No abstract available.
Lymphoproliferative Disorders ; T-Lymphocytes

No abstract available.
Carcinoma, Hepatocellular ; Fingers

Gallstone is a common disease with a prevalence of about 10%, but biliary ileus is a rare entity with a frequency of about 1% for all the symptomatic patients. We are reporting on a case of perforated terminal ileum that was due to gallstone, and this was without any associated intestinal obstruction or bilioenteric fistula. A 76 year old man presented with a history of jaundice and dark colored urine for a 3-month duration with no clinical features of intestinal obstruction. There was no past history of biliary tract disease. The abdominal radiograph demonstrated no biliary stones or classical findings of gallstone ileus, but there was a suspicion of cholangiocarcinoma. Laparotomy was performed. A perforation of terminal ileum was identified in the mesenteric border of the terminal ileum and adjacent to ileocecal valve, and it was wrapped by omentum. A small 1.5 cm sized stone was impacted in the mesentery at the site of the perforation. The perforation site was closed. Cholecystectomy and proximal common bile duct resection with Roux-en-Y choledochojejunostomy was then performed.
Aged ; Biliary Tract Diseases ; Cholangiocarcinoma ; Cholecystectomy ; Choledochostomy ; Common Bile Duct ; Fistula ; Gallstones* ; Humans ; Ileocecal Valve ; Ileum* ; Ileus ; Intestinal Obstruction ; Jaundice ; Laparotomy ; Mesentery ; Omentum ; Prevalence

We report a rare case of a double cystic duct in a 55-year-old woman. The patient complained of upper abdominal pain and jaundice. The patient was diagnosed with distal common bile duct (CBD) cancer by endoscopic retrograde cholangiopancreatography (ERCP). ERCP was unable to reveal the presence of a double cystic duct. However, magnetic resonance imaging (MRI) and a percutaneous transhepatic biliary drainage (PTBD) were performed as images for obstructive jaundice before surgery showed two ducts that looked like cystic ducts-one duct branched from the common bile duct and the other duct branched from the right hepatic duct. A pancreatoduodenectomy was performed to remove the distal CBD cancer and the presence of a double cystic duct was confirmed with the naked eye. This case suggests that the imaging studies, such as preoperative ERCP and MRI or intraoperative cholangiography are required to avoid complications during hepatobiliary surgery.
Abdominal Pain ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Cystic Duct ; Drainage ; Eye ; Female ; Hepatic Duct, Common ; Humans ; Jaundice ; Jaundice, Obstructive ; Magnetic Resonance Imaging ; Middle Aged ; Pancreaticoduodenectomy ; Urinary Bladder

Purpose: This study aimed to examine how the expertise and interactivity of a physical therapist impact a patient’s intention to revisit a hospital based on trust. Methods: We surveyed 274 patients who received physical therapy in Seoul and Gyeonggi Province to assess their reliability and revisit intentions based on their expertise and interactivity. SPSS 22.0 was used for frequency analysis and reliability verification, while AMOS 18.0 was used for confirmatory factor analysis and model verification. Results: Physical therapist interactivity significantly impacted patients’ intentions to revisit based on trust. The physical therapist’s expertise had a significant effect on trust but did not demonstrate a significant effect on the intention to revisit. Conclusion The interactivity of physical therapists has an important effect on patients’ intentions to revisit a hospital based on trust. Although therapist-centered expertise can generate trust in patients, it positively affects the intention to revisit the hospital. Therefore, it is suggested that physical therapists’ patient-centered expertise and interactivity build patients’ trust and are important for revisiting intention.

BACKGROUND: Programmed cell death ligand 1 (PD-L1) plays a major role in the immune responses of a variety of cancers. Recently, several studies revealed that PD-L1 is differently expressed in some cases of non-melanoma skin cancer. The expression of PD-L1 in cutaneous squamous cell carcinoma has not yet been described in Korea. OBJECTIVE: To investigate the expression of PD-L1 in cutaneous squamous cell carcinoma and its association with variable clinicopathological factors. METHODS: We performed immunohistochemical staining of 52 cutaneous cell carcinoma cases, including 28 high-risk cases and 24 low-risk cases. Cases were selected from patients who had visited the department of dermatology of our hospital from 2001 to 2017. The expression patterns were assessed using the H-score. Cases demonstrating at least 1+ of PD-L1 in more than 1% of tumor cells were considered positive. RESULTS: PD-L1 expression of tumor cells was 19.2% (10/52) for all cases, 0.0% (0/24) for the low-risk group, and 35.7% (10/28) for the high-risk group. PD-L1 positive cutaneous squamous cell carcinoma cases showed a significantly higher proportion of large tumors and tumors with deep invasion and a higher lymphatic metastasis rate when compared to PD-L1 negative cutaneous squamous cell carcinoma cases. CONCLUSION: Our study shows that cutaneous squamous cell carcinoma exhibits PD-L1 expression in 19.2% of cases. PD-L1 positive tumors are associated with high-risk cases of cutaneous squamous cell carcinoma, which may help guide the choice of therapeutic strategy.
Carcinoma, Squamous Cell* ; Cell Death ; Dermatology ; Epithelial Cells* ; Humans ; Korea ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Skin Neoplasms

Background: The prevalence of psoriasis differs by population, and it appears to be more common among Europeans than in East Asians. Recent genome-wide association studies (GWAS) have identified alleles that increase the risk of psoriasis, and these alleles may present different frequencies in different geographic regions. Objective: We aimed to gain insights into the causes of differences in disease frequencies according to populations and the factors affecting prevalence and pattern differences. Methods: We collected a total of 147 psoriasis-associated single-nucleotide polymorphisms (SNPs) from the GWAS catalog and compared the allele frequency differences in 27 populations using public population frequency in the 1000 Genomes Project phase 3 (n=2,504) and the Korean Reference Genome Database (n=1,722). Additionally, we calculated the composited genetic risk scores across the population groups. Results: There were distinct patterns of allele frequencies in different population groups.In many cases, East Asians exhibited allele frequencies opposite to that of Europeans. The genetic risk score was higher in Europeans (average: 0.487) and Americans (average: 0.492) than in East Asians (average: 0.471). The prevalence of psoriasis correlated with the average genetic risk score of the population. Conclusion We observed a difference in the allele frequencies of psoriasis-associated SNPs between the studied populations. This result suggests that the difference in the prevalence of psoriasis between population groups can be interpreted to some extent by the genotype.

Entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities in young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomical relationships between vascular and musculotendinous structures in the popliteal fossa. A 55-year-old male patient visited Yonsei University College of Medicine with the chief complaint of claudication in his right calf. He had undergone stent insertion in the right popliteal artery for peripheral artery occlusive disease 2 years earlier. Lower extremity CT angiography showed stent fracture and in-stent thrombosis. He underwent femoral-to-popliteal artery bypass surgery. Postoperative lower extremity CT angiography showed that the vein graft was compressed between the medial head of the gastrocnemius and the semimembranosus muscle. However, the blood flow was normal and his pain was relieved.
Aneurysm ; Angiography ; Arteries ; Head ; Humans ; Ischemia ; Lower Extremity ; Male ; Middle Aged ; Muscles ; Popliteal Artery ; Stents ; Thrombosis ; Transplants ; Veins

A 72-year-old man presented with incidentally found palpable abdominal mass of unknown duration. On admission, he had blood pressure of 120/80mmHg and pulse of 70 beats per minute. He consumed a pack of cigarettes per day for 45 years. He denied any prior chest pain episodes. The serum lipid profiles were within normal range. Electrocardiogram revealed sinus rhythm without ST-T wave change. Digital subtraction angiography revealed aneurysmal dilatation of both common iliac arteries to the proximal part of the external iliac arteries. Transthoracic echocardiography revealed normal left ventricular wall motion except a pseu-doaneurysm at the apex (Fig. 1). Color Doppler (Fig. 2) and intravenous contrast echocardiography (Fig. 3) showed free blood flow communication through the neck of the pseudoaneurysm. Coronary angiography revealed no significant luminal narrowing of coronary arteries. Left ventriculogram showed an aneurysm at the apex (Fig. 4). During the period of 8 months follow-up, the patient did not have any event or complain any symptom.
Aged ; Aneurysm ; Aneurysm, False* ; Angiography, Digital Subtraction ; Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dilatation ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Humans ; Iliac Artery ; Neck ; Phenobarbital ; Reference Values ; Tobacco Products