BACKGROUND: Cleaning and disinfection of fiberoptic bronchoscope requires careful attention, especially to mycobacterium species because the contamination of mycobacteria could raise confusion on diagnosis. Recently, we detected contamination of Wydex(R) solution used in bronchoscope washer with Mycobacterium chelonae. In this study, we evaluated the mycobactericidal effect of 12 kinds of disinfectants for M. chelonae. METHOD: To evaluate the bactericidal effect of Wydex(R) 2%, Cidex(R) 2.25%, Cidex(R) 3%, Bacteriokiller (BK) disinfectant, Perasafe(R), HICLO-S(R), Lamicine(R), ethanol, Instrusept(R), Virkon(R), Betadine(R), and Vipon(R) against M. chelonae, culture was performed after exposure of two M. chelonae strains (ATCC 35749, the type strain and the strain isolated from contaminated Wydex(R) solution) to each disinfectant solution. The growth of organism was examined for up to 8 weeks. RESULTS: Growth of M. chelonae (reference strain of ATCC 35749 and isolated strain) was observed after a week incubation for Wydex(R) 2%, Cidex(R) (2.25%, 3%) and control. For BK disinfectant and Perasafe(R), they grew after 2-3 weeks, and 3-4 weeks, respectively. For HICLO-S(R) and Lamicine(R), only the contaminated strain grew after two and three weeks, respectively. For ethanol, Virkon(R), Betadine(R), Vipon(R), and Instrusept(R) , growth was not observed from either strain. CONCLUSIONS: On the basis of these results, Instrusept(R), virkon(R), ethanol, Betadine(R), and Vipon(R) were effective for the disinfection of M. chelonae. Especially, Instrusept(R) was thought to be useful as a disinfectant for bronchoscopes because it has advantages including non-corrosiveness, chemical stability, and non-irritativeness. And additional washing with ethanol might be effective. The finding that strain isolated from contaminated bronchoscopes was more resistant to disinfectants than reference strain suggested that the more resistant strains are selected throughout the improper disinfection.
Bronchoscopes ; Diagnosis ; Disinfectants* ; Disinfection ; Ethanol ; Mycobacterium chelonae* ; Mycobacterium*

PURPOSE: To evaluate the effects of wearing rigid gas permeable (RGP) contact lenses on the topographic changes in keratoconus. METHODS: Seventy-seven keratoconic eyes that wore multicurve RGP contact lenses and 30 keratoconic eyes that wore no contact lenses were retrospectively analyzed. The mean follow-ups were 22.6 and 20.5 months in the lens-wearing and control groups, respectively. Visual acuity, comfort, daily wearing time, and corneal staining were evaluated for both groups. The changes in topographic indices were compared between the lens-wearing and control groups. RESULTS: Multicurve RGP lens corrected logarithm of the minimum angle of resolution visual acuity of the lens-wearing group significantly improved from -0.016+/-0.065 to -0.032+/-0.10 at follow-up (p=0.05). In the lens-wearing group with advanced keratoconus, the Sim Kmax, Sim Kmin, apical power, astigmatic index, and anterior elevation significantly decreased from 57.68+/-4.26 diopter (D), 50.50+/-2.32 D, 62.79+/-5.11 D, 7.20+/-0.55 D and 67.36+/-16.30 microm to 55.51+/-4.28 D, 49.62+/-3.26 D, 60.31+/-5.41 D, 5.90+/-0.51 D and 60.61+/-16.09 microm, respectively (paired t-test, p<0.05). The irregularity index of 3 mm did not significantly change. Meanwhile, in the control group, the apical power and irregularity index increased from 55.56+/-7.25 D and 3.06+/-1.68 D to 57.11+/-7.75 D and 3.25+/-1.71 D, respectively (paired t-test, p=0.008, p=0.01). CONCLUSIONS: Properly fitted multicurve RGP contact lenses are not likely to contribute to the progression of keratoconus.
Adult ; Astigmatism/etiology/pathology/therapy ; *Contact Lenses ; Cornea/*pathology ; *Corneal Topography ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Keratoconus/complications/pathology/*therapy ; Male ; Prognosis ; Prosthesis Design ; Retrospective Studies ; Time Factors ; Young Adult

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.
Cesarean Section ; Child ; Diagnosis ; Dwarfism ; Extremities ; Female ; Humans ; Hypertension ; Liver Failure ; Pelvic Bones ; Pregnancy ; Recurrence ; Renal Insufficiency ; Thorax ; Uremia

OBJECTIVE: In the ovary apoptosis eliminates granulosa cells (GC) during follicle atresia. While we identified many cell death regulatory molecules not yet characterized in the ovary, of particular interest were members of the Bcl-2 family which contain only the Bcl-2 homology (BH)-3 domain. The objectives of this study was to investigate and compare the expression patterns of BH3-only Bcl-2 family members in various organs and evaluate their function in ovarian granulosa cells. METHODS: Total RNA was extracted from GC, ovaries, uteri, hearts (low rate of cell turnover) and livers (high rate of cell turnover) of prepubertal female mice. BH3-only Bcl-2 family members were cloned to make riboprobe. The expression patterns in the tissues evaluated by Northern blot analysis. Nix mRNA expression in ovarian granulosa cells after gonadotropin treatment also compared by Northern blot analysis. RESULTS: Bad, Bid, Bim, Bmf, Map-1 and Nix were expressed in granulosa cells. Nix was most abundantly expressed in GC. In contrast, Blk was expressed in the ovary, liver, heart and uterus, but not in GC. Bmf, a sensor or microfilament disassembly, was expressed in GC, ovary and uterus, with limited to no expression in non-reproductive tissues. Nix mRNA expression was not regulated by gonadotropin after 42 hour. CONCLUSION: These studies will help to complete a molecular blueprint of the regulatory network that controls GC death during follicular atresia. In addition, these data, which show a tissue/cell-selective profile of BH3-only expression, may also explain the known variation in the in vivo apoptotic response of different tissues/cells to generic stimuli that should be globally lethal.
Actin Cytoskeleton ; Animals ; Apoptosis ; Blotting, Northern ; Cell Death ; Clone Cells ; Female ; Follicular Atresia ; Gonadotropins* ; Granulosa Cells* ; Heart ; Humans ; Liver ; Mice* ; Ovary* ; RNA ; RNA, Messenger ; Uterus

Axillary disorders originate from an axillary lymph node, subcutaneous fat layer, accessory breast, nerve, vessel and muscle. The most common causes of a palpable axillary mass are a lymph node pathology containing a benign axillary lymphadenopathy, and malignant lymph nodes such as a metastatic lymphadenopathy from breast cancer and a malignant lymphoma. For the detection of masses in the axilla, mammography and sonography are the imaging modalities of choice. We present a spectrum of various axillary masses with correlative radiological imaging and pathological findings in this pictorial essay. Knowledge of the radiological findings of various axillary disorders is useful for a differential diagnosis and for preventing unnecessary invasive procedures.
Animals ; Axilla ; Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Lymph Nodes ; Lymphatic Diseases ; Lymphatic Metastasis ; Lymphatic System ; Lymphoma ; Mammary Neoplasms, Animal ; Mammography ; Neoplasm Metastasis* ; Pathology ; Radiography ; Subcutaneous Fat ; Ultrasonography

PURPOSE: The purpose of this study was to demonstrate by functional MRI (MRI) the location of the primarymotor cortex in patients with schizencephaly. MATERIALS AND METHODS: fMRI was performed in four patients withschizencephaly who complained of seizures;three were right handed and one was ambidex trous. Associated lesionswere agenesis of the corpus callosum in one patient and absence of the septum pellucidum in another. fMRI employedthe single sliced FLASH BOLD technique using a 1.5-T MR imager with a standard head coil, and was obtained in theaxial plane. Thirty consecutive images were obtained on finger movements of each hand were obtained;the motor taskconsisted of repetitive finger to thumb opposition. Percentage change in primary motor cortex signal intensity wascalculated, and ipsilateral activation index was compared betweenthe affected and unaffected hemispheres. RESULTS: Percentage change in signal intensity increase in the activated area of the unaffected hemisphere ranged from4.8% +/-0.9% to 9.2+/-1.2%(mean:5.6%+/-1.5%) of the baseline value. The ipsilateral activation index of the affectedhemisphere was 0-0.38 and that of the unaffected hemisphere was 15.4-Infinity;in patients with schizencephalysignificantly different(p<0.01). CONCLUSION: Our results suggest that increased activation in the unaffectedhemisphere reflect functional reorganization of the primary motor cortex.
Corpus Callosum ; Fingers ; Hand ; Head ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Motor Cortex* ; Septum Pellucidum ; Thumb

A l9-year-old boy was admitted because of progressive spastic quadriparesis and bulbar palsy which developed from 3 years ago. The results of all performed laboratory tests were normal, but neuroradiologic tests revealed intracerebral calcification and degeneration of oilateral pyramidal tracts. Idiopathic familial intracerebral calcification was rarely occurred and presented usually with various extrapyramidal and cortical symptoms. Mild pyramidal symptoms were also associated in some reported cases, but none of them showed predominant spasticity as well as suspicious pyramidal tract degeneration on magnetic resonance imaging.
Bulbar Palsy, Progressive ; Humans ; Magnetic Resonance Imaging ; Male ; Muscle Spasticity ; Pyramidal Tracts* ; Quadriplegia

PURPOSE: To evaluate the characteristics of contrast enhancement of peripheral cholangiocarcinoma, as seen on spiral CT. MATERIALS AND METHODS: Spiral CT was used to examine twelve patients with peripheral cholangiocarcinoma of the liver. All underwent conventional CT before contrast enhancement. After the administration of contrast material, two-phased spiral CT was used to investigate seven patients, and three-phased spiral CT, to investigate five. In each phase, we analysed the patterns of contrast enhancement at the central and peripheral portions of the lesion, and compared these with the patterns of normal liver parenchyma. We evaluated changes, according to time lapse, in the central low-density area, and obtained the phase-density curve with the cursor placed at the central portion of the lesion. For three-phased spiral CT examinations, we also tried to determine the phase dvring which the margin of the lesion was most clearly demonstrated. RESULTS: During the arterial phase, eight of twelve patients (67%) showed hyperdensity in the peripheral portion of the lesion; during the portal phase, four of five patients (80%) showed hypodensity in both the central and peripheral portions. During the delayed phase, six of twelve patients (50%) showed isodensity and five showed high density in the peripheral portion. Compared to those in the arterial phase, central hypodense areas relative to normal liver parenchyma in the delayed phase decreased in eleven of twelve patients (92%). On phase-density curves, the density of the central portion of the lesion increased progressively in nine of twelve patients (75%). On three-phased CT, the margin of lesion was-in all five patients - most clearly demonstrated in the portal phase. CONCLUSION: On spiral CT, the central portion of peripheral cholangiocarcinoma always showed low density and the peripheral portion showed high, low, or iso or high density, depending on the phase. In addition, spiral CT clearly demonstrated a minimal centripetal pattern of contrast enhancement. We therefore conclude that in the diagnosis of peripheral cholangiocarcinoma, the characteristics of contrast enhancement are helpful.
Cholangiocarcinoma* ; Diagnosis ; Humans ; Liver ; Tomography, Spiral Computed*

Lymphoid interstitial pneumonia (LIP) is an uncommon process in childhood, and is characterized by interstitial accumulation of mature lymphocytes, plasma cells and reticuloendothelial cells. LIP is believed to have autoimmune or immunologic pathogenesis, because it is frequently associated with acquired immune deficiency syndrome, Epstein-Barr virus infection, common variable immunodeficiency. The patient described in this report had idiopathic thrombocytopenic purpura, Evans syndrome and LIP. The diminished levels of IgG1 & IgG2 were the only immunologic abnormality, which suggest that this patient may be in the early phase of common variable immunodeficiency or selective IgG2 & IgG4 deficiency due to immunoglobulin heavy chain deletion. We can rule out the possibility of lymphoma by clonality study, which showed polyclonal lymphocyte infiltration. On our knowledge, this is the first report of LIP in Korean children.
Acquired Immunodeficiency Syndrome ; Child ; Common Variable Immunodeficiency ; Herpesvirus 4, Human ; Humans ; Immunoglobulin G ; Immunoglobulin Heavy Chains ; Lip ; Lung Diseases, Interstitial* ; Lymphocytes ; Lymphoma ; Plasma Cells ; Purpura, Thrombocytopenic, Idiopathic

PURPOSE: The purpose of this study was to investigate the effect of nursing education using a CD ROM on the anxiety and knowledge of the patients having minor surgery. METHOD: Forty patients hospitalized in K hospital in Seoul from April to August 2002 participated in this study. In the experimental group, twenty patients received nursing education on the operational procedures and post-operational care. The control group, received conventional nursing care only. Anxiety experienced by patients was measured by Spielberger's State-Trait Anxiety Inventory, and knowledge was measured by an instrument developed by Rahe et al. The data were analyzed by SPSS statistical program. RESULTS: There were no significant differences in anxiety level between two groups. However, subjects in the experimental group were found to have significantly higher postoperative knowledge levels than those in the control group, and were very satisfied with the CD ROM program. CONCLUSION: The nursing education program using CD ROM before minor surgery proved to be an effective nursing intervention to increase knowledge of patients and contribute to their self care after discharge. To decrease anxiety of the surgery, the nursing education program should be combined with supprortive emotional nursing intervention, such as touch, and massage.
Anxiety* ; Education, Nursing* ; Humans ; Massage ; Nursing Care ; Nursing* ; Patient Education as Topic ; Self Care ; Seoul ; Surgical Procedures, Minor*