, age, and results from NCS. RESULTS: There were significant differences of SDNN, HF, TP according to the presence or the absence of peripheral neuropathy. There were significant differences of SDNN, HF according to the presence or the absence of H-reflex abnormality. SDNN and HF had reversed-relationship to the degree of H-reflex abnormality. CONCLUSION: We expect HRV might be used as an efficient quantitative method to detect diabetic autonomic neuropathy and suggest HRV to be used for early detection of diabetic peripheral neuropathy.
Diabetic Neuropathies* ; Evaluation Studies as Topic* ; H-Reflex ; Heart Rate* ; Heart* ; Humans ; Neural Conduction ; Peripheral Nervous System Diseases ; Reflex

PURPOSE: Interindividual genetic differences in susceptibility to chemical carcinogens are one of the most important host factors in human cancer. The genetically determined differences in metabolism, related to cytochrome P450 (CYP450) genes have been reported to be associated with various cancer susceptibility. The present study was set up to establish the frequency of the polymorphic genotypes of two CYP450 (CYP2E1/PstI and CYP2E1/DraI) isozymes in Korea, to evaluate a possible increased incidence of the genotype associated with higher cervical cancer risks among Korean cervical cancer patients. MATERIALS AND METHODS: In this study, extracted DNAs from 228 cervical cancer patients and 360 normal healthy controls were analysed with the polymerase chain reaction-restriction fragment length polymosphism (PCR-RFLP) method. RESULTS: In the CYP 2E1 genotypes, detected by PstI or RsaI digestion, there were no statistically remarkable differences between the cervical cancer patients and control groups. And when the cervical cancer patients were divided into subgroups with respect to the age, the frequency of CYP 2E1/PstI polymorphisms in the cervical cancer patients under the 40 years old was not significantly higher compared to the controls or the patients above the 40 years old and, c1/c1 genotype was prominent in this type of polymorphism. The frequency of CYP 2E1/DraI polymorphisms in the cervical cancer patients was not significantly higher compared to the controls, and D/D genotype was prominent in this type of polymorphism. In cervical carcinoma, the polymorphic genotypes of CYP 2E1 were not correlated to other parameters including clinical stage, histological tumor type, and degree of differentiation. CONCLUSION: These results suggest that individuals carrying CYP 2E1/PstI (c1/c1) or CYP 2E1/DraI (D/D) alleles are not genetically susceptible to cervical cancer in Korea.
Adult ; Alleles ; Carcinogens ; Cytochrome P-450 CYP2E1* ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Digestion ; DNA ; Genetic Predisposition to Disease* ; Genotype ; Humans ; Incidence ; Isoenzymes ; Korea ; Metabolism ; Uterine Cervical Neoplasms*

Nitric oxide (NO) regulates proliferation, differentiation and survival of neurons. Although NO is reported to involve in NGF-induced differentiation of PC12 cells, the role of NO has not been characterized in primary neuron cells. Therefore, we investigated the role of NO in neuronal differentiation of primary cortical neuron cells. Primary cortical neuron cells were prepared from rat embryos of embryonic day 18 and treated with NMMA (NOS inhibitor) or PTIO (NO scavenger). Neurite outgrowth of neuron cells was counted and the mRNA levels of p21, p27, c-jun and c-myc were measured by RT-PCR. Neurite outgrowth of primary cortical neuron cells was inhibited a little by NOS inhibitor and completely by NO scavenger. The mRNA levels of p21 and p27, differentiation-induced growth arrest genes were increased during differentiation, but they were decreased by NOS inhibitor or NO scavenger. On the other hand, the level of c-jun mRNA was not changed and the level of c-myc mRNA was increased during differentiation differently from previously reported. The levels of these mRNA were reversed in NOS inhibitor- or NO scavenger-treated cells. The level of nNOS protein was not changed but NOS activity was inhibited largely by NOS inhibitor or NO scavenger. These results suggest that NO is an essential mediator for neuronal differentiation of primary cortical neuron cells.
Animals ; Butyrates ; Cyclic N-Oxides ; Embryonic Structures ; Hand ; Imidazoles ; Neurites ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; PC12 Cells ; Rats ; RNA, Messenger