Chronic intestional pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis. Causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel. And may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distention and defication difficulty. Five had urinary bladder distention. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepsis within one year. All had gaseous distention of small and large bowel on abdominal films. In small bowel series. Consistent findings were variable degree of dilatation. Decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.
Dilatation ; Hirschsprung Disease ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Parenteral Nutrition ; Parturition ; Peristalsis ; Sepsis ; Urinary Bladder

A histopathological study was performed on nevus sebaceus to observe its aging effect based on 75 cases of neuvs sebaceus those were collected during the past 10 years from three university hospitals in Seoul. The results are as follows: 1) Clinical findings The incidence was most frequent in the teenage group. The 75 cases consisted of 41 males and 34 females with a sex ratio of 1.2:1. Most of cases developed in the head and neck areas with 62.7% on the scalp and 29.3% on the face. 2) Histopathologic findings. The epidermal changes such as acanthosis(40%), papillomatosis(73%), hypergranulosis(44%) were most remarkable in the second decade and gradually decreased with aging. The apparent proliferation of sebaceous gland was observed in 73% and it was most prominent in the second decade. Apocrine glands were absent before the first decade but apparently increased after then. Proliferation of eccrine gland was not significant in all the age groups. Mild increase of immature hair follicles were noted in 49% of our cases with gradually decreasing tendency in the older age. The dermal inflammatory infiltrates were noted from the 2nd decade(28%) and thereafter gradually increased. Associated neoplasms were one apocrine adenoma, one sebaceous adenoma, two trichilemmomas and two arteriovenous hemangiomas. The majority of tumors occured in the third decade. Therefore, it is observed that neuvs sebaceous undergoes dynamic histopathologic changes according to the age of patient and later develop various secondary neoplastic changes. The pathogenesis of the nevus sebaceus is suggested to be closely related with developmental anomalies of primitive hair germ units in fetal stage.
Adolescent ; Male ; Female ; Humans ; Incidence

Adult polycystic kidney disease is a genetic disease characterized by bilateral multiple renal cysts and is transmitted as an autosomal dominant traits. The disease usually manifests in the fourth decade of life. The affected patients usually die with end stage renal failure, cardiovascular assaults and infection etc. Cardiovascular assaults include ruptured berry aneurysm, spontaneous intracranial hemorrhage, acute myocardial infarction, dissecting aortic aneurysm and hypertensive heart failure. Fatal intracranial hemorrhage and hypertensive heart failure occur in 15% and 2% of patients, respectively. Genetically-determined structural weakness in the arterial wall have been suggested as a possible factor in the genesis of berry aneurysm. We have experienced three autopsy cases with cardiovascular causes of sudden death. Two cases have intracranial hemorrhage (1 berry aneurysm and 1 intracerebral hemorrhage) and the remaining one is dead with hypertensive cardiomyopathy. All of them are aged over 40 years and associated with polycystic liver disease. Histologically, myriad cysts of enlarged bilateral kidney are lined by single layer of cuboidal cells with focal hyperplastic epithelial configuration. Diffusely scattered liver cysts are also lined by flat to cuboidal epithelium and often associated with portal fibrosis.
Adult* ; Aortic Aneurysm ; Autopsy ; Cardiomyopathies ; Cerebral Hemorrhage ; Death, Sudden ; Epithelium ; Fibrosis ; Heart Failure ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Kidney ; Liver ; Liver Diseases ; Myocardial Infarction ; Polycystic Kidney, Autosomal Dominant* ; Renal Insufficiency

Glutathione S-Transferase (GST) is a conjugation enzyme in the metabolism of exogenous and endogenous lipophilic compounds for their excretion and detoxification. Acidic isozyme of GST, GST-Pi, has been recognized as a preneoplastic marker in the experimental hyperplastic nodules of liver in rats, and GST-Pi is abundant in the squamous cells of the skin, also. This histochemical study was carried out to evaluate the distribution and the relationship between the differentiation status of squamous cells in dysplastic or neoplastic epithelium in various organs. The human placental form of glutathione S-transferase (GST-Pi) were stained immunohistochemically with specific anti GST-Pi rabbit antibody in 23 cases of human squamous cell carcinomas. The patients consisted of 14 cases from the uterine cervix, 3 cases from the esopahgus, 3 cases from the lung and 3 cases from the larynx. The results obtained were as follows; 1. Basal cells in normal mucosa were stained negative for GST-Pi while superficial keratinocytes were stained moderately positive. Basal dysplastic cells were stained negatively or weakly positive. Carcinoma cells especially large cells either keratinizing or nonkeratinizing were stained moderately to strongly. Carcinoma cells surrounding keratin pearl were strongly reacted with GST-Pi than other carcinoma cells. 2. Differentiated cells of squamous cell carcinoma showed moderate to strong positive reaction to GST-Pi staining irrespective of its site of origin. 3. Therefore, Immunohistochemical staining pattern of GST-Pi in various squamous carcinoma cells showed similar immunohistochemical reaction to the GST-pi, which is closely correlated to the degree of differentiation, keratinigation and also suggested that squamous carcinoma cells had abundant GST-Pi related detoxifying system.
Humans ; Rabbits ; Animals

No abstract available.
Hernia*

PURPOSE: To correlate the preoperative staging of gastric adenocarcinoma using two-phase spiral CT withpathologic staging. MATERIALS AND METHODS: One hundred and eighty patients with gastric cancers confirmed duringsurgery underwent two-phase spiral CT, and were evaluated retrospectively. CT scans were obtained in the proneposition after ingestion of water. Scans were performed 35 and 80 seconds after the start of infusion of 120mL ofnon-ionic contrast material with the speed of 3mL/sec. Five mm collimation, 7mm/sec table feed and 5mmreconstruction interval were used. T- and N-stage were determined using spiral CT images, without knowledge of thepathologic results. Pathologic staging was later compared with CT staging. RESULTS: Pathologic T-stage was T1 in70 cases(38.9%), T2 in 33 (18.3%), T3 in 73 (40.6%), and T4 in 4 (2.2%). Type-I or IIa elevated lesions accountedfor 10 of 70 T1 cases(14.3%) and flat or depressed lesions(type IIb, IIc, or III) for 60 (85.7%). PathologicN-stage was N0 in 85 cases(47.2%), N1 in 42 (23.3%), N2 in 31 (17.2%), and N3 in 22 (12.2%). The detection rate ofearly gastric cancer using two-phase spiral CT was 100.0%(10 of 10 cases) among elevated lesions and 78.3%(47 of60 cases) among flat or depressed lesions. With regard to T-stage, there was good correlation between CT image andpathology in 86 of 180 cases (47.8%). Overstaging occurred in 23.3%(42 of 180 cases) and understaging in 28.9%(52of 180 cases). With regard to N-stage, good correlation between CT image and pathology was noted in 94 of 180cases (52.2%). The rate of understaging(31.7%, 57 of 180 cases) was higher than that of overstaging(16.1%, 29 of180 cases)(p<0.001). CONCLUSION: The detection rate of early gastric cancer using two-phase spiral CT was 81.4%,and there was no significant difference in detectability between elevated and depressed lesions. Two-phase spiralCT for determing the T- and N-stage of gastric cancer was not effective ; it was accurate in abont 50% of casesunderstaging tended to occur.
Adenocarcinoma* ; Eating ; Humans ; Pathology ; Retrospective Studies ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Water

OBJECTIVE: Our aim was to evaluate the accuracy of prenatal sonographic detection of fetal gastrointestinal(GI) anomalies and to present perinatal outcome of fetal GI anomalies, incidence of polyhydramnios, other malformations and chromosomal abnormalities associated with fetal GI anomalies. MATERIALS AND METHODS: Prenatal sonographic results were compared with GI anomalies found in 32 neonates during recent 8 years. 32 cases of fetal GI anomalies were divided into three groups based on the level of obstruction and complication; group 1: upper GI obstruction(4 esophageal, 5 duodenal and 8 ileojejunal atresia); group 2: lower GI obstruction(1 colonal, 9 anorectal atresia); group 3: GI obstruction with secondary complication(1 ascites, 2 meconium peritonitis, 2 meconium pseudocyst). RESULTS: The accurate prenatal sonographic detection rate of fetal GI anomalies was 70.6% in group 1 and 100% in group 3 and there was no detection in group 2. False positive diagnosis was made in 5 cases(2: esophageal atresia, 3:ileojejunal atresia), but none of them except one case of multiple cardiac anomalies confirmed by autopsy, was followed by termination of pregnancy. Polyhydramnios was significantly associated with group 1 and associated malformations with group 2. An abnormal karyotype existed in three out of 32(1 case of trisomy 18 in esophageal atresia, 2 cases of trisomy 21, each one in duodenal and anorectal atresia). Survival rate of group 1, 2, 3 were 76%, 25%, and 40% respectively. CONCLUSIONS: The upper GI anomalies were easily detected by prenatal sonographic examination and had a good prognosis. But, the lower GI anomalies were difficult to diagnose prenatally and had a poor prognosis. Therefore, further efforts to diagnose for lower GI anomalies should be performed.
Abnormal Karyotype ; Ascites ; Autopsy ; Chromosome Aberrations ; Colon ; Diagnosis ; Down Syndrome ; Esophageal Atresia ; Humans ; Incidence ; Infant, Newborn ; Meconium ; Peritonitis ; Polyhydramnios ; Pregnancy ; Prognosis ; Survival Rate ; Trisomy ; Ultrasonography*

Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.
Axillary Vein ; Catheters, Indwelling/*adverse effects ; Cough/*complications ; Device Removal/*methods ; Foreign-Body Migration/*etiology/radiography ; Heart Atria ; Humans ; Lung Neoplasms/drug therapy ; Male ; Middle Aged

The treatment of a long segment stricture of the upper ureter, destroyed pelvis and ureteropelvic junction obstruction with intrarenal pelvis presents a difficult surgical question. A small isolated segment of the ileum was interposed between the lower pole calyx of the kidney and the ureter. This procedure takes advantage of the presence of normal and nonrefluxing ureterovesical junctions, and serves to diminish any potential problems of electrolyte imbalance and restricture of the ileal ureter. Here, a case of calycoileoureterostomy in a 32-year-old man, with an intrarenal pelvis and a severe ureteropelvic junction obstruction following pyelolithotomy, is described.
Adult ; Constriction, Pathologic* ; Humans ; Ileum ; Kidney ; Pelvis ; Ureter

PURPOSE: This study was designed to describe the burnout experiences of nurses counseling people living with HIV/AIDS (PLWHA) in hospital-based counseling services in Korea. METHODS: A qualitative research technique with focus group interviews was used and the data were collected in 2012. Participants were 13 counseling nurses from 16 medical hospitals in South Korea who had worked full-time for more than six months as a counseling nurse for PLWHA. The 13 nurses made up 68.4% of all 19 official HIV counseling nurses in South Korea. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe-Wamboldt. RESULTS: Burnout experience of counseling nurses for PLWHA was analyzed for two domains-causes of, and effects of burnout. Each domain was classified into three categories; personal, job-related, and relationships. Further 17 sub-categories and 47 concepts were discovered. CONCLUSION: In this study various causes and effects of burnout experienced by nurses counseling PLWHA were identified. These findings can be used in developing effective strategies for nurses, administrators, and health policy makers to solve the burnout of counseling nurses. Further research is required to develop detailed and practical job description for nurses counseling PLWHA.
Administrative Personnel ; Counseling ; Focus Groups ; Health Policy ; HIV ; Humans ; Job Description ; Qualitative Research ; Republic of Korea