Recently, we experienced a patient with a B cell leukemia which could not be classified as chronic lymphocytic leukemia (CLL), prolymphocytic leukemia (PL) or follicular lymphoma in leukemic phase. He is a 58-year-old male and suffered from progressive lymphadenopathy at both inguinal and cervical areas. His blood film showed lymphocytosis (79%), and the cells were heterogeneous in size and shape. Twenty-five percent of the lymphocytes had nuclear irregularities or cleavages unlike the lymphocytes of CLL In which the cells often shows monomorphic features, small size with scanty cytoplasm and round nucleus. The bone marrow trephine biopsy specimen showed a diffuse pattern of infiltration of atypical Iymphoid cells. The lymph node histology showed atypical lymphoid colls proliferated as wide mantles around non-neoplastic appearing germinal centers. The immunophenotype of circulating lymphocytes in peripheral blood showed strong reactivity with CD5, CDl9 and CD20 without expression of CD2, CD3, CD7, CD10, CD22 and CD23. Although this case resembled CLL, the laboratory features showed major differences, notably in the Peripheral blood morphology, histology Patterns and the membrane Phenotype. By combining these data, we diagnosed this case as a leukemic phase of mantle cell lymphoma.
Biopsy ; Bone Marrow ; Cytoplasm ; Germinal Center ; Humans ; Leukemia, B-Cell ; Leukemia, Lymphocytic, Chronic, B-Cell ; Leukemia, Prolymphocytic ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Lymphoma, Follicular ; Lymphoma, Mantle-Cell* ; Male ; Membranes ; Middle Aged ; Phenotype

The present study was undertaken to assess the effect of nitric oxide on the retinal vascular relaxation and retinal toxic effect.in pigmented rabbits. S-nitroso-N-acetyl-D, L-penicillamine[SNAP], as a NO onor, dissolved in dimethyl sulfoxide[DMSO]was injected into vitreal space.N-acetyl-D, L-penicillamine[NAP]was used as a control. We used Doppler Ultrasound to measures blood flow velocity.In the flow velocity between NAP group and SNAP group, the resistance index did not differ significantly for both central retinal artery and ciliary artery[p>0.05] 3 to 6 hours after NAP &SNAP injection. On electroretinographic study, a-wave amplitude of maximal combined response was reduced in SNAP treated group.In contrast, b/a ratio was increased between 3 hours and 6 hours after injection.Histologic examinations showed vacuolar degeneration and clumping and lysis of nuclei of photoreceptors.Lysosome and autophagic vacuoles were also noted in the cytoplasm of outer neuronal cells.In conjunction with above results, further studies about should be required to find the optimal concentration of NO & NO donor with minimal retinal toxicity and maximal therapeutic effect.
Blood Flow Velocity* ; Cytoplasm ; Humans ; Neurons ; Nitric Oxide* ; Rabbits ; Relaxation ; Retinal Artery ; Retinaldehyde* ; Tissue Donors ; Ultrasonography* ; Vacuoles

One case of Rt. lacrimal gland mixed tumor is reported. The patient is a 26 years sold Korean male with right exophthalmos which growth slowly for 4 years. Pneumogaphy was done preoperalively and x-ray findings revealed that large tumor in the superior wall of the orbit, ladmaI gland tumor. In this case, pathologic findings were mixed tumor of lacrimal gland with no evidence of malignaney. Superior lateral approch was performed, without any complication. The vision was inproved and cosmetic result was satisfactory.
Exophthalmos ; Humans ; Lacrimal Apparatus* ; Male ; Orbit

The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing factors explained 17.1 and 8.9% correspondingly.
Causality ; Chronic Disease ; Family Characteristics ; Humans ; Jeollanam-do ; Poverty Areas ; Prevalence

We made a mistake in our recently published article.

No abstract available.
Fallopian Tubes* ; Female ; Pregnancy*

BACKGROUND: The last two decades have seen an increase in the incidence of cesarean section. Spinal anesthesia has been popular in cesarean delivery because of the ease and effectiveness, as well as the rapidity in estabilishing adequate levels of analgesia. The clinical effects of subarachnoid administeration of preservative-free fentanyl were assessed in 30 healthy women who underwent cesarean section with spinal anesthesia using 0.5% hyperbaric bupivacaine. METHODS: Sixty parturients were allocated to group I; bupivacaine (n=30) only and group II; bupivacaine/fentanyl mixture (n=30) in random order. The dose of bupivacaine varied from 9~10 mg depending on the patients height. Maximum level of sensory blockade, time to reach T4 level, incidence of hypotension, time to get complete motor recovery, perioperative analgesic effect and complications were evaluated. RESULTS: There were no differences in maximum level of analgesia, time to reach T4 level and to get complete motor recovery, and incidence of hypotension between two groups. However, duration of analgesia was longer in group II with the bupivacaine/fentanyl mixture (191.9 +/- 77.6 min) than in group I with the bupivacaine alone (74.2 +/- 30.8 min). Spinal anesthesia was excellent in 100% of the fentanyl mixture group but in 80% of the bupivacine only group. CONCLUSION: 0.5% hyperbaric bupivacaine mixed with 25 g fentanyl provided improved perioperative analgesia without affecting the onset of sensory blockade and duration of motor blockade.
Analgesia ; Anesthesia, Spinal* ; Bupivacaine ; Cesarean Section* ; Female ; Fentanyl ; Humans ; Hypotension ; Incidence ; Pregnancy

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: To evaluate the radiologic features of endodermal sinus tumor of the ovary. MATERIALS AND METHODS:The radiologic findings of eight patients with pathologically-proven endodermal sinus tumor of the ovary wereretrospectively evaluated for bilaterality, size, margin, architecture, septa, local invasion, distant metastasis,ascites and lymphadenopathy ; serum alpha-FP was also evaluated. RESULTS: All endodermal sinus tumors were unilateralwith irregular septa and ascites ; the longest diameter was 7-18(mean, 12.6)cm. Four of eight tumors had smoothmargins and four, lobulated. Four were predominantly cystic in internal architecture, one was purely cystic, andthree were predominantly solid. There was local invasion or distant metastasis in three patients, andretroperitoneal lymphadenopathy in one ; in seven cases, alpha-FP level was more than 1.000ng/ml. CONCLUSION: Endodermal sinus tumors of the ovary appeared as nonspecific large complex abdominal masses and it was difficultto differentiate them from other malignant ovarian tumors. This tumor should be included in the differentialdiagnosis of a large complex abdominal mass in girls and young women, especially in patients with a predominantlycystic mass and markedly elevated serum alpha-FP.
Ascites ; Endoderm* ; Endodermal Sinus Tumor* ; Female ; Humans ; Lymphatic Diseases ; Neoplasm Metastasis ; Ovary*

BACKGROUND: Bupivacaine induces cardiac depression, which is resistant to treatment. Therefore early recognition of its development is important so that the injection of bupivacaine can be discontinued promptly. We compared the efficacy of continuous mixed venous oxygen saturation (cSvO2) monitoring with that of the mean arterial blood pressure (MBP) monitoring in terms of the prediction of cardiac output (CO) changes in anesthetized dogs with bupivacaine-induced cardiovascular depression. METHODS: Bupivacaine was infused to pentobarbital-anesthetized mongrel dogs (n = 8) at a rate of 0.5 mg/kg/min until the MBP decreased to 40 mmHg or less (end of bupivacaine infusion; BIE). We defined the early period as the interval from baseline till 30 minutes after the bupivacaine infusion and the late period as that after the 30 minutes till BIE. We monitored cSvO2 with a fiberoptic pulmonary artery catheter. The MBP and CO were measured every ten minutes after the initiation of the bupivacaine infusion. Arterial blood gas analysis, mixed venous gas analysis, measurement of serum electrolyte concentrations and serum bupivacaine concentrations were performed simultaneously. The relationship between CO versus cSvO2 or versus MBP was compared retrospectively by regression analysis. RESULTS: The Pearson's correlation coefficients between CO and cSvO2 were 0.782 (r2 = 0.6111, P < 0.01) in the early period and 0.824 (r2 = 0.6790, P < 0.01) in the late period. The correlation coefficients between CO and MBP were 0.019 (r2 = 0.0003, P > 0.05) in the early period and 0.799 (r2 = 0.6381, P < 0.01) in the late period. CONCLUSIONS: cSvO2 is superior to MBP for the prediction of CO changes in bupivacaine-induced cardiac depression in dogs, especially in the early period. We might expect a profound reduction of CO when MBP begins to decrease in the late period.
Anesthesia ; Animals ; Arterial Pressure* ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cardiac Output ; Catheters ; Depression* ; Dogs* ; Oxygen* ; Pulmonary Artery ; Retrospective Studies