PURPOSE: The sentinel lymph node is defined as the first draining node from a primary tumor and reflects the histologic feature of the remainder of the lymphatic basin status. The aim of this study was to evaluate the usefulness of lymphoscintigraphy and intraoperative radioguided gamma probe for identification and removal of sentinel lymph node in breast cancer. MATERIALS AND METHODS: Lymphoscintigraphy was performed preoperatively in 15 patients with biopsy proven primary breast cancer. Tc-99m antimony sulfide colloid was injected intradermally at four points around the tumor. Imaging acquisition included dynamic imaging, followed by early and late static images at 2 hours. The sentinel lymph node criteria on lymphoscintigraphy is the first node of the highest uptake in early and late static images. We tagged the node emitting the highest activity both in vivo and ex vivo. Histologic study for sentinel and axillary lymph node investigation was done by Hematoxylin-Eosin staining. RESULTS: On lymphoscintigraphy, three of 15 patients had clear lymphatic vessels in dynamic images, and 11 of 15 patients showed sentinel lymph node in early static image and three in late static 2 hours image. Mean detection time of sentinel lymph node on lymphoscintigraphy was 33.5+/-48.4 minutes. The sentinel lymph node localization and removal by lymphoscintigraphy and intraoperative gamma probe were successful in 14 of 15 patients (detection rate: 93.3%). On lymphoscintigraphy, 14 of 15 patients showed 2.47+/-2.00 sentinel lymph nodes. On intraoperative gamma probe, 2.36+/-1.96 sentinel lymph nodes were detected. In 7 patients with positive results of sentinel lymph node metastasis, 5 patients showed positive results of axillary lymph node (sensitivity: 72%) but two did not. In 7 patients with negative results of sentinel lymph node metastasis, all axillary nodes were free of disease (specificity: 100%). CONCLUSION: Sentinel lymph node biopsy with lymphoscintigraphy and intraoperative gamma probe is a reliable method to predict axillary lymph node metastasis in breast cancer, and unnecessary axillary lymph node dissection can be avoided.
Antimony ; Biopsy ; Breast Neoplasms* ; Breast* ; Colloids ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Lymphoscintigraphy* ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy*

Open heart surgery is itself a difficult and risky procedure, so patients who receive surgery experiences severe stress and anxiety from physiological and psychological sources. These stresses increase workload of heart and oxigen consumption so that increased pulse rate, blood pressure, arithmia can being a harmful effect to the patients. Thus, nursing intervention should be given in order to reduce these stresses. The purpose of this study was to define "caring touch" which could relieve a patient's anxiety and reinforce his immune reactions. This study examined how "caring touch" could be a easy and useful way of nursing care. Finally, this research attempted to find out when it is appropriate to begin this caring touch compared effect of caring touch given before and after operation. This study was designed using a quasi-experimental approach with non-equivalent control groups and non-synchronized design. The study subjects consisted of 65 adult patients who have undertaken open heart surgery in the two general hospitals of K. and S. located in Inchon and Buchon from the 4th of Jannuary to the 28th of May in 1998. Group A was a study group consisting of 22 patients who were given caring touch twice a day from the day before the operation untill the 7th day after the operation. Group B was a study group consisting of 20 patients who received the care from the 1st day after the operation to the 7th day in the same manner as Group A. The control group consisted of 23 patients who were not given this care. This study used two measuring instrument: Visual Analogue Scale Anxiety which was developed by Cline(1922), and Trait and State Anxiety by Spielberger(1970). Measuring items were blood pressure, pulse rate, cortisol level, percentages of T-lymphocyte, and natural killer cell in the blood. Data collected were analyzed by SAS program for x2 test, ANOVA, Repeated measures of ANOVA, Pearson-correlation, Scheffe multiple comparison, and Profile multiple comparison methods. The results of the study are as follows: 1. Emotional stress reaction Level of VAS anxiety and State anxiety of group A and B showed a significant decline compared to the control group(P<.o5). The anxiety of group A and B showed significant lower level on the 1st day after operation than the day before operation, and the anxiety level was also lower on the 7th day after operation than 1st day after operation(P<.001). 2. Physiological stress reaction Systolic BP measured in groups A and B showed significant higher difference between before and after receiving caring touch compared to control group(P<.05). Systolic BP measured on the 1st day after the operation was lower than the day before and the 7th day after operation(P<.01). The control group however, showed no difference. Diastolic BP measured in group A showed signigicant higher difference between before and after receiving caring touch than control group(P<.05). However, there was no significant difference in it on the three points of measurings. Pulse rate measured in group A showed significant higher difference between before and after receiving caring touch than control group(P<.05), and the pulse rates measured on the 1st day after operation were significantly lower than the day before operation and the 7th day after operation(P<.01). But these was no difference in the control group. The cortisol level of all three groups showed no significant difference, and the level of cortisol measured on 1st day after operation was significantly higher than the day before operation and 7th day after operation(P<.01). 3. Immune reactions T-lymphocyte of group B was found higher rates than the control group(P<.05), and the T-lymphocyte measured on the day befor operation and 7th day after operation were significantly higher than the 1st day after operation(P<.001). NK-cell rate of all three groups revealed no significant difference and NK-cell measured on the 1st day after operation showed higher rates than the 7th day after operation(P<.001). Based on above mentioned results, it is found that emotional and physiological stress of open heart surgery patients can be relieved by giving caring and which was identified on the measured items of VAS Anxiety, State anxiety, BP, and pulse rate. And those measurings were markedly decreased on the 1st day after opertion. Especially group A, which began caring touch before undergoing operation showed less anxiety compared to group B, which received caring touch from the 1st day after operation. Thus, the most appropriate time for giving caring touch was a day before the operation. And also it was found that caring touch increased the T-lymphocyte rate, and immune reactions when anxiety level decreased. Therefore caring touch was proved to be a way of emotional nursing intervention to relieve anxiety and increse immune reaction.
Adult ; Anxiety ; Blood Pressure ; Heart Rate ; Heart* ; Hospitals, General ; Humans ; Hydrocortisone ; Incheon ; Killer Cells, Natural ; Nursing ; Nursing Care ; Stress, Physiological ; Stress, Psychological ; T-Lymphocytes ; Thoracic Surgery*

Human wart diseases are benign skin tumors caused by viruses of the papova group which usually affect children and almost always regress until adulthood. Various therapeutic modalities have been tried for the treatment of warts, however there is no single satisfactory method and the clinical course as well as the prognosis is always variable. The spontaneous regression of warts may represent an increase in the activity of host immune responses. Recent studies have tended to confirm that serum antiviral antihodies and cellular immune responses occur in relation to regression of warts, but there is no convincing evidence of a correlation between the appmrance of immune responses and resolution of the warts. BCG and some of similar extra,cts have becn known to be capable of initiating a wide range of non-specific immune reactions to cancerous diseases. The aim of the present investigation has been to study no-specific irnmune response of Tubercin-3 in patients with svarts, based on the findings that RCG and some of similar extracts were found to be a potent reticuloendothelial stimulant. Taventy casee attending a, dermatolo-ical out-ptient department consists of eight verrua plana juvenilis, seven verruca vulgaris, one verruca plxntaris and four molluscurn contagiosum were trezted with Tubercin-R. The results revealed complete cure in six(37. 5.) and clinical improvemeat in nine. (56. %) of sixteen cases of various warts, and one of four czses of molluscum contagiosurn showed a slight decrea,se in size and nu!nber of the lesions. There is no eviclence of a correlation among the age of patient, type of verruca and therapeutic effect. On the basis of our findings, we can state that non-specific immune response of BCG .and some of similar extracts may be facilitate the involution of warts. The relationship of thes immune respons to the involution of warts clezrly require further study.
Child ; Humans ; Immunity, Cellular ; Mycobacterium bovis ; Prognosis ; Skin ; Warts*

No abstract available.
Meconium* ; Peritonitis*

Disfiguring hyperpigmentation of the exposed areas may have impartant and lasting effects on the emotional well-being of the patient. And many attempts to treat areas of hyperpigmentation have been earried out, but all of them are not very successful. Recently 4-isopropylcatechol has been known to inhibit melanin pigmentation with a selective action on melanocytes either destroying or inactivating the melanocytes experimentally. There is no report on its clinical trial till now. In this study, 1% 4-isopropylcatechol cream was topieally applied to the hyperpigmented lesions of 29 patieots of melasma, freckle, and cafe-au-lait spot. The bleaching effect on meiasmas was very satisfactory in all patients but coantact dermatltis in 3 patients and reticular hyperpigmentation with areas of depigmented spots in one patient were developed as the side effects of the drug. Freckle and cafe-au-Iait spots were not bleached.
Cafe-au-Lait Spots ; Humans ; Hyperpigmentation ; Melanins ; Melanocytes ; Melanosis ; Pigmentation

The purpose of this study was to examine the effect of slow stroke back massage(SSBM) on anxiety and immune response in patients undergoing open heart surgery and to compare the effect of 5-minutes with 10-minutes SSBM. Among the sixty-four patient subjects, twenty-one were one experimental group receiving massage for 10-minutes, twenty for the other experimental group receiving massage for 5-minutes and twenty-three for the control group. Subjects were admitted at Hospitals in Inchon and Puchon for open heart surgery. This study was carried out from October 10, 1997 to May 10, 1998. The levels of anxiety were measured by the Visual Analogue Scale(VAS), Trait anxiety scale, systolic and diastolic blood pressure, pulse rate, blood cortisol and the levels of immune response were measured by the blood T-lymphocyte and Natural killer cell. Study measurements were taken before and after SSBM on the 1st pst operative day. Data were analyzed using x2test, oneway ANOVA, paired t-test, t-test and Pearson product moment correlation. The results were summarized as follows: 1. After SSBM, VAS anxiety level, systolic and diastolic blood pressure and pulse rate of the experimental group were decreased significantly than those measurements before the SSBM. After SSBM, significant difference in the VAS anxiety level, systolic blood pressure and pulse rate between the experimental and control groups were found. 2. After SSBM, the blood cortisol of the experimental and control groups were increased significantly compared with before SSBM. But the significant difference in blood cortisol between the two groups was not found. 3. After SSBM, the blood T-lymphocyte percentages of the experimental and control groups were decease significantly and blood Natural killer cell percentages of the two groups were increased compared with before SSBM. But significant difference in blood T-lymphocyte and Natural killer cell percentages between the two groups was not found. 4. Significant difference in VAS anxiety level, systolic and diastolic blood pressure, pulse rate, blood cortisol, blood T-lymphocyte and Natural killer cell percentages between SSBM for 5 minutes and SSBM for 10 minutes were not found. Based upon the results, this study concludes that the slow stroke back massage for 5 minutes is a useful intervention that decreases anxiety and produces relaxation in patients undergoing open heart surgery.
Anxiety* ; Blood Pressure ; Gyeonggi-do ; Heart Rate ; Heart* ; Humans ; Hydrocortisone ; Incheon ; Killer Cells, Natural ; Massage* ; Relaxation ; Stroke* ; T-Lymphocytes ; Thoracic Surgery*

Necrobiotic xanthogranuloma(NXG) is a characteristic cutaneous manifestation associated with paraproteinemia. A case of NXG associated with an IgG (lambda) monoclonal gammopathy occurred in a 48-year-old man. Skin lesions were dome-shaped, hard palpable nodules, 2x3 cm to 4x4 cm sized, on both arms and forearms. They were arranged in a linear pattern. Also, hard palpable tumors, 1x2 cm to 2x3 cm in size, were present on the left leg and the dorsum of the left foot. They were violaceous, slightly protruded, and hard on palpation. Histologically, the lesion was characterized by inflammatory xanthogranuloma with broad hands of hyaline necrobiosis. Many foreign body type of bizarre giant cells, Touton type of giant cells and foamy histiocytes were infiltrated into the dermis and subcutaneous fat tissue. Three days after medication with ledercort and immuran, the cutaneous masses decreased in size and became soft.

Because blood pressure (BP) is an ever changing hemodynamic phenomenon, a BP value, once measured at a physician's office (Office BP), is often unrepresentative of an individual's true BP status. Both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) provide more accurate and reproducible estimate of BP, and produce stronger predictive ability for cardiovascular outcome than conventional office BP. Two BP measuring techniques, ABPM and HBPM have been widely in clinical use for the detection and management of hypertension. However, they have different advantages and limitations in practice. At present, it has become crucial to understand the characteristics and clinical implications of these BP measuring techniques for those responsible for the care of hypertensive patients.
Benzhydryl Compounds ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Hemodynamics ; Humans ; Hypertension ; Physicians' Offices

No abstract available.
Malaria* ; Plasmodium vivax* ; Plasmodium*

The distribution of transforming growth factor -alpha (TGF -alpha ) and epidermal growth factor (EGF) on the cardiovascular system of developing mouse embryos of gestational age 7 to 12 days were immunohistochemically (ABC method) studies to investigate the differential expression of these growth factors. Paraffin embedded sections were immunostained with antibodies for TGF -alpha and EGF. In the 8 -day -old mouse embryos, the endocardial tissue, myocardial tissue and cardiac jelly were all TGF -alpha stained. EGF stain was observed in the cardiac jelly and myocardial tissue but was not observed in the endocardial tissue. This suggests that in the initial phase of the cardiovascular system development, TGF -alpha function as earlier growth factor than EGF. The 9, 10 and 11 -day -old embryos showed TGF -alpha stain in the broad spectrum of developing cardiovascular tissues such as, the bulbus cordis, primitive atrium, sinus venosus, aortic sac, dorsal aorta, vitelline artery, endocardial cushion tissue, and myocardium of primitive ventricle. However, EGF stain was observed only in the bulbus cordis, primitive atrium and endocardial tissue. This finding indicates that TGF -alpha function as a more extensive growth factor than EGF. The 12 -day -old embryos showed stronger EGF stain than TGF -alpha in the primitive ventricle, bulbus cordis, and endocardial tissue. This suggests that EGF function as a more growth factor than TGF -alpha at this particular developmental stage and plays important role at the end stage of the primitive heart development.
Animals ; Antibodies ; Aorta ; Arteries ; Cardiovascular System ; Embryonic Structures* ; Endocardial Cushions ; Epidermal Growth Factor* ; Gestational Age ; Heart ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Mice* ; Myocardium ; Paraffin ; Transforming Growth Factors* ; Vitellins