No abstract available.

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

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

Purpose: Artificial intelligence (AI) has had a profound impact on humanity; in particular, chatbots have been designed for interactivity and applied to many aspects of daily life. Chatbots are also regarded as an innovative modality in nursing education. This study aimed to identify nursing students' awareness of using chatbots and factors influencing their usage intention. Methods: This study, which employed a descriptive design using a self-reported questionnaire, was conducted at three university nursing schools located in Seoul, South Korea. The participants were 289 junior and senior nursing students. Data were collected using self-reported questionnaires, both online via a Naver Form and offline. Results: The total mean score of awareness of using chatbots was 3.49±0.61 points out of 5. The mean scores of the four dimensions of awareness of using chatbots were 3.37±0.60 for perceived value, 3.66±0.73 for perceived usefulness, 3.83±0.73 for perceived ease of use, and 3.36±0.87 for intention to use. Significant differences were observed in awareness of using chatbots according to satisfaction with nursing (p<.001), effectiveness of using various methods for nursing education (p<.001), and interest in chatbots (p<.001). The correlations among the four dimensions ranged from .52 to .80. In a hierarchical regression analysis, perceived value (β=.45) accounted for 60.2% of variance in intention to use. Conclusion The results suggest that chatbots have the potential to be used in nursing education. Further research is needed to clarify the effectiveness of using chatbots in nursing education.

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patientʼs age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan–Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis.Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

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*

A 30-year-old, 16-week primipara woman visited with complaints of lower back pain over the past 3 weeks. She had a history of ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization (IVF) 14 weeks earlier. Lumbar spine magnetic resonance imaging showed infectious spondylitis and the results of blood and spinal biopsy cultures showed Staphylococcus aureus. Intravenous cefazolin was continued for 6 weeks, and 4 months later, she delivered a healthy girl. This is the first reported case of successful term delivery following S. aureus bacteremia with vertebral osteomyelitis after IVF and embryo transfer. It should be considered that S. aureus bacteremia can be a serious complication of IVF.
Adult ; Bacteremia ; Biopsy ; Cefazolin ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Oocyte Retrieval ; Osteomyelitis ; Pregnancy ; Spine ; Spondylitis ; Staphylococcus aureus

Objective: Using microRNA (miR) as a biomarker has been a new way for diagnosing many diseases. Although many studies on miR-biomarker have been published, researches on miR-biomarker in ankylosing spondylitis (AS) are limited. Therefore, the objective of this study was to valiate a candidate serum miR as a novel disease-specific novel miR for AS. Methods: Total RNAs were extracted from sera samples of patients with AS (n=57), patients with rheumatoid arthritis (RA) (n=37), or healthy controls (HC) (n=19). Through serum miR screening by microarray, differential levels of miR were subsequently validated by real time PCR. At the time of serum sampling, clinical values such as sex, age, disease duration, AS-disease activity score, uveitis, peripheral arthritis, enthesitis, human leukocyte antigen-B27 presence, and recent medication were evaluated. Results: We found that the expression level of serum miR-3620-3p in AS was notably lower than that in RA or HC. The receiver–operator characteristics curve for determining the diagnostic accuracy showed an area under the curve of 0.919 (p＜0.001) with a sensitivity of 87.1% and a specificity of 86.0%. Correlation studies showed that the expression level of miR-3620-3p was only associated with the development of uveitis (p＜0.05). Conclusion Serum miR-3620-3p can be as a new biomarker for diagnosing AS.

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

We report a case of catheter-related bacteremia due to Tsukamurella pulmonis. T. pulmonis is a rare cause of opportunistic infection in immunosuppressed patients and in cases of indwelling foreign materials. This infection was nearly impossible to identify using conventional phenotyping methods because of its similarities to the related genera Nocardia, Rhodococcus, Gordonia, Streptomyces, Corynebacterium, and Mycobacterium. This organism was initially misidentified as Mycobacterium aubagnense through PCR-RFLP analysis. We correctly identified this organism using 16S rRNA sequencing combined with phenotyping tests.
Bacteremia ; Catheters ; Corynebacterium ; Humans ; Korea ; Mycobacterium ; Nocardia ; Nontuberculous Mycobacteria ; Opportunistic Infections ; Rhodococcus ; Streptomyces