ABSTRACT
The lacrimal drainage system begins at the puncta and empties through the valve of Hasner into the inferior meatus. The varieties of the anatomic location, size and morphology of this valve can predispose susceptible individuals to an increased incidence of iatrogenic injury during nasal surgical procedures, thus necessitating a comprehensive understanding of the system. We report two cases of epiphora following two-jaw surgeries for cosmetic purposes. Nasolacrimal duct obstructions were diagnosed, and the symptoms were improved with dacryocystorhinostomies.
Subject(s)
Dacryocystorhinostomy , Drainage , Incidence , Lacrimal Apparatus Diseases , Nasal Surgical Procedures , Nasolacrimal Duct , Osteotomy , Osteotomy, Le FortABSTRACT
Churg-Strauss syndrome is a rare systemic vasculitis occurring in patients with asthma and peripheral eosinophilia. Lungs, skin, and the nervous system are the most common sites of involvement, although many other organs are affected frequently. We report a case of 54-year-old male with a history of asthma and chronic rhinosinusitis who was admitted to the emergency department because of dyspnea and pleural pain. He was diagnosed with Churg-Strauss syndrome based on bronchial asthma, peripheral eosinophilia, pulmonary infiltration, chronic rhinosinusitis, and extravascular eosinophil infiltration. His symptoms were resolved dramatically after treatment with corticosteroids. Allergic rhinitis and chronic rhinosinusitis with or without polyps may be present at the early stage of Churg-Strauss syndrome. Therefore, otolaryngologists may play a pivotal role in making an early diagnosis of this disease.
Subject(s)
Humans , Male , Middle Aged , Adrenal Cortex Hormones , Asthma , Churg-Strauss Syndrome , Dyspnea , Early Diagnosis , Emergency Service, Hospital , Eosinophilia , Eosinophils , Lung , Nasal Cavity , Nervous System , Polyps , Pulmonary Eosinophilia , Rhinitis , Skin , Systemic Vasculitis , VasculitisABSTRACT
BACKGROUND/AIMS: Bacterial infection is accepted as a precipitating factor in cholesterol gallstone formation, and recent studies have revealed the presence of Helicobacter species in the hepatobiliary system. We utilized the polymerase chain reaction (PCR) to establish the presence of bacterial DNA, including from Helicobacter species, in gallstones, bile juice, and gallbladder mucosa from patients with gallstones. METHODS: At cholecystectomy, 58 gallstones, 48 bile samples, and 46 gallbladder mucosa specimens were obtained and subjected to nested PCR using specific 16S rRNA primers of H. pylori and other bacteria. Bacterial species were identified by DNA sequencing analysis. Bacterial 16S rRNA was detected in 25 out of 36 mixed-cholesterol gallstones, 1 out of 10 pure-cholesterol gallstones, and 9 out of 12 pigmented stones. Furthermore, 16S rDNA sequencing identified Escherichia coli, Pseudomonas, Citrobacter, Klebsiella, and Helicobacter species. RESULTS: Helicobacter DNA was detected in 4 out of 58 gallstones, 6 out of 48 bile samples, and 5 out of 46 gallbladder specimens. Direct sequencing of Helicobacter amplicons confirmed strains of H. pylori in all four gallstones, five out of six bile samples, and three out of five gallbladder specimens. Almost all mixed-cholesterol gallstones appear to harbor bacterial DNA, predominantly E. coli. CONCLUSIONS: H. pylori was also found in the biliary system, suggesting that these bacteria are of etiological importance in gallstone formation.
Subject(s)
Humans , Bacteria , Bacterial Infections , Bile , Biliary Tract , Cholecystectomy , Cholecystitis , Cholesterol , Citrobacter , DNA , DNA, Bacterial , DNA, Ribosomal , Escherichia coli , Gallbladder , Gallstones , Helicobacter , Helicobacter pylori , Klebsiella , Mucous Membrane , Polymerase Chain Reaction , Precipitating Factors , Pseudomonas , Sequence Analysis, DNAABSTRACT
BACKGROUND: The overexpression of transforming growth factor-beta 1 receptor II (TGF-beta1RII) and transforming growth factor-beta 1 (TGF-beta1) ligand may be involved in the formation of a bulla. In this study, we tested if serum TGF-beta1 ligand levels correlated with the expression level of TGF-beta1RII and TGF-beta1 in bullous tissues from patients with spontaneous pneumothorax. MATERIAL AND METHOD: Bullous lung tissues and blood samples were obtained from 19 patients with spontaneous pneumothorax, 18 males and 1 female, aged 17 to 35 years old. The bullous tissues were obtained by video-assisted thoracic surgery (VATS), fixed in formalin, embedded in paraffin, and cut into 5~6micrometer thick slices. Sections were immunohistochemically stained with primary antibodies against TGF-beta1 or TGF-beta1RII, and serum levels of TGF-beta1 in patients and normal controls was measured by enzyme-linked immunosorbent assay (ELISA). RESULT: Of the 19 patients, 16 were TGF-beta1 positive and 10 were TGF-beta1RII positive. Among the 16 TGF-beta1 positives, 9 were also TGF-beta1RII positive. As seen previously, strong immunohistochemical staining of TGF-beta1RII and TGF-beta was detected in the boundary region between the bullous and normal lung tissues. Average TGF-beta1 blood levels of both TGF-beta1 and TGF-beta1RII positive patients was 38.36+/-16.2 ng/mL, and that of five controls was 54.06+/-15 ng/mL. CONCLUSION: These results suggest that overexpression of TGF-beta1 and TGF-beta1RII expression may be involved in the formation of bullae. TGF-beta1 blood levels in patients with primary spontaneous pneumothorax is lower than normal people, suggesting that the high level of local TGF-beta1 expression in the bullous tissue region, but not in the whole blood, may contribute more in the formation of bullae.
Subject(s)
Aged , Female , Humans , Male , Antibodies , Blister , Enzyme-Linked Immunosorbent Assay , Formaldehyde , Lung , Paraffin , Pneumothorax , Thoracic Surgery, Video-Assisted , Transforming Growth Factor beta , Transforming Growth Factor beta1ABSTRACT
Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 32nd weeks gestation by using color doppler and "lying down" adrenal sign.
Subject(s)
Female , Pregnancy , Anal Canal , Cardiovascular System , Congenital Abnormalities , Diagnosis , Oligohydramnios , Prenatal Diagnosis , Ultrasonography , Urinary BladderABSTRACT
OBJECTIVE: This study was performed to determine whether large loop excision of the transformation zone (LLETZ) affects the outcome of pregnancy after 20 weeks gestation. METHODS: In a retrospective case control study 20 women who had undergone large loop excision of the transformation zone and were subsequently delivered at Ilsin Christian Hospital were identified between 1991 and 2003. 40 controls were identified and matched for age and parity from women delivered immediately before and after index cases. Maternal factors were analyzed such as pregnancy gestation, use of oxytocin, analgesia, whether labor was induced, mode of delivery, length of labor, estimated blood loss and birth weight of previous delivery. Perinatal outcome measured fetal weight and admission to the neonatal unit. RESULTS: There was no significant difference between the women who had undergone LLETZ and the controls except women delivered after LLETZ had increased rate of emergency cesarean section and amount of blood loss. CONCLUSION: Previous studies investigating pregnancy outcome after LLETZ have been generally reassuring and this study also have no difference. However, in this study women who were delivered after LLETZ had slight increased rate of emergency cesarean section, this may be related to adverse obstetrical history (recurrent abortion, infertility etc.). However socioepidemiological factors were not controlled and the small number of case groups were included, so larger controlled studies will be necessary to confirm this findings.
Subject(s)
Female , Humans , Pregnancy , Pregnancy , Analgesia , Birth Weight , Case-Control Studies , Cervix Uteri , Cesarean Section , Emergencies , Fetal Weight , Infertility , Oxytocin , Parity , Pregnancy Outcome , Retrospective StudiesABSTRACT
Helicobacter pylori has a diversity of vacA allelic types. The purpose of this study was to correlate the vacA status and the clinical outcome. After constructing specific primers for the vacA signal sequence, H. pylori-positive antral biopsy specimens were examined for the vacA status in 25 gastric ulcers, 31 duodenal ulcers, 22 gastric cancers, 42 chronic gastritis, and 8 gastroduodenal ulcers. The relationship between the vacA allele and the clinical disease was examined. The vacA genotype s1c/m1 is predominant in Korea (71/128, 55.5%). Other strains including s1b or s2 were not found in this study. s1c/m1 was more prominent in duodenal ulcers, than in gastric ulcers (p=0.041) and cancer (p=0.029). Seven out of 8 patients with gastric and coexistent duodenal ulcers had the s1c/m1 allele. No statistical differences in the positive rates of the s1a/m1, s1a/m2, and s1c/m2 alleles among the disease groups were found. In conclusion, s1c/m1 is the main vacA allele in Korea and it is particularly associated with duodenal ulcers.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Humans , Alleles , Amino Acid Sequence/genetics , Bacterial Proteins/genetics , Helicobacter Infections/physiopathology , Helicobacter pylori/genetics , Korea , Middle Aged , Molecular Sequence DataABSTRACT
Maximizing peak bone mass is advocated as a way to prevent osteoporosis. To evaluate the peak bone mass and the affecting factors in Korean women, we analyzed bone stiffness in 116 middle school students, 118 high school students and 115 female college students by using the Achilles densitometer (Lunar Corporation). Peak bone stiffness of Korean women was relatively lower than that of white women (94% of white women) and a rapid rise of bone stiffness was observed in those subjects 3-4 years after menarche. In adolescent females without menstruation, the bone stiffness was lower than that of adolescent girls with menstruation. The factors affecting the peak bone mass was similar to the risk factors of post menopausal osteoporosis: menstruation status, calcium intake and physical activity. The amount of calcium intake in Korean girls at the critical age (3-4 years after menarche) was lower than the RDA (requirement of daily allowance) at this age. To improve any program aimed at maximizing peak bone mass, further intensive study will be required to evaluate some other common factors affecting peak bone mass in Korean.