There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.
Antibodies ; Antibodies, Monoclonal ; Antigens, CD5 ; B-Lymphocytes* ; Biomarkers ; Classification ; Cyclin D1 ; Hyperplasia ; Immunohistochemistry* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Paraffin*

No abstract available.
Encephalitis* ; Encephalitis, Herpes Simplex*

PURPOSE: Apoptosis is active cell death which plays an important role in developing normal tissues. Various conditions such as genetic defects, drugs, ischemia or infections are known to induce apoptosis. We studied the effect of maternal infection on fetal brain development during pregnancy. METHODS: We treated 46 C3H pregnant mice with lipopolysaccharide (LPS) or phosphat-buffered saline and observed the changes in apoptosis and expression of bcl-2, bcl-xS, bax. The fetal brain tissues were removed 1-48 hours after LPS treatment. The number of apoptosis per 100 neurons and glial cells was counted in H&E stained tissue and was analyzed statistically. Immunohistochemical staining with primary antibodies of bcl-2, bcl-xS, bax was done and their expression was classified by the degree of staining. RESULTS: The number of apoptosis was increased significantly in both neurons and glial cells of LPS-treated group and its degree of staining was more remarkable in glial cells. Immunohisto chemistry for bcl-2, bcl-xS, bax oncoprotein revealed mildly decreased expression of bcl-2 and markedly increased expression of bax in both neurons and glial cells, but it was more remarkable in glial cells. Immunochemistry for bcl-xS revealed no expression in neurons and minimal expression of bcl-xS in glial cells in both study groups. CONCLUSOIN: We observed an increase in the number of apoptosis, mildly decreased expression of bcl-2 and markedly increased expression of bax in both neurons and glial cells of fetal brain after treating pregnant mice with LPS. Maternal infection during pregnancy may have profound effects on developing fetal brain.
Animals ; Antibodies ; Apoptosis* ; bcl-2-Associated X Protein* ; Brain* ; Cell Death ; Chemistry ; Immunochemistry ; Ischemia ; Mice* ; Neuroglia ; Neurons ; Pregnancy

PURPOSE: We investigated whether in utero exposure to magnesium sulfate is associated with lower incidence of neonatal mortality, morbidity, and neurodevelopmental abnormalities in very low birth weight infants. METHODS: We evaluated 172 infants with birth weight less than 1,500g. According to the maternal receipt of magnesium sulfate, we divided into two groups. We reviewed the medical records of mothers and their babies to evaluate clinical outcome. RESULTS: Of 172 infants, 58(GA 30.0+/-2.3weeks, BW 1,20+/-2221g) received magnesium sulfate prior to delivery for tocolysis or preeclampsia(study group). The remaining 114(GA 29.6+/-2.3weeks, BW 1,220 +/-198g) served as the control group. Neonatal mortality was not significantly different between the two groups(12.5% vs 26.0%). There was no significant difference between the two groups in neonatal complications' RDS(52.4% vs 67.6%), BPD(16.7% vs 29.6%), apnea(52.4% vs 67.6%), IVH(23.8% vs 31.0%), PVL(4.8% vs 11.3%), NEC(7.1% vs 7.0%), ROP(26.8% vs 41.2%), and neal infection(33.3% vs 54.9%). The duration of ventilator therapy(10.9+/-7.3 vs 14.2+/-10.6 days), oxygen administration(20.2+/-20.0 vs 24.3+/-19.9 days) and admission(51.5+/-16.9 vs 54.6+/-16.7 days) were not different. Among 64 patients in whom follow up evaluation was possible more than 1 year, the incidence of cerebral palsy or developmental delay was not different(12.0% vs 12.8%). CONCLUSION: Maternal receipt of magnesium sulfate does not seem to be associated with an appreciably reduced risk of neonatal mortality, morbidity, and neurodevelopmental abnormalities in very low birth weight infants. (Abbreviations. GA, gestational age, BW, birth weight; RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia, IVH, intraventricular hemorrhage; PVL, periventricular leukomalacia; NEC, necrotizing enterocolitis; ROP, retinopathy of prematurity)
Birth Weight ; Bronchopulmonary Dysplasia ; Cerebral Palsy ; Enterocolitis, Necrotizing ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant Mortality* ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Leukomalacia, Periventricular ; Magnesium Sulfate* ; Magnesium* ; Medical Records ; Mothers ; Oxygen ; Tocolysis ; Ventilators, Mechanical

PURPOSE: The primary purpose of this study is to provide a useful insight for developing effective teaching and student counseling methods by understanding the relationship between four preference patterns of MBTI personality types and EWHA defense mechanisms of nursing college students. METHOD: The data used in this research were collected administrating EWHA defense mechanism test and MBTI personality type instrument to 195 nursing students in the period of November 3 through September 16 in 2000. Collected data were analysed by pc-SPSS 10.0. RESULT: Three general conclusions were drawn from the study results: (1) in terms of personality type, 'Extraversion', 'Sensing', 'Thinking', and 'Judgement' types showed high frequency respectively; (2) in terms of defense mechanism, 'Identification' showed the highest score, and then 'suppression' scored next followed by 'Humor'. However, 'Acting out' showed the lowest average score, and then 'Projection' followed by 'Denial'; (3) Based on the relationship between defense mechanism and four MBTI preference patterns, it can be drawn that students with the preference of 'Extraversion' usually use defense mechanism of 'Altruism', 'Sublimation', 'Distortion', 'Controlling', and 'Humor'. In comparison, students with the preference of 'Introversion' often use the defence mechanism of 'Evasion' and 'Projection'. CONCLUSION: The study results can be utilized in both fields of education and counseling: (1) in the field of education, this study can provide a basis for developing a suitable teaching method for each personality types of nursing students; (2) for counseling practitioners, the results of this study provide the useful insights to understand nursing college students' communication skills, behavior patterns, and ability of coping with problems in the process of counseling.
Counseling ; Defense Mechanisms ; Education ; Humans ; Nursing* ; Students, Nursing ; Teaching

Granuloma is a chronic inflammatory process associated with non-infectious agents or infectious diseases such as tuberculosis. It is well known that AFB staining, which has been used to determine the etiology of the granulomatous inflammation, lacks both sensitivity and specificity. Due to the slow growth rate of most pathogenic mycobacteria, culturing of organisms can take up to eight weeks. It is not uncommon for specific therapy to be delayed, or for an inappropriate treatment be given to patients without mycobacterial infections or with infections caused by atypical mycobacteria. Determination of the causative agent in Papanicolaou stained cytology specimens gives pathologists even more difficulties when only necrotic material has been aspirated from the center of the granuloma. In recent years, the use of a polymerase chain reaction for the amplification of DNA has appeared promising in terms of speed, efficiency, sensitivity, and specificity. Since a polymerase chain reaction permits the sensitive genetic analysis of small amounts of tissue, it is ideally suited to the genetic analysis of cytologic specimens. A polymerase chain reaction is easily performed on unfixed and unstained cells, however, an analysis of ethanol fixed and Papanicolaou-stained archival smears has also been described. We have recently established a method to detect Mycobacterium tuberculosis organism by a nested polymerase chain reaction with primers in the insertion sequence IS 6110, using cellular digests of ethanol-fixed and Papanicolaou-stained archival specimens aspirated from the lymph nodes, lungs, thyroid, etc. Inhibitors present in Papanicolaou stained material was removed by destaining the slides with 0.5% HCl solution for 10-30 minutes. Eight out of ten cases which have shown the epithelioid granulomas revealed a positive reaction and four out of ten cases which have shown lymphohistiocytic cells in a necrotic background without any evidence of granuloma revealed a positive reaction. This study showed that it was possible to employ a polymerase chain reaction to detect Mycobacterium tuberculosis in Papanicolaou stained archival cytology specimens.
Communicable Diseases ; DNA* ; Ethanol ; Granuloma ; Humans ; Inflammation ; Lung ; Lymph Nodes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Gland ; Tuberculosis

PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Education ; Humans ; Marriage ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sexuality

Actinomycosis causes a chronic suppurative infection most commonly involving the cervico-facial region, thorax, and the abdomen. Thoracic infection results from an aspiration of contaminated material from mouth or oropharynx. Actinomyces was known to have a predilection for the periphery of the lung and the endobronchial lesion is extremely rare. We report two cases of actinomycosis presenting as an endobronchial mass which arose in 53-year-old and 44-year-old women. The first case presented with cough, sputum, weight loss and had a history of pulmonary tuberculosis 24 years ago. Chest CT revealed a right lobe collapse simulating mass and suggested carcinoma. The second case presented with hemoptysis for 2 years. Chest CT revealed cystic bronchiectasis of both lungs and intracystic soft tissue mass in the anterior segment of the right upper lobe which suggested aspergilloma. The gross features of them were similar to those of aspergilloma. Characteristic sulphur granules consisting of a granular basophilic center surrounded by a radiating zone of eosinophilic, hyaline, club-shaped projection were histologically confirmed in both cases. Granulomas containing P. westermani eggs were present in the second case. Staphylococcus, true fungal organism, nocardia, and streptomyces shoud be distinguished by analysing their morphologic characteristics in the appropriate stains. Actinomycosis should be included in the differential diagnoses of an endobronchial mass.
Abdomen ; Actinomyces ; Actinomycosis* ; Adult ; Basophils ; Bronchiectasis ; Coloring Agents ; Cough ; Diagnosis, Differential ; Eggs ; Eosinophils ; Female ; Granuloma ; Hemoptysis ; Humans ; Hyalin ; Lung ; Middle Aged ; Mouth ; Nocardia ; Oropharynx ; Ovum ; Sputum ; Staphylococcus ; Streptomyces ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; Weight Loss

OBJECTIVES: To evaluate the effect of transdermal estrogen on arterial tone. METHODS: In 30 postmenopausal women, doppler ultrasound was used to assess blood flow characteristics in internal carotid arteries. As the pulsatility index(PI) represents impedance to blood flow distal to the point of sampling, pulsatility index of internal carotid artery was measured from the flow velocity waveform. Patients were studied pretreatment and at weeks 8, 12, and 24 of treatment with transdermal estradiol 50microgram/day. RESULTS: Blood pressure was not changed during transdermal estrogen replacement therapy. Serum estradiol was increased from 13.4+/-13.7pg/ml to 55.8+/-32.8pg/ml with week 8 of treatment and it was maintained until week 24. The mean pulsatility index was fallen to 0.1+/-0.1 during week 8 of therapy and a significant reduction in PI was maintained until week 24(p=0.0001). CONCLUSION: We believe that transdermal estrogen replacement therapy affects on the arterial tone and prevents cardiovascular disease in postmenopausal women.
Blood Pressure ; Cardiovascular Diseases ; Carotid Artery, Internal* ; Electric Impedance ; Estradiol ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Ultrasonography

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.
Bone Density* ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Obstetrics ; Osteoporotic Fractures ; Retrospective Studies