BACKGROUND: Anesthesiologists should understand the physiology of intraocular pressure and the implications of anesthetic drugs and maneuvers on intraocular pressure(IOP). Although most anesthetics reduce IOP, succinylcholine causes a transient but significant increase in IOP. And thiopental by itself does not prevent to increase blood pressure, IOP. This study was designed to evaluate the preventive effect of propofol on IOP changes during tracheal intubation. METHODS: IOP was measured with a hand-held applanation tonometer in the eye. Baseline(control) IOP was measured before the induction of anesthesia(stage 1) and serial measurements of IOP were made after administration of the induction agent before intubation(stage 2), immediately after intubation(stage 3) and 10 minutes after intubation(stage 4). Heart rate and systolic blood pressure were recorded simultaneously. According to induction agent and neuromuscular blocker, the 60 patients were divided into control group(C; thiopental, succinylcholine), pretreatment group(T) using defasciculation dose of vecuronium bromide, propofol group(P; propofol, succinylcholine) and vecuronium group(V; propofol, vecuronium bromide). RESULTS: Administration of either propofol or thiopenal resulted in a significant reduction in IOP(P<0.01). At stage 2, IOP of gpoup P and V were significantly lower than that of group C(P<0.05). At stage 3, IOP increased significantly compared to the values of stage 1 in all group(P<0.01). At stage 4, IOP decreased significantly compared to the values of stage 1 in all group(P<0.01), but there was no significant difference between groups in IOP at stage 4. CONCLUSIONS: Propofol may be a useful induction agent of general anesthesia for opthalmic surgery, but cannot prevent to increase IOP during endotracheal intubation.
Anesthesia, General ; Anesthetics ; Blood Pressure ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation* ; Intubation, Intratracheal ; Neuromuscular Blockade ; Physiology ; Propofol* ; Succinylcholine ; Thiopental ; Vecuronium Bromide

Clinical manifestations of hypothyroidism are very various and these degree are related to the severity and duration of the disease. Pericardial effusions, one of the manifestations of hypothy-roidism, were relatively common in the past. However, recently they may not be so frequent representative of hypothyroid subjects. The higher frequency of Hashimotos thyroiditis in Turners syndrome, especially those with an X-isochromosome, compared with the general population is well known. The pathophysiological process of autoimmunity is thought to be linked with the presence of an abnormal X-chromosome. Recently we experienced a case of X-isochromosome Turners syndrome with hypothyroidism and pericardial effusion and report it with reviews of the literatures.
Autoimmunity ; Hypothyroidism* ; Pericardial Effusion* ; Thyroid Gland ; Thyroiditis ; Turner Syndrome*

Mitral valvular heart diseases are known to be one of the easily detectable and the hemodynamic chane to the severity and duration of diseases can directly be described by echocardiography. The objective of this study was to determine the echocardiographic characteristics in 3 groups of mitral valvular diseases, that is mitral stenosis(112 cases), mitral stenoinsufficiency (66 cases). and mitral insufficiency(20 cases). 1) In mitral valve study, closing velocity of anterior leaflet reduced in mitral stenosis than other two groups and DE amplitude was greater in mitral insufficiency but there were no significant differences in 3 groups of mitral valvular diseases. DE and AC slope were slightly more rapid in mitral stenosis group and left ventricular outflow tract was much increased in mitral insufficiency group. 2) In aorta and left atrium study, aortic cusps separation was much increased in mitral insufficiency and left atrium was slightly more dilated in mitral stenoinsufficiency than other two groups. But left atrial dimension in mitral insufficiency was more diminished than that in mitral, stenosis, which is probably due to the short durationn of diseases and small range of materials in mitral insufficiency group. 3) In left ventricle study, thickness of interventricular septem, LSa, Ena, left ventricular dimension, LVPW, LV volume. and stroke volume were more increased in mitral insufficiency than mitral stenosis, because of the left ventricular volume overloading. Vcf and PEP/LVET were higher in mitral insufficiency than other two groups. Ejection fraction and fractional shortening were more diminished in mitral stenoinsufficiency but no significant difference was found. 4) In right ventricle study, there were no remarkable changes in right ventricular dimension and right ventricular internal dimension index in all 3 groups of mitral valvular diseases. 5) Calcification of mitral leaflets was observed in 85.7% of mitral stenosis, 90.9% of mitral stenoinsufficiency and 10% of mitral insufficiency, but heavy calcification was more remarkable in mitral stenosis group(25%). 6) Atrial fibrillation was observed in 47% of total mitral valvular diseases, mitral stenosis being 43.8%, mitral stenoinsufficiency 60.6% and mitral insufficiency 20%. In cases of atrial fibrillation, left atrial dimension was significantly enlarged compared with the group without atrial fibrillation.
Aorta ; Atrial Fibrillation ; Constriction, Pathologic ; Echocardiography* ; Heart Atria ; Heart Valve Diseases* ; Heart Ventricles ; Hemodynamics ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Stroke Volume

Lipoma is a benign fatty tumor that can arise in any location of the body where fat is present. It is found most commonly in the upper half of the body, particularly the head and neck, shoulders, and back. A mass in the antero-inferior part of the neck may be initially thought to be thyroid masses and then other cervical masses should be considered. Ultrasongraphic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. Although the location of tumors, its consistency, and its motion with deglutition, seperation from the thyroid on sonographic examination, all pointed to nonthyroidal origin, did not rule out a possible mass that isolated from the lobes of the thyroid. Fine needle aspiration and biopsy can provide clear answer.We herein report a case of anterior cervical mass in a 48-yr-old male patient presenting a non-tender, slightly hard and nodular mass slowly growing for several years and moved with swallowing, and diagnosed his case as benign lipoma using thyroid scan and ultrasonography. When we encounter patients with anterior neck mass, we should consider benign lipoma mimicking diffuse goiter.
Biopsy ; Biopsy, Fine-Needle ; Deglutition ; Goiter ; Head ; Humans ; Lipoma ; Male ; Neck ; Shoulder ; Thyroid Gland ; Ultrasonography

Classification ; Consensus ; Diagnosis ; Hematologic Neoplasms ; Hematology ; Lymphoid Tissue

Foxg1 (previously named BF1) is a winged-helix transcription factor with restricted expression pattern in the telencephalic neuroepithelium of the neural tube and in the anterior half of the developing optic vesicle. Previous studies have shown that the targeted disruption of the Foxg1 gene leads to hypoplasia of the cerebral hemispheres with severe defect in the structures of the ventral telencephalon. To further investigate the molecular mechanisms by which Foxg1 plays essential roles during brain development, we have adopted a strategy to isolate genes whose expression changes immediately after introduction of Foxg1 in cultured neural precursor cell line, HiB5. Here, we report that seventeen genes were isolated by ordered differential displays that are up-regulated by over-expression of Foxg1, in cultured neuronal precursor cells. By nucleotide sequence comparison to known genes in the GeneBank database, we find that nine of these clones represent novel genes whose DNA sequences have not been reported. The results suggest that these genes are closely related to developmental regulation of Foxg1.
Animals ; Base Sequence ; Brain ; Cell Line ; Cerebrum ; Clone Cells ; Neural Tube ; Neurons ; Rats ; Stem Cells ; Telencephalon ; Transcription Factors

A large number of studies for genes involved in oncogenesis have been done during last decade. Over 20 oncogenes have been isolated characterized, and the oncogene expressions in human tumors have been examined. The proto-oncogenes of c-Myc, c-Fos and c-Jun, which modulate the transcription factors, have overexpressed in a variety of human cancers. Immunohistochemical method was used in this study to examine c-Myc, c-Fos and c-Jun oncoprotein expression in 31 patients with human pheochromocytoma 28(90.0%) were benign and 3(10.0%) malignant. C-Myc oncoprotein immunoreactivity was found in 24 cases(77.4%), c-Fos in 29(93.5%), and c-Jun in 25(80.6%). Twenty-one(67.7%) showed positive immunoreactivity for all these oncoproteins, six(19.4%) for 2 oncoproteins, 3 for one oncoprotein. Only 1 case showed negative immunoreactivity for all 3 oncoproteins. The oncoprotein immunoreactivity did not correlate with the amount of 24 hour urinary catecholamine excretion. Although the number of malignant pheochromocytomsa was not so many, most of them showed that the immunoreactivity for oncoprotein was more than 30 percent of tumor cells.The expression of c-Myc, c-Fos and c-Jun oncoprotein were frequently found in human pheochromocytoma. These results suggest that the oncoprotein expression may play an important role in tumorogenesis and proliferation of human pheochromocytoma.
Carcinogenesis ; Humans ; Methods ; Oncogene Proteins ; Oncogenes ; Pheochromocytoma ; Proto-Oncogenes ; Transcription Factors

Hyperprolactinemia is the most common hypothalamo-pituitary disorder encountered in clinical endocrinology. Excluding the drug-induced hyperprolactinemia, the most common cause of this disorder is a pituitary tumor. Prolactinoma is mainly made up of prolactin-secreting cells but pseudoprolactinoma is tumor that does not secrete prolactin itself. The pseudoprolactinoma interrupts the flow of prolactin inhibiting factor, dopamine, from the hypothalamus through the pituitary stalk to the normal pituitary. The differentiation prolactinoma from pseudoprolactinoma is vitally important since true prolactinomas are most commonly responded well in terms of tumor shrinkage to medical treatment using dopamine agonist therapy, whereas pseudoprolactinomas do not. Thus surgical treatment is clearly indicated as first-line treatment if we know that a lesion is a pseudoprolactinoma. We compared prolactinoma with pseudoprolactinoma in clinical and endocrinologic characteristics of 48 cases after immunohistochemical diagnosis. We could not find any differential point of both tumors in clinical and radiological characteristics although some differences were exist. But we had found the relationship between the mean level of pretreatment serum prolactin and the presence of positive immunohistochemical stain for prolactin. The pretreatment serum prolactin level was significantly higher in patients with tumors showing many prolactin immunohistochemical staining cells than in those with none(p<0.05). When the pretreatment serum prolactin exceeded 100ng/ml, the tumors contain 94% of prolactin positive cells in stain. So, if the pretreatment serum prolactin exceeds 100ng/ml, we primarily suspect prolactinoma and medical treatment should be considered. If the pretreatment level below 100ng/ml, we suspect pseudoprolactinoma and surgical treatment should be considered.
Diagnosis ; Dopamine ; Dopamine Agonists ; Endocrinology ; Humans ; Hyperprolactinemia ; Hypothalamus ; Pituitary Gland ; Pituitary Neoplasms ; Prolactin ; Prolactinoma

No abstract available.
Body Composition* ; Bone Density* ; Female ; Humans

The causes of central diabetes insipidus (CDI) are numerous; some primary cases are idiopathic while most secondary cases are surgically induced or the result of tumor. The frequency of metastatic tumor as a cause of DI is 6% to 20% of cases, Variety of malignancies including breast, lung, colon, prostate cancer, and leukemia/lymphoma have been reported to metastasize to the pituitary, although most patients are asymptomatic. Clinical manifestations of pituitary metastases include anterior pituitary failure, visual disturbance, and extraocular muscle weakness. DI is the most common clinical manifestation of hypothalamic-pituitary axis (HPA) metastases. Anatomical basis far this clinical picture is that most metastases occur in the posterior lobe. We report on a 35-year-old male patient with meningeal involvement of malignant lymphoma that was thought to be associated with DI. Confirmation of primary malignancy was made by biopsy at site of cervical lymph node and tonsil, Pituitary involvement was suspected on brain MRI, and satisfactory symptornatic relief was obtained with vasopressin. Because of the progres-sion of underlying lymphorna that has shown no response to combined anticancer chemotherapy, the patient expired on 60th hospital day.
Adult ; Axis, Cervical Vertebra ; Biopsy ; Brain ; Breast ; Colon ; Diabetes Insipidus, Neurogenic* ; Drug Therapy ; Humans ; Lung ; Lymph Nodes ; Lymphoma* ; Magnetic Resonance Imaging ; Male ; Muscle Weakness ; Neoplasm Metastasis ; Palatine Tonsil ; Prostatic Neoplasms ; Vasopressins