No abstract available.
Humans ; Pregnancy* ; Twins*

No abstract available.
Humans ; Infant, Newborn*

Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.
Adenocarcinoma ; Aged ; Asian Continental Ancestry Group ; Cervix Uteri ; Female ; Herpesvirus 4, Human* ; Humans ; Keratins ; Lung ; Lymphocytes ; Male ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Skin ; Stomach* ; T-Lymphocytes ; Thymus Gland

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

Ophthalmoplegic migraine is a syndrome characterized by the typical history of migrainous headache followed by ophthalmoplegia in the absence of demonstrable intracranial lesion. Until now, investigations of regional cerebral blood flow (CBF) in patient,; with migraine have been performed during prodromal and/or headache phases by brain SPECT with Tc-99m HMPAO. However, no such paper has described patients with ophthalmoplegic migraine. We present a 14-year-old girl with 4 episodes of paroxysmal migrainous headache on the right fronto-orbital area without aura followed by ptosis and diplopia, which were always gradually resolved without aberrant regeneration over 2 or 3 weeks period. Neurologic examination showed the right internal and external ophthalmoplegia. Diagnostic studies (including laboratory testis, Tensilon test, brain MRI, and cerebral angiography) were normal. Serial brain SPECT studies with Tc-99m HMPAO showed the presence of reversible ischemia in the branches of the posterior cerebral artery.
Adolescent ; Brain* ; Diplopia ; Edrophonium ; Epilepsy ; Female ; Headache ; Humans ; Ischemia* ; Magnetic Resonance Imaging ; Migraine Disorders ; Neurologic Examination ; Ophthalmoplegia ; Ophthalmoplegic Migraine* ; Posterior Cerebral Artery ; Regeneration ; Technetium Tc 99m Exametazime ; Testis ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Previous studies examining the pharmacodynamic effects of succinylcholine(SCC) on subsequent doses of nondepolarizing muscle relaxants showed potentiation with resultant prolonged respiratory depression or no interaction at all. The interaction between SCC and mivacurium especially has not been investigated in animal and other clinical studies. METHODS: The pharmacodynamic effects of SCC on mivacurium-induced neuromuscular blockade and its reversal were investigated in 10 cats of either sex using the anterior tibialis muscle-sciatic nerve preparation. RESULTS: There was no significant difference at the onset of mivacurium neummuscular blockade between the control group(1.81+/-0.48 min) and SCC-pretreated group(1.86+/-1.04 min). However the duration of action of mivacurium neuromuscular blockade was significantly longer in the SCC-pretreated group(33.08+/-19.13 min) than that of the control group(10.65+/-2.45 min). In the control group recovery indices(RI) were 2.35+/-1.01 min and 0.68+/-0.30 min at spontaneous recovery and antagonism with neostigmine, respectively and in the SCC-pretreated group they were 6.88+/-2.42 min and 1.90+/-0.64 min. RI were significantly shortened by antagonism with neostigmine whether or not SCC was pretreated. In the SCC-pretreated group, RI were significantly longer than in the control group at spontaneous recovery and antagonism with neostigmine. But the maximal recovery and antagonism effect were 100% in all cases. There was no sigriificant difference in the train-of-four ratios measured after antagonism with neostigmine between the control group(0.91+/-0.01) and the SCC-pretreated group(0.93+/-0.06). CONCLUSIONS: The prior administration of SCC prolonged the duration of mivacurium-induced neuromuscular blockade and delayed recovery but had no influence in antagonism with neostigmine in cats.
Animals ; Cats* ; Drug Interactions ; Neostigmine ; Neuromuscular Blockade* ; Respiratory Insufficiency ; Succinylcholine*

Healthcare accreditation program was started in November 2010. The program was operated by newly born institute, Korea Institute for Healthcare Accreditation. Major characteristic of healthcare accreditation program in Korea is spontaneous program that hospitals voluntarily request for accreditation survey. Goals of healthcare accreditation program in Korea are to change the culture of healthcare supply side from supplier oriented to consumer oriented culture and to change regulation for quality improvement from government initiated regulation to self regulated quality improvement activities by hospitals. Objectives of accreditation are to assure the patient safety and to improve quality of healthcare services in hospitals. Korean Association of Hospital Management conducted a survey on the impact of accreditation program on hospital management, the survey was supported by Korea Institute for Healthcare Accreditation. Results of the survey showed that accredited hospital had changed to positive direction in patient safety, decision making process, organizational culture and hospital management. Assignments of accreditation program in Korea to be solved are to develop incentive for active participation of small size hospitals, to improve quality of surveyors and to increase the apprehension of accreditation of general population. Korea Institute for Healthcare Accreditation endeavor to improve quality of surveyors under in depth training program and to advertise accreditation program through radio and TV to the general population. However the incentive program must be developed by government policy.
Accreditation ; Decision Making ; Delivery of Health Care ; Korea ; Motivation ; Organizational Culture ; Patient Safety ; Quality Improvement ; Quality of Health Care

Inflammatory fibroid polyp(IFP), a localized non-neoplastic growth of the digestive wall, is a rare diseaseand arising from the deep mucosa and submucosa of the gut wall. It is not a true neoplastic tumor; forconve-nience, however, it is referred to as a submucosal tumor. Although the exact pathogenesis of an IFP isun-known, it thought to result from a reactive process rather than a neoplasm. We report the radiologic findingsof IFP of the stomach, demonstrating histopathologic correlation.
Leiomyoma* ; Mucous Membrane ; Polyps* ; Stomach*

PURPOSE: To evaluate preoperative N staging of advanced gastric cancer(AGC) using helical CT according to thenew TNM classification. MATERIALS AND METHODS: Helical CT findings of AGCs in N staging were prospectivelyevaluated and correlated with pathologic staging in 60 patients with AGCs who underwent surgery. In all patients,contrast-enhanced helical CT with 5 -7 mm silce thickness and 5 -7 mm reconstruction was performed after ingestionof 600 - 800ml of water. A total of 150ml of contrast medium was administered intravenously at a rate of 4mL/secand CT scans were obtained 60 seconds after the initiation of intravenous administration of contrast medium. CTnodal status was assessed according to the 1997 UICC/AJCC N staging system as: N0, no lymph node metasta-sis; N1,1 -6 metastatic regional lymph nodes; N2, 7 -15 metastatic regional lymph nodes; N3, more than 15 metastaticregional lymph nodes. Lymph nodes at least 5mm in short-axis diameter or more than three lymph nodes in a focalarea (clustered appearance) regardless of size were interpretated as positive for metastasis. RESULTS: Of thetotal 1,334 lymph nodes dissected, 352(26%) were positive for metastasis. The sensitivity of helical CT scans in Nstaging of AGCs was 61%, specificity was 36 %, and overall accuracy was 55% (33 of 60cases), Nine(15 %) cases wereoverstaged and 18(30 %) were understaged. CONCLUSION: Our results indicate that the results of helical CT inpreoperative N staging of AGCs according to the new TNM classification showed no improvement despite theapplication of favorable criteria for lymph node metastasis. Further evaluation using various analytic approachesis necessary.
Administration, Intravenous ; Classification ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Water