Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.
Female ; Humans ; Diagnosis, Differential ; Adenocarcinoma ; Adenoma

No abstract available.
Biopsy, Fine-Needle* ; Breast*

No abstract available.
Biopsy, Fine-Needle* ; Histiocytosis, Langerhans-Cell*

No abstract available.
Pierre Robin Syndrome*

No abstract available.
Child* ; Glomerulonephritis* ; Humans

BACKGROUND: In the United States, the Centers for Disease Control and Prevention recorded a 20-fold increase in the incidence of vancomycin-resistant enterococci (VRE) associated with nosocomial infections between 1989 and 1991. Although VRE has been reported in Korea since 1992, infections caused by these organisms are still extremely rare in Pusan, Korea. Therefore, a point prevalence culture survey was carried out to investigate the prevalence of intestinal colonization with VRE among patients admitted to Kosin Medical Center, which can predict the appearance of clinical infections with VRE. METHODS: Between July 1997 and August 1997, stool specimens were obtained from 303 patients. Specimens were placed in bile esculin azide broth containing vancomycin (64 microgram/mL) and aatreonam (60 microgram/mL). Cultures were done for 48 hours at 37degrees C, and turbid solutions were subcultured on blood agar. Minimal inhibitory concentrations (MIC) of vancomycin and teicoplanin to Enterococcus isolates were determined by Etest on Mueller-Hinton agar. For amplification of the vanA, vanB, and vanC genes, polymerase chain reactions were performed. RESULTS: VRE isolates were isolated from 6 of the patients (2%). Four of them were identified as E. faecium, and 1 was identified as E. avium, and 1 was identified as Enterococcus spp. All of them were highly resistant to vancomycin (MICs >256 microgram/mL), and they were also resistant to teicoplanin (MICs 32-->256 microgram/mL). All of 6 VRE strains carried vanA gene. CONCLUSION: The colonization of VRE was not infrequent among the patients of a university hospital in Pusan, Korea. Moreover, a large proportion of the colonizing VRE was revealed Enterococcus faecium with vanA gene, which implies quite a possibility of a sudden rising of infections by this organism in the near future. So we propose that the vancomycin susceptibility test should be done for every enterococcal isolate from clinical specimens and the intestinal colonization rate of VRE should be closely monitored at regular intervals for the purpose of surveillance 50 that proper establishment of plans for the prevention of this troublesome pathogen's spread can be promptly made.
Agar ; Bile ; Busan ; Centers for Disease Control and Prevention (U.S.) ; Colon* ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Esculin ; Humans ; Incidence ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; United States ; Vancomycin

Nurses are at the forefront of providing hands-on care to patients infected with HIV(Human Immunodeficiency Virus). Therefore, appropriate and sensible infection control precaution should be taken at all times. The purpose of this study is to find out nurse's learning needs about HIV/AIDS ; and nurse's willingness to perform nursing care to HIV/AIDS patients ; and the degree of following universal precautions in nursing care ; and the degree of knowledge of HIV/AIDS to provide information on the guide for the further continuing education. The respondents of this study were 280 nurses in a university hospital in Kwang-Ju city. Data were collected using a self-administered questionnaire and analyzed by using percentages, means, Pearson's correlation, t-test, ANOVA, Duncan's grouping. The findings were as follows ; 1. The mean age of the nurses was 28.9 years, and the mean duration of their clinical experience was 6.8 years. Majority of the nurses(83.9%) had no experience in taking care of the AIDS patients. 2. The contents nurse's need to learn were showed in order such as clinical manifestations, infection control, patient care, and the mode of transmission of HIV/AIDS. 3. Even though the nurses had quite low knowledge about HIV/AIDS(mean score was 12.2 from the total of 26), they are willing to take care of the AIDS patients (mean score was 39.5 from the total of 60), and the degree of following universal precaution was also not so bad (mean score was 40.8 from the total of 50). 4. Nurses who are over 35 years old and had informal education regarding HIV/AIDS better following universal precautions. Nurses who had over 12 years of clinical experiences have more willingness to perform nursing care to the AIDS patients. Nurses who had experiences in taking care of the AIDS patients were more knowledgeable about HIV/AIDS. These findings suggest that some strategies should be develope to increase the willingness to perform the nursing care to the AIDS patients. And also continuing education program should be develope and run for the clinical nurses so that they can provide effective and appropriate nursing care to the AIDS patients.
Adult ; Surveys and Questionnaires ; Education* ; Education, Continuing ; Gwangju ; Humans ; Infection Control ; Learning ; Nursing Care ; Patient Care ; Universal Precautions

PURPOSE: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). MATERIALS AND METHODS: One hundred fifty patients (M:F=83:67, age 48.6+/-11.2 yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive ( 200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. RESULTS: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were 45+/-27 dpm in grade 0, 707+/-584 dpm in grade 1, 1558+/-584 dpm in grade 2, 1851+/-604 dpm in grade 3, and 2719+/-892 dpm in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. CONCLUSION: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.
Azure Stains ; Biopsy ; Breath Tests* ; Diagnosis ; Eating ; Helicobacter pylori* ; Helicobacter* ; Humans ; Scintillation Counting ; Sensitivity and Specificity ; Urea* ; Urease

We report a case of a large asymptomatic Rathke cleft cyst in a 14-year-old boy. This cyst was of considerable size, measuring 2x1.8x1.8 cm, but did not produce any symptoms and was confined to the suprasellar area. The cyst wall was lined by pseudostratified ciliated columnar epithelium with goblet cells. The lining epithelium of the Rathke cleft cyst was immnoreactive for cytokeratin, EMA and CEA.
Cysts

No abstract available.
Dandy-Walker Syndrome* ; Prenatal Diagnosis* ; Trisomy*