Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

Recent studies(Rorke et al., 1968: Moir 1970: Baraka, 1970: Fox and Houle, 1971) have demonstrated that the maternal arterial oxygen tension during Cesarean section is an important determinant of fetal oxygenation and consequently of the clinical condition of the infant at birth for oxygen is transferred by simple diffusion across the placenta to the fetus. Fetal blood oxygen tension is affected by the arteiral oxygen tension and concentration of the mother, and also is affected by uterine blood flow(Fox and Houle, 1971). The enlarged uterus pushes the diaphragm upwards. This results in a change in position of the heart which is lifted upwards, shifted to the left and anteriorly, and a change in the thoracic cage, and heart rate is increased about 10~12 beats above normal. There is a significant increase in cardiac output which reaches a peak 30~50% above normal until term, and in respiratory rate, so that it follows that oxygen consumption increases but its direct cause is the metabolic need of the uterus, placenta and fetus(Atkinson et al., 1977). As well as increased oxygen consumption in parturients hypoxia may occur in situations of difficult intubation, laryngoscopy for intubation, extubation and during endotracheal suctioning. Because of the markedly decreased oxygen tension, these procedures are more dangerous than for non-parturients. Therefore sufficient oxygenation is recommanded(Archer and Marx, 1974). We selected at random 78 adult female patients who had received Cesarean section and other surgical procedures under general anesthesia with intubation at Severance Hospital from September to November, 1980. They were divided into 3 groups. Group 1 was ventilated with 100% oxygen for 5 minutes followed by 1 minute of apnea. Group 2 was ventilated with 50% oxygen for 5 minutes followed by 1 minute of apnea. Group 3 was ventilated with 50% oxygen for 5 minutes followed by 1 minute of apnea with endotracheal suction. We analysed the decrease in oxygen tension between parturients and onoparturients. The results were as follows: 1) During apnes, the decreases in arterial blood oxygen tension were significantly greater (p<0.05) in parturients than in non-parturients in the 100% oxygen group. 2) During apnea, the decreases in arterial blood oxygen tension were significantly greater(p<0.05) in parturients than in non-parturients in the 50% oxygen group. 3) During apnea, the decreases in oxygen tension were significantly greater(p<0.05) in paturients than in non-paturients in the 50% oxygen and endotracheal suction group. These results indicate the importance of preoxygenation prior to endotracheal intubation and endotracheal suction and also of prompt reoxygenation following endotracheal intubation, extubation and endotracheal suction.
Adult ; Anesthesia, General ; Anoxia ; Apnea* ; Cardiac Output ; Cesarean Section ; Diaphragm ; Diffusion ; Female ; Fetal Blood ; Fetus ; Heart ; Heart Rate ; Humans ; Infant ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Mothers ; Oxygen Consumption ; Oxygen* ; Parturition ; Placenta ; Pregnancy ; Respiratory Rate ; Suction ; Uterus

Anti-HLA antibody related neonatal thrombocytopenia is an uncommon disorder caused by platelet antigen incompatibility between mother and fetus in Korea. Mothers who lack the specific platelet antigen produce the IgG against the platelet antigen which the fetus inherits from the father. These IgG antibodies are then transported across the placenta into the fetal circulation where they lead to the destruction of fetal platelets. We report a case of neonatal alloimmune thrombocytopenia related with anti-HLA antibody in second baby of dizygotic twin who had petechia on trunk and platelet count 43,000/mm. Initially, mother and twin showed the positives in antiplatelet antibodies. In microlym- phocytotoxic test at 6 months of age, anti-HLA antibodies was negative in twins but anti-HLA A2, A24 was positive in their mother. The patient was treated with intravenous immunoglobulin and clinically improved and her platelet count was norrnalized.
Antibodies ; Blood Platelets ; Fathers ; Fetus ; Humans ; Immunoglobulin G ; Immunoglobulins ; Infant, Newborn ; Korea ; Mothers ; Placenta ; Platelet Count ; Thrombocytopenia, Neonatal Alloimmune ; Twins ; Twins, Dizygotic

BACKGROUND AND OBJECTIVES: Many people experience problems with a dry nasal mucous membrane, often without wondering why. The cause of problem is known as rhinitis sicca, senile rhinitis, and atrophic rhinitis, etc. A common form of treatment for patients who have such symptoms has been to begin by rinsing the inside of the nose with saline solution, to drop peanut oil, to apply antibiotic-ointment and moisturizing agents. Lanolin has been know as a safe skin moisturizing agent and used to treat dry nose. The purpose of this study was to evaluate the effect of lanolin on a group of patients seeking treatment for dryness of the nose. MATERIAL AND METHODS: Ninety-three patients experiencing problems with dry nasal mucosa were selected from the out-patient clinic. Fifty-seven patients, average age 36.3 years old, were treated with 1:2 mixture of lanolin and vaseline ointment. Thirty-six patients, average age 32.0 years, were treated with vaseline ointment. Both ointments were applied three times a day for two weeks. The efficacy of treatment was determined with pre and post-treatment six symptoms on a visual analogue scale: nasal obstruction, crust formation, mucosal dryness, respiratory discomfort, sleep disturbance, and general discomfort. RESULTS: For subjects treated with lanolin, the average VAS value for nasal obstruction was 5.84+/-2.28 and it decreased to 2.89+/-1.29, while the corresponding values for subjects treated with vaseline were 4.39+/-1.77 decreasing to 3.11+/- 1.24 (p<0.05). Crust formation of lanolin treated subjects were 5.67+/-2.39 and it decreased to 2.09+/-1.46, while the vaseline treated subjects were 4.83+/-1.99 decreasing to 2.33+/-1.31 (p<0.05). Average total symptom improvement was 65.7% (from 27.95+/-9.30 to 9.86+/-4.58) in lanolin treated group, while it was 44.8% (from 20.9+/-76.59 to 11.64+/-4.18) in vaseline treated group. CONCLUSION: We found that the efficacy of lanolin was statistically signigicantly better than that of vaseline. During the study period, there was no local reactions have been reported, nor have any allergic reactions. The present study underlines the fact that the way to treat nasal mucosal dryness is to use lanolin ointment.
Humans ; Hypersensitivity ; Lanolin* ; Mucous Membrane ; Nasal Mucosa ; Nasal Obstruction ; Nose* ; Ointments ; Outpatients ; Petrolatum ; Rhinitis ; Rhinitis, Atrophic ; Skin ; Sodium Chloride

OBJECTIVE: Periodontal ligament fibroblasts have an ectomesenchymal origin and are thought to play a crucial role for not only homeostasis of periodontal tissues but also bone remodeling, wound healing and regeneration of tissues. Recently, it has been reported that UNC-50 is not expressed in gingival fibroblasts but in PDL fibroblasts. The purpose of this study was to examine the expression of UNC-50 and osteocalcin in the periodontium after application of intermittent force. METHODS: Twelve rats had 40 grams of mesially-directed force applied at the upper molar for 1 hour/day. Four rats were sacrificed at 1, 3 and 5 days. Immunohistochemical localization of UNC-50 and osteocalcin antibody was carried out. The results showed apposition of new cellular cementum and a slight increase in periodontal space at the tension side. RESULTS: Strong UNC-50 expression was observed in the differentiating cementoblasts close to PDL fibroblasts in the tension side whereas it was barely expressed at the compression side. Expression was strong at day 3, and decreased at day 5. Osteocalcin immunoreactivity expression was strong in differentiating cementoblasts at the tension side. CONCLUSION: It can be suggested that UNC-50 is related to the differentiation of cementoblasts, and may be responsible for the molecular event in PDL cells under mechanical stress.
Animals ; Bone Remodeling ; Dental Cementum ; DNA* ; Fibroblasts ; Homeostasis ; Molar ; Osteocalcin ; Periodontal Ligament ; Periodontium ; Rats* ; Regeneration ; Stress, Mechanical ; Wound Healing

Tracheoesophageal fistula with esophageal stenosis were described by Gibson in 1697, and successful primary surgical repair was accompished in 1941 by Haight, but this anomaly had a very grave prognosia, due to prematurity, combined other congenital anomaly, and [ostoperative pulmonary complication. Recently, early diagnosis, better preoperative and postoperative care, and proper anesthetic management have helped lower the mortality rate. Eighteen infants with esophageal atresia with T.E fistula were admitted to Severance Hospital, and 9 infants among these infants were surgically corrected under general anesthesia from Feb. 1970 to Feb. 1981 at Severance Hospital. This report described the results of anesthetic experience in the management of tracheoesophageal fistula, and the problems of anesthetic management of patients with trachoesophageal fistula were reviewed and discussed.
Infant ; Male ; Female ; Humans ; Mortality

BACKGROUND: Reactive oxygen species (ROS) contribute to development of neuropathic pain. A neuropathic pain syndrome was produced in rats following prolonged hindpaw ischemia/reperfusion injury, creating an animal model of complex regional pain syndrome-Type I (CRPS-I). This study was designed to evaluate the validity of this model for ROS and pain research. Herein we show superoxide produces N-methyl-D-aspartate (NMDA) mediated mechanical allodynia. METHODS: Male adult SD rats were used for neuropathic pain model. Plasma superoxide production rates of before ischemia (BI) and 5 min after reperfusion (JR) were measured via cytochrome C reduction in the presence of xanthine (without xanthine oxidase, kinetics, 550 nm). Mechanical allodynia was measured in both hindpaws. Activation of NMDA receptor subunit 1 (P-NR1) of lumbar spinal cord (L4-L6) in accordance with the change of allodynia was analyzed by the Western blot. RESULTS: Allopurinol-inhibitable, xanthine oxidase-mediated plasma superoxide production was increased at AR. Mechanical allodynia was present in both hindpaws as early as 1 hr after reperfusion, and lasted at least 1 week. The expression of P-NR1 was the highest at 3 days after reperfusion when the withdrawal threshold was the lowest point. SOD significantly blocked P-NR1 activation. CONCLUSIONS: This study suggests that ischemia/reperfusion injury induced neuropathic pain model is a good candidate for the research fields of ROS and pain mechanism. The generation of ROS, especially superoxide is partly responsible for NMDA-mediated mechanical allodynia.
Adult ; Animals ; Blotting, Western ; Central Nervous System Sensitization ; Cytochromes c ; Hindlimb ; Humans ; Hyperalgesia ; Ischemia ; Kinetics ; Male ; Models, Animal ; N-Methylaspartate ; Neuralgia ; Plasma ; Rats ; Reactive Oxygen Species ; Reperfusion ; Spinal Cord ; Superoxides ; Xanthine ; Xanthine Oxidase

PURPOSE: The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity. METHODS: A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program. RESULTS: Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity. CONCLUSION: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.
Adult ; Attitude of Health Personnel ; Burnout, Professional/psychology ; Female ; Humans ; Job Satisfaction ; *Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; Personnel Turnover ; Questionnaires ; Republic of Korea

PURPOSE: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-γ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. METHODS: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015. Blood samples for IGRA were collected, processed, and interpreted according to manufacturer protocol. RESULTS: Among 149 children, 31 (20.8%) and 10 (6.7%) were diagnosed with LTBI and active pulmonary TB, respectively. In subjects lacking contact history with active TB patients, TST and IGRA results were positive in 41.4% (29 of 70) and 12.9% (9 of 70) subjects, respectively. The agreement (kappa) of TST and IGRA was 0.123. The control group, consisting of non-TB-infected subjects, showed no correlation between age and changes in interferon-γ concentration after nil antigen, TB-specific antigen, or mitogen stimulation in IGRAs (P=0.384, P=0.176, and P=0.077, respectively). In serial IGRAs, interferon-γ response to TB antigen increased in IGRA-positive LTBI subjects, but did not change considerably in initially IGRA-negative LTBI or control subjects. CONCLUSION: The lack of decrease in interferon-γ response in young children indicates that IGRA could be considered for this age group. Serial IGRA tests might accurately diagnose LTBI in children lacking contact history with active TB patients.
Child* ; Diagnosis* ; Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis* ; Skin Tests ; Tuberculin ; Tuberculosis

BACKGREOUND: The ideal drug for treatment of pulmonary hypertension would be a vasodilator which acts preferentially on the pulmonary vascular bed. The aim of this study was to compare the effects of prostaglandin I2 (PGI2) on central hemodynamics and right ventricular function with the more widely used vasodilators, prostaglandin E1 (PGE1) and nitroglycerin (NTG) and to investigate whether PGI2 is more selective to the pulmonary vascular bed compared with PGE1 and NTG in dogs. METHODS: We have used a method for producing sustained pulmonary hypertension in vivo by continuous infusion of U46619 adjusting the infusion rate until a mean pulmonary artery pressure (PAP) exceeded 25 mmHg. And the pulmonary and systemic effects of the three pulmonary vasodilators were compared at doses producing equivalent, lowered approximately 20% of mean arterial pressures (MAP) or mean PAP returned to baseline. RESULTS: After infusion of the three vasodilators, heart rate, cardiac output, and mean PAP/MAP ratio were significantly increased, but there was no statistical significant differences among the three vasodilators. PGI2 and PGE1 significantly increased (worsened) the PVR/SVR ratio, but NTG decreased. However there was no significant difference among the three vasodilators. After infusion of the three vasodilators, the arterial oxygen tension (PaO2), mixed venous oxygen tension (PO2), O2 deliver, and O2 uptake were increased, and shunt ratio (s/t(%)) were significantly decreased, but there were no significant differences among three vasodilators. CONCLUSIONS: PGI2, PGE1, and NTG all decreased both PVR and SVR. None of these vasodilatorswere more selective to the pulmonary vascular bed, myocardial performance, and improved gas exchange.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Alprostadil* ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Epoprostenol* ; Heart Rate ; Hemodynamics* ; Hypertension, Pulmonary* ; Nitroglycerin* ; Oxygen ; Pulmonary Artery ; Vasodilator Agents ; Ventricular Function, Right