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

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

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

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*

PURPOSE: We aimed to estimate the prevalence of overactive bladder (OAB) in Korea, to assess the variation in prevalence by sex and age, and to measure the impact of OAB on quality of life. METHODS: A population-based, cross-sectional telephone survey was conducted between April and June 2010 with a questionnaire regarding the prevalence of OAB, demographics, and the impact of OAB on quality of life. A geographically stratified random sample of men and women aged > or =30 years was selected. RESULTS: The overall prevalence of OAB was 22.9% (male, 19%; female, 26.8%). Of a total of 458 participants with OAB, 37.6% and 19.9% reported moderate or severe impact on their daily life and sexual life (5.6% and 3.5%, respectively, in participants without OAB). Anxiety and depression were reported by 22.7% and 39.3% of participants with OAB, respectively (9.7% and 22.8%, respectively, in participants without OAB). Only 19.7% of participants with OAB had consulted a doctor for their voiding symptoms, but 50.7% of respondents with OAB were willing to visit a hospital for the management of their OAB symptoms. CONCLUSIONS: This study confirmed that OAB symptoms are highly prevalent in Korea, and many sufferers appear to have actively sought medical help. OAB has severe effects on daily and sexual life as well as psychological health.
Aged ; Anxiety ; Demography ; Depression ; Female ; Humans ; Korea ; Male ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Telephone ; Urinary Bladder, Overactive

OBJECTIVES: To investigate the relationship of neurochemical changes of brain in SCHE patients and the level of cognitive function, the authors measured hydrogen containing neurochemicals in two brain regions using 1H MRS, and compared those changes with the level of cognitive performances such as attention, visual analysis, or fine motor function. METHODS: A total of patients with liver cirrohosis were defined as SCHE, for they performed poorly(out of 1 SD of normative data) in more than one neuropsychological tests conventionally used(digit symbol and block design tests in KWIS, trail making test A and B). They were further evaluated in attentional ability and efficacy of visual analysis using Cognitrone subtest in Vienna Neurocognitive Test battery. Fine motor coordination were also measured by Grooved Pegboard test. Patients and 20 normal controls underwent proton MRS study. Proton containing neurochemicals, such as myoinositol(mI), N-acetyl-L-aspartate(NAA), creatine(Cr), choline(Cho) were measured from 2*2*2cm3 voxel of basal ganglia and parietal white matter using 1.5 tesla clinical MRI/MRS system. The ratios of above metabolites to Cr were analyzed. RESULTS: 1) Patients with SCHE showed reductions in Cho/Cr and mI/Cr in both basal ganglia and parietal white matter compared to normal subjects. 2) Performance of Grooved Pegboard test were negatively correlated with mI level of basal ganglia and with Cho level of parietal white matter(r=-0.59, p<.05). 3) Mean time of correct responses in Cognitrone test showed negative correlation with NAA level of parietal white matter(r=-0.55, p<.05). CONCLUSION: Certain neurocognitive disturbances in SCHE patients seemed to be related with neurochemical changes in basal ganglia or parietal white matter. To further elucidate the relationship of focal biochemical changes and neurocognitive deficits in SCHE patients, however, follow-up study according to the illness stage must be performed. Studies on other disorders showing similar cognitive deficit patterns would be helpful.
Basal Ganglia ; Brain ; Hepatic Encephalopathy* ; Humans ; Hydrogen ; Liver ; Neuropsychological Tests ; Protons* ; Rabeprazole ; Trail Making Test