The superficial lymph nodes may be enlarged in consequence of biologic or non-biologic antigenic stimuli, lymphoreticular maligna ntneoplasm, metastatic tumor or infiltrative disorders such as histiocytosis-X, and biopsy of the enlarged superficial lymph node is a time-honored diagnostic, therapeutic and follow-up tool. At present it is performed with ease and wideness. But in Korea there is no comprehensive studies about the diseases involving superficial ly-mph nodes of pediatric ages based on clinical and histopathological aspects. The present study is an sttempt to research for the histopathological aspects. The present study is an attempt to research for the histopathological findings of the superficial lymphadenopathy in correlation with the clinical characteristics. The histopathological findings of enlarged superficial lymph nodes, biopsied in Yonsei Univ-ersity Hospital for a 5year-period from 1976 to 1980, were reviewed. All patients were under 15year-old age, whose chief complaints were palpable lymph node with or without other sympt-oms. The results were as follows; 1. Of the 150 enlarged superficial lymph nodes, the male to female ratio was 1.68:1. Most of the biopsies were performed after the preschool age group and only 8 were of neonate or inf-ancy. 2. Of the 150 enlarged superficial lymph nodes, 79(52.7%) showed reactive hyperplasia, and inflammatory and malignant lymphadenopathies were 37.3% and 10.0% respectively. 3. Nonspecific reactive hyperplasia was the most common cause of the superfical lymphad-enopathy in pediatric ages, being 52.1% of total. Tuberculous lymphadenitis comprised 26.7%, being the 2nd most common cause, and of the 15 malignant lymphadenopathy 11 were primary lymphoreticular and 6 of the latter were histiocytic medullary reticulosis. 4. Ten percent of the patients with tuberculous lymphadenitis were of infancy, but none of those with both primary and metastatic malignant lymphadenopathy was of that age group. 5. The clinical symptoms and signs observed were fever, hepatosplenomegaly, gastrointest-inal symptoms and signs, rash, upper respiratory infection and others, irrespective of the histol-ogical classification. 6. The duration of superficial lymphadenopathy was less than 6 months in most cases of fu-ngal, acute and subacute nonspecific inflammatory and malignant origin, whereas it was more than 6 months in 38.5% of tyberculous lymphadentis and 41.7% of nonspecific reactive. 7. Superficial lymph node enlargement was most frequently found at cervical area which was followed by inguinal and axillary areas. 8. The superficial lymphadenopathy involved a single node in 63.9% of tuberculous origin but it tended to involve multiple ondes of one or more anatomical sites in nonspecific inflamm-ation, fungal infection, nonspecific reactive hyperplasia and malignancy. 9. The enlarged superficial lymph noded tendes to be soft and nontender in tuberculosis and nonspecific reactive hyperplasia, in contrast to the acute and subacute lymphadenitis and mali-gnant lymphadenopathy where they were more commonly hard with variable tenderness.
Biopsy ; Classification ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Hyperplasia ; Infant, Newborn ; Korea ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Male ; Tuberculosis ; Tuberculosis, Lymph Node

BACKGROUND: Fosinopril is a new phosphorous containing angiotensin converting enzyme inhibitor. To assess the antihypertensive efficacy and safety of fosinopril, the clinical trial was done in patients with mild to moderate hypertension. METHODS: In 30 patients with mild to moderate essential hypertension, we administered fosinopril 10-20mg once daily for 10 weeks and checked their blood pressure every 2 weeks. RESULTS: The blood pressure decreased from 158+/-12.3/103.4+/-4.2mmHg to 139+/-7.5/88.4+/-5.9mmHg at the end of treatment(p<0.05). Heart rate did not change significantly during therapeutic period. Of 30 patients, the efficacy of fosinopril therapy disclosed 25 patients(83.7%) with normal diastolic pressure of more than 10mmHg decline of diastolic blood pressure. But two patients had no effects and three patients were not followed up. The adverse reactions due to fosinopril were reported in 3 patients(10%) with dry cough, 2 patients with palpitation(6.7%) and 1 patient with weakness(3.3%), but there were no patients who discontinued fosinopril due to adverse effect. CONCLUSION: Fosinopril has an excellent antihypertensive effect at low dosage as a first line antihypertensive agent or as a substituting agent for other antihypertensives in patients with mild to moderate essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A

Three cases of synchronous carcinomas of endometrium-fallopian tube, endometrium-cervix and endometrium-ovary are reported. Case 1 is endometrial endometrioid adenocarcinoma with FIGO stageIb, Grade 2 and tubal serous adenocarcinoma with FIGO stage Ib, Grade 2. Case 2 is endometrial serous carcinoma with FIGO stage Ilb and squamous cell carcinoma with FIGO stage Ial. Case 3 is endometrial endometrioid adenocarcinoma with FIGO stage Ia, Grade 1 and ovarian mucinous adenocarcinoma with FIGO stage IIIa, Grade 2. There is much confroversy with respect to staging and management of such cases since these tumors may represent either two synchronously occuring primaries or single primary with metastases. It is suggested that when each tumor is different histological subtype the tumors may be considered as two separate primaries and treatment may be less aggressive. It may be a favorable prognosis. The authors present three cases of synchronous carcinomas with a review of literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid ; Carcinoma, Squamous Cell ; Neoplasm Metastasis ; Prognosis

The purpose of the present study was to evaluate the histologic results of bone cavities that were surgically created in the calvaria of rabbit and filled with HA/beta-TCP composite powders, which had been developed in Korea (Dentium, Korea). Ten young adult rabbits were used. Four defects were surgically produced in calvaria of each rabbit. Each rabbit was anesthetized with Ketamine-HCl (5 mg/kg, Yuhan Cor. Korea) and Xylazine-HCl (1.5 ml/kg, Yuhan Cor. Korea)). An incision was made to the bony cranium and the periosteum was reflected. Using a trephine bur (external diameter: 8 mm, 3i, USA), 4 'through-and-through' bone defects were created with copious irrigation, and classified into 4 groups: control group: no graft materials, experimental group I: normal saline + graft materials: experimental group II: venous blood + graft materials: experimental group III: graft materials only. The defects were randomly filled with graft materials. The defects were closed with resorbable suture material. At the end of the surgical procedure, all animals received a single intramuscular injection of antibiotics Gentamicin (0.1 mg/kg, Dae Sung Microb. Korea). Rabbits were sacrificed with phentobarbital (100 mg/kg) intravenously at 1-, 2-, 4-, 6- and 8-week after. Specimens were treated with hydrochloric acid decalcifying solution (Fisher Scientific, Tustin, CA) and sectioned by bisecting the 8 mm diameter defects. The histologic specimens were prepared in the general method with H & E staining at 6 micrometer in thickness. The results were as follows; 1. New bone formation showed from after 2-week of surgery in defect area. As time lapsed, lots of new bone formation and mature bones showed. 2. Histologically, degree of new bone formation could not be discerned among the experimental groups. But, for experimental group II, lots of cells gathered around graft materials after 1-week of surgery, new bone formed slightly faster and than the others at 1-week after. For experimental group I, a few inflammatory finding showed around graft material at after 1-week and after 2-week of surgery. 3. No bone formation did show for control group. Based on histologic results, the new HA/beta-TCP composite powders appeared to act as a scaffolding material for regeneration of osseous defects.
Animals ; Anti-Bacterial Agents ; Gentamicins ; Humans ; Hydrochloric Acid ; Injections, Intramuscular ; Korea ; Osteogenesis* ; Periosteum ; Powders* ; Rabbits ; Regeneration ; Skull ; Sutures ; Transplants ; Young Adult

PURPOSE: Verapamil is one of the most extensively characterized modulators of P-glyco- protein (P-gp) mediated multi-drug resistance (MDR), but its plasma concentration required to reverse MDR can cause cardiovascular toxicity. KR-30035 is a newly synthesized verapamil analogue with more potent cytostatic effects, but has lower cardiovascular effects than verapamil. We have assessed the MDR reversing effects of KR-30035 by measuring Tc-99m MIBI uptake in cultured tumor cells and in nude mice bearing human tumor xenografts. MATERIALS AND METHODS: In-vitro uptake of Tc-99m MIBI was measured in murine leukemia cells (L-1210) and those MDR-positive variants after incubation with different concentrations of KR-30035. Results were compared to those with verapamil. Organ and tumoral uptake of Tc-99m MIBI was compared between P-gp (+) human colon cancer (HCT15 cells) and P-gp (-) lung cancer (A549 cells) in nude mice, treated with either KR-30035 or verapamil. RESULTS: There was no significant difference in in-vitro uptake of Tc-99m MIBI between verapamil and KR-30035 group at any concentrations. MIBI uptake in P-gp (+) cells continuously increased either with verapamil or KR-30035 in a dose-dependent manner. Tc-99m MIBI uptake ratios of the tumor [P-gp (+' tumor uptake divided by P-gp (-) uptake] were significantly higher with KR-30035 than with verapamil in tumor bearing nude mice. Washout rate of Tc-99m MIBI from P-gp (+) HCT15 cells was lower in verapamil or KR-30035 groups than in the control group, which was 0.19, 0.19 and 0.27 respectively. CONCLUSION: These studies revealed that KR-30035 can potentially be used as an active modulator of MDR, with its significantly lesser cardiovascular toxicity than verapamil. Our results warrants further evaluation of this novel agent.
Animals ; Colonic Neoplasms ; Drug Resistance, Multiple ; Heterografts ; Humans ; Leukemia ; Lung Neoplasms ; Mice ; Mice, Nude ; P-Glycoprotein ; Plasma ; Robenidine ; Tumor Cells, Cultured ; Verapamil

Intravesical instillation of the bacillus Calmentte-Gu rin(BCG), an attenuated strain of Mycobacterium bovis, is an approved method for the treatment of superficial bladder cancer. Because BCG is a living organism, the potential for infection exists. BCG is generally well tolerated, with complications in less than 5% of those treated with use of current practices. The most frequent symptoms of toxicity associated with intravesical BCG immunotherapy include bladder irritation, frequency, and dysuria. Systemic reactions are less common but more serious than local side effects, and include fever, chills, malaise, rash, hepatitis, pneumonitis, arthritis and sepsis. In rare cases, BCG treatment can result in a systemic infection that requires antituberculous therapy. The pulmonary toxicity that results from intravesical BCG treatment is generally characterized by one of two types : systemic allergic reaction with pulmonary reticulonodular opacities depicted on chest radiographs with cellular findings consisting of activated lymphocytes, and actual BCG mycobacteremia with a miliary pattern depicted on chest radiographs and granuloma formation which rarely results in positive acid-fast stain or culture results. Recently we experienced two types of pulmonary complications following intravesical BCG immunotherapy in patients with superficial bladder cancer. We report two cases with a review of literatures.
Administration, Intravesical ; Arthritis ; Bacillus* ; Chills ; Dysuria ; Exanthema ; Fever ; Granuloma ; Hepatitis ; Humans ; Hypersensitivity ; Immunotherapy* ; Lymphocytes ; Mycobacterium bovis ; Pneumonia ; Radiography, Thoracic ; Sepsis ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: Primary gastrointestinal lymphoma is one of the most common extranodal lymphomas. The purpose of this study was to collect information on the clinical features and treatment of patients with primary gastrointestinal diffuse large B-cell lymphoma (DLBCL) at a single healthcare facility in Korea. METHODS: Between May 1998 and December 2003, 76 primary gastrointestinal DLBCL patients at Asan Medical Center were identified and evaluated. RESULTS: Male patients accounted for 40 cases. The median age was 53 years. A total of 38 patients had primary gastric DLBCL. With a median follow-up of 25 months, the five year overall survival (OS) rate was 61.4% and the five year event free survival (EFS) rate was 59.3%. B symptoms, performance status, LDH levels and involved sites did not affect survival. Twenty-seven patients who underwent primary surgical resection did not demonstrate a difference in survival when compared to patients who did not undergo surgery. However, for intestinal lymphoma, primary surgical resection had a significant influence on EFS (p=0.030). Age (p=0.038), sex (p=0.017), stage (p=0.048), and the number of extranodal sites (p=0.002) were significant factors for EFS. The three year EFS rate for each International Prognostic Index (IPI) risk group was as follows: 78.4% for low risk, 63.7% for low-intermediate risk, 30.0% for high-intermediate risk and 0% for high risk (p=0.002). Cox multivariate analysis revealed that the IPI was the only independent prognostic factor for EFS (p=0.002). CONCLUSIONS: Here we report on the unique pattern of clinical features of primary gastrointestinal DLBCL from a single healthcare center in Korea. The IPI system had prognostic value for primary gastrointestinal DLBCL.
B-Lymphocytes* ; Chungcheongnam-do ; Delivery of Health Care ; Disease-Free Survival ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell* ; Male ; Multivariate Analysis ; Prognosis

No abstract available.
Wound Healing* ; Wounds and Injuries*

No abstract available.
Dental Enamel* ; Wound Healing* ; Wounds and Injuries*

OBJECTIVES: The aim of this study was to develop a Mental Health Questionnaire for Adults (MHQ-A) and investigate its validity and reliability. METHODS: A 73-item questionnaire was developed or selected by seven psychiatrists and a clinical psychologist. The questionnaire was administered to 351 subjects in Seoul and Gyeonggi area. The construct validity was investigated by performing principal component analysis, and the reliability was assessed in terms of the internal consistency using Cronbach's alpha. RESULTS: Principal component analysis revealed 15 factors underlying the psychiatric disorder and symptom category. Taken together, these 15 factors accounted for 64.023% of the common variance. Cronbach's alpha was high, indicating that the reliability of the questionnaire was satisfactory. Every category showed a positive correlation with most psychological measures. CONCLUSION: These results indicate that the MHQ-A is a reliable and valid scale for assessing psychiatric disorders. Although there were many limitations, the present study has significance as the basis of future research.
Adult ; Gyeonggi-do ; Humans ; Mental Health ; Principal Component Analysis ; Psychiatry ; Psychology ; Reproducibility of Results ; Seoul