Hydrops of the endolymphatic space in the inner ear deteriorates hearing and balance function. This idiopathic syndrome of endolymphatic hydrops is Meniere's disease and is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. For the pathophysiologic mechanisms of the episode, the progression of the hydrops leads to ruptures in the membranes separating endolymph from perilymph, producing a sudden increase in potassium concentration in the perilymph. Recurrent episodes may interfere with routine daily activities and sometimes accompany sudden drop attacks, so called Tumarkin's otolithic crisis, which may lead to serious injuries. Life style modification, low salt diet and prescription of diuretics have been traditionally tried in order to relieve endolymphatic hydrops. Surgical and destructive treatment options are necessary in selected intractable patients depending on the frequency of vertigo, severity of hearing loss and the possibility of bilateral involvement. However, a large proportion of these patients shows a spontaneous cure of vertigo with the aggravation of hearing loss (burnt out stage) over time. The goal of treatment is trying not to make the patient worse than this natural course of disease.
Diet ; Diuretics ; Dizziness ; Ear ; Ear, Inner ; Edema ; Endolymph ; Endolymphatic Hydrops ; Hearing ; Hearing Loss ; Humans ; Life Style ; Membranes ; Meniere Disease ; Otolithic Membrane ; Perilymph ; Potassium ; Prescriptions ; Rupture ; Syncope ; Tinnitus ; Vertigo

No abstract available.
Drug Therapy*

Giant cell tumor (GCT) occurs very unusually in the rib (less than 1% of GCT). We present the cytologic features of GCT of the rib. It showed multiple cellular clusters composed of characteristic, benign looking osteoclast-like multinucleated giant cells and fibroblast-like mononuclear cells. The multinucleated giant cells contained numerous nuclei (average, 30 to 40 per cell, which were closely packed. The nuclei in giant cells were remarkably uniform and round to oval. The mononuclear, neoplastic stromal cells were elongated and spindle-shaped, There was no cytologically malignant portion in the tumor.
Child* ; Giant Cell Tumors ; Giant Cells ; Humans ; Ribs ; Stromal Cells ; Urinary Tract*

No abstract available.
Child* ; Hemorrhagic Fever with Renal Syndrome* ; Humans

The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular changes due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypical cells may become standardized, but the cytologic criteria has not been well defined yet. We evaluated 160 cases of atypical squamous cells of undetermined significance(ASCUS) by the Bethesda System(TBS). Among 30,428 cases screened, a cytologic diagnosis of ASCUS was made in 498 cases(1.6%) and 160 cases were histologically verified. ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows: One hundred and twenty three cases(76.9%) revealed chronic cervicitis. Thirty seven cases(23.1%) demonstrated squamous intraepithelial lesion. Among intraepithelial lesions, condyloma and mild dysplasia were 28 cases(75.7%). Moderate and severe dysplasia were 5 cases(13.5%) and 4 cases(10.8%), respectively. It is concluded that patients with ASCUS should be colposcopically examined.
Breast ; Diagnosis ; Hemolytic-Uremic Syndrome* ; Humans ; Inflammation ; Pneumococcal Infections* ; Streptococcus pneumoniae* ; Streptococcus* ; Uterine Cervicitis

Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.
Adult ; Child* ; Collagen ; Cytoplasm ; Diagnostic Errors ; Follow-Up Studies* ; Histiocytoma, Malignant Fibrous ; Humans ; Hypercalciuria* ; Pilomatrixoma ; Pleura ; Sarcoma

BACKGROUND: Recent studies have suggested that house dust mite allergy is an important cause of the atopic dermatitis(A.D). However, it is not clear that. what factors may be related to the development of the mite illergy in patients with AD. OBJECTIVE: This study was done to see whether the presence of a familial background of RA implies a relationship to the mite allergy in AD. METHODS: Skin prick test and fluoroallergosorbent, test (FAST) with house dust mit,e were performed in 47 patients wih AD. RESULTS: 1. In comparison the esult of prick test with that of FAST to house dust mite antigen, it showed a concordance ra!e of 82%. And the prick test was more sensitive than the FAST. 2. The prevalence of positive FAST reactions was significantly increased in the patients with AD who had a family hitory of RA than those in patients with AD who had neither family or personal history of RA. 3. The level of specific IgE against house dust mite did not relate to the presence of family cr personal history of RA. 4. The prevalence of positive prick test results did not relate to the presence of family or personal history of RA. 5. The prevalence of positive FAST reactions, the level of specific IgE, and the rate of positive prick test results did not relate to the severity of skin involvement. 6. The most common allergens which caused positive skin reactions were house dust, cat fur, Dermatophagoides farinac, Dermatophagoides pteronyssinus, et al. Antigen score of prick test to 55 common antigens wa. significant increased in the patients with AD who had a family history of RA, but did not relat to the severity of skin involvement or the presence of personal history of RA. CONCLUSION: We may conclude that type I allergy to the house dust mit,e is not directly related to AD perse. This type of allergy to the mite seems to occur predominantly in those patient s with AD who have a farilial background of RA.
Allergens ; Animals ; Cats ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Prevalence ; Pyroglyphidae* ; Skin

No abstract available.
Vestibular Nuclei*

A 66 years old male presented with severe right-sided otalgia and throat pain, which persisted more than a year. He also complained of bilateral tinnitus. Tinnitus was continuous and high-pitched. Severe pain usually followed swallowing food. Pressing his right tonsil aggravated such symptoms. Pure tone audiogram showed both high frequencies hearing loss. Neck CT image revealed a small tonsillolith in his right tonsil. Gabapentin and non-steroidal anti-inflammatory drugs reduced the intensity of pain, but could not eradicate the pain. Finally, we performed radiofrequency tonsil ablation to eliminate right side tonsillolith. After ablation, pain immediately subsided and his tinnitus also disappeared. Tiny impacted tonsillolith may induce glossopharyngeal neuralgia and somatic tinnitus.

BACKGROUND: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75+/-9.74 years) RESULT: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06+/-10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombombolism free rate at 36 months were 96.9% and 98.4% respectively. CONCLUSIONS: The CarboMedics valve stands for low valve related complicatons.
Carbon ; Cardiac Output, Low ; Cause of Death ; Embolism ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Hemorrhage ; Mortality ; Polyethylene Terephthalates ; Thrombosis