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.

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

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

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

Creeping eruption is a rare cutaneous serpiginous eruption caused by fhe accidental invasion of the skin by parasites. The patient was a 26 year-old female presented with a severe pruritic erythematous serpiginous linear skin lesion on the dorsal surface of left foot for 10 days. Histopathologic finding revealed a typical burrow containing inflammatory cells and necrotic epithelial cells in the epidermis and diffuse patch infiltration of mononuclear cells and eosinophils in the dermis. Laboratory examination shows eosinophilia. The patient was treated with oral flubendazole 500mg per day for 10 days. The skin lesion disappeared without. recurrence. We described a typical case of creeping eruption never reported in Korea.
Adult ; Dermis ; Eosinophilia ; Eosinophils ; Epidermis ; Epithelial Cells ; Female ; Foot ; Humans ; Korea ; Larva Migrans* ; Parasites ; Recurrence ; Skin

Epiduroscopy is a new method for managing chronic back pain. However there are potential complications such as hemorrhage, infection, neural damage, and increased pain due to increased epidural and intrathecal pressure. A 59-year-old male patient, suffering from lumbar radiculopathy after spine surgery was referred to the pain clinic. To ensure proper deposition of steroids and epidural lysis of adhesions, fibroptically directed epiduroscopy was planned. After positioning the epiduroscopy, 20 ml of normal saline was injected slowly. Immediately after injection, the patient complained of severe back pain and radiating pain to the lower extremities. When the pain was relieved, we restarted a saline injection. However, severe pain ocurred again and was sustained for more than an hour. There was no clinically significant findings on an emergency MRI. The symptoms improved slowly over a period of two hours.
Back Pain ; Emergencies ; Hemorrhage ; Humans ; Low Back Pain* ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pain Clinics ; Radiculopathy* ; Spine ; Steroids

The lung nodule is one of the pleuropulmonary menifestations in rheumatoid arthritis. We report here a case exhibiting hydropneumothorax due to a bronchoplerual fistula resulting from a ruptured rheumatoid lung nodule complicated with a aspergilloma in it. A 39 year-old man with rheumatoid arthritis was admitted because of cough for one month. Multiple subcutaneous nodules were noted and multiple lung nodules were seen on chest X-ray, Peripheral white cells were 9,600/mm3 with 1896 of eosinophils. The percutaneous needle aspiration biopsy of the largest lung nodule of right upper lobe showed massive necrosis without acid fast bacillus, fungus, or malignant cell. Three months after discharge, air-meniscus sign was seen on the biopsied lung nodule on X-ray. Five months later, the patient was readmitted due to dyspnea and chest pain and simple chest X-ray showed hydropneumothorax on the right side. The pneumothorax was not healed after closed thoracotomy and tube drainage, and high fever developed. The pleural fluid culture revealed Pseudomonas aeroginosa and Aspergillus fumigatus. Seventy days after admission, exploratory thoracotomy was done. Aspergilloma was found in the cavitated lung nodule which was ruptured into the pleural cavity through bronchopleural fistula.
Adult ; Arthritis, Rheumatoid* ; Aspergillus fumigatus ; Bacillus ; Biopsy, Needle ; Chest Pain ; Cough ; Drainage ; Dyspnea ; Eosinophilia* ; Eosinophils ; Fever ; Fistula* ; Fungi ; Humans ; Hydropneumothorax ; Lung* ; Necrosis ; Needles ; Pleural Cavity ; Pneumothorax ; Pseudomonas ; Thoracotomy ; Thorax

Previously, strains of Streptococci genera were isolated from osteomyelitis caused by the post-infection after extraction. In present study, to test the sensitivity of the Streptococci strains against seven antibiotics, penicillin G, amoxicillin, tetracycline, ciprofloxacin, cefuroxime, erythromycin, clindamycin, and vancomycin, minimum inhibitory concentration (MIC) was performed using broth dilution assay. Our data showed that the value of MIC of the Streptococci against antibiotics were different among the strains. In addition, the degree of resistance to antibiotics of Streptococci strains was mainly depended on the origin of isolation. Our results suggest that the development of the rapid and accurate method to detect the antibiotics-resistant bacteria is need to prevent the misuse or abuse of antibiotics and outbreak of antibiotics-resistant bacteria.
Amoxicillin ; Anti-Bacterial Agents ; Bacteria* ; Cefuroxime ; Ciprofloxacin ; Clindamycin ; Erythromycin ; Jaw* ; Microbial Sensitivity Tests ; Osteomyelitis* ; Penicillins ; Tetracycline ; Vancomycin

PURPOSE: Monitoring pneumococcal carriage rates is important. We developed and evaluated the accuracy of a real-time reverse transcription polymerase chain reaction (RT-PCR) protocol for the detection of Streptococcus pneumoniae. METHODS: In October 2014, 157 nasopharyngeal aspirates were collected from patients aged <18 years admitted to Chung-Ang University Hospital. We developed and evaluated a real-time PCR method for detecting S. pneumoniae by comparing culture findings with the results of the real-time PCR using genomic DNA (gDNA). Of 157 samples, 20 specimens were analyzed in order to compare the results of cultures, realtime PCR, and real-time RT-PCR. RESULTS: The concordance rate between culture findings and the results of real-time PCR was 0.922 (P <0.01, Fisher exact test). The 133 culture-negative samples were confirmed to be negative for S. pneumoniae using real-time PCR. Of the remaining 24 culture-positive samples, 21 were identified as S. pneumonia-positive using real-time PCR. The results of real-time RT-PCR and real-time PCR from 20 specimens were consistent with culture findings for all S. pneumoniae-positive samples except one. Culture and real-time RT-PCR required 26.5 and 4.5 hours to perform, respectively. CONCLUSIONS: This study established a real-time RT-PCR method for the detection of pneumococcal carriage in the nasopharynx. Real-time RT-PCR is an accurate, convenient, and time-saving method; therefore, it may be useful for collecting epidemiologic data regarding pneumococcal carriage in children.
Child* ; DNA ; Humans ; Methods ; Nasopharynx ; Pneumonia ; Polymerase Chain Reaction* ; Real-Time Polymerase Chain Reaction ; Reverse Transcription* ; RNA* ; Streptococcus pneumoniae