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

We investigated the capacity of low dose aspirin in reducing the incidence of pregnancy induced hypertension and affecting the pregnancy outcomes in women at high risk for this disorder. And we also studied the efficacy of Doppler ultrasound as an effective means of selecting a patient population of good candidate to administer low dose aspirin. Seventy women with chronic hypertension or a history of severe preeclampsia in their previous pregnancy were randomly assigned to treated group receiving low dose aspirin(60 mg/d, n=32) or control group(n=38). Daily administration of low dose aspirin could not prevent the development of pregnancy induced hypertension in the treated group(21.9% vs. 28.3%, p > 0.05). And there was no differences between the treated and control groups in the rates of emergency cesarean section for fetal distress(6.3% vs. 10.3%, p > 0.05), neonatal intensive care unit admission(9.4% vs. 15.8%, p > 0.05), fetal growth retardation(15.6% vs. 13.2%, p > 0.05), and perinatal death(3.1% vs. 7.9%, p > 0.05). In the group showing abnormal Doppler flow velocity waveform, aspirin seemed to improve the mean gestational age(35.7+/-2.8 vs. 34.4+/-3.1 weeks), birth weight(2271.9+/-730.8 vs. 1887.0+/-619.0 gm) and the pregnancy outcomes(31.3% vs. 60.6%), however, these results were not statistically significant(p > 0.05). This study suggests that low dose aspirin therapy is not effective in reducing the incidence of pregnancy induced hypertension. However, combination of Doppler ultrasound study with low doe aspirin therapy may improve pregnancy outcomes in women with high risk pregnancy.
Aspirin* ; Cesarean Section ; Emergencies ; Female ; Fetal Development ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Parturition ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy, High-Risk* ; Ultrasonography*

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

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*

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

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

Patients who visited to the pediatric department sometimes present psychiatric problems, but this interesting field seems to have been neglected frequently by clinicians. The authors were analyzed 130 cases of pediatric patients who referred to psychiatric department for the evaluation of psychiatric problems from July, 1974 to June, 1977 at the St. Mary's hospital, Catholic medical college. The results were as follows: 1. Of the 130 children, 63.1% were male and 36.9% were female and the ratio was 1.7:1. The majority of the patients (68.4%) fall into the age group of primary school children. 2. In sibling order, the first and second child were occupied of 60.8% of total patients. The frequency of only son and daughter among the observed children were 28.5%. 3. Ten major reasons for referral in the order of frequency were somatic compainlts (23.9%), anxiety (6.7%), conversion symptom (5,7%), sleep disturbance (5.4%), convulsive disorder (5.0%), tic (4.7%), depression (4.4%), hyperactivity (4.0%), over sensitivity (2.7%) and aggressive behavior (2.7%). There were diffierent reasons for referral by sex. Somatic complaints were the most common reason in both sex, but convulsive disorder and tic were more common in male and anxiety and depression in female respectively. 4. Neurosis (40.0%) was the most common psychiatric diagnosis found on consultation and the other frequent diagnosis were organic brain syndrome (15.4%), transient situational disorder (14.6%), special symptom (10.8%) and psychophysiologic disorder (9.2%). 5. The primary physician's reason for referral correlated with the psychiatric diagnosis. When a child was referred for a somatic complains on the pediatric clinic he was more likely to be a neurosis, transient situational disorder and psychophysiologic disorder than to have any other diagnosis. Referral for convulsive disorder and hyperactivity were associated with the diagnosis of organic brain syndrome and conversion symptoms with neurosis respectively. Also the reason for referral correlated with the school age group. Hyperactivity and sleep disturbance were more common in preschool age group and somatic complaints in middle school age group respectively.
Anxiety ; Brain ; Child* ; Depression ; Diagnosis ; Female ; Humans ; Male ; Mental Disorders ; Nuclear Family ; Psychophysiologic Disorders ; Referral and Consultation ; Siblings ; Tics

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