PURPOSE: To evaluate the usefulness of imaging diagnosis in patients with atypical oculomotor abnormalities and paralytic strabismus. METHODS: The magnetic resonance imaging (MRI) or computed tomography (CT) of 3 patients with atypical Y pattern vertical incomitance and medial rectus (MR) paresis after MR impingement reduction and A pattern vertical incomitance were analyzed. High-resolution, surface coil MRI was used to obtain sets of contiguous, 2-mm thick quasi-coronal images in 9-cardinal gaze directions. Digital image analysis was used to evaluate the results. RESULTS: MRI revealed lateral displacement of the superior rectus (SR) and inferior displacement of the lateral rectus (LR) during upper temporal gaze and inferior displacement of the LR during lateral gaze in patients with Y pattern vertical incomitance. In patients with MR paresis, the maximal surface area of MR cross section is in the image plane 10 mm posterior from the orbital center at primary gaze. The maximal surface area of MR cross section is in the image plane 22 mm posterior from the orbital center during medial gaze. Quasi-coronal images show that contraction tends to cause the plane of maximum cross-section to move posteriorly. Surgical treatment was avoided and observational treatment maintained. There is incyclotorsion of both extraocular muscles in patients with A pattern vertical incomitance and upslanted palpebral fissure. CONCLUSIONS: Imaging diagnosis of pulley position and rectus muscle contractility is helpful for determining accurate diagnosis and treatment methods at atypical oculomotor abnormalities and paralytic strabismus.
Contracts ; Displacement (Psychology) ; Humans ; Magnetic Resonance Imaging ; Muscles ; Orbit ; Paresis ; Strabismus

Auditory neuropathy is a hearing disorder characterized by an absent or severely abnormal auditory brainstem response, with preservation of the cochlear microphonics and otoacoustic emissions. This suggests that outer hair cell (OHC) function is normal but that auditory function proximal to the OHCs is impaired. These patients demonstrate mild to severe hearing loss for pure tones and impaired word discrimination out of proportion to pure tone loss. Hearing aid alone is of little or no benefit in patients with auditory neuropathy. Visual support via cued speech or signed language can be a fail-safe method for insuring language development. Recently, there are some reports that cochlear implantation is highly successful in patients with auditory neuropathy. We report three cases (two children and one woman) with auditory neuropathy. Each patient was tested with cochlear microphonics, otoacoustic emissions, auditory brainstem response and middle latency response, etc. All three patients had normal cochlear microphonics or otoacoustic emissions with absent auditory brainstem response. Two of them had evidence of a peripheral neuropathy. We should be aware of auditory neuropathy and implications for its management, which differs from treatment of sensorineural hearing loss. Auditory neuropathy also raises a concern about the risk of false-negative findings when newborn hearing screening is restricted to otoacoustic emissions.
Child ; Cochlear Implantation ; Cochlear Implants ; Discrimination (Psychology) ; Evoked Potentials, Auditory, Brain Stem ; Hair ; Hearing ; Hearing Aids ; Hearing Disorders ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Infant, Newborn ; Language Development ; Mass Screening ; Peripheral Nervous System Diseases

(188)Re(Rhenium) is easily obtained from an in-house (188)W/(188)Re generator that is similar to the current (99)Mo/(99m)Tc generator, making it very convenient for clinical use. This characteristic makes this radionuclide a promising candidate as a therapeutic agent. Polyethylenimine (PEI) is a cationic polymer and has been used as a gene delivery vector. Positively charged materials interact with cellular blood components, vascular endothelium, and plasma proteins. In this study, the authors investigated whether intratumoral injection of (188)Re labeled transferrin (Tf)-PEI conjugates exert the effect of radionuclide therapy against the tumor cells. When the diameters of the Ramos lymphoma (human Burkitt's lymphoma) xenografted tumors reached approximately 1 cm, 3 kinds of (188)Re bound compounds (HYNIC-PEI-Tf, HYNIC-PEI, (188)Re perrhenate) were injected directly into the tumors. There were increases in the retention of (188)Re inside the tumor when PEI was incorporated with (188)Re compared to the use of free 188Re. The (188)Re HYNIC-Tf-PEI showed the most retention inside the tumor (retention rate=approximately 97%). H&E stain of isolated tumor tissues showed that (188)Re labeled HYNIC-PEI-Tf caused extensive tumor necrosis. These results support (188)Re HYNIC-PEI-Tf as being a useful radiopharmaceutical agent to treat tumors when delievered by intratumoral injection.
Animals ; Burkitt Lymphoma/pathology/*radiotherapy ; Cations ; Female ; Injections, Intralesional ; Mice ; Mice, Inbred BALB C ; Pilot Projects ; Polyethyleneimine/chemistry/*pharmacology ; Radioisotopes/chemistry/*pharmacology ; Research Support, Non-U.S. Gov't ; Rhenium/chemistry/*pharmacology

Biliary-pancreatic cancers are frequently associated with vascular invasion, as well as adjacent organ invasion, due to their biologic and anatomical characteristics. These findings preclude the curative resection of these tumors due to the high mortality and morbidity following a combined vascular resection. The object of this study was to assess the safety and the effect on survival of the combined vascular resection for patients with biliary-pancreatic malignancies through an analysis of our experience. Fifteen biliary-pancreatic cancer patients underwent curative surgery, including major vascular resection, during the period from Mar. 1993 to Oct. 1996. The risk factors such as the operative mortality, the morbidity, operative time, demand for transfusion, postoperative hospital stay, and the pathological characteristics for the 12 patients who underwent pancreaticoduodenectomy(PD) with combined vascular resection were compared with those of 75 cases who underwent a PD without vascular resection from 1993 to 1995. After resections and reconstructions of superior mesenteric and portal veins, vascular patencies were mostly well preserved, and there were no damage to the liver function. Combined vascular resection did not increase the mortality, the morbidity, the hospital stay, or the operative risk. With respect to pathologic characteristics, tumors with vascular invasion did not have more metastases to the lymph node, but did have more frequent perineural invasions and were slightly larger in size. Vascular invasion alone is not a contraindication to curative resection of biliary-pancreatic cancers and combined vascular-superior mesenteric and portal vein-resection should be considered in selected cases in which histologically curative resection is possible.
Humans ; Length of Stay ; Liver ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Operative Time ; Pancreaticoduodenectomy ; Portal Vein ; Risk Factors ; Vascular Patency ; Veins*

Malignant biliary or pancreatic duct stricture is dilatated using dilatating catheter or balloon catheter but a high grade stricture is difficult to dilate by general dilatating methods. Using Soehendra stent retriever is an effective method for exchanging an impacted stent. Recently, high grade malignant biliary strictures have been dilatated by Soehendra stent retriever. We report 3 cases of successful biliary drainage in high grade malignant biliary strictures using 7 Fr Soehendra stent retriever.
Catheters ; Constriction, Pathologic* ; Drainage* ; Pancreatic Ducts ; Stents*

Methamphetamine is one of the most popular abuse drug in the South Korea. Intracranial hemorrhage or ischemic stroke have been well known as one of the complications with methamphetamine abuse. We experienced two cases with cerebral vasculopathy which had developed after intravenous use of methamphetamine. The first patient was a previously healthy 20-year-old woman, who was admitted because of drowsy mentality with left hemiparesis and dysarthria. The second patient was a 24-year-old man who was admitted because of seizure and left extremity weakness. They reported several intravenous administration of methamphetamine during previous months. In both case, brain CT showed cerebral infarction compatible with vascular territories. And also, carotid angiographys demonstrated that multiple intracranial vessels were involved with narrowing and stenotic nature, consisting with vasculitis in the both cases.
Administration, Intravenous ; Brain ; Cerebral Infarction* ; Dysarthria ; Extremities ; Female ; Humans ; Intracranial Hemorrhages ; Korea ; Methamphetamine* ; Paresis ; Seizures ; Stroke ; Vasculitis ; Young Adult

Osteoma is a slowly growing benign tumor composed of compact or cancellous bone and usually found in paranasal sinuses. Lobular capillary hemangioma is a rapidly growing lesion usually affecting skin and oral mucosa. Both lesions may occur at any age group but most frequently in the third decade. The authors experienced a case of concurrent osteoma and lobular capillary hemangioma in the middle turbinate, which were removed via endonasal endoscopic approach. Concerning our case, we speculate that the slow growth of the osteoma may have caused inflammatory change on nasal mucosa, resulting in lobular capillary hemangioma. We report a case with a review of literatures.
Granuloma, Pyogenic* ; Hemangioma, Capillary ; Humans ; Mouth Mucosa ; Nasal Mucosa ; Osteoma* ; Paranasal Sinuses ; Skin ; Turbinates*

Mucous membrane plasmacytosis is a rare benign condition characterized by plasma cell infiltration of the mucosa of upper aerodigestive tract. The lesions typically produce a cobblestone or warty appearance of the larynx, pharynx, palate, lips, mouth, tongue and trachea. Histologically, the lesions are characterized by a diffuse expanse of inflammatory cells situated in submucosal tissues, composed mainly of mature plasma cells with scattered polymorphonuclear cells and lymphocytes. Immunohistochemistry for kappa, lambda light chain showed polyclonal immunoglobulin content in all cases examined. A variety of medical and surgical treatments have been tried but none has led to improvement in the condition. In this study, we report, with a review of literature, a mucous membrane plasmacytosis arising from oropharynx in a 30 year-old female patient.
Adult ; Female ; Humans ; Immunoglobulins ; Immunohistochemistry ; Larynx ; Lip ; Lymphocytes ; Mouth ; Mucous Membrane* ; Oropharyngeal Neoplasms ; Oropharynx* ; Palate ; Pharynx ; Plasma Cells ; Tongue ; Trachea

Single spore isolates of Plasmodiophora brassicae e4 and e9 obtained from diseased Chinese cabbage were identified as race 4 and race 9, respectively, by the Williams' differential variety set. To confirm the possibility of variation in same generation and progeny of a single spore isolate of P. brassicae, random amplified polymorphic DNA (RAPD) analysis was conducted using the URP 3, 6 and OPA 7 primers. There was no difference in band type at each part of the gall of Chinese cabbage obtained by inoculation of e4 and e9 and amplification using the URP 3 and 6 primers when the same generation was analyzed. In addition, the progeny analysis, which was expanded to the third generation and conducted using the URP 3 and OPA 7 primers, revealed no differences in the band type of the e4 isolate. Based on these results, the single spore isolate of P. brassicae was genetically stable.
Asian Continental Ancestry Group ; Brassica ; Continental Population Groups ; DNA ; Genetic Variation ; Humans ; Plasmodiophorida ; Spores

OBJECTIVES: The aim of this study was to investigate the relationship between job stress and the willingness of male workers in small and medium scale industry to cease smoking. METHODS: A structured self-reported questionnaire was used to assess each respondent's socio-demographics, job stress, and the will to cease smoking. A KOSS (Korean Occupational Stress Scale)- based questionnaire survey was conducted which targeted 4,435 male workers at 69 small and medium scale industries. 2,840 men returned these questionnaires with 1,663 of them being smokers. We analyzed 1,345 of the smoker returns. We estimated the relationship between the will to cease smoking and the employee job stress factors using logistic regression analyses. RESULTS: After adjusting for education, exercise, and tobacco use per day, the logistic regression analysis revealed a significantly positive association with the will to cease smoking and job stress. The odds ratios regarding insufficient job control were at 1.69 (95% CI, 1.26~2.27), organizational system at 1.37 (95% CI, 1.03~1.82), and lack of reward at 1.37 (95% CI, 1.03~1.82). CONCLUSIONS: These results indicated that job stress may play a significant role in the will to cease smoking. Further preventive efforts and studies are needed in order to reduce job stress.
Humans ; Logistic Models ; Male ; Odds Ratio ; Questionnaires ; Reward ; Smoke ; Smoking ; Smoking Cessation ; Tobacco