Primary lymphoma of the kidney is rare, and in most cases is attributable to lymphomatous renal infilitration of systemic non-Hodgkin's lymphoma or an extension from an adjacent site of the disease. Since the renal parenchyma is not a lymphoid organ, the mechanism by which renal lymphoma occur remains poorly understood. We report here a case of primary bilateral B-cell renal lymphoma in 26-year-old man who was treated successfully with combination chemotherapy.
Adult ; B-Lymphocytes* ; Drug Therapy, Combination ; Humans ; Kidney ; Lymphoma* ; Lymphoma, Non-Hodgkin

Postoperative pain relief and the side effects of epidurally injected morphine were investigated in 164 patients who received various types of operation including abdominal, genitourinary and lower extremities. Epidural morphine injection was given via an epidural catheter after operation. In 58% of total patients, pain relief was considered excellent, good in 30% and fair in 12%. The analgesia of each dose of epidural morphine lasted for 13 hours with everage. The side effects of epidural morphine were few and mild but urinary retention was in 9.8% of total patients, respiratory depression, pruritus, vomiting, catheter obstruction, catheter dislogement and bleeding through the catheter in one case respectively.

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.
Adult ; Male ; Female ; Humans

Renal osteodystrophy is a leading cause of morbidity in patients with end stage renal disease(ESRD), including a diverse clinical spectrum and histologic lesions. Since the invasiveness and practical limitations of bone biopsy to diagnose the exact nature of bone disease in ESRD patients, many attempts have been made to investigate the biologic markers of bone disease. Bone-specific alkaline phosphatase(bAP) is localized in the plasma membrane of osteoblast to be involved in bone formation and skeletal mineralization. This study was undertaken to evaluate the value of bAP in the diagnosis of renal osteodystrophy and to examine the correlation between bAP (Immunoassay, Metra, U.S.A.) and other known markers of bone turn-over, total alkalilne phosphatase (tAP), intact parathyroid hormone(iPTH) and osteocalcin in 49 HD patients(M:F 29:20, mean age 51 years, mean HD duration 57 months). We also evaluated the impact of metabolic acidosis, which is known to stimulate the osteoclastic activity and bone resorption, on plasma levels of these bone markers. The median value of bAP in HD patients was 30.1ng/ml with a distribution of 8.8-140.1ng/ml (normal 12-23ng/ml). There was a significant positive correlation between the duration of HD and plasma levels of tAP, bAP, iPTH and osteocalcin. Significant positive correlaton was also observed between iPTH and other markers of bone turn- over-bAP, tAP and osteocalcin. bAP was correlated better with iPTH(r=0.8483, P<0.001) than tAP(r= 0.7588, P<0.01). In the patients group whose arterial blood bicarbonate below 20mEq/L(30 cases), plasma iPTH and bAP were significantly higher compared to the patients with arterial bicarbonate higher than 20mEq/L(19 cases). In conclusion, high bAP can be an useful marker of increased bone turn-over in HD patients. Increased concentrations of iPTH and bAP in patients with metabolic acidosis(arterial bicarbonate below 20 mEq/L) may reflect an increased bone resorption with resultant increase in osteoblast activity. However, a prospective study with alkali supplementation and bone biopsy will be necessary to define the exact role of metabolic acidosis in the development and progression of renal osteodystrophy.
Acidosis* ; Alkalies ; Alkaline Phosphatase* ; Biomarkers ; Biopsy ; Bone Diseases ; Bone Resorption ; Cell Membrane ; Diagnosis ; Humans ; Kidney Failure, Chronic ; Osteoblasts ; Osteocalcin ; Osteoclasts ; Osteogenesis ; Plasma ; Renal Dialysis* ; Renal Osteodystrophy

To compare geographic differences in anesthesia between Wonju City and another city, Seoul, anesthetic experiences of a total of l6,457 cases performed at the Department of Anesthesiology of Wonju Christian Hospital, Yonsei University Medical College, from Nov. 1957 tO Dec. 1977 were analyzed statistically according to age, sex, physical status, emergency operation, anesthetic agents and methods and complications. The results are as follows: 1) The cases of anesthesia tended to increase year by year and the rate of increasing was remarkable in female patients. 2) Sexual distribution was 8994 cases of males(54.7%) and 7463 cases of females(45.3%). 3) 44. 5% of cases were of patients in the 2nd to 4th decade of age and the patients under 10 years and over 60 years of age tended to increase. 4) The patients in general surgery were more than half of the total cases and the patients in neurosurgery tended to increase. 5) General anesthesia was given to 91. 6% of total cases, and regional anesthesia to 8.4%. 6) Ether anesthesia was used in about 67% of all surgical patients. 7) About 30% of total cases were emergency cases. 8) Of ll cases of cardiac arrest, 7 cases were successfully resuscitated.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesiology ; Anesthetics ; Emergencies ; Ether ; Female ; Gangwon-do ; Heart Arrest ; Humans ; Neurosurgery ; Seoul

Cancer is one of the leading causes of morbidity and mortality worldwide; therefore there is a need to discover new therapeutic modules with improved efficacy and safety. Immune-(cell) therapy is a promising therapeutic strategy for the treatment of intractable cancers. The effectiveness of certain chemotherapeutics in inducing immunogenic tumor cell death thus promoting cancer eradication has been reported. Ginsenoside Rg3 is a ginseng saponin that has antitumor and immunomodulatory activity. In this study, we treated tumor cells with Rg3 to verify the significance of inducing immunogenic tumor cell death in antitumor therapy, especially in DC-based immunotherapy. Rg3 killed the both immunogenic (B16F10 melanoma cells) and non-immunogenic (LLC: Lewis Lung Carcinoma cells) tumor cells by inducing apoptosis. Surface expression of immunogenic death markers including calreticulin and heat shock proteins and the transcription of relevant genes were increased in the Rg3-dying tumor. Increased calreticulin expression was directly related to the uptake of dying tumor cells by dendritic cells (DCs): the proportion of CRT+ CD11c+ cells was increased in the Rg3-treated group. Interestingly, tumor cells dying by immunogenic cell death secreted IFN-gamma, an effector molecule for antitumor activity in T cells. Along with the Rg3-induced suppression of pro-angiogenic (TNF-alpha) and immunosuppressive cytokine (TGF-beta) secretion, IFN-gamma production from the Rg3-treated tumor cells may also indicate Rg3 as an effective anticancer immunotherapeutic strategy. The data clearly suggests that Rg3-induced immunogenic tumor cell death due its cytotoxic effect and its ability to induce DC function. This indicates that Rg3 may be an effective immunotherapeutic strategy.
Animals ; Apoptosis ; Calreticulin ; Carcinoma, Lewis Lung ; Cell Death* ; Dendritic Cells ; Heat-Shock Proteins ; Immunotherapy* ; Melanoma ; Mortality ; Panax ; Saponins ; T-Lymphocytes

Various anesthetic agents have successfully used for patients undergoing surgery for pheochromocytoma removal. A review of the literature on the anenthetic marnagement of pheochromocytoma discloses no general agreement regarding choice of an anesthetic agent. It would appear that the selection of the anesthetic agent is not as important as the proper management of the patient Previously the anesthetic experience of a case of pheochromocythma removal managed under methoxyflurane anesthesis has been reported by us. Thereafter we have had another five eases of pheochromocytoma removal operation under general anesthesia, employing methoxyflmrane as a primary anesthetic, with relatively satisfactory results.
Anesthesia, General ; Anesthetics ; Humans ; Methoxyflurane* ; Pheochromocytoma*

PURPOSE: Because vascular access sites in neonates are limited, intravenous (IV) medications must often be mixed with maintenance fluids, including parenteral nutrient (PN) solutions. This study was done to determine whether IV medications commonly prescribed in the neonatal in- tensive care unit (NICU) are compatible with the two neonatal PN solutions. METHODS: The compatibility of neonatal PN solutions and selected other drugs during Y-site delivery was evaluated. Secondary drugs were administered at selected concentrations, rates and delivery by method commonly used at the NICU. Drugs administered by syringe pump over 30min : amikacin, cefotaxime, ceftriaxone, piperacillin, phenytoin, aminophylline, ceftazidime, fluconazole, indomethacin. Drugs administered by IV push : ampicillin+sulbactam, penicillin G potassium, NaHCO3, ranitidine, epinephrine, furosemide, dexamethasone. Drugs administered by IV infusion for at least 60min : acyclovir, amphotericin B, vancomycin, dobutamine, dopamine, doxapram. After each test, the Y injection site and tube below the Y injection site were visually inspected for precipitation and color change. If no particles or color change was detected, the solution was tested and analyzed by a liquid borne particle analyzer (LBPA). RESULTS: White precipitate formed immediately after Y-site administration : phenytoin, aminophylline (undiluted solution), ampicillin+sulbactam (undiluted solution). Number of particles observed with LBPA exceeded the KP guideline limit immediately after Y-site administration and white precipitate formed after 3-4 hour : ceftriaxone, NaHCO3 (1 : 2 diluted solution). CONCLUSION: These results revealed that several lV drugs prescribed in NICU formed precipitate and had a color change, when mixed with neonatal TPN solutions.
Acyclovir ; Amikacin ; Aminophylline ; Amphotericin B ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Dexamethasone ; Dobutamine ; Dopamine ; Doxapram ; Epinephrine ; Fluconazole ; Furosemide ; Humans ; Indomethacin ; Infant, Newborn ; Parenteral Nutrition, Total ; Penicillin G ; Phenytoin ; Piperacillin ; Ranitidine ; Syringes ; Vancomycin

PURPOSE: Because vascular access sites in neonates are limited, intravenous (IV) medications must often be mixed with maintenance fluids, including parenteral nutrient (PN) solutions. This study was done to determine whether IV medications commonly prescribed in the neonatal in- tensive care unit (NICU) are compatible with the two neonatal PN solutions. METHODS: The compatibility of neonatal PN solutions and selected other drugs during Y-site delivery was evaluated. Secondary drugs were administered at selected concentrations, rates and delivery by method commonly used at the NICU. Drugs administered by syringe pump over 30min : amikacin, cefotaxime, ceftriaxone, piperacillin, phenytoin, aminophylline, ceftazidime, fluconazole, indomethacin. Drugs administered by IV push : ampicillin+sulbactam, penicillin G potassium, NaHCO3, ranitidine, epinephrine, furosemide, dexamethasone. Drugs administered by IV infusion for at least 60min : acyclovir, amphotericin B, vancomycin, dobutamine, dopamine, doxapram. After each test, the Y injection site and tube below the Y injection site were visually inspected for precipitation and color change. If no particles or color change was detected, the solution was tested and analyzed by a liquid borne particle analyzer (LBPA). RESULTS: White precipitate formed immediately after Y-site administration : phenytoin, aminophylline (undiluted solution), ampicillin+sulbactam (undiluted solution). Number of particles observed with LBPA exceeded the KP guideline limit immediately after Y-site administration and white precipitate formed after 3-4 hour : ceftriaxone, NaHCO3 (1 : 2 diluted solution). CONCLUSION: These results revealed that several lV drugs prescribed in NICU formed precipitate and had a color change, when mixed with neonatal TPN solutions.
Acyclovir ; Amikacin ; Aminophylline ; Amphotericin B ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Dexamethasone ; Dobutamine ; Dopamine ; Doxapram ; Epinephrine ; Fluconazole ; Furosemide ; Humans ; Indomethacin ; Infant, Newborn ; Parenteral Nutrition, Total ; Penicillin G ; Phenytoin ; Piperacillin ; Ranitidine ; Syringes ; Vancomycin

BACKGROUND/AIMS: It is unknown whether pulmonary rehabilitation (PR) is an effective intervention to manage coal-worker pneumoconiosis (CWP). We evaluated the efficacy and safety of an individualized PR program in 53 patients with CWP hospitalized in two medical institutions. METHODS: The PR program consisted of upper and lower extremity exercises to improve exercise endurance and skeletal musculoskeletal strength. All subjects performed treadmill and ergometer exercise with steady loading weights three times/week for 12 weeks. The following tests were performed before and after the study to investigate the efficacy of the PR program: modified Borg scale, pulmonary function test, mid-thigh circumference, maximum muscular strength, 6-min walk distance (6MWD), and the St. George's Respiratory Questionnaire (SGRQ), Korean version. RESULTS: Forty patients (75.5%) completed their PR programs. They improved significantly on the modified Borg scale, mid-thigh circumference, maximum muscular strength, 6MWD (all p < 0.000), and SGRQ (p = 0.007); however, no significant improvement was observed on the pulmonary function test. A significant improvement in dyspnea (p = 0.004) and 6MWD (p = 0.002) was observed in 12 patients with forced expiratory volume in 1 sec < 60%. The PR program with smoking cessation resulted in significantly more improvement on the 6MWD (p < 0.0001) and the SGRQ score (p = 0.002), as compared to those of patients who did not quit smoking. CONCLUSIONS: Our results show that an individualized 12-week PR program improves exercise capacity and quality of life for patients with CWP.
Dyspnea ; Exercise ; Exercise Therapy ; Forced Expiratory Volume ; Humans ; Lower Extremity ; Pneumoconiosis* ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation* ; Respiratory Function Tests ; Smoke ; Smoking ; Smoking Cessation ; Weights and Measures