Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé’s test. Results: Compared with emergency room nurses, paramedics were more positive about the government’s spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

The purpose of this study is to evaluate the applicability of intravenous atropine sulfate therapy in infantile hypertrophic pyloric stenosis (IHPS). From 1998 to 2000 among 35 cases of IHPS, pyloromytomy was performed in 13 (Group A), and intravenous atropine was given as a primary therapy in 22 cases (Group B). In group A, all cases were cured completely. In group B, 13 (59 %) out of 22 cases were successfully treated with atropine, but 9 were failed therapy, and required operation. The recovery period to normal feeding and the hospital stay of the successful atropine group were longer than those of pyloromyotomy, 8.6 days vs. 2.9 days and 13.2 days vs. 4.1 days, respectively. In conclusion, intravenous atropine therapy did not replace pyloromyotomy, but it might be an alternative for the selected patients with contraindications for operation.
Atropine* ; Humans ; Length of Stay ; Pyloric Stenosis, Hypertrophic*

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

Cervical pregnancy is one of most rare form of ectopic pregancy in which the blastocyst implants within the cervical canal below the internal os of uterine cervix. Most cervical pregnancy result in early spontaneous abortion, complicated by severe hemorrhage frm the eroded blood vessels within the cervix. Because of fear of rofuse hemorrhage, abdominal hysterectomy has been historically considered the standard therapy. However, a number of new therapies have been aimed at uterine preservation, conservative treatment is highly desirable for young women who want to be pregnancy in the future. Methotrexate has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of a cervical preganncy that was successfully managed with methotrexate and leucovorine.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Cytochrome P-450 CYP1A1 ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Methotrexate* ; Pregnancy*

Although talus fractures are uncommon, proper management is important because they are often associated with severe complications. Talar neck and body fractures occupy most of the talar fractures. It remains controversial whether talar neck fractures require emergent or elective treatment. Elective definitive fixation, however, may reduce risks of wound complications. Many surgeons recommend dual surgical approaches—anteromedial and anterolateral—to allow accurate visualization and anatomic reduction. Although there are various methods of fixation, the use of plates is necessary in comminuted talar fractures. Outcomes may vary and will be dependent on the degree of the initial fracture displacement. It is necessary to restore articular congruency and axial alignment for normalizing hindfoot function. Common complications include posttraumatic arthritis, avascular necrosis, malunion, and nonunion.
Arthritis ; Neck ; Necrosis ; Surgeons ; Talus* ; Wounds and Injuries

PURPOSE: The purpose of this study was to investigate the association of generalized aggressive periodontitis with IL-6 promoter gene single nucleotide polymorphisms(SNP). MATERIAL AND METHODS: The study population consisted of 52 generalized aggressive periodontitis patients(GAP) and 30 periodontally healthy control subjects, who were systemically healthy non-smokers. Genomic DNA was obtained from buccal swab. The IL-6 promotor SNP at the positions of -597, -572, and -174 were genotyped by amplifying the polymorphic region using polymerase chain reaction(PCR), restriction enzyme digestion and gel electrophoresis. RESULT: The genotype distributions for G/G, G/A and A/A genotypes of IL-6 -597 were 30.8%, 40.4%, and 28.8% in the GAP group and 53.3%, 40%, and 6.7% in the control group and were statistically different between 2 groups(p<0.05). Allele 2 frequency of IL-6 -597 were significantly higher in the GAP group than the control group(p<0.01). At the position of IL-6 -572, the distribution for C/C, C/G and G/G genotypes were 23.1%, 55.8% and 21.2% in the GAP group and 20%, 33.3%, and 46.7% in the control group. In female subjects, the genotype distribution were significantly different between 2 groups (p<0.01). In male subjects, allele 2 frequency of IL-6-572 was significantly lower in the GAP group than the control group(p<0.05). The genotype distribution of IL-6 -174 in the GAP group were 96.2%, 3.8% for G/G, G/C genotypes whereas only the G/G genotype was detected in the control group. CONCLUSION: In conclusion, significant associations were found in IL-6 gene promoter(-597, -572) polymorphisms and generalized aggressive periodontitis. Further cohort study will be necessary in larger population.
Aggressive Periodontitis ; Alleles ; Cohort Studies ; Digestion ; DNA ; Female ; Genotype ; Humans ; Interleukin-6 ; Male

No abstract available.
Arrhythmias, Cardiac* ; Heart* ; Thoracic Surgery*