Central lines are indispensable in hospital care. The main complication resulting from their use is central line-associated bloodstream infection (CLABSI). CLABSI is one of the most frequent healthcare-associated infections associated with high costs, morbidity, and potential lethality. Recent studies on CLABSI prevention show that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates. The question today, then, is not 'what to do,' but 'how to do it.'
Catheter-Related Infections ; Central Venous Catheters ; Comprehensive Health Care

PURPOSE: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. MATERIALS AND METHODS: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. RESULTS: The mean radial displacements were 2.26 (+/-1.03) mm in the control group and 3.05 (+/-1.97) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. CONCLUSION: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.
Consensus ; Displacement (Psychology) ; Head ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Masks ; Neck ; Skull Base ; Spine

A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.
Aged ; Atrioventricular Block ; Female ; Hemoptysis ; Humans ; Neck ; Radiotherapy* ; Thorax ; Thyroid Neoplasms

No abstract available.

No abstract available.

Pseudolymphoma, the term clinically synonymous with pseudotumor, is one of the lymphoproliferative disease which frequently causes unilateral proptosis in adults. The clinical manifestations and the pathologic pictures may resemble that of a true neoplasm. Recently, immunologic methods such as immunofluorescent and immunohistochemical study were popularly used in the diagnosis and study of lymphoproliferative diseases. We have experienced three cases of pseudolymphoma of the orbit which were diagnosed with PAP(proxidase-antiperoxidase) stain of the immunohistochemical method.
Adult ; Diagnosis ; Exophthalmos ; Humans ; Orbit ; Pseudolymphoma*

No abstract available.
Vincristine*

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

BACKGROUND: Alteration of a wide variety of cellular oncogerms have now been implieated in the causation of many human cancers. However, genetic studies have indicated that an abnormality of a single gene is usually insufficient to elicit the fug transformed phenotype and that two or more genetic leaions may be necessary for this to occur. OBJECT: The purpose of this study is to examine the possibity of oncogene interaction which might be involved in the pathogenesis of human skin tugois. METHODS: The expression of the epidermal growth factor rattor(EGFR), c-jun protein, c-fos protein and p53 protein was assessed in frozen and corresgoAhng paraffin-embedded sections of 37 separate skin lesions (6 actinic keratoses, 6 squamo is ell carcinomas and 25 basal cell carcinomas using immunohistochemistry. RESULTS: Substantial number of the p53 positive cases were negative for c-fos, in contrast to normal tissue, which was p53 negative and c-fos positive. The negative correlation between p53 and c-fos staining was statistically significant(P<0.005). CONCLUSION: Although p53 appeared to have lost its normal role of regulatory early S phase protein in some lesions, in others high levels of p53 were assocated with underexpression of c-fos, reflecting the diversity of c-fos oncogene and the possible down regulation of c-fos expression by high levels of p53 protein.
Carcinoma, Basal Cell ; Down-Regulation ; Epidermal Growth Factor ; Humans ; Immunohistochemistry ; Keratosis, Actinic ; Oncogenes* ; Phenotype ; S Phase ; Skin*

We report a case of classic Kaposis sarcoma(KS) in a 74-year-old man who had asymptomatic red-dish-blue or dark-brown macules, papules and nodules on his bo hower extrimities. The biopsy specimen showed typical histopathologic features of FS including a highly vascularized lesion with a proliferation of spindle-shaped cells accompanied by etravasated erythrocytes and variable number of inflammatery cells. Many of the spindle-shaped cells associated with the proliferating vessels in KS lesion expressed factor VIII-related antigen. He was treated with 1500 cGy of radiation(300 cGy per day for 5 successive day. Four weeks after radiotherpy, gross and histopathologic findings were mucl improved and healed leaving hyperpigmentation.
Aged ; Biopsy ; Erythrocytes ; Humans ; Hyperpigmentation ; Radiotherapy* ; Sarcoma* ; von Willebrand Factor