In humans, the major stimulus for cutaneous pigmentation is ultraviolet radiation. Little is known about the mechanism underlying this response, in part, because of the complexity of the interactions involving the whole epidermis. The present stucy was undertake to evaluate the effects of a single exposure of UVB on cultured normal melanocytes. Melanocytes were exposed to UVB from 5.1 mJ/cm to 203 mJ/cm. The results were as follows : 1. The main morphologic changes in UVB-exposed groups w re larger sized cells, more blunted dendrites, and shorter dendrites than in the control group. These cells increased sized according to the increased doses of VVB, but above 101.5 mJ/cm, the melanocytes shrunk and were destroyed. 2. From 20.3 mJ/cm of UVB, the proliferation of melanocyte was decreased, Especially, there was statistical!y significant difference above 50.8 mJ/cm (p<0.05, p<0.01). 3. The antiproliferativo effect increased with the passage of tirie after UVB exposure. So, cell count could not be done in 101.5 mJ/cm and 203 mJ/cm on the third day, and in 50.8 mJ/cm, 101.5 m J/cm and 203 mJ/cm on the seventh day. 4. Statistically the melanin content per well was significantl dicreased to 11-28% of each control group with dose above 50.8 mJ/cm (p<0.05, p<0.01). The melanin content per cell was increased to 107-128% of each control group when doses were below 20.3 mJ/cm and decreased to 49-79% of each control group when above 0.8 mJ/cm on the third day, but there was no statistically significant difference. In summary, when melarocytes were exposed to UVB, morphclogic changes progressed to cell differentiation. The results also suggested that a low or dose of UVB has an antiproliferative arid mild melanogenic effect, and a higher dose of UVB has a direct cytotoxic effect.
Cell Count ; Cell Differentiation ; Dendrites ; Epidermis ; Humans ; Melanins ; Melanocytes* ; Pigmentation

We present a case of malignant melanoma associated wi h itiligo in the 49 year-old female patient. Skin lesions showed that centrally located dark black nodile surrounded with brownish colored plaque on the upper half and depigmented patch on the lower half on the left upper thigh and depigmented patch on the right forehead. In western countries, patients with melanoma have been obscrved to develop vitiligo or depigmented spots on the skin, while in korea, rarely observed. We reports that malignant melanoma associated with vitiligo.
Female ; Forehead ; Humans ; Korea ; Melanoma* ; Middle Aged ; Skin ; Thigh ; Vitiligo*

The main purpose of this study was to examine factors related to exercise behavior of civil airmen. The subjects for the study were 200 civil airman including pilots, flight officers and flight engineers working for "A" airline in South Korea. The data was collected from April, 1 to 30, 1996 using a questionnaire that was developed for this study, and analyzed using SPSS(Statistical Package for Social Science). The subjects consisted of 200 males. The average age was 42 years old and the majority(82.5%) were married. The large proportion of subjects had received four years of college education or more(86%), and reported having a religion(71%). The average height and weight were 171.7cm and 69.4kg respectively. The average working period and total flight time were 8 years and 6002 hours respectively. Ninety-five percent of sample exercised regularly. As for the frequency of the exercise, 4% of the sample never exercised and 26% of the sample exercised less than once per week, while 44.5% and 24.5% of the sample exercised once or two times, and more than three times per week respectively. The type of exercise was strengthening (30.0%) and aerobic exercise such as jogging(54%), mountain climbing(37.5%) and golf(33.0%). Nearly three fourths of the sample were involved in more than the "light heavy" level of intensity(72.5%) and the average duration was 74.9 minutes. The following factors are related to the exercise behavior. 1) Age and marriage were positively related to exercise behavior(p<.05). 2) The cognitive/perceptual factor is related to exercise behavior. Those who perceived that their health was poor, that health was out of their control exercised less frequently. Also those who showed low self efficacy, and those who valued their health less exercised less frequently. 3) Among environmental factors, social support such as peers, spouse and media influenced exercise behavior. Also the use of a health center was related to a higher level of exercise behavior compared to self-regulated home exercise. Irregular duty was the higher barrier to exercise. 4) The type and intensity of exercise were related to exercise behavior, but not duration. Those who have been jogging or mountain climbing regularly, and those who exercised rather intensely showed a higher frequency of exercise. However, there was no difference in duration 5) The results of stepwise multiple regression analysis showed that the variables which were related to exercise behavior were exercise intensity, exercise place and whether the subject was married. These three factors accounted for 37% of the variance.
Adult ; Education ; Exercise ; Fibrinogen ; Humans ; Jogging ; Korea ; Male ; Marriage ; Self Efficacy ; Spouses ; Surveys and Questionnaires

NK/T-cell lymphoma, which often shows an angiocentric growth pattern, is a distinct clinicopathologic entity highly associated with Epstein-Barr virus. The disease is characterized by a destruction of the upper respiratory tract, particularly the nasal cavity, palate and paranasal sinuses. Interestingly, NK/T-cell lymphoma is closely linked to a variety of complications, such as hemophagocytic syndrome, second primary cancer, sepsis and bleeding. Here we report a case of a 50-year-old man diagnosed initially as NK/T-cell lymphoma of the oropharynx and who developed a second primary carcinoma of the hard palate during combination chemotherapy and radiation therapy.
Carcinoma, Squamous Cell/*pathology/therapy ; Case Report ; Combined Modality Therapy ; Fatal Outcome ; Human ; Killer Cells, Natural ; Lymphoma, T-Cell/*pathology/therapy ; Male ; Middle Age ; Neoplasms, Second Primary/*pathology/therapy ; Oropharyngeal Neoplasms/*pathology/therapy ; Palatal Neoplasms/*pathology/therapy

PURPOSE: The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000. RESULTS: The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001). CONCLUSION: In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.
Aged* ; Burkitt Lymphoma ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Male ; Multivariate Analysis ; Survival Rate ; T-Lymphocytes ; Treatment Outcome*

BACKGROUND: During hemorrhagic shock, acidosis was frequently treated with sodium bicarbonate, but various adverse reactions were reported. Most adverse effects of sodium bicarbonate have been attributed to increased CO2 production and paradoxical intracellular acidosis. This study was designed to compare the effects of Carbicarb and sodium bicarbonate on hemodynamics and acid base states in canine hemorrhagic shock. METHODS: 12 mongrel dogs were randomly divided as sodium bicarbanate group (group 1, n=6) and Carbicarb group (group 2, n=6). The study was divided into three successive phases as prehemorrhagic phase (I), hemorrhagic shock phase (II), acid-base correctoin phase (III+1 min, III+5 min, III+15 min, III+30 min). At the beginning of phase III, group 1 received sodium bicarbonate 2.5 ml/kg and group 2 received Carbicarb 2.5 ml/kg. During each phase a complete set of hemodynamic parameters, arterial and mixed venous blood gas measurements were recorded. RESULTS: 1) Arterial and end-tidal CO2 of sodium bicarbonate treated group were increased significantly compared with that of Carbicarb treated group after treatment. 2) Acidosis was improved in both groups, but pH of Carbicarb treated group showed more increase compared with pH of sodium bicarbonate treated group (P <0.05). 3) There was significant hemodynamic improvement on both group after treatment, but there was no statistical significance between groups. CONCLUSION: The treatment of Carbicarb shows more increase in arterial pH and less increase in carbon dioxide compared with sodium bicarbonate to treat metabolic acidosis due to hemorrhagic shock in mongrel dogs. So we suggest that Carbicarb is useful in the treatment of metabolic acidosis during hemorrhagic shock.
Acidosis ; Animals ; Carbon Dioxide ; Dogs ; Hemodynamics* ; Hydrogen-Ion Concentration ; Shock, Hemorrhagic* ; Sodium Bicarbonate* ; Sodium*

A 53 year old man with gastric cancer was admitted for radical subtotal gastrectomy. The patient received general anesthesia with epidural analgesia. Epidural catheterization was performed using an 18-gauge Tuohy needle at the T10-11 interspace, and the epidural space was confirmed after a repeated attempt. An epidural catheter was then advanced smoothly 5 cm in cephalad direction without bleeding or CSF leakage. The patient received a test dose of lidocaine and epinephrine and continuous infusion with morphine and lidocaine 30 minutes before operation finished. Vital signs during the operation were stable. Two days after the operation, the patient complained of an orthostatic headache, and relieved ketolorac. On the seventh day, the patient complained of bilateral diplopia. Diffuse pachymeningeal gadolonium enhancement was seen on the brain MRI, and his CSF pressure was 0 mmHg by spinal tapping. We suspected abducent nerve palsy due to CSF hypovolemia and performed an epidural blood patch with 15 ml of autologus blood at the previous puncture site. The patient is receiving regular examinations at the Neurology and Opthalmology department. Abducent nerve palsy completely recovered by the Hess Screen test 6 months after operation, and diplopia disappeared 10 months after the operation.
Abducens Nerve ; Analgesia, Epidural ; Anesthesia, General ; Blood Patch, Epidural ; Brain ; Catheterization* ; Catheters* ; Diplopia* ; Epidural Space ; Epinephrine ; Gastrectomy ; Headache ; Hemorrhage ; Humans ; Hypovolemia ; Lidocaine ; Magnetic Resonance Imaging ; Middle Aged ; Morphine ; Needles ; Neurology ; Pain, Postoperative* ; Paralysis ; Punctures ; Spinal Puncture ; Stomach Neoplasms ; Vital Signs

BACKGROUND: Although modified Mapleson D systems connected to ventilators have been used for controlled ventilation of anesthetized infants and children, the complexity of factors affecting rebreathing within the Mapleson D circuit has resulted in a variety of recommendations for fresh gas flow and minute ventilation. We constructed a formula for ventilator settings which would provide normal tidal volume, respiratory rate, and minute ventilation without rebreathing during mechanical ventilation in pediatric anesthesia and would like to compare this method to commonly recommended Bain-Spoerel's method. METHODS: Seventy eight infants and small children who anesthetized with enflurane and nitrous oxide were studied. We performed controlled ventilation with each method and measured SpO2, PETCO2 at 10, 20, 30 min after anesthetic induction. At 20 min after anesthetic induction, we drew a arterial blood sample to evaluate PaCO2 and PaO2. RESULTS: In patients above 10 kg, mean PaCO2 was within normal range. But in patients below 10 kg, PaCO2 was significantly higher(p<0.01) with the Bain-Spoerel's method than with the Paik Hosp.'s method. CONCLUSIONS: We conclude that our method for ventilator settings can be safely and competently applied to mechanical ventilation with Modified Mapleson D circuit in pediatric anesthesia.
Anesthesia* ; Child ; Enflurane ; Humans ; Infant ; Nitrous Oxide ; Reference Values ; Respiration, Artificial* ; Respiratory Rate ; Tidal Volume ; Ventilation ; Ventilators, Mechanical