A 49-year-old man had a 5-year history of left proptisis accompanied by headache, ocular pain, ocular motility and visual disturbance. Corrected visual acuity was 1.0 in the right and 0.2 in the left eye. There was 9mm of left proptosis by Hertel exophthalmometry. A hard, nontender mass was palpable in the superotemporal part of the orbit. Lateral and up gaze were impaired in the left eye. On the slit lamp examination of the left eye, there were moderate corneal edema and erosions resulting from lagophthalmos. Computed axial tomgraphy showed a large ill-defined massi with homogenous enhancement in the superior temporal part of the left orbit. The mass was removed by modified Kronlein operation as much as possible and diagnosed as the adenoid cystic carcinoma of the lacrimal gland by the light microscopic examination. The tumor cell already extended to contiguous bone, blood vessel. perineurium and adjacent muscles. One month after the operation, 5040 rad of radiation therapy was given. The mass was remarkably decreased in size after radiation. We are planning further radiation therapy now.
Adenoids* ; Blood Vessels ; Carcinoma, Adenoid Cystic* ; Corneal Edema ; Exophthalmos ; Headache ; Humans ; Lacrimal Apparatus* ; Middle Aged ; Muscles ; Orbit ; Peripheral Nerves ; Visual Acuity

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

A 33-year-old female suffered from bilateral mass in the medial area and epiphora for 20 years. The mass recurred after incomplete removal several times. Ocular examination showed that the puncta and papillae of the both lower and upper lids were completely missing. At operation, there was obstruction in the bony portion of the nasolacrimal duct. The mass was a distended lacrimal sac. The lacrimal sac and the mucosa of the nasolacrimal duct were compJetely excised in the right side. The excision of lacrimal sac and mucosa of the nasolacrimal duct and conjunctivo-rhinostomy using Jones tube were performed in the left side. Nine months after operation, the patient was happy with the results and there was no recurrence.
Adult ; Female ; Humans ; Lacrimal Apparatus Diseases ; Mucous Membrane ; Nasolacrimal Duct ; Recurrence

No abstract available.
Lithotripsy* ; Shock*

PURPOSE: To find if the alpha adrenergic blocker, terazosin, changes the PSA in BPH patients. MATERIALS AND METHODS: Patients with a PSA level over 2.5ng/ml, who visited our hospital with lower urinary tract symptoms, were reviewed, and excluded from having prostate cancer (n=101). After a routine check up for BPH, included history taking, a physical examination, laboratory examinations and a transrectal ultrasound, on their first visit, the PSA level and IPSS were checked again after 4 weeks of alpha adrenergic blocker (terazosin) management. RESULTS: The average size of the prostates and age of the patients were 40.6ml and 67.7 years, respectively. Overall, the PSA levels before the treatment was 4.12+/-2.03ng/ml, which decreased significantly, to 3.57+/-1.99ng/ml, after the terazosin treatment (p=0.002). The subgroups, divided by age, prostate size and IPSS score, all showed meaningful declines in the PSA levels, but with no statistical differences. CONCLUSIONS: The results from this research shows that terazosin treatment reduces the PSA levels in BPH patients complaining of lower urinary tract symptoms, and the changes in the pattern of the level may help to differentiate prostatic cancer, and reduce the incidence of a prostatic biopsy.
Adrenergic Antagonists* ; Biopsy ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Physical Examination ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Ultrasonography

No abstract available.
Emergencies ; Humans

PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with multi-organ involvement. Bones, cardiovascular system, central nervous system, kidney, skin and many different organs can be involved but laryngeal involvement has not been reported in literatures. The diagnosis of ECD was based on clinical manifestations and immunohistochemical findings including CD68(+), CD1a(-) and S100(-). Currently, Interferon-a is the most extensively studied agent in the treatment of ECD and serves as the 1st line of treatment. Surgical resection of involved lesions can be tried but it leads to temporary improvement. A 60-year-old man visited with respiratory symptoms because of ECD with laryngeal involvement. We resected the obstructive lesion to relieve the symptoms. Tissue biopsy gave a diagnosis of ECD. As it is rare to encounter ECD involving the larynx, we report this case with a review of literatures.
Biopsy ; Cardiovascular System ; Central Nervous System ; Diagnosis ; Epiglottis ; Erdheim-Chester Disease* ; Histiocytosis ; Humans ; Kidney ; Larynx ; Middle Aged ; Skin

No abstract available.

To investigate the morphologic evidence of acute renal failure by folate, histological, histochemical (PAS), enzyme histochemical (Na-K-ATPase, G6PD, and ALP), and ultrastructural studies were performed. The results are as follows: l) Oliguria was most severe 3 hours after folate and the urine volume was 24.8% that of the control group. 2) Histologically, dilatation of tubules, degeneration and focal necrosis of the cortical tubules, and PAS(+) droplets in the tubular lumen were noted. And also frequent mitoses, mild interstital connective tissue proliferation, and neutrophilic infiltrates were observed in the late stage. 3) On enzyme histochemical examination, the activities of Na-K-ATPase and ALP were decreased, but G6PD activity was increased in comparison with the control group. 4) The ultrastructural studies revealed cytoplasmic vacuoles, apical cytoplasmic blebbing, dense bodies, mildly swollen mitochondria, dilated endoplasmic reticulum, loss bf brush border of the proximal tubules, and loss of microvilli of the thin limb of Henle's loop. Later, marked attenuation or loss of infoldings of basal plasma membrane of the cortical tubules was recognized. According to above results, the cause of acute renal failure by late is thought to be the injuries of tubular epithelial cells including sodium pump secondary to tubular obstruction.
Rats ; Animals