PURPOSE:The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinome. MATERIALS AND METHODS: We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocarcinoma, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. RESULTS:The overall incidence of nodal metastases was 59.8 % (55/92); 66.7 % in peripheral cholangiocarcinoma, 54.5 % in hilar cholangiocarcinoma, 55.6 % in gallbladder carcinoma, and 42.9 % in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarci nome. CONCLUSION:The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.
Adenocarcinoma ; Axis, Cervical Vertebra ; Biliary Tract* ; Cholangiocarcinoma ; Common Bile Duct ; Diagnosis ; Gallbladder ; Humans ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Omentum ; Tomography, X-Ray Computed

Purpose: This study aimed to examine the level of acculturative stress, career stress, social support and depression, and identify factors affecting depression among Korean international students in China. Methods: Data were collected from 157 Korean students studying in undergraduate, graduate, students exchange programs and language training courses in G university, J university, and S university in G city, Guangdong Province, China, from September 1 to October 27, 2017. The data were analyzed with descriptive statistics, t-test, ANOVA, and multiple linear regression. Results: The mean acculturative stress was 62.24±18.08 out of 165, whereas the mean career stress was 65.47±19.79 out of 125. The mean social support was 95.03±14.64 out of 125, and the mean depression score was 13.83±9.24 out of 60. The factor that had the greatest effect on depression among the participants was acculturative stress (β=.26, p=.001), followed by career stress (β=.24, p=.002), frequency of weekly phone calls with family (β=.19, p=.006), source of tuition payment (β=.18, p=.009), and self-perceived health (β=.15, p=.040). The model explained 33% of the variance. Conclusion It is necessary to develop depression prevention and management programs as well as a customized health promotion program that account for the factors identified to have an effect on depression, namely, acculturative stress, career stress, frequency of weekly phone calls with family, source of tuition payment, and self-perceived health, and increase awareness of depression among international students.

No abstract available.

In consecutive 56 patients with cervical carcinoma, we retrospectively analyzed the accuracy of magnetic resonance imaging (MRI) in regard of determining the depth of stromal invasion and reviewed the pitfalls in MRI interpretation. All patients underwent hysterectomy and were categorized into 3 groups: (1) no stromal invasion, (2) invasion to inner 2/3 of stromal thickness, (3) invasion to outer 1/3 of stromal thickness. In each group, MR image was analyzed for the size of the tumor mass and the ratio of spared stromal thickness to normal stromal full thickness (invasion ratio). Most tumor masses were not detected in the group of no stromal invasion. The degree of the depth of stromal invasion increased with the tumor size, and invasion ratio decreased as stromal invasion deepened. Overall accuracy for stromal invasion on MRI was 69.6%,and positive predictive value (PPV) for no stromal invasion was relatively lower than those of the other two groups. MRI is a promising modality to evaluate stromal invasion of cervical carcinoma by measuring the tumor size and invasion ratio, if MRI is performed prior to biopsy in axial scan perpendicular to the endocervical long axis.
Biopsy ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Pathology, Surgical* ; Retrospective Studies

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is common in young Asian women under the age of 30, and is usually characterized by fever, myalgia, fatigue, and cervical lymphadenopathy. Because patients with KFD often present with necrotic lesions that are also features of lymph node metastasis, ipsilateral or bilateral lymph node enlargement in head and neck cancer patients can be disguised as lymph node metastasis. We present an unusual case of KFD mimicking bilateral metastatic papillary carcinoma of the thyroid. This study emphasizes that KFD should be considered when diagnosing lymph nodes with necrotic lesions but without malignant cells in young women.

Congenital chloride diarrhea (CLD) is an autosomal recessive disorder with the hallmark of persistent watery Cl(-)-rich diarrhea from birth. Mutations in the solute carrier family 26, member 3 (SLC26A3) gene, which encodes a coupled Cl-/HCO3- exchanger in the ileum and colon, are known to cause CLD. Although there are a few reports of CLD patients in Korea, none of these had been confirmed by genetic analysis. Here, we describe the case of a Korean infant with clinical features of CLD. Using direct sequencing analysis, we identified 2 sequence variants: a missense variant of unknown significance (c.525G>C; p.Arg175 Ser) and a splicing mutation (c.2063-1G>T) in the SLC26A3 gene; these had been inherited from the father and mother, respectively. Whilst CLD is rare, its main symptom, diarrhea, is very common in infants. Hence, the diagnosis of CLD can prove difficult. Mutational analysis of the SLC26A3 gene should be considered as a viable method to confirm a diagnosis of CLD in Korean infants with persistent diarrhea.
Asian Continental Ancestry Group/*genetics ; Chloride-Bicarbonate Antiporters/*genetics ; DNA Mutational Analysis ; Diarrhea/*congenital/diagnosis/genetics/radiography ; Heterozygote ; Humans ; Infant ; Male ; Metabolism, Inborn Errors/*diagnosis/genetics/radiography ; Mutation ; Mutation, Missense ; RNA Splicing ; Republic of Korea ; Ultrasonography, Prenatal

BACKGROUND: This study was performed to determine the biopsy sites that are suitable for the diagnosis of Helicobacter pylori infection and to assess the sensitivity of culture, histology, and dual-priming oligonucleotide (DPO)-based multiplex PCR. Moreover, we evaluated the usefulness of PCR for the detection of 23S rRNA mutations, which are responsible for the clarithromycin resistance of H. pylori. METHODS: From 90 patients, we obtained biopsy specimens for culture, histology, and Seeplex(R) ClaR-H. pylori PCR (Seegene Inc., Korea). Phenotypic susceptibility to clarithromycin was evaluated using the E-test (AB Biodisk, Sweden). RESULTS: H. pylori was detected in 48 of 90 patients. The positive rates of infection in the antrum and body were higher than those in the biopsies obtained from the duodenal bulb. The positive rates in histology, PCR, and culture were 46.7%, 42.2%, and 34.4%, respectively. Using histology or PCR, we identified H. pylori in 46 of the 48 patients. 23S rRNA mutations were detected in 8 patients. The clarithromycin E-test showed that all the 10 wild-type patients were susceptible. However, the results of the PCR and E-test of 3 of the 8 mutation-positive patients were discrepant. CONCLUSIONS: We observed that a combination of histology and PCR affords a high detection rate of H.pylori infection and that DPO-based PCR can be practically used for the diagnosis of H. pylori infection and the determination of clarithromycin resistance. These techniques were useful for biopsy sampling simultaneously from the antrum and body for the detection of clarithromycin resistance of multiple strain infection or heteroresistance.
Anti-Bacterial Agents/*pharmacology ; Biopsy ; Clarithromycin/*pharmacology ; Drug Resistance, Bacterial ; Genotype ; Helicobacter Infections/*diagnosis/drug therapy/pathology ; Helicobacter pylori/drug effects/genetics/*isolation & purification ; Humans ; Microbial Sensitivity Tests ; Mutation ; Polymerase Chain Reaction ; RNA, Ribosomal, 23S/genetics

An adult beagle dog was presented with a cervical mass detected by palpation and computed tomography. Fine needle aspirates revealed numerous epithelial cells with plasmacytoid appearance and frequent naked nuclei. Histologically, the mass consists of multiple packets of neoplastic cells and extensive areas of necrosis and fibrosis. Neoplastic cells were also found in submandibular lymph nodes. Immunohistochemistry showed that neoplastic cells were positive for calcitonin and negative for thyroglobulin. Based on these findings, the cervical mass was diagnosed as thyroid C-cell carcinoma. Almost one year after the surgical excision, the dog remains healthy without any symptom of recurrence or metastasis.
Adult ; Animals ; Calcitonin ; Dogs* ; Epithelial Cells ; Fibrosis ; Humans ; Immunohistochemistry ; Lymph Nodes ; Necrosis ; Needles ; Neoplasm Metastasis ; Palpation ; Recurrence ; Thyroglobulin ; Thyroid Gland*

Edwards syndrome, also called trisomy 18, is one of the most common autosomal anomalies. The survival rate of patients with Edwards syndrome is very low and its characteristic findings include cardiac malformations, mental retardation, growth retardation, specific craniofacial anomalies, clenched hands, rocker-bottom feet, and omphalocele. Compared with the classic Edwards syndrome, the symptom of partial duplication of chromosome 18 is relatively mild with a good prognosis. We report the case of a baby with partial duplication 18q11.2-q12. The characteristic phenotype features of Edwards syndrome were observed in the patient. However, the symptom was milder than the typical Edwards syndrome. At present, we can expect better prognosis for this patient.
Chromosomes, Human, Pair 18 ; Foot ; Hand ; Hernia, Umbilical ; Humans ; Intellectual Disability ; Phenotype ; Prognosis ; Survival Rate ; Trisomy

Evaluation of postpneumonectomy space (PPS) by CT in patients with lung cancer for operation-related complication or tumor recurrence is critical, but often difficult. We retrospectively analysed CT scans of 38 patients who underwent pneumonectomy for lung cancer. CT scans were obtained on 7-10th post-operative day for baseline image and at varying intervals of 2 to 24 months thereafter. Usual postoperative findings in patients without complication included mediastinal shifting, changes in subpleural space, changes in parietal pleura, and herniation of contralateral lung. Four patients had postoperative complications including empyema(n=3) and bronchopleural fistula(n=2). Twelve patients showed findings of tumor recurrence such as lymph node metastasis, local recurrence, and pericardial and contralateral pleural effusion. By comparing follow-up CT with baseline CT, we were able to detect early cancer recurrence and postoperative complications. Our results indicate that serial chest CT play an important role in the evaluation of the patients who underwent pneumonectomy for lung cancer.
Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Pleura ; Pleural Effusion ; Pneumonectomy* ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed*