Primary extranodal lymphoma of the liver is very rare, approximately thirty-one cases having been reported in the literature. We report one case of primary malignant lymphoma of the liver in a 26-year-old female, who was presented with palpable abdominal mass on the epigastrium for about 40 days. Laboratory findings revealed no specific abnormalities. Peripheral lymph nodes or spleen were not palpable. An abdominal ultrasonogram revealed a huge mass involving the entire left lobe of the liver. Left lateral segmentectomy of the liver was done. The resected lateral portion of left lobe of the liver showed a large solitary mass, 12 cm in the greatest dimension, with a yellowish gray fleshy solid cut surface. Though light microscopic feature was compatible with primary malignant lymphoma, diffuse large cell type, intermediate grade by the working formulation, undifferentiated carcinomas including hepatocellular carcinoma, plasmacytoma, and pleomorphic sarcomas could not be completely ruled out. Thus, marker studies and electron microscopic examination were performed. Immunoperoxidase stains for common leukocyte antigen was positive, and the Leder stain for myeloid granule was negative. Electron microscopic stuids revealed findings of neoplastic lymphoid cells, consistent with malignant lymphoma. Primary lymphoma of the liver has only rarely been reported, and its natural history is unclear. Many of the reported cases have been large cell lymphomas, as in this case.
Female ; Humans ; Carcinoma, Hepatocellular

Free flaps have been widely used in lower leg reconstruction. However, in cases with extensive injury to the vessels as well as to the bone and soft tissues, and having only one intact major vessel in the lower leg(single vessel leg), careful selection of recipient vessels for the free flap transfer is mandatory for preventing further vascular compromise of the distal lower leg. The sural artery and its vena comitantes are frequently protected form externally harmful forces by the bulky surrounding gastrocnemius muscle and can be used as recipient vessles for free flaps without any detrimental influence on the vascularity of the distal lower leg. In our department, three latissimus dorsi muscle free flap were transferred with sural vessels as recipient vessels in the reconstruction of the single vessel legs. Except for one case of flap failure due to serious infection at the microvascular anastomoses site, all the other cases were successfully reconstructed without any necrosis of the gastrocnemius muscle or the distal leg. In addition, the sural vessels were easily accessed in any patient position and their caliber was similar to that of the vascular pedicles of the donor muscle flaps. In conclusion, the sural vessels can be another useful option in selecting recipient vessels for free flap transfer in the reconstruction of the single vessel leg.
Arteries ; Free Tissue Flaps* ; Humans ; Leg* ; Muscle, Skeletal ; Necrosis ; Superficial Back Muscles ; Tissue Donors

No abstract available.
Candidiasis*

The high incidence antigert Jr" was first identified in 1970 by Stroup and Macllroy. Anti-Jr~ was immune antibodies developed by transfusion or pregnancy and occasionally cause hemolytic disease of the newborn and transfusion reaction, but these usually mild. We are reporting the first case of anti-Jra in Korea, which was identified in pregnant woman with transfusion history. The 35 year old pregnant woman(G6P4L1D3A1) admitted to treat for incompetent internal os of cervix on department of Obstetrics and Gynecology. Prenatal irregular antibody screening was negative. One unit of RBC was transfused at 21 gestational weeks for correction of anemia. One week later, irregular antibody was detected in her serum. The antibody reacted best by indirect antiglobulin test and panagglutinated all identified cells. The titer was 1 : 8. The antibody was identified as anti-Jr by Dr. Osaka Red Cross Center. Her phenotype of Jra was Jr(a-), but there was no Jr(a-) person in her family. She might have anti-Jra in her serum with undetectable level due to multiple pregnancies. In this case, the development of anti-Jr was stimulated by one unit of RBC transfusion with anamnestic reaction. The titer of anti-Jr was gradually reduced during pregnant period. She delivered at 37 gestational weeks by cesarian section. The baby was clinically well at birth and typed as Jr(a+).
Adult ; Anemia ; Antibodies ; Blood Group Incompatibility ; Cervix Uteri ; Coombs Test ; Female ; Gynecology ; Humans ; Incidence ; Infant, Newborn ; Korea ; Mass Screening ; Obstetrics ; Parturition ; Phenotype ; Pregnancy ; Pregnancy, Multiple ; Pregnant Women* ; Red Cross

OBJECTIVE: To determine whether there is a difference in nerve conduction studies depend on the body mass index (BMI) of subjects METHOD: Twenty normal healthy volunteers were enrolled for the study. A routine usual sensory and motor nerve conduction study and a sensory nerve conduction study using the near nerve needle technique were performed. BMI was calculated as weight (kg) divided by height (m) squared. In order to evaluate the effect of BMI on the various measure ments of the nerve conduction study, one-way analysis of variance (ANOVA) was used. RESULTS: The sensory nerve amplitudes of median, ulnar and sural nerves correlated significantly (p<0.05) with BMI. However, no correlation was noted between BMI and sensory nerve amplitude by near nerve needle technique. There was no statistical differences noted in the measurements of latency of examined motor and sensory nerves neither the velocity of examined motor nerves. CONCLUSION: In clinical practice, the effect of BMI should be taken into account when the interpretation of abnormal sensory nerve study has to be soli.
Body Mass Index* ; Healthy Volunteers ; Needles ; Neural Conduction* ; Obesity ; Sural Nerve ; Weights and Measures

OBJECTIVE: To obtain the mean value of physical parameters of those over 65- years of age. METHODS: Physical parameters including body weight, height, chest circumference, length of upper limb and lower limb, hand power, and range of motion of cervical, thoracic, lumbosacral spines and other major joints were measured in two hundred fourteen elderly subjects. RESULTS: Subjects were divided into three groups according to age (group 1, 65~74 years; group 2, 75~84 years; group 3, above 85 years) and sex (male; female). Descriptive statistical analysis of data provided the following results. 1) Mean measurement in order of group 1-men, group 2-men, group 3-men followed by women of each group: Body weight (kg) - 60.2, 59.6, 54.9, 56.8, 51.6, 47.2; Standing height (cm) - 156.7, 160.8, 156.6, 151.2, 146.9, 142.2; Sitting height (cm) - 99.8, 100.8, 103.1, 100.9, 104.9, 97.0; Chest circumference (cm) - 91.5, 93.5, 91.4, 92.1, 89.5, 86.4; Upper limb length (cm) - 72.3, 72.5, 71.3, 67.1, 66.9, 65.4; Lower limb length (cm) - 82.3, 82.1, 81.4, 77.3, 76.1, 74.6. 2) The hand power of grasping, tip pinch, lateral pinch, palmar pinch showed a decreasing trend in older age group in both sexes. 3) The range of motion of cervical, thoracic, and lumbosacral spine in group 1 had limitation of about 50% compared to normal range. 4) Of the major joints, limitation of motion or deformity was most common in the shoulder and knee joints. CONCLUSION: These data and knowledge of physical parameters of the elderly can aid in design of living environment and assistive devices for elderly.
Aged* ; Body Weight ; Congenital Abnormalities ; Female ; Hand ; Hand Strength ; Humans ; Joints ; Knee Joint ; Lower Extremity ; Range of Motion, Articular ; Reference Values ; Self-Help Devices ; Shoulder ; Spine ; Thorax ; Upper Extremity

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.

No abstract available.

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.
Cesarean Section ; Child ; Diagnosis ; Dwarfism ; Extremities ; Female ; Humans ; Hypertension ; Liver Failure ; Pelvic Bones ; Pregnancy ; Recurrence ; Renal Insufficiency ; Thorax ; Uremia