Mucoepidermoid carcinoma occurs commonly in salivary gland, but rarely in lacrimal gland. In literature about ten or more cases of mucoepidermoid carcinoma of the lacrimal gland have been described. A 73-year-old woman had noted upper lid swelling and lacrimation of the left eye for 2 months. Computed tomographic scan demonstrated a large homogenous mass on superotemporal portion of the left orbit. The mass extended into the left temporal fossa, middle cranial fossa, and ethmoidal sinus with bone destruction. Histopathologically, the mass was proved to be a intermediate grade mucoepidermoid carcinoma of the lacrimal gland.
Aged ; Carcinoma, Mucoepidermoid* ; Cranial Fossa, Middle ; Female ; Humans ; Lacrimal Apparatus* ; Orbit ; Salivary Glands

PURPOSE: It is important to diagnose paragonimiasis in early active stage because it can be dured by chemotherapy. However, it is difficult to make a correct diagnosis of cerebral paragonimiasis in the early active stage, and the radiographic findings of cerebral paragonimiasis have been rarely reported. Thus, this experimental study was designed to produce early active cerebral paragonimiasis and to demonstrate radiologic-pathologic correlations. MATERIALS AND METHODS: In 8 cats, 7-8 metacercariae of Paragonimus westerrnani were directly introduced into the brain parenchyma of each cat's after trephination of the skull. In anogher 16 cats, the juvenile worms and the adult worms that had developed for varying periods (2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks) in the lunges of another cats were introduced into the brain parenchyma of each cat's with the same procedures described above. Follw-up MR images and chest radiographs were obtained at 2 days, 1 weeks, 2 weeks, 4 weeks and 8 weeks after innoculation. The autopsies and histopathological examinations of the cat's brain were undertaken in 22 cats. In 9 cats that were suspected with pulmonary lesions on chest radiograph, the soft tissue radiographs of inflated-fixed lungs were obtained. RESULTS: In one cat with innoculation of adult worm, acute suppurative inflammation of the brain parenchyma was demonstrated. But the other cats with innoculction of adult worm or juvenile worm and the cats with innoulation of metacercaris did not reveal any evidence of acute cerebral paragonimiasis. More than half of the introduced metacercariae(5 out of 8 cats) were found in the lung parenchyma, while only 25%(4 out of 16 cats) of the adult worm innoculated cats were. CONCLUSION: Acute suppurative inflammation suggesting acute stage cerebral paragonimiasis was obtained in one case of adult worm innoculated cat. Most of the innoculated metacercariae and some of the juvenile worms or adult worms were migrated to the lungs.
Adult ; Animals ; Autopsy ; Brain ; Cats* ; Diagnosis ; Drug Therapy ; Humans ; Inflammation ; Lung ; Metacercariae ; Paragonimiasis* ; Paragonimus ; Radiography, Thoracic ; Skull ; Trephining

No abstract available.
Population Characteristics* ; Thyroid Gland* ; Thyroiditis*

BACKGROUNDS: As the elderly population in-creases the health problem, especially dementia, becomes the clinically important problem. So in the part of primary care medicine it becomes so important that family physician make a focus on the detection, evaluation, and management of demented patient. Until nowadays there is few cohort study about the dementia and few nursing home in Korea. So author performed the MMSE-K in the elderly who are over 65 to get the cognitive function for early diagnosis, management and rehabilitation of psychosocial problem. METHODS: One hundred three persons who included in community society in Seoul and nursing home of Kyunggido were tested. The survey was done twice on september 1997 and September 1998. Author used the MMSE-K to the elderly by same doctors. The analysis was done by SAS 6.12 and t-test, one-way ANOVA and two-way ANOVA with linear trend test. RESULTS: The mean of first MMSE-K score in the community is 26.1 and in the nursing home is 24.4. And the mean of second MMSE-K score in the community is 25.5 and in the nursing home is 22.0. The MMSE-K score is elevated with male and longer duration of education and is decreased with the advanced age in two groups. According to the classification by MMSE-K score the number of people who have normal cognitive function is 45(43.7%), mild impaired cognitive function is 45(43.7%), moderately impaired cognitive function is 13(12.6%) and none has severely impaired cognitive function in both groups. The follow up MMSE-K score shows that the difference of two MMSE-K scores increases as the age increases. CONCLUSION: Until todays there is few study that designed in the form of cohort study about the elderly cognitive function in Korea. So family physicians must perform the prospective cohort study with the consistent concern and effort to get the research data about the dementia for earthy detection, management and rehabilitation for elderly.
Aged* ; Classification ; Cohort Studies ; Dementia ; Early Diagnosis ; Education ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Male ; Nursing Homes ; Physicians, Family ; Primary Health Care ; Rehabilitation ; Seoul

PURPOSE: We tried to evaluate the effect of oxalate on the growth of distal renal tubular epithelial cells MATERIALS AND METHODS: Madin-Darby canine kidney(MDCK) cell line, derived from canine distal renal tubular epithelial cell, supplied from American Type Culture Collection was used in this study. RPMI 1640 containing 10mM HEPES-buffer, 100IU/ microliterpenicillin, 100 microgram/ microliterstreptomycin, 300 microgram/ microliterglutamine, and with or without 10% fetal bovine serum(FBS) was used as the culture media. And the cell survivals under various concentrations of ammonium oxalate were assessed by MTT assay. RESULTS: Exposure of MDCK cells to oxalate resulted in a concentration dependent suppression of the cell growth in both 10% FBS supplied media and FBS deprived media. CONCLUSIONS: From these observations we could conclude that oxalate is not a mere constituent of calcium oxalate stone, but oxalate might offer a good environment for calcium oxalate stone formation in the urinary tract via MDCK cellular damage.
Calcium Oxalate ; Cell Line ; Culture Media ; Epithelial Cells* ; Madin Darby Canine Kidney Cells ; Oxalic Acid ; Urinary Tract

We experienced a case of aeute cerebral infaretion after operation. A 74 year old female patient slipped down and received left femoral neck fracture. Preoperatively, orthopedist, internist and anesthesiologist visited and evaluated her but could not find any suspicious symptoms related to cerebral infarction. She have suffered from hypertension and diabetes mellitus for 1Q yrs. She underwent bipolar endoprosthesis under general anesthesia. Postoperatively, she became deep drowsy and revealed respiratory depression, abnormal neurological sign and was diagnosed as acute cerebral infartion on cranial computed tomography and ultimately expired.
Aged ; Anesthesia, General* ; Cerebral Infarction* ; Diabetes Mellitus ; Female ; Femoral Neck Fractures ; Humans ; Hypertension ; Respiratory Insufficiency

Dedifferentiated chordoma (DC) is defined as a chordoma containing sarcoma components. DC is distinguished from conventional chordoma by the rapidity of tumor growth and the potential for distant metastasis. We report two cases of DC, which are developed in the sacrum. We reviewed the medical records and imaging studies of 2 patients diagnosed with DC and the literature published. In the first case, percutaneous biopsy revealed that it was conventional chordoma in the sacrum. Patient underwent radiation therapy (RT). Six years after the RT, the tumor recurred. Surgical removal was performed and the recurrent tumor was diagnosed as DC in histopathologic examination. In the second case, a patient underwent gross total resection of sacral tumor, which was diagnosed with conventional chordoma. Aggravated tumor was detected after 4 months, and patient underwent reoperation. The second operation revealed the transformation of the tumor into DC. The survival time of the patients after the diagnosis was 10 and 31 months. Dedifferentiated chordoma is a rare and highly aggressive tumor. De novo type exists, but it usually transformed from recurrent chordoma after surgical resection or radiation.
Biopsy ; Chordoma* ; Diagnosis ; Humans ; Medical Records ; Neoplasm Metastasis ; Reoperation ; Sacrum* ; Sarcoma

Ureteroscopy has been used widely to remove urethral calculi, especially distal ureter stones. In this study we tried to evaluate the exact role of ureteroscopic manipulation for ureter stones in the era of ESWL. We report our experience on performing ureteroscopic removal of ureteral calculi without anesthesia. Between August 1994 and August 1996, ureteroscopy was performed in 62 cases without anesthesia. We examined the feasibility of performing ureteroscopy under sedation only. Age distribution was 17~71 years old (mean 49.3). Overall success rate was 91.9% (57 cases among 62 cases). The success rates according to sex were 92.9% in male and 91.2% in female. The success rates according to location were 100% in proximal ureter, 83.3% in middle ureter and 92.6% in distal ureter. The success rates according to size were 92.7% in < or =10 mm and 85.7% in >10 mm stone patients. We could not find any statistical meaning about the success rates according to sex, location and size (p>0.05). In 7 cases the procedure were performed at outpatient department. Mean duration of hospitalization (in 55 cases) was 3.83 days. The associated complication rate was relatively low (8.1%), with most patients being treated conservatively. We conclude that ureteroscopy, when performed without general or regional anesthesia, does not increase the risk of complications or compromise the results of treatment. So we recommend ureteroscopy without anesthesia as a primary choice in the manipulation of urethral calculi.
Age Distribution ; Anesthesia* ; Anesthesia, Conduction ; Calculi ; Female ; Hospitalization ; Humans ; Male ; Outpatients ; Ureter* ; Ureteral Calculi* ; Ureteroscopy

Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta (PLEVA), or febrile ulcerative Mucha-Haberman disease (FUMHD) is very rare, but potentially lethal variants of PLEVA. This subtype is characterized by rapidly progressive ulceronecrotic lesions and systemic manifestations, such as high fever, gastrointestinal, neurological, cardiologic and pulmonary involvement, and rheumatologic manifestations. Several treatments with variable response have been challenged, such as systemic steroid, antibiotics, methotrexate, dapsone, cyclosporine and ultraviolet therapy. But there is no standard therapy for FUMHD to date. We report a 59-year-old woman with FUMHD, who recurred after discontinuation of systemic steroid, but successfully treated with oral cyclosporine.
Anti-Bacterial Agents ; Cyclosporine ; Dapsone ; Female ; Fever ; Humans ; Methotrexate ; Middle Aged ; Pityriasis ; Pityriasis Lichenoides ; Ulcer ; Ultraviolet Therapy

Giant aneurysms present challenging problems with conventional techniques because the lesion is in a difficult area or lacks a definitive aneurysmal neck. For the safety of operation and protection from cerebral ischemia, deep hypothermic circulatory arrest and cerebral protection with barbiturate is considered a useful technique. But deep hypothermia may produce myocardial depression and coagulopathy with high mortality. We report our experience with cardiopulmonary bypass with deep hypothermic circulatory arrest for the management of a patient with giant aneurysm of basilar artery and mild coronary artery stenosis. No significant complications were related to the technique of cardiopulmonary bypass with deep hypothermic circulatory arrest.
Aneurysm* ; Basilar Artery* ; Brain Ischemia ; Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced* ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Humans ; Hypothermia ; Mortality ; Neck