We studied retrospectively 46 patients of primary malignant eyelid tumors who were histologically diagnosed in Korea Cancer Center Hospital from May, 1987 to December, 1994 and followed for 6 months or longer. 46 patients consist of, 22 cases of basal cell carcinoma(47.8%), 10 cases of squamous cell carcinoma(21.7%), 9 cases of sebaceous gland carcinoma(19.6%), and 5 cases of malignant melanoma(10.9%). Our modalities of treatment for eyelid malignancy included excision under frozen-section control, radiotherapy and cryotherapy. In case of regional lymph node metastasis we performed radiation treatment with or without excision of primary tumor and regional lymph node dissection. A case with distant metastasis underwent radiotherapy combined with chemotherapy. Following initial treatment, 4 cases showed recurrence and 3 cases developed regional or distant metastasis. In this study, we emphasize that suspected eyelid malignancy should be histologically diagnosed with biopsy and treated adequately at an early stage to reduce recurrence or metastasis.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cryotherapy ; Drug Therapy ; Eyelids* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Sebaceous Glands

No abstract available.

BACKGROUND: The progression of hydronephrosis due to urinary obstruction is one of major causes of end stage renal failure. The activation of renin-angiotensin system (RAS) and renal cell apoptosis may be involved in this mechanisms. METHODS: In order to investigate the role of RAS in renal injury mechanism and renal expression of TGF-beta, bcl-2 and Fas in experimental unilateral ureteral obstruction (UUO) mouse model, 15 CBA strain mice were underwent sham operation (n=5), UUO without treatment (n=5) and UUO with angiotensin converting enzyme inhibitor (ACEI, enalapril, n=5) under ethyl ether anesthesia. Each group was sacrificed at 72 hours after surgery. Competitive RT-PCR was performed for the estimation of renin, angiotensin II AT1 receptor (AT1 R), TGF-beta, bcl-2, Fas and glyceraldehyde-3-phosphate-dehydrogenase (GAPDH) gene expression levels in the kidneys. RESULTS: Systolic blood pressure (SBP) and renal gene expressions of renin and AT1 R in untreated control UUO group were significantly increased compared to sham operated group at 72 hours after surgery. The level of TGF-beta and bcl-2 gene expressions of ACEI treated UUO group was significantly lower than that of untreated UUO group. On the other hand, Fas gene expression of ACEI treated UUO group was not significantly different from that of ACEI untreated UUO group. CONCLUSION: We speculate that the upregulation of bcl-2 and Fas gene expressions and the early activation of renin-angiotensin system of kidney are important factors of renal injury mechanism in this model. (Korean J Nephrol 2003;22(2): 174-184)
Anesthesia ; Angiotensin II ; Animals ; Apoptosis ; Blood Pressure ; Enalapril ; Ether ; Gene Expression ; Genes, bcl-2 ; Hand ; Hydronephrosis ; Kidney ; Mice ; Peptidyl-Dipeptidase A ; Renal Insufficiency ; Renin ; Renin-Angiotensin System* ; Transforming Growth Factor beta ; Up-Regulation ; Ureter* ; Ureteral Obstruction*

PURPOSE: Nevus sebaceus is a congenital hamartomatous lesion, typically involving head and neck. Various benign and malignant neoplasms can develop in association with nevus sebaceus. We report a case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma in nevus sebaceus. METHODS: A 73-year-old man presented with erythematous to black verrucous nodules on the right subauricular area. The upper part was accompanied with inflammation and ulceration, and no specific findings suspicious for malignant degeneration were found in the lower part preoperatively. The mass was totally excised and the defect was directly closed. Lymph nodes were not involved on concomitant neck dissection. RESULTS: Histopathologic examination confirmed the presence of squamous cell carcinoma in the upper part and basal cell carcinoma in the lower part of a nevus sebaceus. Negative margins were achieved on resection. No clinical problems were found during the 3-month follow-up period. CONCLUSION: We experienced a rare case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma within the same nevus sebaceus. Because patients with nevus sebaceus have risk of malignant changes, surgical excision and work-up for recurrence and metastasis should be considered in suspicious cases. And even in a totally asymptomatic case, the possibility of occult secondary cancer should be informed before surgery in aged patients.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Head ; Humans ; Inflammation ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Nevus ; Recurrence ; Ulcer

BACKGROUND: It has been suggested that the activation of proinflammatory cytokines and growth factors play an important role in many renal injury processes including ischemia-reperfusion. The activation of renin-angiotensin system in ischemia-reperfusion renal injury may be also involved in injury process. METHODS: In order to evaluate the renal gene expressions of renin, TGF-beta, TNF-alpha, MCP-1, endothelin-1, iNOS, Fas and the role of renin-angiotrensin system (RAS) in experimental unilateral renal ischemia-reperfusion (I-R) injury, 28 male Sprague-Dawley rats weighing 250-270 g underwent sham operation (n=6), I-R injury (clamping left renal artery for 60 minutes) without any treatment (n=11), I-R injury with angiotensin converting enzyme inhibitor (enalapril 100 mg/L in drinking water for one week, n=11) under thiopental sodium anesthesia (50 mg/kg, body weight, I.P.). Systolic blood pressure was measured with tail cuff method before surgery and 24 hours after surgery. Plasma renin activity (PRA) of all study group was measured at the time of sacrifice, 24 hours after surgery. Competitive RT- PCR was performed for the estimation of renin, TGF-beta, TNF-alpha, MCP-1, endothelin-1, iNOS, and Fas gene expression levels of the kidneys. The magnitude of each gene expression was expressed the ratio to beta-actin gene. RESULTS: The systolic blood pressure of untreated I-R injured group (135+/-6 mmHg, mean+/-SE) was significantly higher than those of sham operated (105+/-3 mmHg) rats and enalapril treated I-R injured rats at 24 hour after surgery (98+/-2 mmHg) (p<0.05, p<0.05). PRA of untreated I-R injury group was 6.6+/-1.1 ng/mL/hr and also significantly higher than that of sham operated rats (2.6+/-0.3 ng/mL/hr) (p<0.05). Renal gene expressions of renin, TGF-beta, MCP-1, TNF-alpha, endothelin-1, iNOS and Fas of untreated I-R injured rats were significantly higher than those of sham operated rats at 24 hours after surgery. The level of TGF-beta, TNF-alpha, MCP-1, endothelin-1, iNOS and Fas gene expressions of ACEI treated I-R injured rats was significantly lower than those of untreated I-R injured rats (all, p<0.05). CONCLUSION: With the above result, we speculate that the early up-regulation of renin, TGF-beta, MCP- 1, TNF-alpha, endothelin-1, iNOS, and Fas genes in the kidney may be related to the renal injury mechanism in this model and at least in part, the early activation of renin-angiotensin system of the kidney may be involved in this mechanism.
Actins ; Anesthesia ; Animals ; Blood Pressure ; Body Weight ; Cytokines ; Drinking Water ; Enalapril ; Endothelin-1 ; Gene Expression ; Humans ; Intercellular Signaling Peptides and Proteins ; Kidney ; Male ; Peptidyl-Dipeptidase A ; Plasma ; Polymerase Chain Reaction ; Rats ; Rats, Sprague-Dawley ; Renal Artery ; Renin ; Renin-Angiotensin System* ; Tail ; Thiopental ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Up-Regulation

A Reversible Posterior Leukoencephalopathy Syndrome(RPLS) consists of neurologic symptoms and signs - headache, consciousness change, seizure, visual impairment - and brain imaging finding showing brain(espicially white matter) edema usually involving the posteior parietal-temporal-occipital areas. The causes are thought to be hypertensive encephalopathy, pre-eclampsia or eclampsia, renal failure with fluid overload and immunosuppressive agents such as cyclosporin A or FK506. RPLS may usually reversible if treated early by decreasing blood pressure and discontinuing offending drugs. A 23-year-old man had been hemodialyzed with chronic renal failure for two years. His blood pressure elevated to 240/150mmHg 3 days before admission and he complained of severe headache, vomiting, and total visual loss at the day of admission. Brain T2-weighted MRI imaging showed increased signal intensity involving the both parietal, posterior temporal, and occipital lobes. After antihypertensive and dexamethason treatment, a follow-up brain MRI performed on 7 days after admission showed nearly normalized findings and all symptoms including visual loss were recovered completely in one week.
Blindness ; Blood Pressure ; Brain ; Consciousness ; Cyclosporine ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Headache ; Humans ; Hypertensive Encephalopathy ; Immunosuppressive Agents ; Kidney Failure, Chronic* ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Neuroimaging ; Neurologic Manifestations ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Pregnancy ; Rabeprazole ; Renal Insufficiency ; Seizures ; Tacrolimus ; Vomiting ; Young Adult

Angiotensin II(A II) -a main effector molecule of renin-angiotensin system(RAS) has been known to increase blood pressure and glomerular capillary pressure, and filtration fraction which may be involved in the progressive renal injury process. The action of A II takes place mainly through AT1 receptor. RAS can be blocked by angiotensin converting enzyme inhibitor(ACEI) and recently developed A II AT1 receptor antagonist(AT1 RA). ACEI also activate kinin system, simultaneously. However, AT1 RA does not affect kinin system. The renoprotective mechanism of ACEI may be related with activation of kinin system. In order to evaluate the renoprotective mechanism of long-term ACEI(enalapril, 100mg/L in drinking water for 12 weeks) or AT1 RA treatment(losartan 300mg/L in drinking water for 12 weeks), and its effect on the cytokines and growth factor expressions of renal cortical tissue by compatitive RT-PCR, 46 5/6 nephrectomized(5/6 NPX) rats and 8 sham operated rats were included in this study. Five sixth NPX rats showed marked hypertensin, significant proteinuria and glomerulosclerosis(mean 30.5%) in 12 weeks after surgery. However, enelapril or losartan treated rats revealed significantly lower 24 hour urinary protein excretion(UProtV), systolic blood pressure(SBP), and glomerulosclerosis than those of control 5/6 NPX rats. Plasma renin activity and angiotensin II levels of 5/6 NPX untreated control rats were not significantly increased compared to sham operated rats in 12 week after surgery. Renal cortical renin gene expression of untreated 5/6 NPX rats was significantly suppressed compared to sham operated rats. Enalapril or losartan treated 5/6 NPX rats showed significantly increased renin gene expression compared to untreated 5/6 NPX rats. Renal cortical gene expressions of TGF-beta, TNF-alpha, MCP-1, IL-6, osteopontin, and endothelin-1 were significantly increased in 5/6 NPX untreated control rats compared to sham operated rats. Enalapril or losartan treated 5/6 NPX rats showed significantly less level of renal TGF-beta gene expression compared to 5/6 NPX control rats. The magnitude of SBP and UProtV were significantly positively correlated with the degree of glomeruloslerosis(p<0.001, p<0.001). With the above result, we speculate that because ACEI or AT1 RA showed similar renoprotective effect in 5/6 NPX rats, at least in part, local activation of RAS plays an important role in the progressive renal injury process of this model.
Angiotensin Amide ; Angiotensin II ; Angiotensins ; Animals ; Blood Pressure ; Capillaries ; Cytokines ; Drinking Water ; Enalapril ; Endothelin-1 ; Filtration ; Gene Expression ; Interleukin-6 ; Losartan ; Osteopontin ; Peptidyl-Dipeptidase A ; Plasma ; Proteinuria ; Rats ; Renin ; Renin-Angiotensin System* ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

Angiotensin II(A II) -a main effector molecule of renin-angiotensin system(RAS) has been known to increase blood pressure and glomerular capillary pressure, and filtration fraction which may be involved in the progressive renal injury process. The action of A II takes place mainly through AT1 receptor. RAS can be blocked by angiotensin converting enzyme inhibitor(ACEI) and recently developed A II AT1 receptor antagonist(AT1 RA). ACEI also activate kinin system, simultaneously. However, AT1 RA does not affect kinin system. The renoprotective mechanism of ACEI may be related with activation of kinin system. In order to evaluate the renoprotective mechanism of long-term ACEI(enalapril, 100mg/L in drinking water for 12 weeks) or AT1 RA treatment(losartan 300mg/L in drinking water for 12 weeks), and its effect on the cytokines and growth factor expressions of renal cortical tissue by compatitive RT-PCR, 46 5/6 nephrectomized(5/6 NPX) rats and 8 sham operated rats were included in this study. Five sixth NPX rats showed marked hypertensin, significant proteinuria and glomerulosclerosis(mean 30.5%) in 12 weeks after surgery. However, enelapril or losartan treated rats revealed significantly lower 24 hour urinary protein excretion(UProtV), systolic blood pressure(SBP), and glomerulosclerosis than those of control 5/6 NPX rats. Plasma renin activity and angiotensin II levels of 5/6 NPX untreated control rats were not significantly increased compared to sham operated rats in 12 week after surgery. Renal cortical renin gene expression of untreated 5/6 NPX rats was significantly suppressed compared to sham operated rats. Enalapril or losartan treated 5/6 NPX rats showed significantly increased renin gene expression compared to untreated 5/6 NPX rats. Renal cortical gene expressions of TGF-beta, TNF-alpha, MCP-1, IL-6, osteopontin, and endothelin-1 were significantly increased in 5/6 NPX untreated control rats compared to sham operated rats. Enalapril or losartan treated 5/6 NPX rats showed significantly less level of renal TGF-beta gene expression compared to 5/6 NPX control rats. The magnitude of SBP and UProtV were significantly positively correlated with the degree of glomeruloslerosis(p<0.001, p<0.001). With the above result, we speculate that because ACEI or AT1 RA showed similar renoprotective effect in 5/6 NPX rats, at least in part, local activation of RAS plays an important role in the progressive renal injury process of this model.
Angiotensin Amide ; Angiotensin II ; Angiotensins ; Animals ; Blood Pressure ; Capillaries ; Cytokines ; Drinking Water ; Enalapril ; Endothelin-1 ; Filtration ; Gene Expression ; Interleukin-6 ; Losartan ; Osteopontin ; Peptidyl-Dipeptidase A ; Plasma ; Proteinuria ; Rats ; Renin ; Renin-Angiotensin System* ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

Four trials of external quality assessment in diagnostic hematology were performed in 2002 with about 400 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, reticulocyte count, white cell differential count, and red blood cell morphology test. The response rate was more than 90%. The performance of quality assessment appeared to be gradually improved year by year.
Equidae* ; Erythrocyte Count ; Erythrocytes ; Hematology* ; Korea* ; Leukocyte Count ; Platelet Count ; Reticulocyte Count

BACKGROUND: Anemia is one of the most important risk factors for cardiovascular morbidity and mortality in patients with chronic renal failure. The most effective treatment modality for anemia is erythropoietin injection. Besides erythropoietic effect, erythropoietin has multiple beneficial effects such as anti-oxidant, anti-hypoxic, anti-apoptotic and vasculogenetic effects, and prevents tubular lesions and interstitial fibrosis. Despite lots of advantages of erythropoietin therapy, the number of patients treated with this agent is modest, particularly during the pre-dialysis chronic renal failure. We conducted a clinical trial to evaluate the effects of erythropoietin on renal function in the anemic pre-dialysis patients with chronic renal failure. METHODS: Data of 23 pre-dialysis patients with chronic renal failure were analyzed retrospectively 6 months prior, and prospectively 6 months after the initiation of erythropoietin therapy. Erythropoietin was admitted at a dose of 3000 IU weekly with supplementary iron. RESULTS: The average hematocrit and hemoglobin rose from 22.1+/-2.5%, 7.4+/-0.8 g/dL to 28.4+/-4.2%, 9.6+/-1.5 g/dL, respectively. When linear regression analysis was applied to pre- and post-erythropoietin glomerular filtration rate and 1/Cr, mean rate of decline of glomerular filtration rate were significantly delayed (p=0.039) but that of 1/Cr had a tendency to be delayed but was not statistically meaningful (p=0.099). CONCLUSIONS: Treatment of the anemia with low dose erythropoietin in pre-dialysis patients with chronic renal failure is relatively safe and may slow the rate of renal function deterioration.
Anemia ; Erythropoietin* ; Fibrosis ; Glomerular Filtration Rate ; Hematocrit ; Humans ; Iron ; Kidney Failure, Chronic* ; Linear Models ; Mortality ; Prospective Studies ; Retrospective Studies ; Risk Factors