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*

Many trials to get informations from arterial waveforms have been done. But it was not so simple as expected because of normally fluctuating characteristics of arterial waveform due to respiration, extracardiac neuro-humoral control, etc. By using power spctral analysis we can figure out powers of these extrinsic contribting factors as well as contours of individual pulse wave by harmonic analysis. The purpose of this study is to compare the results of power spectral analysis and some basic parameters of arterial waveform before and after anesthesia to establish the basic changes during halothane anesthesia. The analog informations, obtained from patients undergoing operation with radial artery cannulated for continuous monitoring, was obtained from analog output of the Cardiocap monitor. It was transformed to digital information by A/D converter and saved to IBM compatible computer with mathcoprocessor. The data was processed offline by the signal analysis software DADiSP version 1.05 with the same computer. Results of mean arterial pressure, heart rate, dp/dt, low frequency peak, high frequency peak and harmonic pulse contour analysis were compared before and after anesthesia. We could conclude that halothane anesthesia diminishes all powers of harmonic components of arterial wave and powers of extrinsic components that affect low frequency area.
Anesthesia* ; Arterial Pressure ; Chromonar ; Halothane* ; Heart Rate ; Humans ; Radial Artery ; Respiration

Recently, a hydroxyapatite sphere has been increasingly used as a buried integrated orbital implant for the great improved motility of the prosthesis after enucleation. To allow more rapid ascess of vasculature into the hydroxyapatite implant, Dacron as a new synthetic wrapping material of the implant for anophthalmic sockets had been used and compared histologically with donor sclera in rabbits. At 4 weeks after implantation, fibrovascular ingrowth was found mainly near the scleral windows, where fibrosis extended 2 mm centrally in scleral-wrapped implants. In Contrast, in Dacron-wrapped implants, there was extensive fibrovascular infiltration through Dacron filaments and windows as well, making the hydroxyapatite sphere completely invested with fibrovascular tissue to the center within 4 weeks of implantation. Thus, Dacron as a new wrapping material appears to allow a more rapid vascularization into the hydroxyapatite implant than other collagen material without any serious complications, resulting in early rehabilitation with an artificial eye.
Collagen ; Durapatite* ; Eye, Artificial ; Fibrosis ; Humans ; Orbital Implants ; Polyethylene Terephthalates* ; Prostheses and Implants ; Rabbits ; Rehabilitation ; Sclera* ; Tissue Donors*

The purpose of this study is to evaluate the histopathologic findings after experimental penetrating keratoplasty using Dacron-Gore-Tex(R) combined graft in rabbits and the clinical efficacy of the treatment of corneal perforation using synthetic materials. Type A which used end to end fixation showed better results than that of type B which used intralamellar fixation and, however, complications and instability of graft occured in most eyes of both types. Type C which modified type B and reduced the thickness of intralamellar portion of graft showed relatively good results compared with type A and B, but there was still instability. Leakage from anterior chamber in early postoperative period prior to fiibrovascular invasion into graft was considered as the main cause of instability of graft. Therefore we performed type D which emphasized on preventing leakage, and well-maintained anterior chamber without extrusion of graft, that is, the best result among all 4 types was observed until 6 weeks postoperatively. Although further study is needed, we think that Dacron-Gore-Tex(R) combined graft can be a good substitute for the management of corneal perforation.
Anterior Chamber ; Corneal Perforation* ; Keratoplasty, Penetrating* ; Polyethylene Terephthalates ; Postoperative Period ; Rabbits* ; Transplants*

The operative technic for the correction of hydronephrosis due to obstruction at ureteropelvic junction has been discussed. There are two different types of technics in pyeloplasty ; 1st. nondismembered pyeloplasty molds and restructures the obstructed ureteropelvic junction without completely dismembering it and 2nd. dismembered pyeloplasty interrupts the continuity of the transport system of the obstructed ureteropelvic junction. Since Andereon-Hynes reported the technics which belongs to dismembered pyeloplasty for retrocaval ureter in 1949, many articles with satisfactory result have been published. We report Anderson-Hynes pyeloplasty for hydronephrosis secondary to obstruction of the ureteropelvic Junction in 7 cases. Advantages of Anderson-Hynes pyeloplasty are as follows. 1. Complete excision of the obstructive segment. 2. Reduction of the dead space. 3. Excision of a good part of the sick pelvis. 4. Activation of latent pacemaker P cells.
Fungi ; Hydronephrosis ; Pelvis ; Retrocaval Ureter

A 66-year-old woman was admitted to our hospital because of a mass in the left abdomen. Ultrasonography, aortography and computed tomographic (CF) scanning revealed the mass occupying the entire left abdominal cavity and the left kidney displaced by huge and avascular mass. Also CT guided needle biopsy demonstrated liposarcoma. At operation, a huge yellow-brownish tumor found in the retroperitoneal space, was removed incompletely due to severe adhesion to the left external iliac artery The tumor was 12x11x10cm and weighed 560gm. Histologically, it was a pleomorphic type liposarcoma. She bas received adjuvant radiotherapy but recurred 10 months later.
Abdomen ; Abdominal Cavity ; Aged ; Aortography ; Biopsy, Needle ; Female ; Humans ; Iliac Artery ; Kidney ; Liposarcoma* ; Radiotherapy, Adjuvant ; Retroperitoneal Space ; Ultrasonography

To evaluate the possibility of Dacron patch for artificial sclera. Dacron(polyethylene terephthalate) which is readily available, biocompatable, safe, and inert synthetic material was implanted in the area of full-thickness scleral defect in rabbits. The histopathologic examinations showed that fibrovascular tissue invested into all interstices of Dacron filaments and fibroconnective tissue encapsulation around Dacron patch had strong connection with collagen fibers of recipient sclera at 4 weeks after graft There were no adverse reactions such as retinal detachment and fibrous proliferation into the vitreous cavity except mild inflammatory response of surrounding tissue at the early postoperative stage. As a result, Dacron graft showed successful firm adhesion to the recipient sclera without serious complications. Thus, We think that Dacron could possibly be used, instead of donor sclera, as artificial scleral graft material for the surgical treatment of perforating scleral diseases.
Collagen ; Humans ; Polyethylene Terephthalates* ; Rabbits* ; Retinal Detachment ; Sclera ; Scleral Diseases ; Tissue Donors ; Transplants*