No abstract available.
Cervix Uteri* ; Female

Malignant lymphomas with cental and/or peripheral low densities suggesting internal infarcted necrosis arerare, probably due to the same reason as that of normal lymph nodes in which spontaneous infarction seldom occuresbecause of dual vascular connection and low oxygen consumption of activated lymphocytes. We report eight cases ofhistologically proven non-Hodgkin's lymphoma, that showed necrotic low density within tumor mass in CT scan, priorto any teatment. The locations of necrotic lymphomas were mediastinum in 3 cases, abdomen in 4 cases, and neck in1 case. The histologic types of the cases wre diffuse histiocytic (Rappaport) in 4 cases, porly differentiatedlymphocytic types in 2 cases, lymphoblastic type in 1 case, and mixed type(predominantly poorly differentiatedlymphocytic) in 1 case. It seems that malignant lymphoma can be included in differential diagnosis oflymphadenopathy with cental and/or peripheral necrotic low densities on CT.
Abdomen ; Diagnosis, Differential ; Infarction ; Lymph Nodes ; Lymphocytes ; Lymphoma ; Lymphoma, Non-Hodgkin ; Mediastinum ; Neck ; Necrosis ; Oxygen Consumption ; Tomography, X-Ray Computed

Ultrasonographic findings in 34 cases of primary hepatoma, and 18 cases of secondary hepatoma, which had been proved histopathologically or suspected clinically and ultrasonographically, were reviewed. The results were summarized as follows. 1. Among 52 cases, 40 cases were male and 12 cases were female. The male predominent than the female with the ratio of 4:1. In 52 cases, 40 cases (77%) of the patients were between 41 years and 60 years.2. The most common ultrasonographic finding of hepatoma was discrete homogeneous hyperechoic mass. 3. Primaryhepatomas were usually solitary and relatively large, while secondary hepatomas were usually multiple andrelatively small. 4. Hepatitis, liver cirrhsis, and clonorchiasis were more common in primary hepatomas than secondary hepatomas.
Carcinoma, Hepatocellular ; Clonorchiasis ; Female ; Hepatitis ; Humans ; Liver ; Male

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.
Airway Resistance ; Anesthesia ; Anesthesia, General* ; Child, Preschool ; Female ; Humans ; Recovery Room ; Tachycardia ; Vital Signs

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.
Airway Resistance ; Anesthesia ; Anesthesia, General* ; Child, Preschool ; Female ; Humans ; Recovery Room ; Tachycardia ; Vital Signs

No abstract available.
Cesarean Section* ; Female ; Pregnancy

BACKGROUND: To investigate the change of iron dynamics, erythropoiesis, and serum transferrin receptor (sTfR) concentration during pregnancy, we measured the reticulocyte subpopulations, reticulocyte maturity index (RMI) and sTfR concentration in normal pregnant women. Also we determined which parameter among sTfR, serum iron, or serum ferritin is more representative for clinical features and erythropoiesis in pregnant women. Method: A total of 283 pregnants were examined for reticulocyte subpopulations, sTfR, and a battery of iron parameters. Reticulocytes and their subpopulations were automatically analyzed by flow cytometry (R-3000; Sysmex, Toa, Japan). Serum iron and TIBC were assayed with the automatic chemical analyzer (Hitachi 747; Hitachi, Tokyo, Japan) and serum ferritin was measured by the chemiluminescence method (ACS 180; Chiron, USA). Soluble transferrin receptor was measured by the immunoenzymometric method (ELISA ; Orion Diagnostica, Finland). RESULTS: There was no significant difference in sTfR concentration between pregnant women in the 1st trimester (2.29+/-0.45 mg/L) and non-pregnant women (2.18+/-0.46 mg/L). However, the sTfR concentration gradually increased with gestational age from the 2nd trimester of pregnancy and reached maximal concentration (5.76+/-1.12 mg/L) in the 3rd trimester. The mean sTfR in postpartum 12 weeks was similar to that in the 1st trimester. RMI in the 3rd trimester was three- to four- fold higher than that in the 1st trimester. The sTfR correlated better with RMI (r=0.62, P<0.01), MCH (r=-0.61, P<0.01) and gestational age (r=0.51, P<0.01) than to serum iron and ferritin. CONCLUSIONS: The sTfR concentration increases with gestational age during pregnancy and returns to normal at 12 weeks after delivery. Elevated sTfR concentration during pregnancy seems to be more influenced by erythroid TfR turnover than by iron depletion. The sTfR is a more reliable predictor of erythropoiesis and iron status during pregnancy than serum iron or ferritin.
Erythropoiesis* ; Female ; Ferritins ; Flow Cytometry ; Gestational Age* ; Humans ; Iron ; Luminescence ; Postpartum Period ; Pregnancy ; Pregnant Women* ; Receptors, Transferrin* ; Reticulocytes ; Transferrin*

Hepatocellular carcinoma(HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration(FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesion-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histologic examination including lobectomy, biopsy, or cell block material, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level(over 400 I. U.). All aspiration smears were stained by the Papainicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endothelial lining, multinucleated giant cells, eosinophilc, globules bile and Mallory body. Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern(80.3%). The irregular(12.6%), the acinar(5.5%), and the dispersed patterns(1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells : the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows : intranuclear cytoplasmic inclusion in 86.8% ; endothelial lining in 56.1% ; bile in 19.8% ; and giant cells in 60.1%. Clear cells were often present in 11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern. hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.
Adenoma, Liver Cell ; alpha-Fetoproteins ; Anaplasia ; Bile ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Eosinophils ; Fibrosis ; Giant Cells ; Hepatocytes ; Inclusion Bodies ; Korea ; Liver ; Mitosis ; Necrosis ; Needles ; Regeneration ; Retrospective Studies

PURPOSE: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning- related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. METHODS: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. RESULTS: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. CONCLUSION: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning.
Adult ; Aged ; Automobiles ; Child ; Death Certificates ; Drowning ; Humans ; Incidence ; Insurance ; Korea ; Male ; National Health Programs ; Prognosis ; Seasons

Kerion celsi is a severe inflammatory type of tinea capitis that presents as a boggy mass studded with broken hairs, oozing purulent material from follicular orifices. This infection is caused most commonly by zoophilic or geophilic pathogens. Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea unguium and tinea pedis. But, kerion celsi caused by T. rubrum is rare. Kerion celsi is uncommon in adult. We report a case of kerion celsi caused by T. rubrum in a 72-year-old woman. She presented with localized tender erythematous plaques with pustules with oozing purulent material on the frontal scalp. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer region for clinical isolate was identical to that of T. rubrum strain UZ1588_14 (GenBank accession number KP326579.1). She was treated with 200 mg of oral itraconazole daily for 3 months. The skin lesions improved 1 month after treatment, and recurrence has not been observed.
Adult ; Agar ; Aged* ; Arthrodermataceae ; Base Sequence ; Female ; Glucose ; Hair ; Humans ; Itraconazole ; Onychomycosis ; Recurrence ; Scalp ; Skin ; Tinea Capitis* ; Tinea Pedis ; Trichophyton*