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*

PURPOSE: The purpose of this study was to understand the meaning of experiences in home visiting nursing service among the elderly in community provided by nursing students. METHOD: This is a phenomenological study to investigate the experience of community-based patients. Data were collected through in-depth interviews from the 4th of March to the 15th of December 2003. Individual interviews were conducted with 8 patients on subjective experiences. Data were analyzed through Colaizzi's method, in which meaningful statements were extracted. RESULT: Four categories were identified from nine theme clusters. The four categories were 'thankfulness', 'dependence', 'sorrowfulness' and 'the sense of being'. CONCLUSION: These results show the importance of visiting nursing service for the elderly in community.
Aged* ; House Calls* ; Humans ; Life Change Events ; Nursing Services* ; Qualitative Research ; Students, Nursing

No abstract available.
Blood Platelets* ; Leukocytes* ; Plateletpheresis*

Human rotavirus has now been established as the leading cause of gastroenteritis in young children worldwide. At least fourteen serotypes of group A rotavirus have been identified on the basis of antibody responses to major neutralizing glycoprotein, VP7 (G type for glycoprotein), present in the outer capsid of the virus. Serotype 1, 2, 3 and 4 are the most highly prevalent in human. In Korea, rotavirus is also the principal cause of severe nonbacterial diarrhea requiring hospitalization in infants and young children, which is commonly detected by EIA method. The epidemiology of rotavirus infection has been monitored by only serologic methods without electropherotyping in Korea. This study shows seasonal and age related variations .of rotavirus infection in Korea according to the genotype using the reverse transcription polymerase chain reaction (RT-PCR). Fecal specimens were obtained from 39 children hospitalized with acute watery diarrhea and gastroenteritis in Ewha Womans University MokDong Hospital in Seoul from Jan. to Dec. of 1996. All four (1, 2, 3, 4) major G serotypes were identified by amplification of segment of the gene for VP7 using RT-PCR. Rotavirus Gl 749 bp, G2 653 bp, G3 374 bp and G4 583bp were shown on 2.9 or 3.3% NuSieve agar gel. Results were as follows: 1) Rotavirus was detected at 53.8% (21/39) by EIA and 89.7% (35/39) by RT-PCR. 2) Serotype Gl, G2, G3, G4 when detected by RT-PCR accounted for 80.0% (28/35), 14.3% (5/35), 2.9% (1/35) and 2.9% (1/35), respectively. 3) Thirty five strains of rotavirus were detected at the frequency of 17.1% (6/35) in Oct., 20.0% (7/35) in Nov. and 20.0% (7/35) in Dec. 4) As for the age range, children affected by rotavirus were mostly under 1 years.
Agar ; Antibody Formation ; Capsid ; Child ; Child, Hospitalized* ; Diarrhea* ; Epidemiology ; Female ; Gastroenteritis ; Genotype* ; Glycoproteins ; Hospitalization ; Humans* ; Infant ; Korea ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus Infections ; Rotavirus* ; Seasons ; Seoul

Astrovirus is frequently associated with diarrhea in children. It can not be readily isolated by cell culture, and an electronmicroscope is usually used for detection of this agent. Recently in 1995 a combined method of reverse transcription-polymerase chain reaction (RT-PCR) was designed for easier detection of astrovirus, which is based on the conserved sequence in 3'-end of genomes of the 7 known serotypes of human astrovirus. As of yet there has not been any report of astrovirus data in Korea using the RT-PCR methods. The purpose of this study was to detect astrovirus incidence, severity of symptoms, seasonal variation and coinfection rate with rotavirus in Korean children inpatients with diarrhea. Fecal specimens from 61 young children hospitalized with gasteroenteritis Korea from Jan. 1996 through Mar. 1997. They were examined for astroviurs infection by RT-PCR method. Results are as follows: 1. Astrovirus was detected at 9.8% (6/61) from fecal specimens of children with severe diarrhea by EIA using monoclonal antibody coated plates. 2. Astorvirus was detected at 29.5% (18/61) from fecal specimens of children with severe diarrhea by RT-PCR. 3. The age of the 18 children affected by astrovirus ranged from 2 monthes to 7 years with mean of 3.0 years. 4. Mean hospital stay of the 1S children was 6.1 days. 5. Five (27.8%) astrovirus RT-PCR positive strains were confirmed in November and in December, respectively out of 18 specimens in total. 6. Astrovirus coinfection with rotavirus type G1 was confirmed in 15/16 specimens (93.8%), and with type G2 was in 1/16 specimens (6.3%).
Cell Culture Techniques ; Child* ; Coinfection ; Conserved Sequence ; Diarrhea ; Feces* ; Genome ; Humans ; Incidence ; Inpatients ; Korea ; Length of Stay ; Mamastrovirus ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus ; Seasons

BACKGROUND: The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during as asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. METHOD: A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age-and sex-matched subjects with stable asthma. RESULTS: The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma (233±175 pg/ml) than in the 48 subjects with stable asthma(169±74 pg/ml). A tread toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids (332±225 pg/ml) than in those who were not (214±159 pg/ml) and higher levels were found in those admitted to the hospital (275±212 pg/ml) than in those discharged after receiving only emergency treatment (190±115 pg/ml). The eotaxin levels inversely correlated with the FEV1 (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent (323±256 pg/ml) and severe persistent asthmatics (276±170 pg/ml) than in mild intermittent asthmatics (160±60 pg/ml). CONCLUSION: Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.
Asthma* ; Case-Control Studies ; Emergency Treatment ; Eosinophils ; Humans ; Plasma* ; Steroids

Canavan disease(CD) is a rare autosomal recessive leukodystrophy caused by the deficiency of aspartoacylase and the accumulation in brain of N-acetylaspartate(NAA). CD has been reported mainly Ashkenazi Jews but also occurs in other ethnic groups. Usually it presents as early as the third month of life with megalencephaly, hypotonia later progressing to hypertonia, psychomotor and mental retardation, blindness, occasionally deafness and seizure. Diagnosis is based on the clinical feature, N-acetylaspartic aciduria, radiologic and pathologic findings. Histologically, the affected white matter shows extensive vacuolation and demyelination. There is no treatment for CD and the only prevention is through genetic counselling and prenatal diagnosis. We experienced a case of Canavan disease that was presented with hypotonia and developmental delay. Diagnosis was confirmed histologically. Radiologic findings are extensive high signal throughout the white matter on T2-weighted MRI and increased NAA peak and decreased choline peak of the white matter on MR spectroscopy.
Blindness ; Brain ; Canavan Disease* ; Choline ; Deafness ; Demyelinating Diseases ; Diagnosis ; Ethnic Groups ; Humans ; Intellectual Disability ; Jews ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Muscle Hypotonia ; Prenatal Diagnosis ; Seizures

Levodopa treatment in Parkinson's disease (PD) can cause a wide range of non-motor manifestations including poor impulse control and stereotyped behaviors. Punding is a term used to describe complex prolonged, purposeless and repetitive behavior in patients under dopamine replacement therapy. We report a 64-year-old PD patient who, concomitantly with self-increment of levodopa, developed punding behaviors in association with dopamine dysregulation syndrome. Gradual reduction of dopaminergic medication partially alleviated repetitive behavior over time.
Dopamine ; Humans ; Levodopa ; Middle Aged ; Parkinson Disease ; Stereotyped Behavior