As public awareness of the various warning signs of malignancy increases, so does the concern evoked by the self identified finding of mass in the head and neck area. Not all the palpable masses are always significantly abnormal, but any nontender mass especially to the adult is significant enough to warrant further full investigation and follow up, the object of which should be to determine the possibility of malignancy and urgency of treatment. Approach to the diagnosis of the neck mass is so important in that it affects decision regarding further evaluation would lead to the determination of the most efficacious mode of therapy, eventually to the good prognosis. So, it should be emphasized that approach to the diagnosis of neck mass should be planned, systematic and thorough, this begins with the taking careful history following performance of complete examination of the head and neck especially to the nasopharynx, tongue base, pyriform sinus, palatine tonsil and larynx. Then a number of laboratory and radiologic studies are available, following triple endoscopy under general anesthesia and blind biopsy if needed. The most important rule to keep is that any biopsy procedures should be delayed to the last modality of effort to the diagnosis and if it should be done, under the plan of radical neck dissection.
Adult ; Anesthesia, General ; Biopsy ; Diagnosis ; Endoscopy ; Follow-Up Studies ; Head ; Humans ; Larynx ; Nasopharynx ; Neck Dissection ; Neck* ; Palatine Tonsil ; Prognosis ; Pyriform Sinus ; Tongue

PURPOSE: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. RESULTS: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. CONCLUSION: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
Complement System Proteins ; Dipyridamole ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon

Hydroa vacciniforme is a very rare photosensitivity disorder. The primary skin lesion is a vesicle or bulla which then heals with vacciniform scarring. We report a case of hydroa vacciniforme recurred after 3 years period of quiescence in a 20 year-old man who had had history of the disease from the age of two. The duplication of the natural lesion, clinically and histologically, was successfully made by artificial UV-A irradiation on the patient's back.
Cicatrix ; Hydroa Vacciniforme* ; Photosensitivity Disorders ; Skin

No abstract available.
Stomach Neoplasms*

Posterior chamber intraocular lenses were implanted into 40 eyes with inadequate capsular or zonular support by securing both haptics of the lenses to the sclera at ciliary sulcus with 10-0 prolene sutures. Our follow-up of 36 eyes with scleral fixated posterior chamber intraocular lenses ranged from 2 months to 8 months(average 4.6 months). At the last follow-up visit. 31 eyes(86%) had a vision of 0.5 or better. Mean refractive error was -1.15 +/- 1.13D. which was -0.67 +/- 0.99D more myopic than predicted (p<0.05). Measurement of anterior chamber depth showed deeper than the control group of posterior chamber intraocular lenses without scleral fixation suture(4.18 +/- 0.42mm, 3.96 +/- 0.29mm, respectively), but which was not statistically significant(p>0.05). Additionally, the difference of postoperative axial length between two groups was not statistically significant(23.39 +/- 0.87mm, 23.42 +/- 0.75mm, respectively). In 4 eyes(ll %), minor intraoperative bleeding oceured but was absorbed spontaneously without any sequelae. One eye(3%) of minimal decentration of PCL, one eye(3%) of subluxation of PCL, and one eye(3%) of exposed scleral fixation suture were noted, but no serious postoperative complication, such as corneal edema, glaucoma, persistent uveitis, or retinal detachment was detected.
Anterior Chamber ; Corneal Edema ; Follow-Up Studies ; Glaucoma ; Hemorrhage ; Lenses, Intraocular* ; Polypropylenes ; Postoperative Complications ; Refractive Errors ; Retinal Detachment ; Sclera ; Sutures* ; Uveitis

The predictive accuracy of the SRK and SRKII formulas were compared in 113 pseudophakic eyes who had extracapsular cataract extraction with implantation of same type of posterior chamber IOL from Feburary 1990 to March 1991. These patients were folio we red up for at least 2 months postoperatively. Their best corrected visual acuities were above 0.5 and their astigmatisms were below 3 diopters by spectacles correction at the time of the last refraction. The results were as follows. 1. Overall, there were no significant differences in predictive accuracy between SRK and SRKII formulas. 2. The revised constant A for same type of implatnts, which constant A was 118.8. was 117.4 The SRK and SRKII formulas with revised constant A were more accurate than conventional formulas(p<0.001). 3. Our results suggested the constant A was to be revised appropriately according to the surgeon's individual regression analysis when using SRK or SRKII formulas for the calculation of intraocular lens power in Koreans.
Cataract Extraction ; Eyeglasses ; Humans ; Lenses, Intraocular* ; Visual Acuity

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

The morpologic change in the lens epithelial cell, which is metabolically the most active part of the lens, are closely related with the formation of the cataract. To evaluate the morphologic changes of lens epithelial cells in electric cataracts, the central 5-6mm of anterior lens capsule and adherent lens epithelial cells were obtained from patients with an electric cataract. One-half of the anterior lens capsule was examined with a light microscope using flat preparation, while the other half was examined with a transmission electron microscope. In the light microscopic findings, the lens epithelial cell, which has a hexagonal shape with monolayer in normal, lost its normal shape and was superimposed in pathologic areas. The electron microscopic findings showed that the number of mitochondria in the cytoplasm was increased. The rough endoplasmic reticulum in the cytoplasm was dilated and microfilaments were enriched. The dense bodies seen in the myofibrotic changes were observed lens capsule were also shown. The intracelluar vacuoles were seen in dying cells and growing of the cytoplasmic processes into the widened intercellular spaces were observed The authors recognized that the abnormal lens epithelial cells had altered cellular activity and that the cells in the patholoic areas had proliferated and degenerated.
Actin Cytoskeleton ; Cataract* ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Epithelial Cells ; Epithelium* ; Extracellular Space ; Humans ; Mitochondria ; Vacuoles

Transitional cell carcinoma(T. C. C) of the bladder is the most common neoplasm of the urinary tract, but it occurs infrequently in younger patients. T. C. C. of urinary tract under the age of 40 is often thought to be a milder form than in older age group. However the literature provides little information on this and is contradictory. So, a total of 28 patients 40 years or less presented with T. C. C. of bladder between Jan., 1968 and Dec., 1987 was followed up and analyzed. It would appear that bladder carcinoma in patients 30 years old or less has a favorable prognosis, but disease occurring when the patient is 31 to 40 years old has a much worse prognosis and is not different from that affecting the older age group.
Adult* ; Carcinoma, Transitional Cell* ; Humans ; Prognosis ; Urinary Bladder* ; Urinary Tract

No abstract available.
Colony-Stimulating Factors* ; Transplantation*