The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.
Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Mucins ; Oncogenes

Neurilemmoma is a relatively rare, which was first described by Stout in 1935. Neurilemmoma is a neoplasm arising from Schwann cells. It is usually solitary and may be benign or malignant, solid or cystic, encapsulated or diffuse. We report one case of retroperitoneal neurilemmoma with review of literature.
Neurilemmoma* ; Schwann Cells

Conjugative R plasmids derived from 74 clinical isolates of Serratia marcescens were epidemiologically analyzed for antimicrobial resistance, EcoRI restriction endonuclease analysis and Southern hybridization with DHFR, TEM and SHV probe. 1. Resistance frequency of isolates against various B-lactam antibiotics was changed by year. 2. Twenty (27%) resistant strains transferred 32 R plasmids to E. coli or Klebsiella by mixed culture. Most strains isolated from 1994 to 1996 transferred only trimethoprim resistance but most strains isolated from 1997 did resistances against gentamicin (Gm) and B-lactams including ampicillin (Ap), carbenicillin (Cb), cefazolin (Cz), cefaloridine (Cl), cefamandole (Cn). 3. Ten plasmids of GmApCbCzC1Cn or GmApCbCzC1 pattern and 3 plasmids of TcSuGmTbApCbCzC1 pattern respectively showed identical EcoRI restriction endonuclease digestion patterns and hybridized fragment patterns with TEM-1 probe by Southern hybridization. These results indicate that the epidemic plasmids carrying blamM gene were present in this hospital in 1997 and molecular genetic analysis of R plasmids can be used to discriminate S. marcescens isolates for epidemiologic studies.
Ampicillin ; Anti-Bacterial Agents ; Carbenicillin ; Cefamandole ; Cefazolin ; Cephaloridine ; Digestion ; DNA Restriction Enzymes ; Epidemiologic Studies ; Epidemiology* ; Gentamicins ; Klebsiella ; Molecular Biology ; Plasmids ; R Factors ; Serratia marcescens* ; Serratia* ; Trimethoprim Resistance

Ninety-two strains of Serratia marcescens isolated from 5 hospitals were analyzed for plasmid profile, antimicrobial drug resistance pattern, biotyping, and production of pigment. Ninety-three percents of strains were resistant to chloramphenicol (Cm), tetracycline (Tc), sulfisoxazole (Su), cefazolin (Cz), ampicillin (Ap), and rifampin (Rf). A majority of strains were susceptible to amikacin (Ak), ciprofloxacin (Ci), and cefotaxim (Ct). Fifty-four resistance patterns were found in 94 strains and the most prevalent resistance pattern was CmTcSuApCzRf. Seventeen (17.4%) isolates could transfer their partial resistance to E. coli or Klebsiella pneumoniae by conjugation. Twenty-seven plasmid profiles in 54 strains (58.7%) were detected, however no predominant patterns were seen in isolates from each hospital. Eleven biotypes were detected. The common types were A3b (29.4%) and A8b (27.1%), predominant types were found in each hospital. Twenty strains from 4 of 5 hospitals showed consistence of 3 types. These results indicate that plasmid profile analysis, Grimont biotyping, and resistance pattern type of strains in combination are useful as an epidemiological tool for S. marcescens isolates and some of isolates were confirmed as nosocomial strains.
Amikacin ; Ampicillin ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Epidemiologic Studies* ; Klebsiella pneumoniae ; Plasmids ; Rifampin ; Serratia marcescens* ; Serratia* ; Sulfisoxazole ; Tetracycline

Eighty-nine isolates of Enterobacter spp. from two university hospitals were analyzed by phenotypic and genotypic characteristics for epidemiologic investigation. Most strains were isolated from sputum, urine, wound, pus and catheter tip. Most isolates of Enterobacter spp. were resistant to ampicillin, cefazolin and cefoxitin and 39% of E. cloacae isolates were also resistant to other cephalosporins and aminoglycoside antibiotics except amikacin but all strains were highly susceptible to imipenem and ciprofloxacin. Twenty-six antimicrobial resistance patterns were obtained from E. clacae, but E. aerogenes showed only 4 patterns. Fourty-two plasmid profiles were identified, but plasmid was not detected from 28.4% of E. cloacae and 58% of E. aerogenes. Six biotypes from E. cloacae and three biotypes from E. aerogenes were obtained by carbohydrate metabolism. Fourteen strains of E. cloacae carried conjugative R plasmids and these plasmids were further analyzed. Among them, ten plasmids showed identical antibiogram, molecular weight, and pI value by isoelectric focusing and nearly identical restriction endonuclease fragment pattern. Their parental strains had identical antibiogram, biotype, plasmid profile, and were isolated from 4 different specimens including 6 catheter tips of different patients. But most clinical isolates showed various types of combination and seemed to be different strains. These results indicate that the epidemic strain were present in this hospital and the combination of antibiogram and plasmid analysis can be used to discriminate the epidemic strains of multi-resistant E. cloacae.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Carbohydrate Metabolism ; Catheters ; Cefazolin ; Cefoxitin ; Cephalosporins ; Ciprofloxacin ; Cloaca ; DNA Restriction Enzymes ; Enterobacter* ; Hospitals, University ; Humans ; Imipenem ; Isoelectric Focusing ; Microbial Sensitivity Tests ; Molecular Weight ; Parents ; Plasmids ; R Factors ; Sputum ; Suppuration ; Wounds and Injuries

One hundred of clinical isolates of Klebsiella spp. from three hospitals were analyzed by phenotypic and genotypic characteristics for epidemiologic investigation. Almost all isolates of Klebsiella spp. showed highly resistance to ampicillin, and carbenicillin and 4.5-7.9% of K. pneumoniae isolates were also resistant to cefotaxime and ceftazidime, and 10-15% to aminoglycoside antibiotics except amikacin. However, all strains were highly susceptible to imipenem, cefotetan, amikacin and ciprofloxacin. All Koxytoca strains were susceptible to antimicrobials tested except Ap, Am and Cb. Twelve strains of K. pneumoniae hybridized with TEM or SHV probe and extended spectrum B-lactamases from 7 strains were TEM type. Eleven conjugative R plasmids and their parental strains were analyzed. Among them, three couples of plasmids showed identical or nearly identical resistance phenotypes of B-lactams and aminoglycosides, molecular weights, and pI values by isoelectric focusing, and hybridized fragment patterns with TEM probe by Southern hybridization, EcoR1 restriction endonuclease fragment patterns. Their parental strains were isolated from sputum, tissue, and ascites of patients and had similar characteristics. These results indicate that the epidemic strains or epidemic plasmids were present in this hospital and antimicrobial resistance anlysis can be used to discriminate clinical isolates of multi-resistant K. pneumoniae.
Amikacin ; Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; Ascites ; Carbenicillin ; Cefotaxime ; Cefotetan ; Ceftazidime ; Ciprofloxacin ; DNA Restriction Enzymes ; Epidemiology* ; Family Characteristics ; Humans ; Imipenem ; Isoelectric Focusing ; Klebsiella* ; Molecular Weight ; Parents ; Phenotype ; Plasmids ; Pneumonia ; R Factors ; Sputum

A long-term effect of pentobarbital on the atrial natriuretic peptide (ANP) system was investigated. The experimental group of rats (Sprague-Dawley, male) was one week previously treated with pentobarbital (50 mg/kg, intraperitoneal), and the control was an age-matched group of rats which had never been anesthetized. ANP reaponse to volume-expansion (VE) induced by intravenous infusion of iso-oncotic saline over 30 min (total volume infused amounted up to 5% body weight) was examined under thiopental anesthesia (50 mg/kg, intraperitoneal). Basal plasma ANP level did not significantly differ between the experimental and control groups. Following VE, while the plasma ANP five-fold increased in the control, it rather decreased in the experimental group. Despite the different ANP responses, the magnitude of urinary responses (volume and sodium excretion) to VE did not differ between the two groups. Right and left atrial tissue contents of ANP were significantly lower in the experimental group than in the controL In another series of experiments, the two-kidney, one clip rats were made under either pentobarbital or ether anesthesia and the blood pressure and ANP responses were compared. While the magnitude of blood pressure increases did not differ, the plasma ANP level measured on Day 12 after the clipping was lower in the pentobarbital group than in the ether group. These results suggest that pentobarbital has a long-term inhibitory effect on the ANP system. Its physiological significance in blood pressure and body fluid homeostasis remains to be determined.
Anesthesia ; Animals ; Atrial Natriuretic Factor ; Blood Pressure ; Body Fluids ; Ether ; Homeostasis ; Infusions, Intravenous ; Pentobarbital* ; Plasma ; Rats* ; Sodium ; Thiopental

Acinetobacter species encounters frequently with clinical specimens and now accounts for a substantial proportion of endemic nosocomial infections in Korea. Recent trends indicate that the antimicrobial resistant strains of Acinetobacter species are increasing. Sixty-one strains were isolated from specimens of patients suspected of nosocomial infections during 1991 to 1996. At present, phenotypic identification of Acinetobacter using biochemical test may not be reliable and resulted in the difficulty to clarify the source of infections and epidemiological study of hospital-acquired infections. Aware of the importance of rational taxonomic proposal for these isolates, correct species identification of these organisms by molecular typing method was carried out. A total of fifty-four strains of A. calcoaceticus-A. baumannii complex species which were identified to genospecies 2 and 13 by biochemical characteristics was subjected to identify by ribotyping using restriction endonuclease EcoRI, ClaI, and SalI. Of fifty-four strains, twenty-five strains were identified as A. baumannii (genospecies 2) and twenty-one strains as genospecies 13, and six strains changed to genospecies 3, and the rest two strains were confirmed as A. haemolyticus (genospecies 4). This result suggests that the ribotyping may be of value for identification of genospecies and epidemiological information of Acinetobacter strains.
Acinetobacter baumannii* ; Acinetobacter calcoaceticus* ; Acinetobacter* ; Cross Infection ; DNA Restriction Enzymes ; Humans ; Korea ; Molecular Typing ; Ribotyping*

PURPOSE: The purpose of this study is to investigate nurses' role conflict and intention to remain and to identify factors that may influence this intention. METHODS: Data were collected from 172 nurses in a 600-plus bed hospital on nurses' intention to remain, which included 47 items and nurses' role conflict, which included 82 items from a self-reported questionnaire. Data were analyzed by descriptive statistics and stepwise multiple regression using SPSS 22.0. RESULTS: The mean of the role conflict frequency was 2.71(±.39) and the mean severity was 2.86 (±.47). The most significant item among the items of intention to remain was “a nurse's job is to help people.” The intention to remain employed showed a significant difference in the duration of desired working period and subjective job satisfaction. The subjective job satisfaction of nurses was the most influential variable as a factor affecting the intention to remain, followed by frequency of role conflict in nursing practice. CONCLUSION: These results suggest that inadequate nursing environments in nursing practice require improvement and support the idea that nurses with positive attitudes of the nursing organization and theirs leaders reduce nurses' related fatigue.
Fatigue ; Intention* ; Job Satisfaction ; Nursing

Urine certified reference material (CRM) has been developed to help clinical labolatories control analytical accuracy. Two levels of freeze-dried urine were prepared. The low level CRM was made from normal urine and the abnormal level CRM was prepared by spiking the normal urine with As, Cd, Cr, Cu, Hg, Ni and Pb. Urine reference materials were analyzed by graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma mass spectrometry (ICP-MS) . Analyte elements were separated from matrix elements by using ion exchange resin and hydride generation. Isotope dilution method was employed to enhance analytical accuracy. Round robin test results are also presented which were carried out with 5 clinical laboratories.
Absorption ; Graphite ; Ion Exchange ; Mass Spectrometry ; Plasma ; Quality Control* ; Songbirds ; Spectrum Analysis