Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

No abstract available.
Adult* ; Growth Hormone* ; Humans

BACKGROUND AND OBJECTIVES: We aimed to analyze the morphologic features of the nose in the human embryo from 4th to 8th developmental weeks according to the Carnegie stage. MATERIALS AND METHOD: A total of 27 cases of embryos, ranging from Carnegie stage of 13 to 23, were analyzed. The external morphology was observed with a stereomicroscope, photographed and analyzed. The histologic features were observed with a light microscope in the horizontally-transected specimens stained with hematoxylin-eosin staining. RESULTS: The nasal placode was observed at the stage 13, and it became flat or even concave at the stage 14. At the stage 15, the nasal pit was formed. At the stage 16, the nasal sac and nasal fin were observed. At the stage 17, the oronasal membrane was formed by thinning of the nasal fin. At the stage 18, the primitive choana was established by rupture of the oronasal membrane. At the stage 19, the lateral palatine process projected vertically below the level of the tongue. The cartilaginous nasal capsule was formed at the stage 20. At the stage 21, the olfactory area was localized to the upper portion of the lateral nasal wall and the nasal septum. At the stage 22, the lateral palatine process developed in a somewhat horizontal orientation. At the stage 23, the premaxilla and primitive choana were formed. CONCLUSION: The development of the nose is most active from the Carnegie stage of 13 to 19, which corresponds to the end of the 4th embryonic week to the end of the 7th week. Thus, this period is considered to be the most important period in human nasal embryonic development.
Embryonic Development ; Embryonic Structures* ; Female ; Humans* ; Membranes ; Nasal Septum ; Nose* ; Pregnancy ; Rupture ; Tongue

Early correction of congenital cardiac defects has been facilitated by the use of deep hypothermia and cardiorespiratory arrest. Simple deep hypothermia has a number of advantages for infant open heart surgery, such as a quiet heart and bloodless operative field, reduced blood requirement, elimination of pulmonary and coagulation problems following cardiopulmonary bypass, elimination of cannulation, simple anesthetic technique, no neccessity of complicated facilities, and stable postoperative course. Deep ether anesthesia is the ideal agent for induction of deep hypothermia by surface cooling, especially when combined with ganglionic blocking agents in large quantities to elimiminate some of the undesirable effects of ether, thus improving and maintaining good peripheral perfusion. We have performed a total correction of TOF on March, 1979. Anesthesia was induced with intravenous thiopental and succinylcholine for intubation and maintained by a tight closed circuit system with ether. As soon as routine EKG, direct intra-arterial pressure, esophageal and rectal temperature monitoring devices were installed, slow intravenous administration of triflupromazine was followed by surface cooling. Surface cooling was done by the technique of covering the child with bags of crushed ice after placing the infant on an ice water blanket. After cooling, the intracardiac procedure was performed under circulatory occlusion and cardiac arrest, following cardioplegic infusion, for 45 minutes. After the intracardiac procedure, cardiac resuscitation and rewarming were accomplished by cardiopulmonary bypass technique. The patient recovered satisfactorily and was discharged on POD14 without any complication.
Administration, Intravenous ; Anesthesia ; Cardiopulmonary Bypass ; Catheterization ; Child ; Electrocardiography ; Ether ; Ganglionic Blockers ; Heart ; Heart Arrest ; Humans ; Hypothermia* ; Ice ; Infant ; Intubation ; Perfusion ; Resuscitation ; Rewarming ; Succinylcholine ; Tetralogy of Fallot* ; Thiopental ; Thoracic Surgery ; Triflupromazine ; Water

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach

Gastric lymphoma occupies about 1-7% of gastric cancer and is the most common type of extranodal lymphoma. To evaluate the endoscopic morphologic characteristics of gastric lymphoma, we analysed the endoscopic findings in 45 patients with pathologically-proven gastric lymphoma. (continue...)
Gastroscopy ; Humans ; Lymphoma* ; Stomach Neoplasms

The purpose of this study was to investigate the physiological effects of forward and backward walking training on lower extremity muscle strength before and after exhausting exercise. Fourteen healthy male adults were randomly divided into backward walking (BW, n=7) and forward walking (FW, n=7) training groups. Each group took part in pre-test consisted of knee extensor and flexor isokinetic peak torque (PT), total work (TW), electromyography (EMG) before and after exhausting exercise. Exhausting exercise was used to measure lower extremity endurance, which is incremental treadmill running using the Bruce protocol. The BW and FW training groups participated in a 6 weeks training program, consisted of 3 sessions per week for a total of 18 sessions. After finishing the training program, the post-test was performed using the same method. BW training group showed significant increases in knee extensor/flexor PT (4.6%/13.9%), TW (17.34%), EMG (35.9%) before exhausting exercise and PT (23.9%/18.8%), TW (46.7%), EMG (59.8%) after exhausting exercise. But FW training group did not show a significant increase in knee extensor/flexor PT (0.1%/3.2%), TW (1.8%), EMG (10.9%) before exhausting exercise and PT (2%/1%), TW (5.6%), EMG (17.2%) after exhausting exercise. BW training has positive effects on lower extremity muscle strength, especially muscle endurance that is important to prevent muscle weakness during competitive sports.
Adult ; Electromyography ; Humans ; Knee ; Lower Extremity ; Male ; Muscle Strength ; Muscle Weakness ; Muscles ; Running ; Sports ; Torque ; Walking

Total parotidectomy is indicated when the tumor is originated from a deep lobe of the parotid gland. Because of the facial nerve, the usual sequence of total parotidectomy of a deep lobe tumor is to first perform superficial parotidectomy separately and then to remove the deep lobe. However, it is desirable to remove the parotid gland en-bloc while preserving the facial nerve. We designed a simple procedure that could remove a deep lobe tumor without separating the superficial portion of the parotid gland. This surgical technique is discussed with the present cases.
Facial Nerve* ; Parotid Gland*

BACKGOUND: It has been suggested that humoral immune mechanisms might play a role in the pathogenesis of a subset of patients with Stevens-Johnson syndrome (SJS). Circulating antibodies (Abs) against desmoplakin I and II (dp I/II) were detected in a subset of patients with SJS, which could impair the function of desmosome-keratinfilament complexes resulting in suprabasal acantholysis as a humoral autoimmune phenomenon. OBJECTIVE: The purpose of this study was to detect the presence of circulating autoantibodies against dp I/II in the sera of patients with toxic epidermal necrolysis (TEN), as well as SJS. METHOD: In this study, the sera of ten patients with TEN and SJS were investigated. Immunoblot analyses of extracts of EDTA-separated normal human epidermis were performed. We also performed an indirect immunofluorescence (IIF) test using normal human skin, mouse tongue, esophagus, and rat bladder. In addition, we performed direct IF studies using three perilesional tissues obtained from one patient of SJS and two patients of TEN. RESULTS: By immunoblotting using human epidermal extract, 215-kD and 250-kD proteins were detected in the sera of six out of ten patients with TEN and SJS. IIF using normal human foreskin demonstrated dense IgG deposits in the intercellular spaces and cytoplasmic membrane of epidermal cells in all sera of patients with SJS and TEN. In the direct IF test, IgG and IgA deposits appeared in an intercellular staining of epidermis of perilesional skin from two out of three patients with TEN and SJS. CONCLUSION: These findings suggest that circulating Abs against dp I/II and constitutive desmosomal plaque proteins might play a role in the pathogenesis of SJS and TEN.
Acantholysis ; Animals ; Antibodies ; Autoantibodies* ; Cell Membrane ; Desmoplakins* ; Epidermis ; Esophagus ; Extracellular Space ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Mice ; Rats ; Skin ; Stevens-Johnson Syndrome* ; Tongue ; Urinary Bladder

OBJECT: More than 75% of women have been reported to experience premenstrual symptoms and three to eight percent of them suffer from premenstrual dysphoric disorder(PMDD). But little is known about prevalence of premenstrual syndrome(PMS) and PMDD among Korean women. The purpose of this study was to investigate the prevalence of PMDD and PMS in Korean women who attended universities at the time of survey. METHODS: One thousand four hundred and nineteen subjects were randomly selected with cluster sampling method among four women's university in Seoul. We measured the severity of premenstrual symptoms using six-point rating scale developed by the authors on the basis of the research criteria for PMDD in DSM-IV. Premenstrual worsening of symptoms was defined as increase in symptom scores of more than 75% from follicular to luteal phase score. And also, we compared characteristic symptoms, eating behaviors, and functional impairments between PMS and PMDD. RESULT: After excluding inadequate data according to our exclusion criteria, 873 of 1419 subjects(61.5%) were included in the estimation of the prevalence of PMS and PMDD. Each prevalence rate of PMS and PMDD was found to be 83.3% and 5.0% on the basis of 75% change method respectively. The most frequent symptom was physical symptoms such as headache or breast tenderness(56.4%) in PMS and 'felt irritable'(95.5%) in PMDD. Of the 44 subjects with PMDD, 39(88.6%) reported to have experienced the impairment in work or school at least once per month because of premenstrual symptoms. CONCLUSION: Our results indicate that prevalence and symptoms of PMDD in Korean university women are similar to those in western culture. The finding that mood symptoms were more frequent and severe in PMDD than in PMS implies that the former may be a disordered condition to be distinguished from the latter physiologic one.
Breast ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Feeding Behavior ; Female ; Headache ; Humans ; Luteal Phase ; Premenstrual Syndrome ; Prevalence* ; Seoul