No abstract available.
Antibody Formation* ; Humans*

We describe a case of fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in the lymph node of the neck presenting a predominantly spindle cell pattern. A 36 year-old male patient complained of dysesthesia on the right face and a palpable neck mass. Fine needle aspiration was done on the neck mass. Tumor cells were present in syncytial groups or singly with mainly spindle shaped nuclei, vesicular chromatin, thin and regular nuclear membrane, occasional prominent nucleoli and a few foci of cellular cohesiveness. The cytoplasm was scant and pale with ill-defined borders. Mature lymphocytes were present in the background of aspirates and within the tumor cell clusters. Histologically, the tumor of nasopharynx showed several areas of spindle cell pattern. Because the tumor cells showed a predominantly spindle shape with vesicular nuclear chromatin, the differential diagnosis of spindle cell sarcoma or granuloma of epithelioid cells were considered, but the characteristic morphology of the nuclei with vesicular chromatin and prominent nucleoli, and cellular cohesiveness were important in making the diagnosis of nasopharyngeal carcinoma. The possibility of metastatic carcinoma should always be considered in fine needle aspiration cytology of the lymph node in the neck because the incidence of metastatic carcinoma, particularly of the nasopharyngeal carcinoma in the lymph nodes of the neck is relatively high.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Incidence ; Neoplasm Metastasis

No abstract available.
Bowen's Disease*

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

OBJECTIVE: To determine the changes of nitric oxide production in preeclampsia, the concentration of nitric oxide metabolite, nitrite, was measured in umbilical vein after perfusing plasma from normal pregnant women and preeclamptic pregnant women. MATERIAL AND METHOD: 15 normal and 15 preeclamptic umbilical cords were obtained at the time of cesarean section. Two pieces of umbilical cord in equal length(20 cm in length) were prepared from each umbilical cord. Two pieces of umbilical cord were connected in parallel in a perfusion chamber. One piece of umbilical cord was perfused sequentially for 20-minutes' interval with the perfusates in the order of cord buffer, cord buffer including 15% normal pregnant serum, 15% normal pregnant serum with histamine(10-5mol/L), 15% normal pregnant serum with calcium ionophore A23187(5 mol/L) and the other one was perfused exactly same way using 15% preeclamptic serum instead of 15% normal pregnant serum. All the perfusates used were gassed with 95% O2 and 5% CO2 and warmed to 37degree C. Perfusates were collected in eppendorf tube and freezed at -70degree C until assayed. NO was measured by means of Greiss reaction. one way ANOVA and paired t-test were used where appropriate and p-value < 0.05 was considered significant. RESULTS: NO production in normal umbilical cords was not different regardless of perfusate. Although adding histamine and calcium ionophore, the NO production was slightly increased but statistically not significant in both groups. NO production in preeclamtic umbilical cords was significantly increased with 15% preclamptic serum(15% normal serum vs. 15% preeclamptic serum; 0.060+/-0.016microgram/ml/min vs 0.075+/-0.014microgram/ml/min, p<0.05). CONCLUSION: The preeclamptic sera may not affect the production of NO in the human umbilical vein endothelial cells. The biologic significance of increased NO production in preeclamptic umbilical cord with perfusing preeclamptic serum is unknown, but it might be compensation for the vasoconstriction of preeclampsia.
Calcium ; Cesarean Section ; Compensation and Redress ; Female ; Histamine ; Human Umbilical Vein Endothelial Cells ; Humans ; Nitric Oxide* ; Perfusion ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Umbilical Cord ; Umbilical Veins ; Vasoconstriction

OBJECTIVES: The Korean version of Bowel disease questionnaire (BDQ-K) was developed to evaluate the symptom items required to meet the definition of functional gastrointestinal disorders (FGIDs). We evaluated the test-retest reliability and validity of the self-reported BDQ-K and prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS) according to the Rome-III criteria. METHODS: Sixty-nine patients participated in the test-retest reliability study, with a two week interval, and another 74 patients were enrolled to assess the self-reported questionnaire versus a doctor's interview (concurrent validity). A total of 3,325 subjects (mean age, 44+/-9 yrs; 58.3% male) presenting for an upper endoscopy responded to the BDQ-K at a health promotion center, but 797 subjects with organic diseases were excluded. RESULTS: In the validity study of the BDQ-K, the median kappa value was 0.74 (0.36~1.0). The median kappa value for the test-retest was 0.56 (range 0.22~1.0), including abdominal pain (kappa=0.51, P<0.001), pain onset before 6 months (kappa=0.51, P<0.001), epigastric pain (kappa=0.69, P<0.001), early satiety (kappa=0.40, P<0.001), and postprandial fullness (kappa=0.34, P<0.001). The prevalence of FD was 8.3% (209/2,528); epigastric pain more than once a week 4.4%, early satiety 2.5%, and postprandial fullness 6.1%. FD was more prevalent in women (P=0.001). The prevalence of IBS was 6.1% and IBS also predominated in women (7.1% vs 5.1% in men, P=0.032). CONCLUSION: The BDQ-K is a reliable and valid instrument for identifying FGIDs. The prevalence of FD according to the Rome III criteria was 8.3% and that of IBS was 6.1%.
Abdominal Pain ; Dyspepsia ; Endoscopy ; Female ; Gastrointestinal Diseases ; Health Promotion ; Humans ; Irritable Bowel Syndrome ; Male ; Prevalence ; Reproducibility of Results ; Rome ; Surveys and Questionnaires

OBJECTIVES: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI, > or =5 vs. <5). METHODS: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having > or =5 ; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. RESULTS: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. CONCLUSIONS: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI> or =5 than non-supine AHI<5.
Body Mass Index ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Cerebrocostomandibular syndrome is characterized by micrognathia, cleft palate, multiple thorax deformity and frequently, mental deficiency. Respiratory compromise is a common cause of death. We experienced a case of cerebrocostomandibular syndrome with congenital heart disease in a 2 day old female baby with the chief complaint of cyanosis and respiratory difficulty since birth. She was delivered by cesarian section due to delayed labor at IUP 42 weeks. The diagnosis was made on the basis of clinical features, radiologic findings and echocardiogram, which showed micrognathia, deformity of 3rd finger Lt, hemivertebrae of T1-T6 Lt., absence of 1-6th rib Lt., dextrocardia, tetralogy of fallot, atrial septal defect secondum. We reported this case and reviewed related litertures briefly.
Cause of Death ; Cleft Palate ; Congenital Abnormalities ; Cyanosis ; Dextrocardia ; Diagnosis ; Female ; Fingers ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Humans ; Intellectual Disability ; Parturition ; Ribs ; Tetralogy of Fallot ; Thorax

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. Previous studies suggested that, Pityrosporum, lipophilic fungi, may play an important role in the pathogenesis of the disease. OBJECTIVE: The purpose of this study was to investigate the disease clinically and mycologically for better understanding of the pathogenesis. METHODS: Two hundred and one new patient.s with seborrheic dermatitis of the scalp and 67 norrnal subjects were obs!,rved clinically by the dermatologist and studied stat,istically by questionnaires. A mycologic study of Pityrosporum was also performed by direct smear. RESULTS: Among a total of 201 patients wit,h seborrheic dermatitis, 72.6% had pityriasis sicca, 10.5% had pityr iasis steartoides and 16.9% had inflammatory seborrheic dermatitis. On clinical grading by the Kligman.. scale, grade III(slightly scaling) was the most common in the patients and 52.6% of the norma. subjects were below grade II (no scaling). Spores of Pityrosporum were observed in 76.7% of the patients and 91.5% of the normal subjects. The incidence of Pityrosporum was lower particularly in t,he patients with inflammatory seborrheic dermatitis t,han in other pa~tients groups. CONCLUSION: According to the results of the study, it, is difficult to conclude that Pityrosporum is a main causative ager t of seborrheic dermatitis. In addition, it is thought t.hat further studies of the role of Pityrosporum in seborrheic dermatitis are needed.
Dermatitis, Seborrheic* ; Fungi ; Humans ; Incidence ; Malassezia* ; Pityriasis ; Scalp* ; Spores ; Surveys and Questionnaires

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. Previous studies suggested that, Pityrosporum, lipophilic fungi, may play an important role in the pathogenesis of the disease. OBJECTIVE: The purpose of this study was to investigate the disease clinically and mycologically for better understanding of the pathogenesis. METHODS: Two hundred and one new patient.s with seborrheic dermatitis of the scalp and 67 norrnal subjects were obs!,rved clinically by the dermatologist and studied stat,istically by questionnaires. A mycologic study of Pityrosporum was also performed by direct smear. RESULTS: Among a total of 201 patients wit,h seborrheic dermatitis, 72.6% had pityriasis sicca, 10.5% had pityr iasis steartoides and 16.9% had inflammatory seborrheic dermatitis. On clinical grading by the Kligman.. scale, grade III(slightly scaling) was the most common in the patients and 52.6% of the norma. subjects were below grade II (no scaling). Spores of Pityrosporum were observed in 76.7% of the patients and 91.5% of the normal subjects. The incidence of Pityrosporum was lower particularly in t,he patients with inflammatory seborrheic dermatitis t,han in other pa~tients groups. CONCLUSION: According to the results of the study, it, is difficult to conclude that Pityrosporum is a main causative ager t of seborrheic dermatitis. In addition, it is thought t.hat further studies of the role of Pityrosporum in seborrheic dermatitis are needed.
Dermatitis, Seborrheic* ; Fungi ; Humans ; Incidence ; Malassezia* ; Pityriasis ; Scalp* ; Spores ; Surveys and Questionnaires