The aim of this study is to analyze the level of target molecule expression in metastatic renal cell carcinoma (RCC) to determine whether there is a correlation between molecular marker expression and clinical response. Ten patients with metastatic RCC, who received receptor tyrosine kinase (RTK) targeted therapy after cytoreductive or radical nephrectomy, were included. The expression of target molecules relating to the RTK, mammalian target of rapamycin, hypoxia inducible factor, mitogen activated protein kinase, and adenosine monophosphate-activated protein kinase pathways were analyzed using real-time polymerase chain reaction and immunohistochemistry. We correlated the level of target molecule expression with clinical response, including efficacy and adverse events experience during RTK targeted therapy. All patients showed similar histological subtype and grade on pathological examination; however, the expression of RCC target molecules was very different among the patients. The expression of molecules related to the RTK pathway in RCC tissue as well as relative expression of molecules in RCC tissue compared to normal kidney tissue, were higher in patients who showed a good response to RTK targeted therapy compared to those that showed a poor response. Target molecule expression in normal kidney tissue was higher in patients who experienced high-grade adverse events than in patients who experienced low-grade events. Target molecule expression in metastatic RCC correlates with targeted therapy clinical response including efficacy and adverse events. Personalized target molecule expression profiles could be used to predict clinical response to different targeted therapies, thus helping optimization of targeted therapies for patients with metastatic RCC.
Adenosine ; Anoxia ; Biomarkers ; Carcinoma, Renal Cell* ; Genetic Variation ; Humans ; Immunohistochemistry ; Kidney ; Nephrectomy ; Protein Kinases ; Protein-Tyrosine Kinases ; Real-Time Polymerase Chain Reaction ; Sirolimus

Toxocariasis is an infection in a human host caused by Toxocara canis or Toxocara cati larvae. Clinical manifestations are classified according to the organs affected, such as visceral larva migrans (VLM) and ocular larva migrans (OLM). Epidemiological evidence suggests that OLM tends to occur in the absence of systemic involvement and vice versa, which has led to two manifestations of this infection being reclassified as VLM and OLM. No case of a patient with VLM combined with OLM has been reported in Korea. Here, we report a case of VLM combined with OLM in a 51-year-old female caused by massive ingestion of raw cow meat, manyplies, and liver.
Eating ; Female ; Humans ; Korea ; Larva ; Larva Migrans ; Larva Migrans, Visceral ; Liver ; Meat ; Middle Aged ; Toxocara ; Toxocara canis ; Toxocariasis

The most promising treatment for stress urinary incontinence can be a cell therapy. We suggest human amniotic fluid stem cells (hAFSCs) as an alternative cell source. We established the optimum in vitro protocol for the differentiation from hAFSCs into muscle progenitors. These progenitors were transplanted into the injured urethral sphincter and their therapeutic effect was analyzed. For the development of an efficient differentiation system in vitro, we examined a commercial medium, co-culture and conditioned medium (CM) systems. After being treated with CM, hAFSCs were effectively developed into a muscle lineage. The progenitors were integrated into the host urethral sphincter and the host cell differentiation was stimulated in vivo. Urodynamic analysis showed significant increase of leak point pressure and closing pressure. Immunohistochemistry revealed the regeneration of circular muscle mass with normal appearance. Molecular analysis observed the expression of a larger number of target markers. In the immunogenicity analysis, the progenitor group had a scant CD8 lymphocyte. In tumorigenicity, the progenitors showed no teratoma formation. These results suggest that hAFSCs can effectively be differentiated into muscle progenitors in CM and that the hAFSC-derived muscle progenitors are an accessible cell source for the regeneration of injured urethral sphincter.
Amniotic Fluid/*cytology ; Animals ; Biological Markers/metabolism ; Cell Differentiation ; Cell Lineage ; Cell Transformation, Neoplastic ; Cells, Cultured ; Coculture Techniques ; Female ; Gene Expression Regulation ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Regeneration ; *Stem Cell Transplantation ; Stem Cells/*cytology/metabolism ; Urethra/physiology ; Urinary Incontinence, Stress/pathology/*therapy ; Urodynamics

Dengue fever is an acute febrile disease caused by the dengue virus. As the numbers of reported patients with dengue fever are increasing, rare complications associated with dengue fever, such as rhabodomyolysis or meningitis, are increasing in Korea. We describe the case of a Korean male presenting with fever, myalgia, nausea, diarrhea and blurred vision, who as a result of serologic test and fundoscopy, was diagnosed with dengue fever complicated by retinitis. He completely recovered with conservative care.
Dengue ; Dengue Virus ; Diarrhea ; Fever ; Humans ; Korea ; Male ; Meningitis ; Nausea ; Retinitis ; Serologic Tests ; Vision, Ocular

PURPOSE: For patients with neuromuscular disease, air stacking, which inflates the lungs to deep volumes, is important for many reasons. However, neuromuscular patients with severe glottic dysfunction or indwelling tracheostomy tubes cannot air stack effectively. For these patients, we developed a device that permits deep lung insufflations substituting for glottic function. MATERIALS AND METHODS: Thirty-seven patients with bulbar-innervated muscle weakness and/or tracheostomies were recruited. Twenty-three had amyotrophic lateral sclerosis, and 14 were tetraplegic patients due to cervical spinal cord injury. An artificial external glottic device (AEGD) was used to permit passive deep lung insufflation. In order to confirm the utility of AEGD, vital capacity, maximum insufflation capacity (MIC), and lung insufflation capacity (LIC) with AEGD (LICA) were measured. RESULTS: For 30 patients, MICs were initially zero. However, with the use of the AEGD, LICA was measurable for all patients. The mean LICA was 1,622.7+/-526.8 mL. Although MIC was measurable for the remaining 7 patients without utilizing the AEGD, it was significantly less than LICA, which was 1,084.3+/-259.9 mL and 1,862.9+/-248 mL, respectively (p<0.05). CONCLUSION: The AEGD permits lung insufflation by providing deeper lung volumes than possible by air stacking.
Adult ; Aged ; Female ; Forced Expiratory Flow Rates/physiology ; Humans ; Insufflation/*instrumentation/methods ; Male ; Middle Aged ; Neuromuscular Diseases/*physiopathology/therapy ; *Ventilators, Mechanical ; Vital Capacity/physiology ; Young Adult

PURPOSE: To report a case of retinal detachment with a giant retinal tear, which was treated with perfluorocarbon liquid as an intraocular substitute. CASE SUMMARY: A 37-year-old woman with a dislocated lens and a giant retinal tear underwent vitrectomy and lensectomy and was instructed to maintain a supine position after the operation. Perfluorocarbon liquid (Perfluoro-N-octane, C8F18) was used as a substitute in the vitreous cavity for 17 days. After 17 days, the perfluorocarbon liquid was removed and intraocular lens scleral fixation was performed. After removal of the perfluorocarbon liquid, the corneal endothelium was stable without other complications (including corneal edema, elevated intraocular pressure, ocular hypotony, macular pucker), and the best corrected visual acuity after intraocular lens scleral fixation was 0.4. CONCLUSIONS: Perfluorocarbon liquid is a useful surgical material in patients with a dislocated lens and retinal detachment with a giant retinal tear who have difficulty maintaining a prone position.
Adult ; Corneal Edema ; Endothelium, Corneal ; Female ; Fluorocarbons ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lenses, Intraocular ; Ocular Hypotension ; Prone Position ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Supine Position ; Visual Acuity ; Vitrectomy

Focal myositis is an uncommon benign inflammatory myopathy of unknown cause affecting skeletal muscle, and presenting as a localized painful swelling within the soft tissue of an extremity. According to some reports, focal myositis may occur in patients with rheumatoid arthritis, sarcoidosis, and other connective tissue diseases. To our knowledge, there has been no case report of focal myositis associated with rheumatoid arthritis. We report first case of focal myositis in a patient with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Connective Tissue Diseases ; Extremities ; Humans ; Muscle, Skeletal ; Myositis* ; Sarcoidosis

PURPOSE: To report a case of epithelioid hemangioendothelioma of the lacrimal sac. METHODS: A 51-year-old woman was admitted to our hospital because of tearing on the left eye. Nasolacrimal duct stenosis was found on dacryocystogram. After observation of 2 months, the tearing became worse and a palpable mass at the medial canthal area was noted. Orbital computed tomography showed the tumor of the left lacrimal sac and complete excision of the tumor and sac was performed. RESULTS: Pathologic diagnosis of the excised mass was epithelioid-hemagioendothelioma. There was no evidence of recurrence until last follow-up at postoperative 4 months.
Constriction, Pathologic ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Middle Aged ; Nasolacrimal Duct ; Orbit ; Recurrence ; Tears

PURPOSE: To investigate the administration of an intravitreal injection of triamcinolone acetonide (IVTA) for the treatment of macular edema in branch retinal vein occlusion (BRVO). METHODS: Forty-four patients with BRVO were enrolled in this study. At the first and third month after the injection of triamcinolone acetonide (4 mg/0.1 cc), the best corrected visual acuity (BCVA) was measured by Snellen chart and the thickness of macula by OCT. RESULTS: BCVA and the macular thickness were not correlated in BRVO. Average BCVA was 0.99 (log MAR), and the mean macular thickness was 498 micrometer before injection. At the third month after injection, the results were 0.7 (log MAR) and 258 micrometer, respectively. Although 3 eyes experienced a transient increase of intraocular pressure, there were no serious complications affecting visual acuity. CONCLUSIONS: Macular edema and various other factors are considered as the causes of decreased visual acuity in BRVO. IVTA is effective in treating macular edema but not in improving visual acuity.
Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity

Biliary web is an extremely rare disease. It has been reported about 40 cases worldwide and 7 cases in Korea. Most cases have been incidentally found at operation or autopsy because of its rare incidence and absence of specific clinical manifestations. On cholangiography, billiary web typically appears as slit like or shelf like radiolucent narrowing. We experienced a case of biliary web of the common bile duct with obstructive jaundice that was diagnosed by endoscopic retrograde cholangiopancreatography and treated by surgery in a 65 year-old male who complained of right upper quadrant pain for 4 days. We report a case of biliary web of the common bile duct with obstructive jaundice with a review of the literature.
Aged ; Autopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis* ; Common Bile Duct* ; Humans ; Incidence ; Jaundice, Obstructive* ; Korea ; Male ; Rare Diseases