Thalidomide, a potent teratogen, is Known as an angiogenic inhibitor. This study was performed to examine the effect of thalidomide on corneal angiogenesis in rabbit cornea induced by chemical cauterization. We applied Whatman filter paper disc soaked in 30% silver nitrate (AgNO3) application on corneas of 12 white rabbits. After 5days, we administered oral dose of 100mm2 thalidomide to the 6 animals everyday and examined the length and extent of neovascularization to evaluate the area of neovascularization. After 2 days of oral administration, the increase of neovascularization is 14.3+/-11.7mm2in thalidomide-treated group and 27.9+/-14.6mm2 in cotrol grop. The area of neovascularization reached to its maximum at day 9 in thalidomide-treated group compared to day 11 in control group and decreased thereafter in both groups. The increase of the area of vascularized cornea revealed 28.0+/-13.5mm2 in thalidomide-treated group and 44.4+/-12.7mm2 in control group at the day 9 (p=0.04, Wilkoxon Matched-pairs signed-rank test). This fact means that treatment with thalidomide resulted in an inhibition of the area of vascularized cornea with the median inhibition of 37.3%. On light micrographs, there were infiltration of inflammatory cell and capillary lumens in corneal stroma in both animals. Electron micrographs of thalidomide-treated animals showed loss of vascular endothelial cell junction, mitochondrial swelling and loss of cristae which were not found in control animals. This results suggest that orally-administered thalidomide has a direct effect on the growing vasculature and an inhibitory effect on corneal angiogenesis.
Administration, Oral ; Animals ; Capillaries ; Cautery ; Cornea ; Corneal Neovascularization* ; Corneal Stroma ; Endothelial Cells ; Mitochondrial Swelling ; Rabbits ; Silver Nitrate ; Thalidomide*

Nonfunctioning carcinoma of the adrenal cortex is an extremely rare disease. We have presented a case of nonfunctioning adrenocortical carcinoma. The patient was a 35 year-old female who had complained of discomfort and gradually growing mass in the left upper quadran1. No significant laboratory findings or evidence of hormonal disturbance wee clinically noted. Ultrasonography and abdominal CT revealed about 15 x 13cm sized mass in the left suprarenal area. Left adrenal gland. kidney and spleen were removed. The tumor was multilobulated but well encapsulated. measuring 16 x 15 x 13cm in size and weighing 420 grams. Cut surface of the tumor showed massive hemorrhage and necrosis, Microscopically, the tumor showed marked cellular pleomorphism, nuclear hyperchromatism and increased mitoses with some atypical mitoses. Capsular and vascular invasion of tumor cells was observed.
Adrenal Cortex ; Adrenal Glands ; Adrenocortical Carcinoma* ; Adult ; Female ; Hemorrhage ; Humans ; Kidney ; Mitosis ; Necrosis ; Rare Diseases ; Spleen ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To evaluate the effect of respiration on the sizes of intrathoracic vasculature, and the trachea,and the main bronchus. MATERIALS AND METHODS: Seventeen volunteers (10males aged 20-39 years and 7 females aged20-39 years) underwent spiral CT, between the apex and lowest base of the lung, collimation was 10mm, pitch was 1,and images were obtained at breath hold forced end-inspiration and breath hold forced end-expiration. Crosssecional areas or diameters were measured in each respiration state at the aorta (ascending, descending, lowerthoracic) and great branches, the IVC (thoracic, abdominal), the SVC, pulmonary artery (right main, leftdescending) and the tracheobronchus (trachea, left upper bronchus). Changes in the size of vessels and airwaysbetween the respiration states were evaluated and compared between inspiration and expiration. RESULT: Duringbreath-hold forced end-inspiration CT, the ascending, descending, and lower thoracic aorta and itsbranches(brachiocephalic, left common carotid, left subclavian) as well as the thoracic IVC and SVC and the rightmain and left descending pulmonary arteries decreased in size: during breath-hold forced end-expiration CT, thesize of all these vessels increased. For the trachea, left upper lobe bronchus and abdominal IVC, the situationwas reversed. Statistically significant changes(p<0.05) were noted in the ascending aorta and descending aorta,the lower thoracic aorta, the thoracic and abdominal IVC, the SVC, the right main and left pulmonary arteries, andthe trachea. CONCLUSION: During respiration, changes in the size of the thoracic vasculature and airways isprobably due to changes in intrathoracic pressure. In the measurement and diagnosis of stenosis or dilatation inthe intrathoracic vesculature and airways, respiration states should therefore be considered.
Aorta ; Aorta, Thoracic ; Bronchi* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Female ; Humans ; Lung ; Pulmonary Artery ; Respiration* ; Tomography, Spiral Computed ; Trachea* ; Volunteers

BACKGROUND: Skin organ culture is widely used as a tool to investigate skin biology or skin disease. OBJECTIVE: The objective of the present study was to develop an ideal skin organ culture model for evaluation of melanin pigmentation. METHODS: An air-liquid interface and submerged method were used. The histology of the cultured skin was studied with H&E stain. To examine the epidermal pigmentation, Fontana-Masson stain and NKI/beteb stain were performed. Pigment modifiers (arbutin, LY294002) were applied to the culture medium for 3 days as an air-liquid interface culture. RESULTS: The general architecture of the skin was well maintained for 5 days. The melanin pigment decreased during culture without change of the number of melanocytes. As expected from previous reports, the effect of pigment modifiers (arbutin, LY294002) on cultured skin was demonstrated. CONCLUSION: The results indicate that this skin organ culture model is useful in evaluating the melanin pigmentation
Biology ; Melanins* ; Melanocytes ; Organ Culture Techniques* ; Pigmentation* ; Skin Diseases ; Skin*

OBJECTIVES: The purpose of this study was to observe the changes of lipid levels during 4 years of hormone replacement therapy (HRT) in postmenopausal women. We also tried to determine whether lipid changes were different according to the treatment regimen and baseline lipid values. METHODS: A total of 108 postmenopausal women were treated with cyclic combined HRT (n=60), continuous combined HRT (n=19), and conjugate estrogen (n=29) alone. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride were measured before and after HRT every year. RESULTS: After 4 years of HRT, HDL-cholesterol level raised significantly (10.1%, p=0.001), but total cholesterol and LDL-cholesterol levels were not changed (1,1%, -0.1%). Triglyceride level significantly raised at first year (22.2%, p=0.001) and maintained over three year, but the level became similar to the baseline value at fourth year. The changing patterns of HDL-cholesterol, LDL-cholesterol and triglyceride were not different among cyclic HRT, continuous HRT and estrogen alone treatment group but total cholesterol levels at fourth year were significantly different according to the treatment regimen (-12.7% in continuous HRT, -0.3% in estrogen alone, and 7.3% in cyclic HRT, p=0.02). HRT had more favorable effect in women with baseline hypercholesterolemia compared to women with baseline normocholesterolemia since the reducing effects on total-cholesterol and LDL-cholesterol and the raising effect on HDL-cholesterol were greater. CONCLUSION: Postmenopausal HRT had a more beneficial effect on lipid profile in women with Hypercholesterolemia. This finding may suggest that those women could be the best candidates for HRT.
Cholesterol ; Estrogens ; Female ; Follow-Up Studies* ; Hormone Replacement Therapy* ; Humans ; Hypercholesterolemia ; Triglycerides

PURPOSE: With long acting time of 24 hours and no peak concentration, insulin glargine (Lantus(R), Aventis Pharma, Frankfurt, Germany) is preferably used as basal insulin to control fasting glucose level. The study was undertaken to evaluate the effect of insulin glargine as a basal insulin of intensive insulin therapy in uncontrolled type 1 diabetic adolescent patients. METHODS: The subject included 47 uncontrolled type 1 diabetic patients who have been treated by NPH and RI or insulin lispro. They were followed up for the mean duration of 7.2 months. Clinical parameters including treatment duration, fasting plasma glucose, glycosylated hemoglobin, total insulin doses, body weight, and body mass index were analyzed and compared before and after introduction of insulin glargine therapy. Mean age was 16.0+/-2.8 years old. RESULTS: Glycosylated hemoglobin was significantly decreased (9.4+/-1.4% to 8.6+/-1.4%, P<0.001) and fasting blood glucose level was also significantly decreased (182.6+/-53.2 mg/dL to 129.1+/-52.3 mg/dL, P<0.001, n=18) after switching to insulin glargine. Body weight increased significantly (56.4+/-9.4 kg to 57.9+/-9.6 kg, P=0.022) but increment of both total insulin dose (1.03+/-0.32 unit/kg/day to 1.04+/-0.29 unit/kg/day) and body mass index were insignificant. The mean dose of insulin glargine was 0.42+/-0.13 unit/kg/day. CONCLUSION: Insulin glargine as a basal insulin of intensive insulin therapy is more efficacious in diabetic control in adolescents with uncontrolled type 1 diabetes mellitus than conventional insulin therapy. Long-term follow up is needed for evaluating the effect of insulin glargine on diabetic control, prevention of hypoglycemia, and complication.
Adolescent ; Blood Glucose ; Body Mass Index ; Body Weight ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Fasting ; Follow-Up Studies ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Insulin Lispro ; Insulin, Long-Acting ; Plasma

BACKGROUND/AIMS: Although intravenous proton pump inhibitor (PPI) has been used for the prevention of post endoscopic submucosal dissection (ESD) bleeding, the route of administration has not been confirmed. The aim of the present study was to compare the efficacy of intravenous and oral PPI administration for the prevention of delayed post ESD bleeding. METHODS: Total 166 consecutive patients were randomly assigned to 30 mg lansoprazol twice a day (PO group) and 120 mg pantoprazole intravenous injection (IV group) for 48 hours. Finally, 65 patients in PO group and 87 patients in IV group were analyzed. After ESD, all patients underwent follow up endoscopy after 24 hours and were observed the symptoms of bleeding up to 60 days after ESD. RESULTS: Age, sex and use of anticoagulants were not different between groups. At follow up endoscopy after 24 hours, oozing and exposed vessel was noted in 4.6% of PO group and 8.0% of IV group and there was no significant difference. Delayed bleeding occurred in 4 of 65 patients (6.2%) in the PO group and 8 of 87 patients (9.2%) in the IV group (p>0.999). By multivariate analysis, oozing or exposed vessels at follow up endoscopy were risk factors for delayed bleeding (OR=17.5, p=0.022). CONCLUSIONS: There was no significant difference in the delayed bleeding, length of hospital stay according to the administration route. Bleeding stigmata at follow up endoscopy was risk factor of delayed bleeding. Oral PPI administration can cost-effectively replace IV PPI for prevention of post ESD bleeding.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; *Administration, Oral ; Aged ; Anticoagulants/therapeutic use ; Endoscopic Mucosal Resection/*adverse effects ; Female ; Gastroscopy ; Humans ; *Injections, Intravenous ; Lansoprazole/therapeutic use ; Male ; Middle Aged ; Odds Ratio ; Postoperative Hemorrhage/etiology/*prevention & control ; Prospective Studies ; Proton Pump Inhibitors/*therapeutic use ; Risk Factors ; Stomach Neoplasms/surgery

Milia are benign primary or secondary keratinous cysts. Multiple eruptive milia (MEM) and milia en plaque (MEP) are rarely reported. A 21-year-old male presented with multiple skin-colored papules on the abdomen and both acral regions, and erythematous plaques featuring similar papules on the wrist and the dorsa of the feet. A biopsy confirmed MEP and he was diagnosed with both MEM and MEP. We thus report a rare case of simultaneous MEM and MEP.
Abdomen ; Biopsy ; Foot ; Humans ; Keratosis ; Male ; Skin Diseases ; Wrist ; Young Adult*

Sodium azide (NaN3) is a white to colorless, crystalline powder that is highly water soluble, tasteless, and odorless. It is used mainly as a preservative in aqueous laboratory reagents and biologic fluids and also as an automobile airbag gas generant. Although it has caused deaths for decades, the toxic properties and effects of sodium azide in humans remains unknown. A 31-year-old comatose female was transported to the emergency department with an empty bottle labeled sodium azide. She developed cardiac arrest 15 minutes after arrival and expired in spite of 30 minutes of resuscitative effort. Subsequently, resuscitation team members incidentally suffered from sodium azide's exposure and developed eye discomfort, skin rashes parasthesias, pruritus, sore throat, and headache.
Adult ; Air Bags ; Automobiles ; Coma ; Crystallins ; Eating ; Emergencies ; Exanthema ; Eye ; Female ; Headache ; Heart Arrest ; Humans ; Indicators and Reagents ; Pharyngitis ; Pruritus ; Resuscitation ; Sodium ; Sodium Azide

Multiple minute digitate hyperkeratosis (MMDH) is a rare disorder of keratinization characterized clinically by multiple, tiny, spiky, keratotic papules. Herein, we report a new case of MMDH. There was no family history of similar lesions or a personal history of underlying disease. The lesions were limited to the face and associated with acne vulgaris. We consider this case as a postinflammatory type of MMDH.
Acne Vulgaris ; Humans