ABSTRACT
A Clostridioides difficile infection (CDI) is one of the major nosocomial diarrheal diseases. Pseudomembranous colitis (PMC) is a characteristic endoscopic finding of CDI, manifested by white or yellowish plaque covering the colonic mucosa. Ischemic colitis is inflammation of the colon manifested by mucosal denudation and friability. Ischemic colitis is rarely associated with CDI. The treatment response might be delayed when CDI is complicated with other diseases that cause diarrhea. Thus far, reports of CDI concomitant with Cytomegalovirus (CMV) colitis are rare. This paper reports a case of PMC and ischemic colitis associated with CDI and CMV infection. After two weeks of oral vancomycin and intravenous metronidazole, the patient’s diarrhea was not improved. Follow-up sigmoidoscopy was performed, and a CMV infection was identified at areas of broad ulceration where ischemic colitis occurred.Finally, the patient was cured with ganciclovir. Follow-up sigmoidoscopy showed an improvement in ischemic colitis.
ABSTRACT
Listeria monocytogenes is a rare cause of bacterial meningitis, particularly beyond the neonatal period. This article describes a 16-month-old girl who presented with a new-onset febrile status epilepticus, and subsequently developed altered mentality and lethargy. L. monocytogenes was detected on a point-of-care, multiplex polymerase chain reaction using the cerebrospinal fluid. On day 3, she developed a rapidly progressive hydrocephalus. Her consciousness improved after placement of an external ventricular drain. After 3-week antibiotic therapy, she was successfully discharged without residual complications.
ABSTRACT
Digital pathology is being gradually adopted in hospitals due to technological advances. We propose that digital pathology can be used in Mohs micrographic surgery (Mohs surgery) to precisely check residual tumor cells in frozen tumor margin tissues. This would aid surgeons and pathologists in accurately recording tumor margins and give patients the benefit of shorter operation time.
ABSTRACT
Objective@#To categorize multiparametric MRI features of Bacillus Calmette–Guérin (BCG)-related granulomatous prostatitis (GP) and discover potential manifestations for its differential diagnosis from prostate cancer. @*Materials and Methods@#The cases of BCG-related GP in 24 male (mean age ± standard deviation, 66.0 ± 9.4 years; range, 50–88 years) pathologically confirmed between January 2011 and April 2019 were retrospectively reviewed. All patients underwent intravesical BCG therapy followed by a MRI scan. Additional follow-up MRI scans, including diffusion-weighted imaging (DWI), were performed in 19 patients. The BCG-related GP cases were categorized into three: A, B, or C. The lesions with diffusion restriction and homogeneous enhancement were classified as type A. The lesions with diffusion restriction and a poorly enhancing component were classified as type B. A low signal intensity on high b-value DWI (b = 1000 s/mm2 ) was considered characteristic of type C. Two radiologists independently interpreted the MRI scans before making a consensus about the types. @*Results@#The median lesion size was 22 mm with the interquartile range (IQR) of 18–26 mm as measured using the initial MRI scans. The lesion types were A, B, and C in 7, 15, and 2 patients, respectively. Cohen’s kappa value for the inter-reader agreement for the interpretation of the lesion types was 0.837. On the last follow-up MRI scans of 19 patients, the size decreased (median, 5.8 mm; IQR, 3.4–8.5 mm), and the type changed from A or B to C in 11 patients. The lesions resolved in four patients. In five patients who underwent prostatectomy, caseous necrosis on histopathology matched with the non-enhancing components of type B lesions and the entire type C lesions. @*Conclusion@#BCG-related GP demonstrated three imaging patterns on multiparametric MRI. Contrast-enhanced T1-weighted imaging and DWI may play a role in its differential diagnosis from prostate cancer.
ABSTRACT
Purpose@#This cross-sectional study aimed to identify factors affecting coronavirus disease 2019 (COVID-19) vaccination intention. @*Methods@#For an anonymous online survey, recruitment notices were posted on an anonymous community by each university, and an online survey was conducted through online form from June to July 2021. COVID-19 knowledge and health-protective behavior were measured using a questionnaire based on previous literature and reflecting the Korea Centers for Disease Control and Prevention’s COVID-19 Response Guidelines. The psychological antecedents of vaccination were measured by 5C scale. @*Results@#Two-hundred and ninety-four college students (women 67.3%) answered the survey; 179 (60.9%) reported that they would accept a COVID-19 vaccine. The mean scores for COVID-19 knowledge and health-protective behavior were 22.97 ± 5.33 (out of 35) and 9.92 ± 2.22 (out of 12), respectively. For the psychological antecedents of vaccination, the mean scores for confidence, collective responsibility, calculation, complacency, and constraints were 4.45 ( ± 1.24), 5.61 ( ± 1.09), 5.09 ( ± 1.18), 2.42 ( ± 1.11), and 2.37 ( ± 1.19) out of 5 points, respectively. The confidence, calculation, and collective responsibility were associated with vaccination intention. Additionally, the top reason for those who were less prone to accept vaccination against COVID-19 was concern about vaccine safety. @*Conclusion@#The higher the confidence in the vaccine and the higher the collective responsibility, the higher the vaccination intention. As it is a factor related to an individual’s perception of COVID-19 information, it is necessary to increase confidence in the vaccines through obtaining accurate information on the safety, effectiveness, and side effects of the COVID-19 vaccines and vaccination.
ABSTRACT
The purpose of the current study was to compare prognostic outcomes between patients with high-grade ovarian Sertoli-Leydig cell tumors (SLCTs) and those with other low-grade SLCTs. We retrospectively reviewed medical records for 24 patients pathologically diagnosed with SLCTs between 2006 to 2019 at two institutions. The patients were grouped according to pathological grade: SLCT was classified as grade 1, well differentiated; grade 2, intermediated differentiated; or grade 3, poorly differentiated (Meyer’s classification). Statistical analysis was performed to compare survival outcomes according to pathological grade. The median patient age was 42.5 years (range 16–75). Eighteen patients (75%) were International Federation of Gynecology and Obstetrics stage I, and none were diagnosed in stage IV. Nine patients (37.5%) were grade 3, and 15 patients (63.5%) were grades 1–2. When comparing clinical baseline characteristics of the grade 1–2 group with those of the grade 3 group, only serum CA125 level at diagnosis was significantly higher in the grade 3 group (38.34 vs. 382.29, p=0.002). Five patients experienced recurrence of grade 3 disease, while no recurrence was reported in grade 1–2 disease. Four of the five recurrent patients died. In result, grade 3 ovarian SLCT showed significantly poorer prognosis than grade 1–2 disease (overall survival, hazard ratio=14.25, 95% confidence interval= 1.881–108.0; log-rank p=0.010). Our findings were consistent with the concept that patients with stage I/grade 1–2 tumors have a good prognosis without adjuvant chemotherapy. Since grade 3 ovarian SLCT appears to be relatively more fatal than grade 1 or 2, patients with grade 3 SLCT might require more aggressive surgical intervention and post-treatment surveillance.
ABSTRACT
Purpose@#Histiocytic and dendritic cell neoplasms are rare hematologic tumors.This study aimed to describe the epidemiologic features of the entire spectrum of histiocytic and dendritic cell neoplasms, including clinicopathological variables and patient outcomes. @*Materials and Methods@#We comprehensively reviewed 274 patients who were diagnosed with histiocytic and dendritic neoplasms at Severance Hospital, Seoul, South Korea between 1995 and 2018. @*Results@#The most common neoplasm was Langerhans cell histiocytosis (LCH), followed by dermal xanthogranuloma. Among non-LCH sarcomas, histiocytic sarcoma (HS) showed a relatively high prevalence, followed by follicular dendritic cell sarcoma (FDCS). Disseminated juvenile xanthogranuloma (DJG), Erdheim-Chester disease (ECD), indeterminate dendritic cell tumor (IDCT), and interdigitating dendritic cell sarcoma (IDCS) rarely occurred. Generally, these tumors presented in childhood, although the non-LCH sarcoma (HS/FDCS/IDCS/IDCT) group of tumors and ECD occurred in late adulthood. Multiorgan involvement and advanced Ann-Arbor stage, as well as recurrence and death of disease, were not uncommon. The non-LCH sarcoma group had the worst overall survival, compared to the DJG, ECD, and LCH groups. @*Conclusion@#Our findings indicate that histiocytic and dendritic cell neoplasms exhibit heterogeneous epidemiologic characteristics and that some patients may have unfavorable outcomes, especially those with non-LCH sarcoma.
ABSTRACT
Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin. In a case with signet ring cell differentiation, differential diagnosis with metastatic signet ring cell carcinoma of the stomach and colon is essential. In this case, the presence of accompanied ductal carcinoma in situ component and mammaglobin and gross cystic disease fluid protein-15 positivity were findings that suggested the breast as the origin.
ABSTRACT
OBJECTIVE: To evaluate the clinical and pathologic characteristics of patients who were diagnosed with ovarian Sertoli-Leydig cell tumors (SLCTs) in a single institution. METHODS: The medical records of 11 patients who were pathologically diagnosed with SLCTs beginning in 1995 in a single institute was reviewed. RESULTS: The median patient age was 31 years (range, 16 to 70 years). Patient International Federation of Gynecology and Obstetrics stages were IA, IC, and IIB in 3 (27.3%), 6 (54.5%), and 2 (18.2%) patients, respectively. Six patients (54.5%) had grade 3 tumors, 3 patients (27.3%) had grade 2 tumors, and 1 patient (9.1%) had a grade 1 tumor. Four patients without children underwent fertility-sparing surgery, and 7 patients had full staging surgery, including a hysterectomy and bilateral salpingo-oophorectomy, with a laparoscopic approach used in 3. Eight patients underwent pelvic lymph node dissection, and 8 patients were administered adjuvant chemotherapy consisting of bleomycin, etoposide, and cisplatin in 6 cases, a modified bleomycin, etoposide, and cisplatin regimen in 1 case, and a combined paclitaxel and cisplatin regimen in 1 case. Two patients died of disease and were re-diagnosed with Sertoli form endometrioid carcinoma. The other patients remain alive without recurrence at the time of reporting. CONCLUSION: Our findings suggest that regardless of tumor stage or grade, ovarian SLCT patients have a good prognosis. Close observation and unilateral salpingo-oophorectomy would be beneficial for women who still wish to have children, while hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy would be the optimal treatment in other cases. Furthermore, meticulous pathologic diagnosis is needed to develop a precise treatment strategy.
Subject(s)
Child , Female , Humans , Bleomycin , Carcinoma, Endometrioid , Chemotherapy, Adjuvant , Cisplatin , Diagnosis , Drug Therapy , Etoposide , Gynecology , Hysterectomy , Lymph Node Excision , Medical Records , Obstetrics , Ovarian Neoplasms , Paclitaxel , Prognosis , Recurrence , Sertoli-Leydig Cell TumorABSTRACT
OBJECTIVE: The chemotherapy response score (CRS) system based on histopathological examination has been recently proposed for tubo-ovarian high-grade serous carcinoma (HGSC) to assess response to neoadjuvant chemotherapy (NAC). This study was aimed at validating the CRS system in an external cohort of tubo-ovarian HGSC patients. METHODS: This study included 110 tubo-ovarian HGSC patients who underwent NAC followed by interval debulking surgery. The 3-tiered CRS of the omental and adnexal tissue sections was determined by 3 independent pathologists. Differences in patient outcomes according to CRS were analyzed. RESULTS: The CRS system was highly reproducible among the 3 pathologists. Fleiss' kappa value and Kendall's coefficient of concordance for the omental CRS were 0.656 and 0.669, respectively. The omental CRS significantly predicted progression-free survival (PFS). The median PFS of patients whose tumors exhibited the omental CRS 1–2 (15 months) was significantly shorter than that of patients with an omental CRS of 3 (19 months; p=0.016). In addition, after adjusting for age, stage, and debulking status, the omental CRS was an independent prognostic factor for PFS of tubo-ovarian HGSC patients who were treated with NAC (adjusted hazard ratio [HR]=1.74; 95% confidence interval [CI]=1.05–2.87). CONCLUSION: The CRS system for assessing NAC response was a reproducible prognostic tool in our cohort. The application of the CRS system after NAC can improve survival estimation in HGSC patients.
Subject(s)
Humans , Cohort Studies , Disease-Free Survival , Drug Therapy , Ovarian NeoplasmsABSTRACT
No abstract available.
Subject(s)
Aged , Female , Humans , Antigens, CD/metabolism , Antigens, Differentiation, Myelomonocytic/metabolism , Cadherins/metabolism , Cholangiocarcinoma/pathology , Giant Cells/metabolism , Osteoclasts/pathology , Tomography, X-Ray ComputedABSTRACT
Immunoglobulin G4-related disease (IgG4-RD) can involve any organ. The majority of reported cases involve IgG4-RD of the biliary tract or pancreas, while only two cases of pericarditis have been reported. A 58-year-old man visited the outpatient clinic of our institution with a seven-day history of progressive dyspnea. Based on his transthoracic echocardiogram and transesophageal echocardiogram, he was diagnosed with constrictive pericarditis. The histopathology of his pericardiectomy revealed the cause of constrictive pericarditis to be IgG4-RD. Prednisolone (40 mg) was initiated after the pericardiectomy. As the patient's symptoms resolved, he was discharged and followed-up on an outpatient basis. This is the first case report of constrictive pericarditis caused by IgG4-RD in Korea.
Subject(s)
Humans , Middle Aged , Ambulatory Care Facilities , Biliary Tract , Dyspnea , Immunoglobulin G , Immunoglobulins , Inflammation , Korea , Outpatients , Pancreas , Pericardiectomy , Pericarditis , Pericarditis, Constrictive , PrednisoloneABSTRACT
BACKGROUND: The study was designed to assess the changes in working conditions through a comparative analysis of the characteristics of working conditions in 2006 and 2010. METHODS: We performed a comparative analysis of the data related to the first Korean Working Conditions Survey (KWCS) and the second KWCS in the categories of demographic characteristics, quality of labor, exposure to hazards, and health problems. RESULTS: From our analysis of the demographic characteristics, we saw an increase in labor force participation rate of women and elderly people. As a result of the investigation with regards to working hours, the ratio of employees who worked for > or = 49 hours per week was decreased and the ratio of employees who worked for > or = 40 h/wk increased. As for exposure to hazards, exposure to tobacco smoke notably decreased in 2010 compared with 2006. With regards to health problems, there was a sharp increase in the number of people who complained of muscle pain in their arms and legs. CONCLUSION: KWCS data included many aspects of working conditions as a nationwide sample. In addition, because this is a periodic nationwide survey, the labor force, working hours, harmful factor exposure, and the change in health problems characteristics according to the flow of time could be investigated. The information comparing the main results of the first survey conducted in 2006 and the second survey conducted in 2010 obtained through this study can be used as an important base material for the establishment of the national policy.
Subject(s)
Aged , Female , Humans , Arm , Employment , Leg , Myalgia , Smoke , TobaccoABSTRACT
Our previous study demonstrated that yuzu has an anti-platelet effect in rat blood. In the present study, we examined whether the anti-platelet effect of yuzu can be extended to human blood by investigating its ability to inhibit aggregations induced by various agonists in human platelet rich plasma (PRP). This study also investigated the underlying mechanism of yuzu focusing on ADP granule secretion, TXB2 formations, and PLCgamma/Akt signaling. The results from this study showed that ethanolic yuzu extract (YE), and its components, hesperidin and naringin, inhibited human platelet aggregation in a concentration-dependent manner. YE, hesperidin and naringin also inhibited TXB2 formation and ADP release. The phosphorylation of PLCgamma and Akt was significantly inhibited by YE, heperidin and naringin. Furthermore, we demonstrated that YE, heperidin and naringin has anti-platelet effects in rat ex vivo studies, and lower side effects in mice tail bleeding time studies. The results from this study suggest that YE, hesperidin and naringin can inhibit human platelet aggregation, at least partly through the inhibition of PLCgamma and Akt, leading to a decrease in TXB2 formation and granule secretion.
Subject(s)
Animals , Humans , Mice , Rats , Adenosine Diphosphate , Bleeding Time , Blood Platelets , Ethanol , Hesperidin , Phosphorylation , Platelet Aggregation , Platelet-Rich Plasma , TailABSTRACT
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six diagnostic categories to standardize communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists. Since several studies have questioned the diagnostic accuracy of this system, we examined its accuracy in our hospital. METHODS: We calculated the incidences and malignancy rates of each diagnostic category in the BSRTC for 1,730 FNAs that were interpreted by four cytopathologists in Gangnam Severance Hospital between October 1, 2011, and December 31, 2011. RESULTS: The diagnostic incidences of categories I-VI were as follows: 13.3%, 40.6%, 9.1%, 0.4%, 19.3%, and 17.3%, respectively. Similarly, the malignancy rates of these categories were as follows: 35.3%, 5.6%, 69.0%, 50.0%, 98.7%, and 98.9%, respectively. In categories II, V, and VI, there were no statistically significant differences in the ranges of the malignancy rates among the four cytopathologists. However, there were significant differences in the ranges for categories I and III. CONCLUSIONS: Our findings suggest that institutions that use the BSRTC should regularly update their diagnostic criteria. We also propose that institutions issue an annual report of incidences and malignancy rates to help other clinicians improve the case management of patients with thyroid nodules.
Subject(s)
Humans , Biopsy, Fine-Needle , Case Management , Diagnosis , Incidence , Pathology , Thyroid Gland , Thyroid NoduleABSTRACT
BACKGROUND AND OBJECTIVES: Hydroxyapatite has biocompatibility and bioactivity and similar to bone of in human body. The purpose of this study is to evaluate osteogenic differentiation of bone marrow stem cell (BMSC) in PLGA Scaffold added various ratio of hydroxyapatite (HAp). METHODS AND RESULTS: PLGA and PLGA/HAp scaffold were prepared using solvent casting/salt-leaching method. BMSC was seeded on the PLGA and PLGA/HAp scaffold and the samples were cultured in 37degrees C incubator with 5% CO2 for 28 days. Alkaline phosphatase (ALP) was carried out to evaluate alkaline phosphatase activity at 1, 3, 7, 10 and 14 days. Alizarin Red S stating was performed to identify calcium in scaffold at 1, 7, 14, 21 and 28 days. Compressive strength was measured to evaluate mechanical property of scaffold. To confirm cell viability, MTT was carried out at 1, 3, 7, 14 and 28 days. RT-PCR was performed to verify specific marker expression of osteoblast and stem cell at 7, 14, 21 and 28 days. CONCLUSIONS: Osteogenic differentiation of BMSC was confirmed through ALP, RT-PCR, and alizarin red S staining in this study. These results suggest that HAp helps osteogenic differentiation of BMSC.
Subject(s)
Alkaline Phosphatase , Anthraquinones , Bone Marrow , Calcium , Cell Survival , Compressive Strength , Durapatite , Human Body , Incubators , Lactic Acid , Osteoblasts , Polyglycolic Acid , Seeds , Stem CellsABSTRACT
OBJECTIVES: This study is based on the report including the psychological assessment results and therapeutic interventions of the survivors from hijacked Samho Jewerly by Somali pirates on January 15th, 2011. METHODS: We first assessed the emotional, cognitive, and personality functions of 7 crews, took 4-sessions of cognitive behavioral therapeutic intervention, conducted after-treatment assessments, and compared them with the previous results. RESULTS: Some of the crew showed PTSD due to the exposure to the stress triggered by the extreme state of fear, presented reexperience, avoidance of the trauma and chronical arousal state. CONCLUSION: Although this study was investigated with the minority group related to the one single accident, each case revealed the changes of symptoms and course after the trauma. The same traumatic event had different influences as how each individual perceived the experience. Furthermore, each clinical course was individually different either, depending on age, psychological resource, social support, daily life stress, or secondary gain.
Subject(s)
Humans , Arousal , Minority Groups , Ships , Stress Disorders, Post-Traumatic , Stress, Psychological , SurvivorsABSTRACT
Three-dimensional ultrsonography has been applied to diagnose mullerian anomalies. However, in Korea, no such case has been reported in literatures. An adolescent female was evaluated for dysmenorrhea, and a hematocolpos was found at private clinic. We performed three-dimensional ultrsonography and found uterus didelphys by confirming seperated uterine fundi and cervices. Abscence of right kidney was also found by ultrsonography. The diagnosis of Herlyn-Werner-Wunderlich syndrome was made and marsupialization of the right hemivagina was performed, with relief of symptoms.
Subject(s)
Adolescent , Female , Humans , Dysmenorrhea , Hematocolpos , Imaging, Three-Dimensional , Kidney , Korea , UterusABSTRACT
OBJECTIVE: Treatment of postpartum bleeding with uterine artery embolization has been well-described so far. However, angiographic differences between early and late postpartum bleeding has not been elucidated. The purpose of this study was to evaluate angiographic differences between early and late postpartum bleeding and therapeutic effect of superselective embolization. METHODS: Medical records and angiographic images of 12 patients (7 early and 5 late) with postpartum bleeding were evaluated. Timing of bleeding, mode of delivery, angiographic findings and treatment outcome were primary variables evaluated. RESULTS: Among 12 patients, 11 patients had been successfully treated with superselective embolization. One patient with amniotic fluid embolism and disseminated intravascular coagulation had expired. Among the early postpartum bleeding, uterine atony was found in every patients except post-cesarean hysterectomy cases. Pseudoaneurysm of uterine artery was found in all patients with late postpartum bleeding. CONCLUSION: Superselective embolization is an effective method to control postpartum bleeding. Pseudoaneurysm of uterine artery is a main cause of late postpartum bleeding.
Subject(s)
Female , Humans , Pregnancy , Aneurysm, False , Angiography , Disseminated Intravascular Coagulation , Embolism, Amniotic Fluid , Embolization, Therapeutic , Hemorrhage , Hysterectomy , Medical Records , Postpartum Hemorrhage , Postpartum Period , Treatment Outcome , Uterine Artery , Uterine Artery Embolization , Uterine HemorrhageABSTRACT
OBJECTIVE: GM-CSF is produced in female reproductive tract and may play an important role in the process of implantation. Body of evidence suggests that GM-CSF could improve pregnancy rate in many species of mammals when it was added in culture media. The aim of this study is to assess how GM-CSF affects the expression of implantation-related genes in mouse embryo. METHODS: Two hundred mouse embryos were divided into control and GM-CSF treated groups. The embryos were treated with or without 10 ng/ml of GM-CSF for 72 hours. Total RNA was isolated and compared with oligo microarray. The implantation-related genes influenced by GM-CSF were repeatedly analyzed by real-time PCR. RESULTS: After oligo microarray, 64 genes were increased and 35 genes were decreased by GM-CSF. Among those genes, MMP2, FABP3, Dppa5 and TAS1 were selected for real-time PCR analysis. Four integrins and FAK were also selected. We confirmed the increase of MMP2 and FABP3 by GM-CSF with real-time RT-PCR (1.687 and 1.580 fold, respectively). Other genes were found to be minimally increased. CONCLUSION: GM-CSF induces the increased expression of MMP2 mRNA in mouse embryo, and then increases the invasiveness of the trophoblast. The role of FABP3 in the process of implantation remained to be elucidated.