The Diego blood group system consists of two pairs of antigens, Dia and Dib The incidence of Dia is low among pure Caucasian, Blacks, Polynesian and Eskimo, however, the rnongolians and American indians have both Dia and Dib. We report a case of two days old male who was admitted on first day of life for jaundice and subsquently exchange transfusion was performed on second day of life for bilirubin of 20 mg/dl. The blood groups of patient and his mother were both Rh D positive 0 type. Direct and indirect Coombstest were strong positive in the patient and indirect Coombstest was positive in his mother. We found anti-Dib antibody in his rnother's serum. The phenotype of Diego blood group system of the patient and his mother were Di (a+b+) and Di (a+b- ), respectively and hemolytic anemia in this case was due to anti-Dib antibody.
African Continental Ancestry Group ; Anemia, Hemolytic ; Bilirubin ; Blood Group Antigens ; Humans ; Incidence ; Indians, North American ; Inuits ; Jaundice ; Male ; Mothers ; Phenotype

BACKGROUND: Compared with conventional routes of delivering potent analgesics to postoperative patients, transdermal administration of fentanyl offers the advantages of simplicity and noninvasiveness. The analgesic efficacy and safty of transdermal fentanyl patch (TDFP) were evaluated postoperatively. METHOD: TDFP releasing 25 mcg/hr (Group 1) or placebo (Group 2) were applied to 40 women 6 hours before total abdominal hysterectomy under the general anesthesia. Postoperatively, self-administered intravenous fentanyl was maintained with a 20-mcg incremental dose and a 10-min. locking interval. Each group was assessed following 48 hours with respects to vital signs, VAS pain scores, hourly-used fentanyl doses, satisfaction scores and side effects. RESULT: VAS observed 24 hours, 36 hours after operation were significantly lower in group 1 than group 2. Hourly-used fentanyl doses were significantly lower in group 1 than group 2 at 2 hours, 6 hours, 12 hours and 24 hours after operation. The incidence of side effects were similar between group 1 and group 2. CONCLUSION: TDFP-25 mcg applied 6 hours before operation provides supplementary analges-ia after the postoperative period without significant side effects such as respiratory depression.
Administration, Cutaneous ; Analgesics ; Anesthesia, General ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p < 0.05). The accuracy of MRI and CT was 77.1% and 72.4% in detecting of gastric tumor respectively (p > 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.
Abdomen ; Butylscopolammonium Bromide ; Compensation and Redress ; Diagnosis ; Glucagon ; Humans ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pancreas ; Spleen ; Tomography, X-Ray Computed

Historically, gastrointestinal stroma tumors (GIST) have been considered as smooth muscle tumors, but the controversy over this histogenesis is provoked due to various results with utilizing immunohistochemical methods. In andeffort to further clarify the histogenesis of GIST, we performed the immunohistochemical study, as well as histopathologic reexamination, of 24 cases, all diagnosed as smooth muscle tumors of gastrointestinal tract, from Seoul Paik Hospital and Ewha University Hospital between 1980 and 1989, and the main results were as follows; 1) In the histopathologic features by light microscopic study, 11 benign and 13 malignant lesions (including one high grade malignancy and 12 low-grade malignant lesions) were disclosed. 2) In the immunohistochemical study, all tumors showed Vimentin positivity (100%), but no tumor showed S-100 protein positivity (0%), and 7 cases (29.1%) showed Desmin positivity. Positive reaction for Desmin made it possible to suggest that the histogenesis of GIST be in smooth muscle, and neurogenic origin would be excluded by all negativity for S-100 protein. In summary, we would like to conclude that GIST would be smooth muscle tumors on account of their morphological characteristics and their intramural location, but most of them appear poorly differentiated by immunohistochemical method.

Acquired tufted angioma is a benign, slowly progressive angioma with a characteristic histologic pattern, that was first described by Wilson Jones in 1979. We present herein a case of this rare disease developed in a 43 year old healthy woman. Routine biopsy specimens and an immunoenzymatic staining of factor 7IE showed compatible findings with those cases reported previously. The lesions were surgically excised, and during the two months of follow up, there was no sign of recurrence.
Adult ; Biopsy ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Rare Diseases ; Recurrence

To evaluate the differentiation status of smooth muscle in gastric stromal tumors which were negative for S-100 protein, immunohistochemistry using desmin, actin, myosin and vimentin was performed in 14 cases of gastric smooth muscle tumors. Ultrastructural Examination was also performed. For comparison a case of leiomyoma of the esophagus, a case of the sigmoid colon, 10 cases of the uterus were also examined. The results obtained were as follows. All gastric smooth muscle tumors showed vimentin-positivity. Six of 14 gastric smooth muscle tumors, (5 of 8 leiomyoma and 1 of 4 leiomyosarcoma) showed positivity for desmin, actin, and myosin(42.9%). All esophageal, colonic, and uterine leiomyomas showed diffuse positive reaction for desmin, actin, and myosin. Vimentin positivity was also noted in leiomyoma of the colon and uterus. Ultrastructurally, a few cells in the gastric stromal tumors had scattered microfilaments with dense bodies, subplasmalemmal dense plaques, and micropinocytic vesicles. However, most of the tumor cells did not have any of the ultrastructural features of smooth muscle differentiation. Leiomyomas of the esophagus and uterus showed many cytoplasmic microfilaments with dense bodies. These results suggest that most of the benign and malignant tumor cells of gastric stromal tumors have features of the undifferentiated cells, immunohistochemically as well as ultrastructurally, although a few cells have. It is speculated that most gastric stromal tumors may have lost their smooth muscle differentiation.

PURPOSE: The purpose of this study was to determine the changes on Index of Nausea, Vomiting, & Retching (INVR) during a cycle of chemotherapy. METHODS: Forty-three patients hospitalized for chemotherapy at C University Hospital during a period of 5 days from March to May, 2003 were examined. Scores of INVR were measured once a day. Anxiety, anorexia, fatigue, and sleep satisfaction were measured before chemotherapy. Data was analyzed by repeated measures of ANOVA. RESULTS: The score of INVR increased over time during the days of hospitalization and showed a peak on the third day. The score was significantly higher on the third and consecutive cycles than on the first and second cycle. The score was significantly higher in patients in their forties and fifties rather than in their sixties. The score was higher in women than in men, and also increased as the sleep satisfaction decreased. CONCLUSION: These results suggested that specific interventions for relief of nausea & vomiting were needed in middle age, women, the third chemotherapy cycle, and the third day after chemotherapy.
Antineoplastic Agents/*adverse effects ; Female ; Humans ; Male ; Middle Aged ; Nausea/*chemically induced ; Neoplasms/*drug therapy ; Time Factors ; Vomiting/*chemically induced

No Abstract Available.
Drug Resistance* ; Korea*

Because of the long intracranial course, the 6th nerve is vulnerable to increased intracranial pressure, trauma to the cranial floor, meningeal edema, inflammation in the base of the skull, and any displacement of the brain stem. The authors had experienced a case of abducens nerve palsy resulting non-concomittent esotropia and lateral gaze palsy due to brain trauma by traffic accident. We had performed modified Jensen procedure that had good result. That procedure is presented to aid in preserving the anterior segment blood supply. The anterior ciliary artery in the lateral rectus is not included in the union. The case report is reviewed with the pertinent literature.
Abducens Nerve Diseases* ; Accidents, Traffic ; Brain Injuries ; Brain Stem ; Ciliary Arteries ; Edema ; Esotropia ; Inflammation ; Intracranial Pressure ; Paralysis ; Skull

PURPOSE: Problem-based learning(PBL) experiences applied in the field of screening for chronic disease during the course of Community Medicine for the 3rd grade medical students were summarized. This study was aimed to train medical students the health appraisal ability and also the ability for public health education and promotion with health-oriented concept rather than disease-oriented one. And also it was aimed to train students to know what to learn and how to search the informations they need for themselves. STUDY SUBJECT AND METHOD: Three to four students in one team spent one and half days(Friday and Saturday) of one-week practical course of Community Medicine. Assigned materials were the medical records which are the files with the results of automated multiphasic screening tests which were applied to generally healthy people. Students were supposed to find, evaluate, solve or manage the real problems encountered from the multiphasic screening test results. RESULTS: The students accepted this self-directed learning process and small group discussion and also health-oriented human approach as new experiences and stimulants.
Chronic Disease* ; Community Medicine ; Education ; Humans ; Learning ; Mass Screening* ; Medical Records ; Multiphasic Screening ; Problem-Based Learning ; Public Health ; Students, Medical