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*

The VATER syndrome is defined as a nonrandom association of congenital anomalies including three or more of vertebral(V), anal(A), tracheoesophageal(TE) and radial or renal(R) deficiencies. We experienced one case of VATER syndrome in a 20 month-old male having lumbarization of sacrum, congenital imperforate anus (Ladd and Gross`s type 3) with urethrorectal fistula and left megaureter with right renal agenesis and urethrocutaneous fistula
Anus, Imperforate ; Fistula ; Humans ; Infant ; Male ; Sacrum

No abstract available.
Plagiocephaly*

The correlation of ventilatory support with sex, age, operation time, aortic cross clamp time was studied in 274 patients undergone open heart surgery after dividing them into total, congenital heart disease, acquired heart disease groups. 1) Ventilatory support time was not significantly different between male and female. 2) In total group, ventilatory support time increased significantly with an increase of pump time, aortic cross clamp time (p<0.05) and age (p<0.01). 3) In congenital heart disease group, ventilatory support time increased significantly with an increase of operation time (p<0.05), pump time, aortic cross clamp time (p<0.001). 4) In acquired heart disease group, ventilatory support time increased significantly with an increase of age (p<0.001).
Anesthesia* ; Female ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Male ; Thoracic Surgery*

Transitional cell carcinoma of the bladder in children is the rarest tumor. Less than 20 cases in children have been reported in the literatures since the first report by Campbell in 1951. We report a case of papillary transitional cell carcinoma of the bladder in a 4-year-old boy and literatures were reviewed.
Carcinoma, Transitional Cell* ; Child ; Child, Preschool ; Humans ; Male ; Urinary Bladder*

Malignant melanoma is an uncommon tumor in Korea. To the best of our knowledge, we could not find malignant melanoma with multiple myeloma in Korean literature. A 57-year-old male patient had a 4×5 cm sized, irregular bordered, dark brownish plaque on the left sole, which has extended gradually since about 1 year ago and showed an occasional bleeding tendency. Laboratory examinations revealed a low hemoglobin level, rouleaux formation on peripheral blood, monoclonal gammopathy of IgG-kappa type and Bence-Jones proteinuria. Bone marrow aspiration findings showed markedly increased immature plasma cells suggesting multiple myeloma. Histopathologic findings of the skin biopsy from the left sole revealed proliferation of atypical melanocytes. We performed a surgical excision with a skin graft for malignant melanoma and chemotherapy (melphalan, vincristine and prednisolone) for multiple myeloma.
Biopsy ; Bone Marrow ; Drug Therapy ; Hemorrhage ; Humans ; Korea ; Male ; Melanocytes ; Melanoma* ; Middle Aged ; Multiple Myeloma* ; Paraproteinemias ; Plasma Cells ; Proteinuria ; Skin ; Transplants ; Vincristine

Although there had been many studies for evaluating an usefulness of expanded polytetrafluoroethylene(Gore-Tex(R)) as a temporary treatment of corneal perforation and a supporting skirt of keratoprosthesis, complications and instability of graft had limited the clinical applications. To find histopathologic factors that can contribute to the instability of graft and to try to modify the surgical methods with models of graft, serial examinations including biomicroscopy and histopathology were performed. According to the results, we were able to divide the causes of instability into two categories as a function of time. Epithelial down growth into the interface between graft and cornea with absence of epithelial coverage over the graft may cause leakage from anterior chamber in early period. Absence of fibrovascular invasion into Gore-Tex(R) resulting no cohesion between graft and cornea might be a factor of instability in late period. Based on these results, modification of surgical techniique and models of graft are needed. Several methods of modificiation are suggested in this report.
Anterior Chamber ; Cornea ; Corneal Perforation* ; Keratoplasty, Penetrating* ; Rabbits* ; Transplants