The lacrimal fossa can be invovled by a wide specturm of orbital pathology. The correct diagnosis is importantto avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimalfossa were evaluated with CT and clinical findings. The results were as follows: 1. Final diagnosis of 14 caseswith lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor incases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2.The duration of symptoms of pleumorphic adenoma was more than 1 year and characteristic CT findings were globularmasses with pressure erosion of the adjacent bone. Patient wih adenoid cystic carcinoma had a short history ofsymptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3.Patients wtih pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-definedinfiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The marginsof neurofibroma and chloroma were well defined while that of the metastatic adenocarcinoma was ill-defined. 5. Thedegree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each diseaseentities and even of the benign and malignant lesions.
Adenocarcinoma ; Adenoma ; Adenoma, Pleomorphic ; Carcinoma, Adenoid Cystic ; Diagnosis ; Diagnosis, Differential ; Humans ; Lymphoma ; Neurofibroma ; Orbit ; Pathology ; Sarcoma, Myeloid ; Sphenoid Bone ; Unnecessary Procedures

Kainic acid[KA], a glutamic acid analogue, has been widely used as a excitotoxin in the study of neurotoxicity due to its ability to induce strong excitation and to increase intracellular calcium concentration of the mature central nervous system[CNS] neurons. However, it is not well known whether KA is also strongly cytotoxic to the neurons of the postnatal brain. We have injected KA into rats at different developmental stages and have investigated the changes in the expression of c-fos[transcriptional factor and a marker of neuronal activity], heat shock proetin 72[hsp 72, a neuronal injury marker], and glial fibrillary acidic protein[GFAP, a neuronal injury marker] mRNAs, which are known to be increased in KA-induced neurotoxicity, and glyceraldehyde 3-phosphate dehydrogenase [GAPDH, a house keeping gene] mRNAs with in situ hybridization histochemistry using specific riboprobes. The expression of c-fos mRNA was first identified in the CA3 area of hippocampus from 6hr after KA treatment in P7 rats. The c-fos mRNA-expressing area and the level of expression was gradually increased from P7 to adult. Hsp 72 mRNA was first expressed in the dentate gyrus and hippocampus from 6hr after KA treatment in P2l rats. In the adult rats, hsp 72 mRNA was broadly expressed in the brain at 2hr after KA treatment. The increase of GFAP mRNA expression was first identified in Pl4 rat brain from 6hrs after KA treatment, and by the development of brain it tends to appear earlier. The expression of GAPDH mRNA, however, did not show changes after KA treatment except for the adult rats showing a slight decrease at 12hr after KA treatment. These results suggest that KA may offer different level of cytotoxicity to the developing neurons by their developmental status and the difference may be correlated with the completion of synaptogenesis and increase of KA receptor.
Adult ; Animals ; Brain* ; Calcium ; Dentate Gyrus ; Glial Fibrillary Acidic Protein ; Glutamic Acid ; Glyceraldehyde 3-Phosphate ; Hippocampus ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; In Situ Hybridization ; Kainic Acid* ; Neurons ; Neurotoxins ; Oxidoreductases ; Rats* ; RNA, Messenger ; Shock

No abstract available.
Hearing* ; Humans ; Tinnitus*

No abstract available.
Otoacoustic Emissions, Spontaneous*

No abstract available.
Aortic Aneurysm*

No abstract available.
Aneurysm, Dissecting* ; Paraplegia*

Three groups of patients with newely diagnosed hypertension, or with hypertension not optimally controlled by previous treatment, completed a comparative study on the effects of Dihydrochlorothiazide, propranolol, and prazosin on plasma lipids after three months therapy. The drugs showed equipotent antihypertensive effects(P<0.01). Dihydrochlorothiazide administration was associated with a significant elevation of total cholesterol(42%, P<0.05), and triglyceride(8.1%, P<0.01). Changes of HDL-C(5.1%), LDL-C(3.3%), and cholesterol ratio(-4.8%) were not significant. Propranolol administration was associated with significant elevation of total cholesterol(3.8%, P<0.05), triglyceride(14.5%, P<0.005), and LDL-C(5.6%, P<0.005). Reduction of HDL-C(-7.8%, P<0.05) and cholesterol ratio(-14.7%, p<0.005) was also statistically significant. Prazosin administration was associated with significant decrease in total cholesterol(-6.6%, P<0.005), triglycride(-9.6%, P<0.005), and LDL-C(-11.7%, P<0.005), and significant elevation of HDL-C(10.6%,P<0.005) and cholesterol ratio(24.2%, P<0.005) was noted.
Cholesterol ; Humans ; Hydrochlorothiazide* ; Hypertension* ; Plasma ; Prazosin* ; Propranolol*

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

24-hour ambulatory ECG monitoring has been examined for the evaluation of heart rate and longest pause in 34 patients with chronic atrial fibrillation (20 patients treated with digoxin and 14 patients without treatment). Following results were obtained: 1. In 34 patients, the mean of average heart rates was 75.7±13.8/minute, fastest heart rates 148.0±32.4/minute, slowest heart rates 48.1±8.4/minute, difference between fastest and slowest heart rates in individual patients 99.9±29.0/minute and longest pauses 2.95±1.06seconds. The longest pauses of more than 4.0 seconds occurred in 4 of the 34 patients and made an exception of comparison groups. 2. In 27 of the 34 patients, ventricular premature contractures were developed and in 11 of 27, mainly occurred less than 100/24 hours and aberrant conduction occurred in all patients. 3. In 20 patients treated with digoxin (0.25 mg/day), the mean of average heart rates was 78.4±13.7/minute, fastest heart rates 152.5±33.1/minute, slowest heart rates 48.9±8.5/minute, difference between fastest and slowest heart rates in individual patients 103.6±31.7/minute and longest pauses 2.55±0.50 seconds. 4. In 10 patients without treatment, the mean of average heart rates was 78.0±10.7/minute, fastest heart rates 154.5±26.8/minute, slowest heart rates 50.6±7.1/minute, difference between fastest and slowest heart rates in individual patients 103.9±22.2/minute and longest pauses 2.66±0.39 seconds. 5. The difference of heart rates and longest pauses between patients with treatment and without treatment were statistically not significant (P>0.05). In summary, authors seemed to consider that 24-hour ambulatory ECG was useful and safe method for clinical evaluation of patients with chronic atrial fibrillation.
Atrial Fibrillation* ; Contracture ; Digoxin ; Electrocardiography* ; Heart Rate ; Humans ; Methods

A 21-year-old man presented with a 7 days history of fever. Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly. Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.
Male ; Humans