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We report a rare case of squamous cell carcinoma of the chest wall in a patient with chronic empyema. The patient was a 74-year-old male who had been treated by closed chest drainage for empyema for 20 years until the development of carcinoma. He received chest wall resection followed by radiation therapy because of disseminated lesions comfirmed at surgery. However, his condition worsened gradually, and he died 2 months postoperatively. In the treatment of chronic empyema, we must pay attention to the possible association of malignant tumor for treating as early as possible, because the associated malignant tumor usually has a poor prognosis.

Background: Steroid treatment is believed to be effective for frosted branch angiitis, but frosted branch angiitis with retinal circulatory insufficiency does not have a good prognosis by steroid treatment alone. Here, we present a case of a patient that had a good outcome when treated with long-term active systemic betamethasone and vasodilation therapy for bilateral frosted branch angiitis with acute chorioretinal circulatory insufficiency., Case: A 69-year-old male presented with sudden visual loss in his left eye. The visual acuity was 1.0 in the right eye and 0.1 in the left eye. In his left eye, only mild inflammation occurred in the anterior chamber, but extensive inflammation such as sheathing of retinal vessels, retinal hemorrhage, and edema of the optic disc was present. Fluorescein angiography showed a delay of the arm-retinal artery circulation time and severe dye leakage from the retinal vessels. The following day, the visual acuity worsened to 0.1 in the right eye and hand motion in the left eye. Moreover, extensive inflammation was now present in both the anterior and posterior segments, and the sheathing of the retinal vessels developed to frosted branch-like angiitis. Doppler examination showed flow in the bilateral ophthalmic artery but did not show flow in the central retinal artery or posterior ciliary artery. These findings were compatible with the diagnosis of frosted branch angiitis with chorioretinal circulatory insufficiency. We initiated active systemic steroid therapy for 7 months and vasodilation therapy for 3 months. Two years later, the visual acuity improved to 0.5 in both eyes., Conclusion: Long-term active systemic steroid therapy for frosted branch angiitis with severe circulatory insufficiency in the retina and choroid may improve visual function.

One hundred and fifty five cases (237 eyes) of children with uveitis were clinically observed in the past 20 years. There was no fluctuation in the number of patients during the period. Concerning the age as the first visit, the smallest group was under 4 years of age and the numbers of patients increased at ages 14 and 15. Chief complaints usually corresponded to the age of the cases. Cases with anterior uveitis accounted for 25% of all cases, intermediate uveitis 12%, posterior uveitis 45% and panuveitis consisted of 17% of all cases, respectively. In the course of treatment, improvement of visual acuity was not statistically significant; the visual prognosis of cases affected under age 7 years was relatively poor. At the time of final observation, the visual acuity of cases, who had first visited during the past 10 years, were better than those who presented during the previous decade. Uveitis had healed or improved in 68% of cases treated in our clinic. As complications, band-shaped keratopathy was seen in 8% of the patients, cataract in 22% and glaucoma in 5%, respectively. Thirty two per cent of the cases received systemic steroid therapy and the average duration was 3.8 months. Fifty two operations were performed in 30 cases (19%), 37 eyes (16%); 16 were cataract operations and 24 were operations for glaucoma.

This report covers 7-year follow-up studies on 35 HBs Ag carriers whose anti-HBc titer levels were 10 (log 2) or more and who had normal liver functions at the start of the studies, when 9 of them (25.7%) were HBe Ag positive, 24 (68.6%) anti-HBe positive and 2 (5.7%) negative to both. 1. There was no significant difference in the incidence of abnormal SGPT levels as a whole between HBe Ag positives and anti-HBe positives. But abnormally high SGPT levels of 100 KU or more were observed at a higher percentage among HBe Ag positives (4/9. 44.4%) than among anti-HBe positives (1/24. 4.2%. p less than 0.02). 2. Based on the results of the 7-year studies, all cases were classified into six clinical stages. HBe Ag positives were divided into three groups by the stage with different SGPT levels: 5 cases (15.2%) whose SGPT leves never rose above 50 KU were classified as Stage 1; 3 cases with chronic active hepatitis (9.6%) whose highest SGPT levels were over 200 KU (2 new cases and 1 case with a relapse of chronic inactive hepatitis) as Stage 2 and 1 case (3.0%) seroconverted to anti-HBe positive following an acute relapse of chronic inactive hepatitis as Stage 3. Anti-HBe positives were divided into another three groups similarly according to their mean HBs Ag titer levels: 6 cases (18.2%) whose mean HBs Ag titer levels ranged from 10 to 13 (log 2) were classified as Stage 4; 13 cases (39.4%) whose mean HBs Ag titer levels ranged from 6 to 9 as Stage 5 and 5 cases (15.2%), including 2 cases turned negative to HBs Ag, whose mean HBs Ag titer levels were below 5 as Stage 6. The average age of each group increased wth its clinical stage, namely, 32.6 in Stage 1, 34.3 in Stage 2, 33.0 in Stage 3, 34.5 in Stage 4 and 37.0 in Stage 5, but the average age in Stage 6 was 29.0. 3. All HBe Ag positives showed fluctuations in HBs Ag titer levels. The fluctuations were particularly noteworthy among cases with chronic active hepatitis in Stage 2 during an acute relapse. The HBs Ag titers rose just before the acute relapses in a case of chronic active hepatitis when SGPT levels went over 200 KU. This suggested a proliferation of the virus. On the other hand, in anti-HBe positives, a decrement of the virus was suggested by the fact that an increasing proportion of cases showed their HBs Ag titer levels to fluctuate or to become lower with the progress of stages (p less than 0.05) and two cases turned negative to HBs Ag as plotted in Stage 6. And the proportion of cases with abnormal SGPT levels decreased with the progress of stages (p less than 0.05). One case whose SGPT level was 125 KU, highest among anti-HBe positives, followed the clinical course of chronic inactive hepatitis and lowered in HBs Ag titer. 4. Between HBe Ag and anti-HBe cases, there were considerable differences in the occurrence of liver disturbances and their clinical courses...