OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.
Animals ; Embryonic Structures* ; Female ; Follicular Fluid* ; Humans* ; Mice*

No abstract available.
Pancreatic Neoplasms* ; Pancreatitis*

PURPOSE: Keratitis-ichthyosis-deafness (KID) syndrome is a congenital ectodermal disorder presenting the triad of vascularizing keratitis, erythrokeratoderma, and sensorineural deafness. Ocular manifestations such as hyperkeratinization of the eyelids, loss of eyelashes, keratoconjunctivitis sicca, corneal erosions, ulceration, neovascularization, and scarring opacity may be absent or mild, but if present and severe, they can lead to major visual loss. We report a patient with KID syndrome with severe ocular manifestations and the histologic characteristics of a corneal lesion. CASE SUMMARY: A 5-year-old boy was referred to the Ophthalmology Department for bilateral hyperkeratinization of eyelids, bare eyelashes, and corneal opacity. He showed hyperkeratotic skin lesions and sensorineural hearing loss. Molecular analysis showed a mutation in the GJB2 gene and confirmed the diagnosis of KID syndrome. Initial conservative treatment did not preserve ocular surface integrity, and instead it was maintained by surgical procedures including superficial lamellar keratectomy with amniotic membrane transplantation. The histologic characteristics of corneal lesions are abnormal epithelial differentiation, absence of connexin 26 expression, and partial destruction of the basement membrane.
Amnion ; Basement Membrane ; Cicatrix ; Connexins ; Corneal Opacity ; Deafness ; Ectoderm ; Eyelashes ; Eyelids ; Hearing Loss, Sensorineural ; Humans ; Ichthyosis ; Keratitis ; Keratoconjunctivitis Sicca ; Ophthalmology ; Preschool Child ; Skin ; Transplants ; Ulcer

PURPOSE: This study was conducted to develop a nurse-learning program for the pain management of cancer patients. METHODS: In this methodological study, a learning program was developed between January and June 2011, following the methodological procedure based on the ADDIE Instructional System Design. RESULTS: The learning program consists of 4 parts: learning goal, learning outcomes, learning method, and evaluation method. Learner-centered learning goal and learning outcomes were established, and lecture-based group learning and self-directed study were combined as the learning method. For the evaluation, we developed a written test, a nursing skill checklist, and a case report evaluation tool. After a pilot test, the learning program was assessed by an expert group for its construct validity and content-related conformance. Moreover, the effectiveness of the program was validated by the results of the learning outcomes evaluation and the achievement levels of 40 trainees who participated in the program. CONCLUSION: On the basis of the results of this study, we suggest that this unit-based core nursing practice learning program, comprising 202 nursing units developed by a research institute nursing department since 2010, be shared by all nurses in clinical nursing care settings to improve their practical performance and ensure necessary specialization.
Academies and Institutes ; Checklist ; Humans ; Learning* ; Methods ; Nursing Care ; Nursing* ; Oncologic Nursing ; Pain Management* ; Programmed Instruction as Topic

Bronchopleural fistula(BPF) occurs as a postoperative complication in 2 to 5 percent of pulmonary resection. The detection of BPF is generally difficult and various diagnostic methods have been utilized to identify the site of the fistula in order to treat it adequately. Closure of these BPF can be surgical intervention or bronchoscopic application of various sealing agents. We report an experience with use of bronchoscopic instillation of n-butyl-2-cyanoacrylate(Histoacryl ) for closure of a postpneumonectomy BPF.
Bronchoscopy ; Enbucrilate* ; Fistula* ; Postoperative Complications

Afferent loop syndrome is a rare complication which can occur in patients with Billroth II gastrectomy. Bile and pancreatic juice is congested at afferent loop in the syndrome. This syndrome can progress rapidly to necrosis, perforation, or severe sepsis, and therefore early diagnosis and swift surgical intervention is important. But, cases of endoscopic or percutaneous transhepatic drainage have been reported when surgical management was inappropriate to proceed. We report a case of afferent loop syndrome accompanying acute cholangitis developed after percutaneous transhepatic cholangioscopic lithotripsy for the retrieval of common bile duct stone in a patient who underwent Billroth II gastrectomy due to early gastric cancer. There was no other organic cause. We treated afferent loop syndrome successfully by performing balloon dilation of afferent loop outlet.
Acute Disease ; Afferent Loop Syndrome/*etiology ; Aged, 80 and over ; Balloon Dilation ; Cholangiography ; Cholangitis/*etiology ; Choledocholithiasis/*diagnosis/radiography/therapy ; Common Bile Duct ; Gallstones/*diagnosis/therapy ; Gastroenterostomy ; Humans ; Lithotripsy/*adverse effects ; Male ; Stomach Neoplasms/surgery ; Tomography, X-Ray Computed

Portal and superior mesenteric vein thrombosis (PMVT) may occur, rarely though, secondary to hypercoagulable states, cirrhosis with portal hypertension, pancreatitis, peritonitis, inflammatory bowel disease and intraabdominal abscess. However, PMVT induced by acute acalculous cholecystitis has not been reported yet. We recently experienced a case of acute acalculous cholecystitis complicating PMVT. A 38-year-old male was admitted for RUQ pain, chill and fever without any previous medical history in particular and diagnosed as acute acalculous cholecystitis and PMVT. The diagnosis of PMVT secondary to acute acalculous cholecystitis was possible since there was no other cause of thrombosis. This patient's condition was improved without any complication after cholecystectomy and anticoagulant regimen. Thus, we report a case of PMVT secondary to acute acalculous cholecystitis for the first time in Korea.
Abscess ; Acalculous Cholecystitis ; Adult ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute* ; Diagnosis ; Fever ; Fibrosis ; Humans ; Hypertension, Portal ; Inflammatory Bowel Diseases ; Korea ; Male ; Mesenteric Veins* ; Pancreatitis ; Peritonitis ; Portal Vein* ; Thrombosis*

Cytomegalovirus is a frequent opportunistic pathogen in immunosuppressed patients and CMV colitis is one of its major complications. It usually presents as gastrointestinal ulceration with bleeding or perforation, but it can also take less common forms resembling many other entities, including viral gastroenteritis, ischemic colitis, intestinal pseudo-obstuction, toxic megacolon. We experienced a 49-year-old man with symptom of severe constipation and lower abdominal pain. He was diagnosed as having focal segmental glomerulosclerosis by renal biopsy, but he was an immunocompetent state. An abdominal X-ray showed marked dilatation of descending colon without air-fluid level. At colonoscopy and biopsy, he was diagnosed as having CMV colitis with focal stenosis. Treatment for two weeks with ganciclovir resulted in resolution of colitis, but stenosis was remained. We report a case of toxic megacolon and focal stenosis due to CMV colitis in a FSGS patient. It was not certain whether FSGS was related with immunosuppressive state.
Abdominal Pain ; Biopsy ; Colitis* ; Colitis, Ischemic ; Colon, Descending ; Colonoscopy ; Constipation ; Constriction, Pathologic ; Cytomegalovirus* ; Dilatation ; Ganciclovir ; Gastroenteritis ; Glomerulosclerosis, Focal Segmental* ; Hemorrhage ; Humans ; Megacolon ; Megacolon, Toxic* ; Middle Aged ; Ulcer

Although intussusception is primarily a disease of children, about 5 to 10 percent of cases occur in adults. The underlying causes of adult intussusception are tumor, postoperative complication, local bowel ischemia, abnormal motility and rarely intestinal tuberculosis. Recently, we experienced a 62-year-old man with intussusception underlying pulmonary tuberculosis. The postoperative pathologic finding was intestinal tuberculosis. For its rarity, we report this case with review of literatures.
Adult ; Child ; Humans ; Intussusception* ; Ischemia ; Middle Aged ; Postoperative Complications ; Tuberculosis* ; Tuberculosis, Pulmonary