PURPOSE: To investigate the clinical features of Korean patients with sarcoid uveitis. METHODS: The medical records of patients with endogenous uveitis who were recruited from the uveitis clinic at Seoul National University Hospital were reviewed. Sex, age at presentation, ocular symptoms and signs, treatment, complications, and the rate of recurrence were analyzed. RESULTS: Of 440 patients with endogenous uveitis, 31 (7.1%) with sarcoidosis were included. The mean age at onset was 54.5 years. Sarcoidosis patients with uveitis tended to be older than those without uveitis (44.1 years). Uveitis was the primary manifestation of sarcoidosis in 16 of 31 patients (51.6%). Anterior uveitis was the most common in terms of the anatomic location of inflammation (54.8%), and posterior involvement (38.7%) was not rare. Systemic corticosteroid therapy was administered to 28 patients (90.3%). Five patients (16.1%) received corticosteroids combined with immunosuppressive agents. CONCLUSIONS: Sarcoid uveitis is not a rare etiology of endogenous uveitis. Topical or systemic corticosteroids could control inflammation in most cases, but immunosuppressive agents are needed in a small percentage of patients. Steroids combined with immunosuppressive agents can prevent severe visual losses in such patients.
Adrenal Cortex Hormones ; Humans ; Immunosuppressive Agents ; Inflammation ; Medical Records ; Recurrence ; Sarcoidosis ; Steroids ; Uveitis ; Uveitis, Anterior

PURPOSE: To evaluate the expression of chemokine and chemokine receptors in the aqueous humor (AH) of patients with recurrent anterior uveitis (AU) in terms of HLA-B-27-association. METHODS: Patients with endogenous uveitis were recruited from the uveitis clinic at Seoul National University Hospital. AH and peripheral blood (PB) were obtained from each patient. The expression of chemokine receptors in T-cells from AH and PB was measured using flow cytometric analysis. Interleukin (IL)-8, interferon-gammainducible protein (IP)-10, and regulated-on-expression, normal T-cell expressed and secreted (RANTES) levels of PB and AH were measured. The expression of chemokine receptor and chemokine levels in PB and AH were compared between HLA-B27-associated AU and idiopathic AU patients. RESULTS: Seventeen patients with HLA-B27-associated AU, 14 patients with idiopathic AU and 5 healthy controls were included in this study. IL-8 and IP-10 levels of AH were shown to be increased more than in PB, and intraocular concentrations of IL-8 and IP-10 were higher in patients with HLA-B27-associated AU than in idiopathic AU patients. RANTES levels in AH were significantly lower than in PB for all groups. In all groups, the expression of chemokine receptor in AH increased more than in PB. CONCLUSIONS: The results from this study show chemokine may play an important role in inflammation in patients with AU. This implies that the chemokine environment may be different in terms of HLA-B-27-association.
Aqueous Humor ; Chemokine CCL5 ; Humans ; Inflammation ; Interleukin-8 ; Interleukins ; Receptors, Chemokine ; T-Lymphocytes ; Uveitis ; Uveitis, Anterior

No abstract available.
Low Back Pain* ; Sciatica*

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16+/-2.1 and 8.03+/-2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3+/-2.9 and 1.2+/-3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Muscles ; Operative Time ; Skin ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

Glomus jugulare tumors are usually slow growing, but highly vascularized tumor. The authors report the case of huge glomus jugulare tumor treated by surgical resection with preoperative embolization. A 32-year old male patient presented with a history of right-sided facial palsy and hearing disturbance. Magnetic resonance imaging demonstrated an irregular large mass with multiple signal voids in the right temporal area. Prior to surgical excision of tumor, the patient underwent superselective embolization. Embolization of the tumor and its dominant feeding arteries were achieved. Six days later, the patient underwent an infratemporal fossa approach to remove the tumor. The patient did well postoperatively except CSF leakage that was treated successfully by dura repair. We discuss the usefulness of preoperative embolization and infratemporal approach for the huge glomus jugulare tumor.
Adult ; Arteries ; Facial Paralysis ; Glomus Jugulare Tumor* ; Glomus Jugulare* ; Hearing ; Humans ; Magnetic Resonance Imaging ; Male

Fibrous dysplasia is a benign disorder of bone primarily affecting young people from childhood through the third decade. It usually manifests as an enlargement of bones in and about the orbits or the the cranial vault. Whether localized or diffuse, it rarely involves the cervical spine. We report a case of fibrous dysplasia involving axis combined with atlantoaxial instability which was caused by odontoid process fracture. Transfacetal screw fixation augmented with Halifax interlaminar clamp technique was applied to obtain atlantoaxial stability. Postoperative course was unevenful and postoperative radiologic findings revealed favorable fixation of atlantoaxial joint. The pertinent literature on fibrous dysplasia and atlantoaxial instability is reviewed and discussed.
Atlanto-Axial Joint ; Axis, Cervical Vertebra ; Odontoid Process ; Orbit ; Spine*

BACKGROUND: Tamoxifen (TAM) inhibits the action of estrogen by binding to estrogen receptors, and also has non-estrogen receptor mediated cytostatic activities. Transforming growth factor-1 (TGF-1) inhibits the proliferation of many other cell types, such as epithelial, hematopoietic and endothelial cells. METHODS: We investigated the effects of tamoxifen on the growth of 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumors and the expression of cyclin D1, cyclin E, p21Cip1, and p27Kip1 by performing immunohistochemistry and Western blot analysis, and studied whether TGF-1 injection amplified the effects of TAM. When tumor size reached between 10-15 mm in the largest dimension, the rats were divided into 3 groups: DMBA-control group (n=12), DMBA-TAM group (n=14) and DMBA-TAM plus TGF-1 group (n=5). RESULTS: The consecutive administration of TAM markedly decreased the tumor development compared with the DMBA-control group. The DMBA-TAM and DMBA-TAM plus TGF-1 groups showed decreased expression of bromodexoyuridine, cyclin D1, cyclin E, and p21Cip1 when compared with those of the DMBA-control group. On the other hand, the labeling index of p27Kip1 was higher in the DMBA-TAM plus TGF-1 group than in the DMBA-control group. CONCLUSION: TAM suppresses tumor development, which may be associated with down-expression of cyclin D1 and cyclin E, and overexpression of p27Kip1, and addition of TGF-1 does not influence tumor development treated by TAM.
Animals ; Blotting, Western ; Breast ; Cell Cycle ; Cyclin D1* ; Cyclin E* ; Cyclins* ; Endothelial Cells ; Estrogens ; Hand ; Immunohistochemistry ; Rats* ; Receptors, Estrogen ; Robenidine ; Tamoxifen* ; Transforming Growth Factor beta

Primary central nervous system (CNS) sarcomas are exceedingly rare, and, to the best of our knowledge, there has not yet been a report of intramedullary sarcoma. Here, we report a primary intradural intramedullary sarcoma of the spinal cord in a four-year-old boy who presented with low back pain and a radiculopathy involving both lower extremities. The tumor showed significant enhancement on magnetic resonance (MR) images due to its extreme vascularity. Gross total tumor removal was performed with microelectrical pulse recording, and the patient also received adjuvant radiotherapy and chemotherapy. After the operation, the patient's sensory deficits were improved. Because CNS dissemination is common, entire neuraxis evaluation is essential, although there was no evidence of dissemination in this case. The prognosis of primary CNS sarcoma is poor due to infiltrative nature and early CNS dissemination is common, and the treatment of choice is radical surgical resection. Adjuvant therapy is also beneficial with radiotherapy and chemotherapy.
Central Nervous System ; Humans ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Spectroscopy ; Prognosis ; Radiculopathy ; Radiotherapy, Adjuvant ; Sarcoma ; Spinal Cord

Posterior interosseous nerve(PIN) syndrome is an entrapment of the deep branch of the radial nerve just distal to the elbow joint. It is caused by acute trauma or masses compressing the nerve. We report an unusual case of PIN syndrome with wrist drop caused by compression of the nerve by anomalous vascular leash. The patient has recovered with the surgical decompression of the offending vessels and arcade of Frohse.
Decompression, Surgical ; Elbow Joint ; Humans ; Radial Nerve ; Wrist

We report a case of cytomegalovirus (CMV) retinitis after intravitreal bevacizumab injection. A 61-year-old woman with diabetic macular edema developed dense vitritis and necrotizing retinitis 3 weeks after intravitreal bevacizumab injection. A diagnostic vitrectomy was performed. The undiluted vitreous sample acquired by vitrectomy was analyzed by polymerase chain reaction and culture. Polymerase chain reaction of the vitreous was positive for CMV DNA. Other laboratory results did not show evidence of other infectious retinitis and systemic immune dysfunction. Human immunodeficiency virus antibodies were also negative. After systemic administration of ganciclovir, retinitis has resolved and there has been no recurrence of retinitis during the follow-up period of 12 months. Ophthalmologists should be aware of potential risk for CMV retinitis after intravitreal bevacizumab injection.
Angiogenesis Inhibitors/administration & dosage/adverse effects ; Antibodies, Monoclonal, Humanized/administration & dosage/*adverse effects ; Cytomegalovirus/genetics ; Cytomegalovirus Retinitis/diagnosis/*etiology/immunology ; DNA, Viral/analysis ; Diagnosis, Differential ; Female ; Humans ; Immunocompetence/*drug effects ; Intravitreal Injections ; Macular Edema/diagnosis/*drug therapy ; Middle Aged ; Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A/antagonists & inhibitors