Adenoid cystic carcinoma (ACC) of lacrimal gland is the most common epithelial neoplasms of the lacrimal gland. This highly invasive tumor disseminates hematogenously, but also infiltrates between tissue planes along nerves and blood vessels into the surrounding bone, represents low rate of the survival and difficult to cure. We experienced the case of a 41-year-old woman who had complained pain and downward displacement of the right eye. These symptoms had been occured 5 months ago. The MRI and the histopathologic findings revealed adenoid cystic carcinoma of the right lacrimal gland. We performed the lateral orbitotomy followed by macroscopical complete resection of tumors being different from radical therapy. The patient received 6.000 cGy of postoperative radiation for prevention of recurrence of tumor. While she has been treated from 9 months ago, there was no evidence of metastasis and recurrence, and we obtained good cosmetic results with our treatment modality. So we present our case with a brief review of the literature.
Adenoids* ; Adult ; Blood Vessels ; Carcinoma, Adenoid Cystic* ; Female ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Recurrence

We report a patient with pachydermoperiostosis accompanied by hypertrophic gastritis. A 26-year-old man showed deep folds and furrows of the face and scalp, and terminal spade-like expansion of fingers and toes. Physical examination revealed no abnormalities except a grotesque appearance. Results of routine laboratory tests were unremarkable. Mild periosteal reactoins of both femurs and humeri were noted on long bone series, and hypertrophic gastritis on fibroscopic examination drew our attention. The relationship between pachydermoperiostosis and hypertrophic gastritis is uncertain. However it is probable that hypertrophic gastritis may be the endodermal counterpart of the ectodermal manifestations of pachydermoperiostosis.
Adult ; Ectoderm ; Endoderm ; Femur ; Fingers ; Gastritis, Hypertrophic* ; Humans ; Osteoarthropathy, Primary Hypertrophic* ; Physical Examination ; Scalp ; Toes

No abstract available.
Diazepam* ; Seizures, Febrile*

Many patients complain of near vision difficulty after PRK surgery. In the prospective study, we report the effect of PRK surgery for myopia on accommodation and binocular vision. 45 myopic eyes (39 patients, 9 males, 30 females) underwent PRK for myopia. Mean preoperative amplitude of accommodation in moderate degree myopia (group 1 < OR = -6.00D in shperical equivalent : range -2.45 ~ -6.00D) was 7.01+/-1.25D, mean preoperative amplitude of accommodation in high degree myopia (group 2 > -6.00D in spherical equivalent : range -6.10 ~ -10.75D) was 6.85+/-1.41D. Mean postoperative amplitude of accommodation of group 1 was 8.13+/-1.38D, mean postoperative amplitude of accommodation of group 2 was 7.80+/-1.33D, the difference of both groups were statistically significant(p>0.05). Mean preoperative amplitude of accommodation of all patients was 6.91+/-1.35D, mean postoperative amplitude of accommodation was 7.93+/-1.36D, the difference are statistically significant (p>0.01). 12 of 39 patients complained of near vision difficulty while reading after PRK surgery on their one eye, but 3 of them who underwent PRK surgery on their the other eye noticed the disappearance of near vision difficulty. Stereopsis was tested and 15 of 36 patient lost more than 50 sec/arc of streoacuity. Near vision difficulty was not related to the amount of myopia corrected, not related to the stereoacuity change but seemed to related to their adaptability or their reaction time of accommodation with their operated eyes.
Depth Perception ; Humans ; Lasers, Excimer* ; Male ; Myopia ; Photorefractive Keratectomy* ; Prospective Studies ; Reaction Time ; Telescopes* ; Vision, Binocular*

Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

No abstract available.
Neurofibromatoses* ; Pseudarthrosis* ; Radius*

No abstract available.
Congenital Abnormalities* ; Humerus* ; Osteotomy*

BACKGROUND: Primary hyperhidrosis is a disorder of excessive sweating, which shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oral glycopyrrolate is one of the treatments available. There are a few published studies on the use of glycopyrrolate given orally in the treatment of hyperhidrosis. METHODS: Thies is study was a review of case notes in a series of 36 patients with primary hyperhidrosis. We made a comparison between the Keller's scale score of a pre-glycopyrrolate medication group and the Keller's scale score f a post-glycopyrrolate medication group. The Milanez de Campos score, Short Form_36 (SF-36) score, Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the two groups. RESULTS: In the post-glycopyrrolate medication group, there were declines in Keller's scale, and Milanez de Campos scale score and BAI score (P < 0.001). In addition, there were increases in SF_36 score in the post-glycopyrrolate medication group (P = 0.03) However, no changes were seen in, BDI score and ANS score in the post-glycopyrrolate medication group (P < 0.001). CONCLUSIONS: Glycopyrrolate is an effective initial method of treating primary hyperhidrosis that, reduces anxiety and improve patients' quality of life.
Anxiety ; Anxiety Disorders ; Autonomic Nervous System ; Cholinergic Antagonists ; Depression ; Glycopyrrolate ; Humans ; Hyperhidrosis ; Quality of Life ; Sweat ; Sweating