Although the reported number of malignant lymphoma of the thyroid has been increased, primary malignant lymphoma of the thyroid associated with chronic lymphocytic thyroiditis has been sporadically reported since its first description by Graham in 1931. The apparent coexistence of these two conditions has undoubtedly been noted by other observers. And they suggested that malignant lymphoma of the thyroid might arise from the lymphoid tissue ina wide variety of preexisting thyroidal disease. This report was made to record a case of primary thyroid lymphoma recently seen in this department with special emphasis on the associated thyroiditic changes in the uninvolved portion of the gland, which suggest the antecedent presence of chronic lymphocytic thyroiditis.

We examined cerebrospinal fluids of 338 patients with syphilis who underwent the routine physical examinations or visited out-patient skin clinic at Kyunghee University hospital from January, 1978 to December, 1979. They were diagnosed as syphilis only with serological tests such as VDRL and TPHA tests. The patients did not have any neurologic symptoms associated with syphilis or any other clinical syphilitic syrnptoms. They did not have any history of receiving antisyphilitic treatment. The VDRL test, cell count, protein value, sugar and chloride levels in cerebr-ospinal fluid were tested in these patients. The results were as follows. 1) CSF VDRL reactive rate was 2. 1% among 388 patients with syphilis. 2) CSF celI count was not less than 5/mm in 2 patients (28. 6%) among the 7 patients with syphilis, who showed the positive reactivity of CSF VDRL, and in 13 patients (3. 9%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 3) CSF protein level was more thnn 45ml/dl in 3 patients (42. 9%) among the 7 patients with syphilis who showed the positive reactivity of CSF VDRL anct ig, 65 patients (19. 6%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 4) Both CSF sugar and chloride levels were within norrnal limits in all of the 7 patients who showed the positive reactivity of CSF VDRL.
Cell Count ; Cerebrospinal Fluid* ; Humans ; Neurologic Manifestations ; Outpatients ; Physical Examination ; Serologic Tests ; Skin ; Syphilis*

Serologic tests for syphilis, including the qualitative and quantitative VDRL test and TPHA test, were carried out on 18, 151 healthy young men, who took a medical check-up for the overseas employment at Kyunghee University Hospital from April, 1978 to February, 1979. The syphilitics who revealed TPHA reactive, were given a questionare that dealt with three items. The results are summarized as follows. 1) The reactive rate of VDRL test was 3. 1% among 18, 151 healthy young men, 2) The biologic false positive rate of VDRL test was 7. 7% among the 520 men in whom TPHA test was carried out, using TPHA as standard. 3) The reactive rate of TPHA test was 2. 7% among 18, 109 men. On 42 men the TPHA test was not carried out. 4) With regard to the VDRL quantitative test, the reactive rate of the group with a titration of 1: 4 or lower was 85,2% out of 480 syphilitics. 5) In 480 syphilitics, 45. 8% (220) had a history of venereal 72.3%(347) had no general knowledge of syphilis, and 86. 2% (414) was unaware of his syphilitic infection.
Employment* ; Humans ; Male ; Prevalence* ; Serologic Tests ; Syphilis*

Angiogenesis is an essential process in tumor growth and metastasis. VEGF has been considered a leading candidate inducing tumor angiogenesis. VEGF expression was significantly correlated with clinical stage, lymph node matastasis, and prognosis of cancers of various parts of body. However, little has been known about the correlation between VEGF expression and clinicopathologic parameters in oral squamous cell carcinoma. The aim of this study was to correlate VEGF expression with the clinicopathological parameters and microvessel density. Forty six oral squamous cell carcinomas were analyzed using immunohistochemical method with primary antibodies to VEGF and CD31. VEGF expression was detected in 33 (71.7%) of the 46 cases. The microvessel density was significantly correlated with VEGF expression (P=0.002). There was no correlation between microvessel density and tumour size, clinical stage, and lymph node metastasis, respectively. VEGF expression did not correlate with the histological grade of tumour differentiation, tumour size, and clinical stages. The VEGF-positive rate seemed to be higher in patients with cervical lymph nodal metastasis than in those without it, but it was not statistically significant. In conclusion, the overexpression of VEGF in the oral squamous cell carcinoma seemed to be associated with a more aggressive course of the disease. Further study is necessary to define the role of VEGF in oral squamous cell carcinoma.
Antibodies ; Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Vascular Endothelial Growth Factor A*

We analyzed ERCP findings of 15 patients with clonorchiasis, that were confirmed by stool examination and operation from May, 1976 to September, 1980. The results were as follows. 1) Filling defects due to adult worm of clonorchis sinensis were significant direct findings of clonorchiasis. 2) Irregular stenosis, fuzziness, raggedness, peripheral dilation and disturbance of peripheral filling of intrahepatic bile ducts were significant indirect findings of clonorchiasis. 3) ERCP was excellent method to evaluate biliary tree in patients with clonorchiasis, who showed obstructive jaundice.
Adult ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Humans ; Jaundice, Obstructive

The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Colloids ; Cricetinae* ; Humans ; Mesocricetus ; Mineral Oil ; Models, Theoretical ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver

A poor prognosis of oral squamous cell carcinoma (SCC) is partly due to the invasiveness and metastasis of the tumor. A key element in tumor invasion and metastasis in the degradation of extracellular matrix is matrix metalloproteinases (MMPs). This study was performed to determine the expression of MMP-2 and MMP-9 of oral SCCs with regard to the histologic invasiveness and differentiation in 5 normal oral mucosa and 36 oral SCCs. The histologic invasiveness of oral SCCs were classified into 4 grades. The differentiation of oral SCCs was divided into 3 grades. The streptavidin-biotin immunohistochemical staining, using MMP-2 and MMP-9 monoclonal antibodies, was performed to determine the expression of MMP-2 and MMP-9. The expression of MMP-2 was positive in 6 of 17 oral SCCs with weak invasiveness and was positive in 7 of 19 oral SCCs with strong invasiveness. The MMP-2 expression did not increase significantly with respect to the invasiveness of oral SCCs (P>0.05). The expression of MMP-9 was strongly positive in 6 out of 17 SCCs with weak invasiveness and was strongly positive in 14 of 19 SCCs with strong invasiveness. The MMP-9 expression increased significantly with respect to the invasiveness of oral SCCs; the stronger the expression, the stronger the invasiveness (P<0.05). The expression of MMP-9 was in 57.9% of well differentiated SCCs, 57.1% of moderately differentiated ones, and 33.3% of poorly differentiated SCCs. The expression of MMP-2 and MMP-9 did not increase significantly with respect to the histologic differentiation. We conclude that with respect to the invasiveness, the MMP-9 expression increases significantly in oral SCCs but the MMP-2 expression does not; and that with respect to the histologic differentiation, their expressions do not increase significantly. These results suggeste that MMP-9 can be used as a tool to evaluate the invasiveness of oral SCCs.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Extracellular Matrix ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Mouth Mucosa ; Neoplasm Metastasis ; Prognosis

PURPOSE: Pharmacotherapy using selective serotonin reuptake inhibitors(SSRls) for men with primary premature ejaculation(PE) is promising. Specially, a strategy taking a pill "as needed" may offer an attractive option. To investigate the possibility of self therapy, patients treated for PE with sertraline "as needed" basis were evaluated. MATERIALS AND METHODS: Since 1996 we have treated 24 males with sertraline "as needed" basis for primary PE. We chose sertraline among SSRIs because alarge dose need not to be divided and peak plasma levels occurring 4-8 hours after oral administration makes 5 p.m. suitable for the time of administration. Five p.m. is the time the ordinary men usually fix their evening schedule including intercourses. Each patient was started on 50mg qd for 2 weeks and then the dose was adjusted to 50 or 100mg only on the day of intercourse. RESULTS: After 6 weeks, 18 men continued to take medication and 6 had dropped out. Of 18 men, mean ejaculation latency were 23 +/-19sec before treatment, 5.9 +/-4.2min after 2wks 50mg qd, 5.1 +/-3.8min after 2wks 50/100mg pm and 4.5 +/-2.7min after 4wks 50/100mg prn and mean sexual satisfaction scores ('5"=extremely satisfied, "0"=extremely unsatisfied) of men were 0.8 +/-0.8 before treatment, 3.8 +/-1.2 after 2wks 50mg qd, 3.4 +/-1.0 after 2wks 50/100mg pm and 3.2 +/-0.7 after 4wks 50/100mg pm. And mean sexual satisfaction scores of partners were 1.1 +/-0.7 before treatment, 3.2 +/-1.6 after 2wks 50mg qd,3.1 +/-1.4 after 2wks 50/100mg pm and 3.3 +/-1.2 after 4wks 50/100mg pm. Side effects were intermittent excessive delay in 1 patient, fatigue in 2 patients, numbness in 1 patient. CONCLUSIONS: If our results were supported by additional clinical long term study, self therapy with sertraline given pm at 5 pm in treatment of PE could be as attractive as self injection therapy in the treatment of erectile dysfunction.
Administration, Oral ; Appointments and Schedules ; Drug Therapy ; Ejaculation ; Erectile Dysfunction ; Fatigue ; Follow-Up Studies* ; Humans ; Hypesthesia ; Male ; Plasma ; Premature Ejaculation* ; Serotonin ; Sertraline*

We performed a retrospective study of 12,307 patients who visited the emergency room of St. Paul's Hospital, secondary medical center, from January 1 to December 31,1996. The results were as follows : 1. Of 12,307 total patients, male to female ratio was 1.16:1 but after 7th decade, there were more female than male. And 3rd decade was the peak age group. 2. The majority o(patients visited our emergency room from noon to midnight (65% of total patients). 3. On average,33.7 patients visited our emergency room per day. Most patients visited on Sundays and other holidays(average 43.3 per day). 4. By monthly distribution, the patients Increased slightly during May, June, July, August and September. 5. Disease to injury ratio was 2.6:1. In disease, male to female ratio was 1 :1 and in injury, the male prominence had a the ratio 1.8:1 In 2nd decade, disease to injury ratio was higher (1.4:1) than that of other decade. And there were mostly disease patients in the group under 1 year old (19.2: 1). 6. Of 12,307 total patients,5,458 patients received only Intern's treatment (44.3%). In 3rd decade, the ratio of Intern's treatment was higher (54.4%). 7, The patients were categorized as follows, Infernal medicine 28.1%, Pediatrics 18.2fo, Orthopedic surgery 13.2%, Plastic surgery 7.4% etc. 8. Averaged admission rate was 25.3% and the rate of general surgery was the highest (49.5%). The rate of admission to intensive care unit (ICU) was 5.5% of total visiting patients and 21.8% of total admission patients. 9. The total patients transferred from other hospitals were 1152 (9.4%), 3.16 per day. The majority used non-emergency vehicles and only 8.5% of patients used the rescue service or ambulances. 10. The average transit time spent in the emergency room was 182 minutes. The longest was 246 minutes in March and the shortest 127 minutes in January.
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Male ; Orthopedics ; Pediatrics ; Retrospective Studies ; Surgery, Plastic

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period