A Case of Small Cell Lung Cancer Metastasis to the Gingiva / 결핵

The incidence of lung cancer and its mortality rate are increasing in Korea. At the time of diagnosis, 40% patients of lung cancer patients had metastatic lesions. The common metastatic sites are the contralateral lung, bone, liver, adrenal gland and the brain. Metastasis to oral mucosa is rarely encountered in lung cancer and metastasis to the gingiva is more uncommon. Approximately 1% of malignant carcinomas in the oral cavity are the result of metastases, and 10-25% of metastatic cancers originate from lung cancer. Clinically metastatic gingival lesions are benign including hemangioma, pyogenic granuloma, giant-cell granuloma or a peripheral fibroma. Often metastases to the gingiva are diagnosed too late and by the time they are detected, they have metastases to other organs. Here we report a case of small cell lung carcinoma that had metastased to the gingiva with review of relevant literature.

Short-term Effect of 0.2% Brimonidine(Alphagan) in Normal Koreans

Brimonidine(Alphagan)is a relatively selective-adrenoceptor agonist that activates receptor in the ciliary body, which lowers intraoculat pressure by decreasing aqueous production and increasing uveoscleral outflow. We investigated the short-term intraocular pressure lowering effect and side effect of 0.2% brimonidine in 8 eyes in 8 normal volunteers. Brimonidine was administered every 8 hours for 7 days. The intraocular pressure, pupil size, pulsatile ocular blood flow of both eyes, blood pressure, and pulse rate were obtained 2, 4 and 8 hours, and 1 and 7 days after instillation. The mean intraocular pressure was lowered in both eyes. The blood pressure, pulse rate, and pupil size were not changed before and after the instillation. The pulsatile ocular blood flow was not changed either, The only side effect which patients complanined of was nasal stuffiness in two of the patients. We concluded that 0.2% brimonidine is a good ocular hypotensive drug that has an intraocular pressure lowering effect in normal Koreans and also has few side effects.

The Change of the Anterior Chamber Inflammation by Lens Epithelial Cell Revoval in Cataract Surgery

Remained lens epithelial cells after the cataract surgery can cause anterior and posterior capsular opacity and other complications from the postoperative anterior chamber inflammation. The removal of lens epithelial cells(LEC) during the cataract surgery is important clinically. We measured the degree of the anterior chamber inflammation after the removal of LEC in 360 degree and the removal of LEC in 180 degree. The anterior chamber inflammation was measured by flare-cell meter postoperatively the 1st day, 4th day, 1st week, 2nd week, 3rd week, 4th week, and 3rd month, and compared the results with the anterior chamber inflammation after the cataract surgery without the removal of LEC. There were no significant differencies among the groups before the 2nd week. The degree of inflammation was decreased significantly in the groups postoperatively compared to the group in which LEC were not removed. And the inflammation was lower significantly in the group of the 360 degree removal than the group of 180 degree removal after the 2nd week postoperatively. We conclude that LEC removal in cataract surgery decreased the anterior chamber inflammation significantly after the 2nd week postoperatively.

Results of Surgical Management of Congenital Glaucoma

Congenital glaucoma is the disease that requires operation and its prognosis is not good. In our study, we estimated the operative results of congenital glaucoma. We retrospectively reviewed the medical records of 39 patients(65 eyes) who were diagnosed with and operated for congenital glaucoma since 1986 and followed at least 6 months thereafter. Operation included goniotomy, trabeculotomy, trabeculectomy, Holmium laser sclerostomy, and Seton operation. Twenty five patients were male and fourteen were female, and the mean age at diagnosis was 18.7 months. Mean operation number ws 2.5. Success rate after only one operation without further medication was 20.0%. Sucess rate after only one operation with or without medical treatment was 32.3%. Success rate after more than two operations was 50.8%, and overall success rate was 83.1%. First operation before 3 years of age and preoperative intraocular pressure below 25mmHg had the higher success rate. And initial cup to disc ratio has no influence on the success rate. In congenital glaucoma, they need mean 2.5 operations on the average for success.