BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

No abstract available.
Hernia, Diaphragmatic*

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

"To evaluate whether different qualifications of a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con- secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as ""favor reactive (25%), favor low grade squamous intraepithelial lesion (LSIL) (24%), favor squamous intraepithelial lesion (SIL) (16%), favor high grade squa- mous intraepithelial lesion (HSIL) (16%), and not otherwise specified (19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the favor reactive, 27% in favor LSIL, 70% in ""favor SIL, 75% in favor HSIL, and 35% in not otherwise specified smears. There were significant associations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, rnost of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of ASCUS, favor LSIL circumspectly."
Biopsy ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Papanicolaou Test ; Venous Thrombosis*

STUDY DESIGN: Consecutive, prospective, radiographic review of adolescent idiopathic scoliosis (AIS) patients. OBJECTIVE: To analyze the change of Cobb angle according to position in AIS. SUMMARY OF BACKGROUND DATA: Cobb angle on standing radiographs was corrected spontaneously while the patients were in the supine position. However, there are few reports on Cobb angle in standing versus supine position in AIS. MATERIALS AND METHODS: We checked AP plain radiographs of 101 AIS patients, 18 male and 83 female, in standing and supine position. Sixty-three cases were under Risser stage V and 38 were Risser stage V. In standing plain radiograph, 27 cases were in Cobb angle 10-19 degrees, 35 in 20-29 degrees, 15 in 30-39 degrees, and 24 over 40 degrees. According to curve pattern, 31 curves were classified as King type I, 32 as type II, 8 as type III, 11 as type IV, 17 as type V, 1 thoracolumbar curve and 1 lumbar curve. Cobb angle reduction was measured on AP radiographs from each group, according to sex, maturation, Cobb angle and curve pattern. RESULTS: Average reduction of Cobb angle was 8.2 degrees(range, 1-21 degrees ), 6.4 degrees for male and 8.6 degrees for female (p=0.19). The reduction value according to maturation was 8.3 degrees for the growing group and 8.0 degrees for the grown group (p=0.73). The average reduction value in Cobb angle 10-19 degrees was 5.4 degrees(40.3%), 20-29 degrees was 7.1 degrees(30.9%), 30-39 degrees was 8.6 degrees(25.7%) and over 40 degrees was 12.8 degrees (23.6%) (p=0.001). The reduction rate decreased in proportion to Cobb angle measured in standing position. The reduction value was 8.2 degrees in King type I curves, 8.6 degrees in type II, 9.1 degrees in type III, 9.1 degrees in type IV and 6.2 degrees in type V (p=0.238). CONCLUSION: An average 8 degrees Cobb angle reduction in supine position, compared with standing position, can influence treatment strategy in AIS patients, because a Cobb angle change more than 5-6 degrees is a threshold value to decide curve worsening. Thus, serial Cobb angle measurement should be performed in standing position.
Adolescent* ; Female ; Humans ; Male ; Prospective Studies ; Scoliosis* ; Supine Position

To examine the protection of retinal cell death by glutamate antagonists in vivo, this study was carried out in pressure-induced ischemia model. Firstly, we observed that ischemia resulted in the similar retinaldamage to the injuries caused by NMAD and Kainate toxicity. Secondly, the retinal cell death caused by ischemia was prevented by MK801 and CNQX, glutamate antagonists for NMDA and Kainate excitotoxicity, respectively at 24hr after ischemia. MK801 was shown to prevent the cell death in ganglion cell layer and CNQX in inner unclear layer. In addition, the combination of CNQX and MK801 protected the retina neuronal cell from ischemic injury better than when they were applied separately. The partial protection of retinal cell death by glutamate antagonists in ischemia model indicates that glutamate eoxicity as well as other cell death mechanism such as apoptosis mediates ischemia induced retinal cell death. Thus, cell death by other mechanism must be also blocked in order to prevent retinal cell death, completely.
6-Cyano-7-nitroquinoxaline-2,3-dione* ; Apoptosis ; Cell Death ; Dizocilpine Maleate* ; Excitatory Amino Acid Antagonists ; Ganglion Cysts ; Glutamic Acid ; Ischemia* ; Kainic Acid* ; N-Methylaspartate* ; Neurons ; Retina ; Retinaldehyde*

In order to elucidate in vivo neuronal cell death in the retina, and involvement of NF-kappa B in this process, we studied the degeneration of retinal ganglion cells (RGCs) and the activation of NF-kappa B after transection of the optic nerve of adult rat at 5 mm from the eyeball. The morphology of dying ganglion cells in the retinal ganglion cell layer was observed by light and electron microscopy, the activation of NF-kappa B was investigated immunohistochemically. Seven and 14 days post-axotomy, dying cells contained pyknotic nuclei. The death of retinal ganglion cells involved apoptosis, activation of NF-kappa B (p50 and p65) was prominent in a time dependent manner. We observed axotomy-induced NF-kappa B activation, which may mediate apoptosis of retinal ganglion cells.
Animal ; Apoptosis/physiology ; Axotomy ; Immunohistochemistry ; Male ; Microscopy, Electron ; NF-kappa B/biosynthesis* ; Optic Nerve/surgery ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells/ultrastructure ; Retinal Ganglion Cells/pathology* ; Retinal Ganglion Cells/metabolism ; Substances: NF-kappa B

It has been known that activation of tyrosine kinases is involved in signal transduction. Role of the tyrosine kinase in vascular smooth muscle contraction was examined in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Male Sprague-Dawley rats underwent uninephrectomy, one week after which they were subcutaneously implanted with DOCA (200 mg/kg) and supplied with 1% NaCl and 0.2% KCl drinking water for 4-6 weeks. Control rats were treated the same except for that no DOCA was implanted. Helical strips of carotid arteries were mounted in organ baths for measurement of isometric force development. Genistein was used as a tyrosine kinase inhibitor. Concentration-response curves to 5-hydroxytryptamine (5-HT) shifted to the right by genistein in both DOCA-salt hypertensive and control rats. Although the sensitivity to genistein was similar between the two groups, the maximum force generation by 5-HT was less inhibited by genistein in arteries from DOCA-salt hypertensive rats than in those from controls. Genistein-induced relaxations were attenuated in arteries from DOCA-salt rats. Genistein affected the contraction to phorbol 12, 13-dibutyrate (PDBu) neither in DOCA-salt nor in control arteries. These observations suggest that tyrosine kinase is involved in 5-HT-induced vascular contraction, of which role is reduced in DOCA-salt hypertension.
Animals ; Arteries ; Baths ; Carotid Arteries ; Desoxycorticosterone Acetate ; Desoxycorticosterone* ; Drinking Water ; Genistein ; Humans ; Hypertension ; Male ; Muscle, Smooth, Vascular ; Phosphotransferases* ; Protein-Tyrosine Kinases ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Serotonin ; Signal Transduction ; Tyrosine*

PURPOSE: Inactivation of glycogen synthase kinase-3beta (GSK-3beta) by S9 phosphorylation is implicated in neuronal cell survival. In this study, we examined the involvement of GSK-3betaS9) phosphorylation on retina cell survival by sulindac (SLD) in model of retina ischemia. METHODS: Retinal ischemia was induced by increasing intraocular pressure to a range of 160 mm Hg to 180 mm Hg for 60 minutes in adult rats. SLD was treated pre and after (0.01 to 0.1 mM) ischemic injury. In vitro study, the retinas were isolated at postnatal 1-2day and were used to glutamate for ischemic injury. For morphological study, retinas were embedded in resin 24 hours after ischemic injury. The patterns of retinal cell were determined using light microscopy. Western blot analysis was performed using GSK-3beta(S9) and phospho-GSK-3beta(S9) antibodies. RESULTS: In ischemic animal model, cell death with necrosis and apoptosis was observed, treatment with SLD was reduced cell death. In vitro study, treatment of glutamate were reduce dose dependent manners, SLD treatment were decrease retina cell death. Western blot analysis of GSK-3beta(S9) phosphorylation known to induce neuronal cell survival, were increased in the SLD treated retina in ischemic injury. CONCLUSIONS: This study suggest that GSK-3beta(S9) is one of the effect by which SLD treatment protect retina from neuronal cell death.
Adult ; Animals ; Antibodies ; Apoptosis ; Blotting, Western ; Cell Death ; Cell Survival* ; Glutamic Acid ; Glycogen Synthase* ; Glycogen* ; Humans ; Intraocular Pressure ; Ischemia ; Microscopy ; Models, Animal ; Necrosis ; Neurons* ; Phosphorylation* ; Rats* ; Retina* ; Retinaldehyde ; Sulindac*