The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.

BACKGROUND: Regulatory T cells (Tregs) may contribute to the immunological hyporesponsiveness against hepatitis B virus (HBV), and this can result in chronic infection. Tregs suppress the T cell responses directed against HBV and they protect hepatocytes by down-regulating the immune responses that cause liver damage, but the role of Tregs has not been well characterized. METHODS: Fifty four patients were selected and classified into three groups (12 were in the immune-tolerance phase, 35 were in the immune-clearance phase and 7 were in the asymptomatic virus carrier phase). We examined the frequency of CD3+, CD4+ & CD8+ T cells and forkhead box P3 (FoxP3)+ Tregs in the needle-biopsied liver tissue by performing immunohistochemistry. RESULTS: The FoxP3+ Tregs were mainly located at the portal tracts. In the immune-clearance phase, the frequency of FoxP3+ Tregs was significantly increased compared to that of the immune-tolerance group and the asymptomatic carrier group. Increased FoxP3+ T cells were observed in the patients with a higher histologic inflammatory index. No correlation was observed among the numbers of FoxP3+ Tregs, the serum alanine aminotransferase level, detection of HBeAg and the HBV-DNA viral load. CONCLUSIONS: FoxP3+ Tregs may play important roles in suppressing the immune response to HBV and the complete elimination of HBV.
Alanine Transaminase ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Liver ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Viruses

Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma (CSMTCL) is a rare disease constituting 2% of all cutaneous T-cell lymphomas. In most cases, CSMTCL occurs as a solitary lesion and has an indolent course. Here we present a 42-year-old woman with multiple, localized, recurrent, erythematous papules and macules that developed after combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP).
Adult ; Cyclophosphamide ; Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Prednisolone ; Rare Diseases ; T-Lymphocytes ; Vincristine

Incontinentia pigmenti is a systemic disorder affecting the skin, teeth, eyes, nervous tissue, hair, nails, musculoskeletal system, and heart. We describe an 11-month-old girl with incontinentia pigmenti associated with a ventricular septal defect, left hemiatrophy, hemangiomas, an abnormal labial frenum, and spastic cerebral palsy manifested as left hemiplegia and developmental delay. We believe this patient illustrates that incontinentia pigmenti is a systemic disorder necessitating a multidisciplinary approach to management.
Cerebral Palsy ; Eye ; Hair ; Heart ; Heart Septal Defects, Ventricular ; Hemangioma ; Hemiplegia ; Humans ; Incontinentia Pigmenti ; Infant ; Labial Frenum ; Musculoskeletal System ; Nails ; Skin ; Tooth

Spindle cell lipoma is a benign tumor composed of ropey collagen, myxoid stroma, CD34-positive spindled cells, and mature fat. The variable proportion of these elements among different cases of the neoplasm makes diagnosis difficult. Furthermore, numerous variants have been reported, including pseudoangiomatous spindle cell lipoma, angiomatous spindle cell lipoma, fibrous spindle cell lipoma, and low-fat or fat-free spindle cell lipoma. Here we report a case of low-fat, fibrous spindle cell lipoma in which fat is noted to be present in <5% of the tumor, whereas fibrous collagenous stroma is predominant.
Collagen ; Lipoma

Doxifluridine is a pyrimidine derivative and is activated to 5-fluorouracil by pyrimidine phosphorylase. Multiple acral hyperpigmented macules have been reported in patients treated with systemic 5-fluorouracil or some of its prodrugs. However, there have been no reports of this adverse event being induced by doxifluridine. Herein we present a 42-year-old woman with multiple pigmented lesions on the palm and sole after chemotherapy with oral doxifluridine.
Adult ; Female ; Floxuridine ; Fluorouracil ; Humans ; Hyperpigmentation ; Immunosuppressive Agents ; Prodrugs ; Pyrimidines

Proliferative fasciitis is a rare, rapidly growing, pseudosarcomatous nodule of subcutaneous tissue. It commonly occurs on the extremities. Lesions on the head and neck are exceedingly rare. Histopathologically, it is characterized by several large basophilic ganglion-like cells deposited in a myxoid stroma with spindled cells. Herein, we report a case of a 54-year-old man who noticed a nodule on his right cheek about six months before examination. At first, its size abruptly increased, and then remained without any change in size. Microscopically, many basophilic ganglion-like cells and spindled cells were deposited in a myxoid stroma. Immunohistochemically, ganglion-like cells and spindled cells were strongly positive for vimentin and weakly positive for smooth muscle actin and CD68. Although it was not radically excised, the lesion has not been found for 3 months.
Actins ; Basophils ; Cheek ; Extremities ; Fasciitis ; Head ; Humans ; Middle Aged ; Muscle, Smooth ; Neck ; Subcutaneous Tissue ; Vimentin

Although a basal cell carcinoma usually results from chronic irradiation of solar ultraviolet, some reports have mentioned that non-solar ultraviolet and trauma also could be etiologic factors of basal cell carcinoma. Herein, we report a case of a 64-year-old man who had worked as a welder for more than thirty years. Four years ago, he was burnt on his right upper eyelid during welding. After that, the lesion had been darkened and indurated, and finally was diagnosed as basal cell carcinoma. The significance of non-solar ultraviolet irradiation and thermal burn during welding in the pathogenesis of basal cell carcinoma is discussed.
Burns ; Carcinoma, Basal Cell ; Eyelids ; Humans ; Middle Aged ; Welding

Mucoepidermoid carcinoma is the most common primary salivary gland malignancy. About 60% of mucoepidermoid carcinomas occur in the major salivary glands and 35% in the minor glands, in which the palate and buccal mucosa are the most frequent sites. Histologically, tumor cells, composed of intermediate, mucous, epidermoid, and clear cells in widely varying proportions, form numerous sheets, islands, duct-like structures and cysts. Many foci of mucin production are prominent. Herein, we report a case of a 37-year-old man who presented a nodule on left buccal mucosa. After the diagnosis, he was referred to a dental surgeon, by whom the tumor was radically excised. But, tumor cells were observed at one of the resection margins. As a result, he received radiation therapies (6 weeks, 60 Gy). He is now undergoing regular follow ups without any signs of recurrence.
Adult ; Carcinoma, Mucoepidermoid ; Follow-Up Studies ; Humans ; Islands ; Mouth Mucosa ; Mucins ; Palate ; Recurrence ; Salivary Glands ; Salivary Glands, Minor

Cutaneous metastasis from renal cell carcinoma is rare. Once metastatic cutaneous involvement of a renal cell carcinoma has occurred, the disease is already widespread and therefore has a very poor prognosis. Herein we report a case of a 59-year-old man who presented with a renal cell carcinoma metastatic to the scalp, lung, brain and contralateral kidney.
Brain ; Carcinoma, Renal Cell ; Humans ; Kidney ; Lung ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Scalp