In 1985, Stein et al, indentified an anaplastic large-cell malignant lymphoma that was distinctive because of the diffuse dermal infiltration of pleomorphic large lymphocytes, sinus growth pattern, and reactivity with the monoclonal antibody Ki-1(CD30). The clinical feature; distinguishing anaplastic large-cell Ki-1 lymphoma include a young median age, frequent peripheral adenopathy with sparing of the mediastinum, and extranodal disease with skin the most common sitc of involvement. We report a case of Ki-1 postive large-cell lymphoma in a 74-year-old male patient who presented with multiple ulcerated nodules on the right shin area.
Aged ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Male ; Mediastinum ; Skin ; Ulcer

No abstract available.
Diabetes Mellitus* ; Insulin*

Treatment of the trigger points(TrP) is the most important thing for management of myofascial pain syndrome(MPS). The most effective treatment of TrP is local injection with various types of drug or dry needling, but the effectiveness of each drug was not the same by each investigator. The purposes of this study are to evaluate diagnostic value of Digital Infrared Thermographic Imaging(DITI) for trigger points and therapeutic effects of lidocaine and normal saline by DITI. This study included 15 patients who have TrP on upper trapezius muscles as a patient group and 10 normal adults as a control group. 2 cc of 2% Lidocaine was injected to the TrP of upper trapezius muscles in a patient group and to one side of upper trapezius muscles in a control group. One week after the first injection, 2 cc of normal saline was injected by the same method in a patient group. DITI was taken sequentially, preinjection(Pre), immediately after injection(P0), 15(P15), 30(P30), 60(P60) minutes and 24 hours(P24h) after injection. The parameters, temperature difference(deltaT) of both sides, changes of deltaT(deltadT), visual analogue scale(VAS) were recorded at each point. It was considered abnormal, when the deltaT was above 0.6oC. The patient group was subdivided as Group I(hot spot), Group II(cold spot) and Group III(no difference) according to preinjection thermographic findings of TrP. The results were as follows: 1) deltaT of control group was within 0.52oC(95% confidence interval), 2) the numbers were 9 in Group I, 3 in Group II and 3 in Group III, and the sensitivity and specificity of hot spots for MPS were 81.8% and 57.1%, respectively, 3) deltaT was more reduced after lidocaine- than normal saline-injection, 4) VAS was more reduced after lidocaine- than normal saline-injection, especially in Group I and II. It is concluded that DITI can be used as one of the diagnostic tools for TrP and lidocaine is more effective than normal saline for the treatment of TrP.
Adult ; Humans ; Lidocaine ; Myofascial Pain Syndromes ; Research Personnel ; Sensitivity and Specificity ; Superficial Back Muscles ; Thermography ; Trigger Points*

OBJECTIVE: The purpose of this study was to evaluate hemodynamics for diabetes mellitus (DM) by transcranial Doppler sonography (TCD) and to evaluate the influences of risk factors to cerebral hemodynamics in DM. METHOD: We examined 54 normal persons, 17 patients with DM without risk factors, and 15 patients with DM and risk factors. The risk factors were hypertension, smoking, and hyper lipidemia (total cholesterol >240 mg/dl, low density lipoprotein >160 mg/dl). Mean blood flow velocity (MBFV) was also analyzed by Angiodine 2 Doppler system operating at 2 MHz frequency from each subjects. RESULTS: There was a significant decrease of MBFV in the diabetes in comparison to control groups (p<0.05). There was a significant decrease of MBFV in the diabetic risk group as compared to diabetic non-risk group (p<0.05). There was significantly increased total cholesterol, low density lipoprotein, low density lipoprotein/high density lipoprotein ratio in the diabetic risk group as compared to diabetic non-risk group (p<0.05). MBFV significantly decreased with increasing concentration of HbA1C and duration of DM (p<0.05). CONCLUSION: We suggest that transcranial Doppler sonography can be used as one of the useful screening tests for early detection of cerebrovascular diseases in DM.
Blood Flow Velocity ; Cholesterol ; Diabetes Mellitus* ; Hemodynamics* ; Humans ; Hyperlipidemias ; Hypertension ; Lipoproteins ; Mass Screening ; Risk Factors ; Smoke ; Smoking ; Ultrasonography, Doppler, Transcranial*

The use of lyophilised bone from calves as a heterograft was introduced by Maatz and Bauermeister in 1957 as an alternative to autografts and freeze-dried homografts which were then in general use. The Kiel bone was known to possess no antigenecity and serial radiographs revealed that it is incorporated into the recipient site by a process of creeping substitution from surrounding bone. In patients with benign bone tumors, the surgical dead space was filled with Kiel bone graft in the departments of orthopedic surgery, Pusan national university hospital. The results were followed up for more than 14 months, and were evaluated by the palin film findings. The results were as follows : l. Of the 22 cases, satisfactory result was obtained in 18 cases(81,8%). 2. The mean lesion size(diameter of lesion/diameter of bone)of success cases was 61.6%, and the mean lesion size of failed cases was 82.8%. 3. The duration from the Kiel bone graft to the evidence of new bone formation and remodelling was 10.5 months on an average with a range of 7months to 15months, and the duratin from the Kiel bone graft to the complete resorption of the Kiel bone was 45.7 months on an average with a range of 29 months to 66 months. 4. The causes of the failed cases were thought to be incomplete removal of the lesion, decreased vascularity due to repeated surgery, large size of the lesion, and the potentiality of tumor, 5. It was difficult to evaluate success rate according to underlying disease because the number of the cases was not large enough, but giant cell tumor showed high recurrence rate.
Allografts ; Autografts ; Busan ; Clinical Study ; Giant Cell Tumors ; Heterografts ; Humans ; Orthopedics ; Osteogenesis ; Pipemidic Acid ; Recurrence ; Transplants

OBJECTIVE: To evaluate peripheral hemodynamics using the doppler ultrasound in the diabetic patients. METHOD: We measured mean blood flow velocity (MBFV), resistance index (RI), pulsatility index(PI) in the dorsalis pedis artery (DPA), posterior tibial artery (PTA), and radial artery (RA) from 18 normal controls (n=36), 17 diabetes patients without neuropathy (n=34), and 21 diabetes patients with neuropathy (n=42) by use of Angiodine 2 Doppler system operating at 8 MHz frequency. RESULTS: MBFV of all the examined arteries increased significantly in the diabetes with neuropathy in comparison to controls and the diabetes without neuropathy (p<0.05). RI and PI of DPA and PTA decreased significantly in the diabetes with neuropathy in comparison to controls and diabetes without neuropathy (p<0.05). The blood flow velocity profile was changed from triphasic to monophasic pattern in the diabetes with neuropathy in DPA and PTA. CONCLUSION: The Doppler ultrasound is considered as a useful tool for screening change of peripheral blood flow in the diabetic patients with neuropathy.
Arteries ; Blood Flow Velocity ; Diabetes Mellitus* ; Hemodynamics* ; Humans ; Mass Screening ; Radial Artery ; Tibial Arteries ; Ultrasonography*

OBJECTIVE: To analyze the diagnostic value of digital infrared thermographic imaging(DITI) and to compare the therapeutic effects of lidocaine injection(LI) and dry needling(DN) in the treatment of myofacial pain syndrome(MPS) by using the DITI and visual analogue scale(VAS). METHOD: After 20 minutes adaptation time, 41 patients with MPS and 15 controls undertook DITI. LI and DN were randomly given in the trigger points of the patient group and to either side of the upper trapezius muscle in the controls. The effects of treatment were immediately assessed by measuring the temperature difference(deltaT) of the involved area and the corresponding area on the opposite side of the body using the DITI and VAS. Follow up assessments of VAS, change of VAS, deltaT and change of deltaT were performed 1, 3, 5 and 7 days after the treatment, respectively. RESULT: 1) The sensitivity and specificity of hot spots for TrP were 78.1% and 73.3 %, respectively. 2) deltaT and VAS continuously declined for 7 days after the treatment as compared to before the treatment in groups Ia (n= 16, deltaT>0.6degrees C, LI) and Ib (n=16, deltaT>0.6degrees C, DN). 3) deltaT and VAS ware not statistically different for groups Ia and Ib. 4) There was no statistically significant correlation between deltaT and VAS in both groups I and Ib. CONCLUSION: These data suggest that DITI can be used as one of the valuable tools for the evaluation of trigger points. No significant difference noted in the therapeutic effects of LI and DN for MPS.
Facial Pain ; Follow-Up Studies ; Humans ; Lidocaine* ; Myofascial Pain Syndromes* ; Sensitivity and Specificity ; Superficial Back Muscles ; Thermography ; Trigger Points

OBJECTIVE: To establish the normal values of the transcranial doppler sonography in healthy Korean adults according to the increasing age and sex. METHOD: We examined 68 healthy adult volunteers who had no history of diabetes mellitus, hypertension, cerebrovascular disease or other neurological illness. The study included 54 subjects from whom good doppler signals from the middle, anterior, and posterior cerebral arteries could be obtained. Mean blood flow velocity (MBFV), Resistance index (RI), and Pulsatility index (PI) were analyzed by Angiodine 2 Doppler System operating at 2 MHz frequency. RESULTS: MBFV significantly decreased with the increasing age in the middle, anterior and posterior cerebral arteries (p<0.05). There was a significantly decreased MBFV of the middle cerebral artery in the 4 th, 5 th, 6 th, and 7 th decades compared to the 3 rd decade (p<0.05). RI and PI were significantly increased with the increasing age (p<0.05). MBFV of the female subjects were greater than the male subjects (p>0.05). There was no significant difference in the RI and PI between the male and female subjects. CONCLUSION: We suggest that the transcranial doppler sonography can be used as one of the useful screening tools for the diagnosis of cerebrovascular diseases.
Adult* ; Blood Flow Velocity ; Diabetes Mellitus ; Diagnosis ; Female ; Hemodynamics* ; Humans ; Hypertension ; Male ; Mass Screening ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Reference Values ; Ultrasonography, Doppler, Transcranial* ; Volunteers

BACKGROUND: There is difference between isoflurane and enflurane in the myocardial sensitization to catecholamines, and their actions on the heart. Enflurane reduces cytoplasmic calcium more than isoflurane. The hypothesis could be suggested that these two volatile anesthetics might cause the different incidences and natures of cardiac arrhythmias. METHODS: The anesthesia was induced by the intravenous injection of thiopental(6 mg, kg-1) and pipecuronium(0.1 mg, kg-1). Two groups were randomly allocated to the patients(n=80) in the maintenance: Group I inhaled isoflurane(1~2%), O2(2 L), and N2O(2 L), Group II, enflurane (1.5~2.5%). Continuous electrocardiographic recordings with Holter monitor were made of those undergoing tympanoplasty during anesthesia. The tapes recorded were scanned using analyzer, and we read out ECG complexes on the screen. Results were categorized as induction, maintenance, and emergence, and inferred from unpaired t-test, and X2-test with p<0.05 considered significant. RESULTS: The results were as follows: 1) The total incidence of cardiac arrhythmias was 65.0%. Isoflurane(52.5%) was lower than enflurane(77.5%) in the incidence. 2) During maintenance and emergence, isoflurane was lower than enflurane in the frequency of supraventicular arrhythmias. 3) Ventricular arrhythmias most frequently occurred in induction. 4) The frequency of supraventricular arrhythmias was more than two times that of ventricular ones. The arrhythmias at the AV junction were the most common, and VPC's the second. CONCLUSIONS: Greatest caution should be paid during peri-induction. It could be suggested that compared to enflurane, isoflurane better be administered for those to whom arrhythmias could be harmful.
Anesthesia ; Anesthetics ; Arrhythmias, Cardiac* ; Calcium ; Catecholamines ; Cytoplasm ; Electrocardiography ; Enflurane* ; Heart ; Incidence* ; Injections, Intravenous ; Isoflurane* ; Tympanoplasty

Chylous ascites is extravasation of lymphatic fluid and retention in the peritoneal cavity due to traurna or obstruction of the lymphatic system. Chylous ascites is very rare complication of Continuous Ambulatory Peritoneal Dialysis (CAPD) and is associated with trauma to the lymphatics during catheter insertion in the early stage of CAPD and repeated mild trauma to the lyrnphatics during longterm dialysis. Chylous ascites in the CAPD is suspected when the drained peritoneal fluid is milky white and confirmed by demonstration of the specific components of chyle, such as elevated triglyceride and low cholesterol than plasma and should be differentiated from pseudochyle and bacterial peritonitis. We report a case of chylous ascites in a patient undergoing CAPD at 2 months later of initiation of CAPD, which was not improved by conservative management. So CAPD catheter was removed and renal replacement therapy was changed to hemodialysis.
Ascitic Fluid ; Catheters ; Cholesterol ; Chyle ; Chylous Ascites* ; Dialysis ; Humans ; Lymphatic System ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Plasma ; Renal Dialysis ; Renal Replacement Therapy ; Triglycerides