As accommodation and repeated tonometry were known to change the level of intraocular pressure, sometimes they may give a misleading indication for the diagnosis and management of early glaucoma, ocular hypertension and low tension glaucoma. The object of this study was to investigate the effects of accommodation and repeated tonometry on intraocular pressure in Korean adults. Repeated tonometry was performed on 120 normal Korean eyes with visual acuity of 20/20 or more under controlled condition of accommodation and relaxation using Goldmann applanation tonometry and Schiotz tonometry. The results were as follows: 1. In repeated Goldmann applanation tonometry, a statistically significant reduction in mean intraocular pressure was produced during accommodation but not during relaxation. The maximum reduction of 3.25mmHg was produced during four minutes of accommodation and significant reduction of 2.01 mmHg was shown in first one minute of accommodation. 2. In repeated Schiotz tonometry, a statistically significant reduction in mean intraocular pressure was produced during accommodation but not during relaxation. The maximum reduction of 3.71mmHg was produced during four minutes of accommodation and significant reduction of 2.39 mmHg was shown in first one minute of accommodation.
Adult* ; Diagnosis ; Glaucoma ; Humans ; Intraocular Pressure ; Low Tension Glaucoma ; Manometry* ; Ocular Hypertension ; Relaxation ; Visual Acuity

A small beam or slit of light focused at the pupillary margin will induce regular, persistent oscillations of the pupil. The period of these cycles is the pupil cycle time that can be easily measured and expressed in milliseconds. When the efferent part of the light reflex of the pupil is normal, determination of the period of these cycles in milliseconds provides a number which may be correlated with conduction time in the anterior visual pathway. Cox and Drews reoorded pupillary response to alternating half-field visual stimuli and found that stimulation of the temporal visual field (nasal retina) caused more pupillary constriction than did equivalent stimulation of the nasal field(temporal retina). These findings imply an asymmertric decussation of pupillomotor pathways in the midbrain in humans as well as greater sensitivity of the nasal retina. We measured nasal and temporal pupil cycle time on 200 normal eyes of Koreans by half-field stimulation of the nasal and temporal retina. And we found that: 1. The mean temporal pupil cycle time was 1071 +/- 92m sec, in right eye and 1068 +/- 81m sec, in left eye. The mean nasal pupil cycle time was 894 +/- 63m sec, in right eye and 899 +/- 57m sec, in left eye. Difference between nasal and temporal pupil cycle time was 177 +/- 73m sec, in right eye and 169 +/- 64m sec, in left eye. 2. The difference of pupil cycle time between the right and left eyes was 3 +/- 84m sec, in temporal retina and 5 +/- 61m sec, in nasal retina. The difference of pupil cycle time between the two eyes was not significant statistically. 3. The mean temporal pupil cycle time of the two eyes was 1069 +/- 85m sec, and the mean nasal pupil cycle time was 897 +/- 62m sec. Difference between nasal and temporal pupil cycle time was 172 +/- 74m sec. In 95% of normal population, the discrepancy between temporal and nasal pupil cycle time was shorter than 253m sec. 4. The mean temporal pupil cycle time was 1066 +/- 86m sec, in male and 1072 +/- 83m sec, in female. The mean nasal pupil cycle time 901 +/- 63m sec, in male and 894 +/- 59m sec, in female. The difference of pupil cycle time between the male and female was not significant statistically.
Constriction ; Female ; Humans ; Male ; Mesencephalon ; Pupil* ; Reflex ; Retina ; Visual Fields ; Visual Pathways

BACKGROUND: Umbilical cord blood (UCB) cells are an alternative source of hemopoietic stem cells for transplantation. However, the use of UCB is limited by the lack of number of hemopoietic stem cells to reconstitute bone marrow of adults or higher weight recipients. The aim of this study was to evaluate the ex vivo expansion effect of various cytokines, especially thrombopoietin (TPO) in isolated CD34 positive UCB cells. METHODS: CD34 positive UCB cells were isolated by biotin-avidin immunoaffinity method. Isolated CD34 positive cells were cultured with various combination of cytokine including TPO, SCF, IL-3, & GM-CSF. CFU-GM, CFU-Mix, and CFU-Meg colony assays were performed. RESULTS: After 3 weeks of culture, the maximal expansion of total nucleated cells was seen in the combination of TPO+SCF+IL-3. After 1 week of culture, the number of CFU-GM was significantly increased in the combination of TPO+IL-3 (P<0.05) or SCF (P<0.05). In the presence of TPO+IL-3, significantly increased number of CFU-Mix was observed (P<0.05). TPO alone enhanced colony formation of CFU-Meg. In the combination of TPO+SCF, the number of CFU-Meg was increased significantly (P<0.05). CONCLUSIONS: TPO expanded the number of CFU-Meg as well as CFU-GM and CFU-Mix. These results suggest TPO acts not only in the megakaryocytopoiesis but also in the early stage of erythropoiesis and granulopoiesis.
Adult ; Bone Marrow ; Cytokines ; Erythropoiesis ; Fetal Blood* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocyte-Macrophage Progenitor Cells ; Humans* ; Interleukin-3 ; Stem Cells ; Thrombopoiesis ; Thrombopoietin* ; Umbilical Cord*

Blood-borne metastatic involvement of the gastric mucosa as a result of cancer is a rare occurrence. The tumors which were most commonly reported to metastasize to the stomach include melanoma, breast carcinoma, and lung carcinoma. Some reports document that large cell carcinoma and squamous cell carcinoma of the lungs have a higher pre- dilection for gastrointestinal tract metastases. Upper gastrointestinal endoscopic findings of metastatic lesions may vary but often produce a characteristic single or multiple bulls eye or target lesion. Therefore, whenever single or multiple target lesions are seen in the stomach on upper gastrointestinal endoscopy or barium study, the examination should include careful radiographic evaluation of the chest. Moreover, when the patient is known to have lung cancer, metastatic disease should be suspected. With a correct diagnosis and proper treatment, relief of symptoms and prolongation of life can sometimes be achieved, A case in reported involving squamous cell lung cancer with stomach metastasis in a 73 year-old woman. The patient was diagnosed by bronchoscopy, upper gastrointestinal endoscopy, chest CT, and abdominal CT. The chest and abdominal CT revealed a poorly marginated, lobulated, and 4 x 3 cm sized mass lesion in the right lower lobe causing obstruction of right lower lobe bronchus with invasion to the left atrium. right inferior pulmonary vein, and superior vena cava. Mediastimal lymph node enlargement and liver metastasis was also detected. Upper gastrointestinal endoscopy showed two "bulls eye" lesions with different sizes and two nodules without tip ulceration.
Aged ; Barium ; Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Heart Atria ; Humans ; Life Support Care ; Liver ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis* ; Pulmonary Veins ; Stomach* ; Thorax ; Tomography, X-Ray Computed ; Ulcer ; Vena Cava, Superior

Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature.
Anti-Bacterial Agents ; Esophageal Perforation ; Foreign Bodies ; Humans ; Parenteral Nutrition

Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer, and gastric cancer. There is evidence that IL-1beta is associated with the development of gastric cancer. Therefore, downregulation of H. pylori-mediated IL-1beta production may be a way to prevent gastric cancer. Withaferin A (WA), a withanolide purified from Withania somnifera, is known to exert anti-inflammatory and anti-tumor effects. In the present study, we explored the inhibitory activity of WA on H. pylori-induced production of IL-1beta in murine bone marrow-derived dendritic cells (BMDCs) and the underlying cellular mechanism. Co-treatment with WA decreased IL-1beta production by H. pylori in BMDCs in a dose-dependent manner. H. pylori-induced gene expression of IL-1beta and NLRP3 (NOD-like receptor family, pyrin domain containing 3) were also suppressed by WA treatment. Moreover, IkappaB-alpha phosphorylation by H. pylori infection was suppressed by WA in BMDCs. Western blot analysis revealed that H. pylori induced cleavage of caspase-1 and IL-1beta, as well as increased procaspase-1 and pro IL-1beta protein levels, and that both were suppressed by co-treatment with WA. Finally, we determined whether WA can directly inhibit ac tivation of the NLRP3 inflammasome. NLRP3 activators induced IL-1beta secretion in LPS-primed macrophages, which was inhibited by WA in a dose-dependent manner, whereas IL-6 production was not affected by WA. Moreover, cleavage of IL-1beta and caspase-1 by NLRP3 activators was also dose-dependently inhibited by WA. These findings suggest that WA can inhibit IL-1beta production by H. pylori in dendritic cells and can be used as a new preventive and therapeutic agent for gastric cancer.
Blotting, Western ; Caspase 1 ; Dendritic Cells* ; Down-Regulation ; Gastritis ; Gene Expression ; Helicobacter pylori ; Helicobacter* ; Humans ; Interleukin-1beta ; Interleukin-6 ; Macrophages ; NF-kappa B* ; Peptic Ulcer ; Phosphorylation ; Stomach Neoplasms ; Withania

Objectives: Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. Methods: The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The “1 minus relative risk” method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. Results: In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99–14.33) and 2.19 (95% CI, 1.24–3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. Conclusion Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death.

Isolated left main coronary ostial stenosis is a very rare condition. In the majority of cases there are coexisting diseases in multiple coronary vessels. Here, a case of isolated left main coronary ostial stenosis due to an acute angle take-off, with clockwise rotation of the coronary sinus, confirmed by cardiac MRI is presented. A 44-year old female patient presented with an exertional and stabbing anterior chest pain. The patient had no premedical history. A coronary angiogram showed an isolated left main coronary ostial stenosis due to an acute take-off of the left main coronary artery. A cardiac MRI showed an acute angle take-off of the left main coronary artery, with clockwise rotation of the coronary sinus. The patient underwent surgical angioplasty of the coronary ostia, with a patch of autologous pericardium. This acute angle take-off may be due to rotation of the coronary sinus.
Adult ; Angioplasty ; Chest Pain ; Constriction, Pathologic* ; Coronary Sinus* ; Coronary Stenosis ; Coronary Vessels ; Female ; Humans ; Magnetic Resonance Imaging* ; Pericardium

BACKGROUND: Inflammatory response on LPS and IFN-gamma induced Macrophage Raw 264.7 cells was secreted NO (nitric oxide) and PGE2 (prostaglandin E2) though expression of iNOS and COX-2. And many pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6 etc.) was secreted on LPS and IFN-gamma induced Macrophage Raw 264.7 cells, too. Atopy dermatitis was inflammatory skin disease with pruritus, xeroderma and specific eczema. OBJECTIVE: We sought to effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. METHODS: The immune response of Raw 264.7 cells were induced by LPS and IFN-gamma. Then LPS and IFN-gamma induced Raw 264.7 cells was measured NO, PGE2 production after treatment of different concentrations for AF-343. The related genes (iNOS, COX-2) for NO, PGE2 production were detected using Western blot in LPS and IFN-gamma induced Raw 264.7 cells after treatment of different concentrations for AF-343. Pro-inflammatory cytokines were detected, too. NC/Nga mice as Atopy dermatitis model was induced atopy dermatitis. Then NC/Nga mice with atopy dermatitis were performed oral administration of AF-343 for 1weeks. After oral administration of AF-343, TEWL was measured on skin tissues of NC/Nga mice with atopy dermatitis according to whether were performed oral administration of AF-343 or not. And pro-inflammatory cytokines and IgE was measured in serum, protein of skin tissues of NC/Nga mice. Skin tissues of NC/Nga mice were performed H&E staining, immunohistochemical staining for PCNA, Involucrin and filaggrin. RESULTS: LPS and IFN-gamma induced Raw 264.7 cells was decreased NO, PGE2 production in dose-dependent after treatment of different concentrations for AF-343. The expression level of iNOS, COX-2 protein was decreased in dose-dependent, too. The related pro-inflammatory cytokines in media with LPS and IFN-gamma induced Raw 264.7 cells were decreased after treatment of different concentrations for AF-343. TEWL level of NC/Nga mice skin (back, ear) with atopy dermatitis according to whether were performed oral administration of AF-343 or not was decreased in NC/Nga mice with atopy dermatitis group was performed oral administration by AF-343. When NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343, induced pro-inflammatory cytokines and IgE expression in serum, protein of back, ear skin tissues of each NC/Nga mice group was decreased. H&E stained Skin tissues of NC/Nga mice was confirmed that thickness of epidermis, dermis were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis. The expression of PCNA, involucrin and filaggrin were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis as results of immunihistochemical staining using specific antibodies such as PCNA as cell proliferation marker, involucrin and filaggrin as keratinocytes differentiation markers for skin tissues (back, ear) of NC/Nga mice. CONCLUSION: We confirmed effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. In conclusion, AF-343 is expecting as therapeutics for atopic dermatitis.
Administration, Oral ; Animals ; Antibodies ; Antigens, Differentiation ; Blotting, Western ; Cell Proliferation ; Cytokines ; Dermatitis ; Dermatitis, Atopic ; Dermis ; Dinoprostone ; Ear ; Eczema ; Epidermis ; Ichthyosis ; Immunoglobulin E ; Inflammation ; Interleukin-6 ; Intermediate Filament Proteins ; Keratinocytes ; Macrophages ; Mice ; Proliferating Cell Nuclear Antigen ; Protein Precursors ; Pruritus ; Skin ; Skin Diseases ; Taraxacum