No abstract available.
Quality of Life*

We have experienced a case of plexiform neurofibrorna of the right upper eyelid and orbit in a 12-year-old girl who had typical skin features of neurofibromatosis and no family history. The non-pulsating proptosis of the right eye and diffuse thickening with hypertrophy of the upper lid, had increased insiduciusly since the birth on. Biopsy taken from eyelirl lesion showed the features of plexiform neurofibroma. Skull X-ray and brain computerized tomogram showed that the right orbit was wider, with the enlarged mass and defects in orbital roof and lesser and greater wings of the sphenoid bone. The surgical excision of the right eyelid lesion was performed.
Biopsy ; Brain ; Child ; Exophthalmos ; Eyelids* ; Female ; Humans ; Hypertrophy ; Neurofibroma, Plexiform* ; Neurofibromatoses* ; Orbit* ; Parturition ; Skin ; Skull ; Sphenoid Bone

PURPOSE: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. MATERIALS AND METHODS: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of 3.7~9.3 GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. RESULTS: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. CONCLUSION: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.
Eating ; Humans ; Neoplasm Metastasis ; Reference Values ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.
Nipples*

Hand tumor may arise as primary growth from any of the tissue present in the hand. Most are benign and malignant are uncommon. The hand is a sensitive organ, has a little potential space and moving parts, so tumors are usually detected early because of pain, impairment of function or swelling. A knowledge of frequency, location and clinical characteristics of hand tumor is invaluable in diagnosis. Usually early susgical measure is the treatment of choice. For the period of 6 years from 1962 to 1977, 29 cases of hand tumor were treated surgically and the results of clinical observation were as follows 1. Of 29 cases, benign tumor was 25 cases (86%) and bone-origin tumor was 18 cases. Enchondroma and enchondromatosis was the most frequent (12 cases). 2. The tumor occurred 22 cases in phalanx, 10 in metacarpal, and 2 in carpal bones. 3. The tumors were treated with excision in 11 cases, curettage & bone graft in 10, amputation in 4, biopsy in 2 and no treamtent in 2. 4. The most frequent site of enchondroma and enchondromatosis were ulnar side, ring and little finger, and of these metacarpophalangeal joints were involved most frequently.
Amputation ; Biopsy ; Carpal Bones ; Chondroma ; Curettage ; Diagnosis ; Enchondromatosis ; Fingers ; Hand ; Metacarpophalangeal Joint ; Transplants

Hyperosmolar therapy is an essential treatment method for increased intracranial pressure and cerebral edema. Mannitol and hypertonic saline are frequently used in clinical practice; however, more helpful recommendations are needed for the optimal management of cerebral edema in terms of the choice, dosage, and timing of these medications. This study aimed to introduce the characteristics and relative strengths of two agents, i.e., mannitol and hypertonic saline, and review clinical data supporting their use in various diseases.Current Concepts: Hyperosmolar therapy reduces intracranial pressure by removing water from the brain tissue and transferring it to the vascular space by creating an osmotic gradient. Mannitol improves cerebral blood flow by reducing the hematocrit, decreasing blood viscosity, and increasing deformability of red blood cells. Hypertonic saline increases intravascular volume, transiently increases cardiac output, and improves tissue oxygen partial pressure in the brain. Hypertonic saline has several advantages over mannitol, including quicker onset and longer-lasting reduction in intracranial pressure. However, no significant differences are noted in clinical, functional outcomes, or mortality between the two treatment agents.Discussion and Conclusion: Both mannitol and hypertonic saline are effective in reducing increased intracranial pressure. Clinicians should be able to select an appropriate agent in different clinical situations based on available evidence and patients’ individual medical conditions.

The fine structure of cells in the trigeminal mesencephalic (Me5) nucleus in the rat was studied by transmission electron microscopy. This nucleus located in the mid-brain and the rostral portion of the pons, most neurons in the caudal part of Me5 nucleus were sufficiently large (40~50micrometer) and appeared as round-shaped unipolar cells. The Me5 neurons had a large, round, centrally located nucleus, and their cytoplasm contained numerous mitochondria, dense granular endoplasmic reticulum, abundant Golgi apparatus, groups of free ribosomes, some heterogeneous particles and neurofilaments. Cell surfaces were studded irregularly with small spinouts processes, and they contained a few fine irregularly arranged neurofilaments and some granular endoplasmic reticulum. Boutons contacting the soma of Me5 neurons were defined as axosomatic synapses and bostons contacting dendrites located between the Me5 neurons were defined as axodendritic synapses. Based on differences in bouton and vesicle morphology, the four synaptic bouton types were identified. 1. Asymmetrical as well as symmetrical synapses with small round vesicles. 2. Asymmetrical synapses with pleomorphic admixture contained predominantlyspherical vesicles. 3. Symmetrical synapses with pleomorphic vesicles of flattened, spherical and dense-core vesicles. 4. Asymmetrical as well as symmetrical synapses with heterogeneous and large dense-core vesicles. Synaptic boutons containing round vesicles and large dense-core vesicles were most frequently observed.
Animals ; Carisoprodol ; Cytoplasm ; Dendrites ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Microscopy, Electron, Transmission ; Mitochondria ; Neurons ; Pons ; Presynaptic Terminals ; Rats* ; Ribosomes ; Synapses

The clinical significance of myocardial bridges (MBs) is variable, and most patients are asymptomatic. However, angina, myocardial infarction and sudden death, associated with MBs, have been reported. Intracoronary stents offer a novel, and potentially definitive, treatment for myocardial ischemia associated with clinically significant MBs. We describe the use of intracoronary stenting for primary angioplasty in a patient with an anterior myocardial infarction associated with MBs.
Angioplasty ; Death, Sudden ; Humans ; Myocardial Infarction* ; Myocardial Ischemia ; Stents*

Actinomycosis is a chronic, granulomatous suppurative disease caused by Actinomyces species. Actinomyces is an anaerobic, gram positive organism that requires special techniques for culture and isolation. Actinomycosis is characterized by formation of multiple abscesses, draining sinuses, abundant granulations (sulfur granule) and dense fibrous tissue. The three major clinical presentations include the cervicofacial, thoracic, and abdominal regions. Since A. israelii is a normal inhabitant of the oral cavity, to make a definitive diagnosis it must be recovered from closed tissue spaces, draining sinuses, or abscesses, or it must be shown to be invasive in histopathologic sections. The drug of choice is penicillin. Because of the dense fibrous tissue surrounding the colonies of organisms and the concentration of organisms in clusters, high doses of pharmacologic agents must be used for long periods, and radical surgical excision should accompany antibiotic therapy if possible. We report three cases of abdominal actinomycosis, preoperatively impressed as appendicitis and pelvic abscess, which was diagnosed by a histological study of operative specimens. The possible pathogenic mechanisms causing clinical symptoms are discussed.
Abscess ; Actinomyces ; Actinomycosis* ; Appendicitis ; Diagnosis ; Mouth ; Penicillins

Osteopontin, a secreted, arginine-glycin-asparate (RGD)-containing phosphoprotein is up-regulated in renal cortex in many experimental models of tubu- lointerstitial fibrosis. Osteopontine gene seems to be induced predominantly in chronic and progressive glomerulosclerosis. To examine the effects of enala-pril and lovastatin alone or in combination on osteopontin, TGF- 8, endothelin- 1, procollagen a 1(I) at an early phase of chronic renal failure in 5/6 nephrectomized rats, randomly assigned 4 groups [untreated 5/6 nephrectomy(group Nx), treated with enalapril(group E) or lovastatin(group L) alone and in combination(group EL)(each group n=6)] were sacrificed at 8 weeks. Four rats were served as normal control ones. Systolic blood pressure, 24 hour urine protein excretion, serum chemistry were mea- sured. mRNA levels of renal cortical osteopontin, TGF- , endothelin-l, procollagen a 1(I) were measured by Northern hybridization. Eight week after nephrectomy untreated neph- rectomized rats had higher systemic blood pressure (157 3 vs. 140 1mmHg, p<0.05) with increasing proteinuria(32.9 11 vs. 1.2 0.2, p<0.05) than normal con- trol rats. mRNA expression of osteopontin(12.5 folds, p<0.05) and endothelin-l(1.6 folds, p<0.05) in renal cortex were elevated, but mRNA expression of TGF- 0 and procollagen a 1(I) were not. The treatment with enalapril or lovastatin alone prevented a further rise in proteinuria and significantly reduced renal cortical osteopontin mRNA expression at 8 weeks. Enalapril reversed systemic hypertension but lovastatin not. Both drugs had no effect on renal cortical endothelin-1 mRNA expression. The treatment with combined enalapril and lovastatin reduced renal cortical osteopontin mRNA expression more and showed trend to reduce proteinuria compared to treatment with each drug alone. The results of the present study indicate that the treatment with enalapril or lovastatin reduces proteinuria and renal cortical osteopontin mRNA expression which are occurred at early phase of chronic renal failure in 5/6 nephrectomized rat model and combined treatment appears to be more effective.
Animals ; Blood Pressure ; Chemistry ; Enalapril* ; Endothelin-1 ; Fibrosis ; Gene Expression* ; Hypertension ; Kidney Failure, Chronic ; Lovastatin* ; Models, Animal ; Models, Theoretical ; Nephrectomy ; Osteopontin* ; Procollagen ; Proteinuria ; Rats* ; RNA, Messenger