No abstract available.
Tibia*

This study was performed to evaluate the clinical symptom, fracture finding, and surgical outcome in children with orbital trapdoor fracture. Forty-four patients with pure orbital trapdoor fracture, under 18 yr of age, were included. Time interval between injury and surgery, length of time for improvement, resolution of ocular motility restriction, and other factors were analyzed in 36 patients who underwent surgery. The median improvement time was 3.5 days for patients (n=8) receiving surgery within 5 days, 18.0 for those (n=19) receiving surgery between 6 and 14 days, and 50.0 for those (n=9) receiving surgery after 15 days (p=0.03). One month after operation, the mean change in supraduction limitation was 3.50+/-0.53 for patients receiving surgery within 5 days, 2.11+/-1.24 for those receiving surgery between 6 and 14 days, and 1.67+/-0.82 for those receiving surgery after 15 days (p=0.04). Three months after operation, the mean change in supraduction limitation was 3.88+/-0.35, 2.94+/-1.55, and 2.50+/-1.38, respectively (p=0.14). In conclusion, trapdoor fracture of the orbit in children must be diagnosed by careful CT evaluation and clinical evidence of entrapment. For patients with severe limitation of ocular motility, early surgery within 5 days of injury leads to more rapid and better postoperative improvement.
Adolescent ; Adult ; Child ; Eye Movements ; Female ; Human ; Male ; *Orbital Fractures/pathology/surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

This study was performed to investigate the changes of tear film and ocular surface in diabetic patients, as well as the ocular and systemic factors related to these changes. We assessed the scoring of keratoepitheliopathy, corneal sensitivity test, tear film break-up time (BUT), Schirmer test, and conjunctival impression cytology in 94 eyes of 47 patients with noninsulin-dependent diabetes mellitus and in 60 eyes of 30 normal subjects. The degree of keratoepitheliopathy was severe, and the corneal sensitivity, BUT, and tear secretion were significantly reduced in the diabetic patients. Conjunctival impression cytology showed a higher grade of conjunctival squamous metaplasia and lower goblet cell density in the diabetic patients. All parameters were related to the status of metabolic control, diabetic neuropathy, and stage of diabetic retinopathy. We think that diabetic patients with poor metabolic control, neuropathy, and advanced stage of retinopathy should be examined for tear film and ocular surface changes.
Adult ; Aged ; Comparative Study ; Corneal Diseases/etiology/*metabolism ; Diabetes Complications/*metabolism/pathology ; Epithelium, Corneal/*metabolism/pathology ; Female ; Goblet Cells/pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Tears/*metabolism

PURPOSE: To evaluate the extent of lesion by using ultrasound biomicroscopy in eyelid tumor. METHODS: We retrospectively analyzed 17 patients with eyelid tumor, who had undergone preoperative ultrasound biomicroscopy to access the extent of the lesion and the depth of involvement, excision and biopsy. These data were compared to the histopathologic findings. RESULTS: On ultrasound biomicroscopic examination, the eyelid tumor showed greater homogeneous hypoechoic density or heterogenous echo density than that of the surrounding tissue, leading to identifying the lateral margin of the lesion and depth of involvement. The mean maximum thickness of the lesion measured by ultrasound biomicroscopy was 2.26 +/- 0.49 mm and that of the histopathologic depth was 2.22 +/- 0.56 mm. Linear regression demonstrated that lesion depth measured by ultrasound biomicroscopy was correlated with histopathologic depth. CONCLUSIONS: In eyelid tumor, ultrasound biomicroscopy is helpful in assessing the extent of the lesion and the depth of involvement preoperatively, and in obtaining good postoperative results.
Biopsy ; Eyelids* ; Humans ; Linear Models ; Microscopy, Acoustic* ; Retrospective Studies ; Ultrasonography*

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

PURPOSE: Differentiation of parathyroid and thyroid nodule is often difficult even with aids of ultrasonography and computed tomography. Tc-9m sestamibi (MIBI) scintigraphy is useful in the detection of hyperfuntioning parathyroid nodules. However, its role in the differentiation between parathyroid and thyroid nodules including malignancies is not well studied. Therefore, the purpose of this study is to evlauate the role of Tc-99m MIBI imaing in the differentiation of parathyroid adenoma from thyroid malignancy. METHODS: Six patients (4 women, 2 men, mean age 43 years) with parathyroid adenoma and 4 patients (2 women, 2 men, mean age 56 years) with thyroid papillary cancer were enrolled. Ten and 180 minutes after injection of 740 MBq Tc-99m MIBI, pinhole image of the anterior neck was obtained. Nodule-to-thyroid ratio (N:T) was measured from same sized region of interests over nodule and normal thyroid bed. Retention Index (RI) was calculated as N:T 10 minus N:T 180 divided by N:T 10. RESULTS: as those with thyroid cancer (1.09 ± 0.35, 1.24 ± 0.36, respectively, P>0.05 ). However, RI of parathyroid patients was higher than thyroid cancer patients (0.64 ± 0.29, -0.12 ± 0.20, respectively, P<0.05). CONCLUSION: Parathyroid adenoma showed higher retention rate of Tc-99m MIBI than thyroid cancer. Therefore, differntiation of parathyroid and thyroid nodule could be possible using Tc-99m MIBI scintigraphy.

PURPOSE: To identify the brain centers associated with visually evoked sexual arousal in the human brain, and to investigate the neural mechanism for sexual arousal using functional MRI (fMRI). MATERIALS AND METHODS: A total of 20 sexually potent volunteers consisting of 10 males (mean age: 24) and 10 females (mean age: 23) underwent fMRI on a 1.5 T MR scanner (GE Signa Horizon). The fMRI data were obtained from 7 slices (10 mm slice thickness) parallel to the AC-PC (anterior commissure and posterior commissure) line, giving a total of 511 MR images. The sexual stimulation consisted of a 1-minute rest with black screen, followed by a 4-minute stimulation by an erotic video film, and concluded with a 2-minute rest. The brain activation maps and their quantification were analyzed by the statistical parametric mapping (SPM 99) program. RESULTS: The brain activation regions associated with visual sexual arousal in the limbic system are the posterior cingulate gyrus, parahippocampal gyrus, hypothalamus, medial cingulate gyrus, thalamus, amygdala, anterior cingulate gyrus, insula, hippocampus, caudate nucleus, globus pallidus and putamen. Especially, the parahippocampal gyrus, cingulate gyrus, thalamus and hypothalamus were highly activated in comparison with other areas. The overall activities of the limbic lobe, diencephalon, and basal ganglia were 11.8%, 10.5%, and 3.4%, respectively. In the correlation test between brain activity and sexual arousal, the hypothalamus and thalamus showed positive correlation, but the other brain areas showed no correlation. CONCLUSION: The fMRI is useful to quantitatively evaluate the cerebral activation associated with visually evoked, sexual arousal in the human brain. This result may be helpful by providing clinically valuable information on sexual disorder in humans as well as by increasing the understanding of the neuroanatomical correlates of sexual arousal.
Amygdala ; Arousal* ; Basal Ganglia ; Brain ; Caudate Nucleus ; Diencephalon ; Female ; Globus Pallidus ; Gyrus Cinguli ; Hippocampus ; Humans ; Hypothalamus ; Hypothalamus, Middle ; Limbic System* ; Magnetic Resonance Imaging* ; Male ; Parahippocampal Gyrus ; Putamen ; Thalamus ; Volunteers

To identify the relation between simple reaction time and height and arm length, simple reaction time was performed to medical students with measurement of height, and arm length. Participants should answer questions about Smoking, drinking, sleep deprivation, history of diseaseand drug, whether to use computer or hot Mean height of men(n=98) was 173.0+/-4.79 cm, that of women (n-22) 161.7+/-4.33 cm. Mean arm length of men was 73.5+/-3.09 cm, and that of women 68.0+/-2.93 cm respectively. Height and arm length were statistically significantly different between-men and women (plt;0.01). Mean simple reaction time of men was 265.4+/-25.03 msec, that of women 286.8+/-28.48 msec. Mean simple reaction time was also statistically significantly different(p<0.01). As a result of correlation analysis, for men. None was significant. However, for women, height and arm length showed statistically significant, correlation with mean reaction time. Correlation coefficient of height and arm length were 0.45 (p<0.05) and 10.57 (p<0.05) respectively.
Arm* ; Drinking ; Female ; Humans ; Male ; Reaction Time* ; Sleep Deprivation ; Smoke ; Smoking ; Students, Medical

This study was performed to evaluate the changes of tear film and ocular surface caused by smoking. Symptom scoring, tear film break-up time (BUT), basal tear secretion test, corneal sensitivity test, keratoepitheliopathy scoring, and conjunctival impression cytology were performed in 29 smokers (58 eyes) and 26 non-smokers (52 eyes). Tear film BUT, basal tear secretion, corneal sensitivity, and squamous metaplasia were 7.71 +/- 2.66 sec, 6.29 +/- 2.85 mm, 53.69 +/- 5.69 mm, and 2.45 +/- 1.26 in smokers and 9.62 +/- 3.14 sec, 10.04 +/- 3.87 mm, 56.46 +/- 4.79 mm, and 1.12 +/- 0.83 in non-smokers, respectively (p< 0.05). Symptom score, keratoepitheliopathy score, and goblet cell density were not significantly different between the two groups. Tear film BUT was shorter, basal tear secretion and corneal sensitivity were lower, and squamous metaplasia was higher in heavy smokers than in light smokers. In conclusion, smoking deteriorates the tear film and ocular surface with decreased quantity and quality of tear film, decreased corneal sensitivity, and squamous metaplasia, and this deterioration is related to the amount of smoking.
Adult ; Aged ; Cell Count ; Conjunctiva/*metabolism/pathology ; Cornea/*metabolism/pathology ; Epithelial Cells/pathology ; Goblet Cells/metabolism/pathology ; Humans ; Lacrimal Apparatus/*metabolism/physiopathology ; Male ; Metaplasia ; Middle Aged ; Smoking/*metabolism/physiopathology ; Tears/chemistry/*secretion

PURPOSE: To investigate the perfusion characteristics of VX2 carcinoma and liver parenchyma in an animal model, and to evaluate the usefulness of perfusion CT in assessing the angiogenesis of hepatic VX2 carcinoma. MATERIALS AND METHODS: Ten rabbits (control, 5; VX2 carcinoma, 5) weighing 2.5 to 3.5 (average, 3.1) Kg were involved in this study. Between 7 and 14 days after implanting VX2 carcinoma, ultrasonography and CT were performed for the purpose of detecting this. Using the cine mode and involving four simultaneous sections, four perfusion CT images were obtained every second for 60 seconds. One radiologist measured the size of the region of interest (ROI) at each liver location, and using the time-density curves for each tumor and normal liver, semi-quantitative perfusion parameters -namely blood volume, mean transit time (MTT), blood flow, and time-to-peak enhancement-were determined. The microvascular densities (MVD) of VX2 tumors and normal liver were correlated with the perfusion CT findings. RESULTS: In the control group, there were no significant differences in perfusion parameters between the left and right hepatic lobes. In the VX2 carcinoma group, there were significant differences between the lobe containing the tumor and adjacent hepatic lobes with respect to blood volume (34.80 vs. 27.2 ml/100 g), MTT (14.1 vs. 19.4 sec), blood flow (119.7 vs. 84.3 ml/100 g/min), and time-to-peak (32.4 vs. 36.9 sec) (p<0.05). The blood volume (27.2 ml/100g) of the hepatic lobe with the VX2 tumor was higher than that of normal liver (22.8 ml/100 g) (p< 0.05), but blood flow (84.3 vs. 66.8 ml/100 g/min), MTT (19.4 vs. 21.3 sec) and time-to-peak (36.9 vs. 38.7 sec) values were not different. The MVD of VX2 tumors was higher than that of normal liver (p<0.05), and significantly higher than that of adjacent and contralateral liver (p<0.05). CONCLUSION: At perfusion CT, blood volume and blood flow of VX2 carcinomas increased more than those of normal liver, as were both mean transit time and time-to-peak. It was confirmed histopathologically that the angiogenesis of VX2 carcinoma was higher than that of normal liver. In conclusion, perfusion CT may be a practically useful diagnostic tool capable of reflecting the neoplastic angiogenesis of the liver.
Blood Volume ; Liver ; Models, Animal ; Perfusion* ; Rabbits ; Ultrasonography