Hairy cell leukemia is an uncommon lymphoreticular disorder which primarily involves bone marrow, spleen, and peripheral blood. Patients, mostly men, present with splenomegaly and pancytopenia usually. A 62-year-old man was admitted with an abdominnal mass which had grown slowly for 20 years. On physical examination, an enlarged spleen was palpated without tenderness. An abdominal CT scan showed a diffusely enlarged spleen, which measured 20 cm in greatest dimension. In the peripheral blood, many atypical lymphocytes with abundant, delicate, surface projections were noted. They had tartrate-resistant acid phosphatase(TRAP) activity. Thrombocytopenia (60,000/mm3) was observed in the complete blood counts, Other laboratory data were within normal limits. He underwent splenectomy. The submitted spleen measured 26x15x5 cm and weighed 2150 gm. It was well encapsulated and the outer surface was smooth. Cut surfaces were diffusely dark-red. White and red pulps were indistinct. There was no mass-like lesion. Microscopically, the spleen consisted of monotonous mononulcear cells which involved red pulp. The white pulp was diminished, and could be barely recognized. Cells had small round nuclei and abundant cytoplasm. Ultrastructurally, cells with numerous slender surface projections were noted. In Korea, hairy cell leukemia is exceedingly rare. We report a case of hairy cell leukemia with characteristic pathologic features of spleen as well as those of peripheral blood.
Male ; Humans

BACKGROUND: Physical and mental health of workers is threatened due to various events and chronic occupational stress. This study was conducted to investigate the relationship between occupational stress and gastric disease in male workers of the shipbuilding industry. METHODS: Occupational stress measured among a total of 498 workers of a shipbuilding firm who visited the hospital for health examination using the Korean Occupational Stress Scale (KOSS)-short form, and the relationship between sociodemographic factors, health-related behaviors, occupational stress, and gastric disease, and the distribution of occupational stress by sociodemographic factors in the gastric disease group was examined. RESULTS: There was no significant association between gastric disease and total occupational stress score and its seven sub-factors. The analysis showed that risk of gastric disease was significantly higher in the Q1 group in which the stress caused by occupational discomfort among seven sub-factors was lowest than that in the Q4 group (odds ratio, 2.819; 95% confidence interval, 1.151 to 6.908). Analysis only on the gastric disease group showed that the stress score of laborers was higher in the four sub-factors than that of office workers (P < 0.05). Analysis on educational background showed that the scores of the three sub-factors were lower in subjects who's highest level of education was high school (P < 0.01). CONCLUSION: This study suggests that it is necessary to improve the culture of Korean collectivism in the workplace and to manage the occupational stress in the low-educated and laborers. It is recommended for future studies to confirm the causal relationship between occupational stress and gastric disease by large scale studies using a KOSS which appropriately reflects workplace culture.
Humans ; Male ; Mental Health ; Stomach Diseases

Cytogenetic analysis of 4 cases of meningiomas from 3 male and 1 female patients is reported. One of male patients suffered from neurofibromatosis type 2. Histologically, the meningiomas were meningotheliomatous (1), transitional (2), and psammomatous (1). Chromosomal abnormalities were found in all cases with a karyotype 45,XY,-22, 45,XY,-16, 45,XX,-2, and 45,XY,t (15p;22q), respectively. Monosomy of chromosome 22 was detected only in the patient with neurofibromatosis type 2. These cytogenetic analysis demonstrates that variable clonal karyotype aberrations exist in meningiomas.
Adolescent ; Adult ; *Chromosome Aberrations ; Female ; Humans ; Male ; Meningeal Neoplasms/*genetics ; Meningioma/*genetics ; Neurofibromatosis 2/genetics

BACKGROUND: Proteins of the Bcl-2 family are intracellular membrane-associated proteins that regulate programmed cell death either positively or negatively by as yet unknown mechanism. Bcl-2 family proteins have an antiapoptotic function, such as the Bcl-2, the long form of Bcl-x and Mcl-l, or a proapoptotic function, like the short form of Bcl-x and Bax. To investigate the potential role of Bcl-2 family proteins in thyroid tumorigenesis, the authors examined the pattern of expression of the Bel-2 family proteins in various thyroid neoplasms. METHODS: Bcl-2 family proteins, including Bcl-2, Bcl-x, Mcl-1 and Bax proteins were immunohistochemically stained in 57 cases of various thyroid neoplasms using formalin-fixed and paraffin embedded tissues; 18 cases of papillary carcinoma, 6 cases of medullary carcinoma, 4 cases of anaplastic carcinoma, 10 cases of follicular adenoma, 9 cases of adenomatous goiter, and 10 autopsy cases of fetal thyroid galnd. The intensity and frequency of the immunostaining were evaluated with the program of Image-Pro Plus Version 3.0 for image analysis. RESULT: Consistent expression of Bcl-2, Mcl-1, and Bax proteins were present in the surrounding normal thyroid tissue, however the expression of Bcl-x protein was not observed. Compare to the expression patterns of adenomatous goiter, and fetal and surrounding normal thyroid tissues, papillary and anaplastic carcinomas showed the decreased Bcl-2 and increased Bcl-x protein expressions(p (0.05). Medullary carcinoma revealed the increased Bcl-x protein expression only(p 0.05). CONCLUSION: These data suggest that combined patterns of decreased Bcl-2 and increased Bcl-x protein expressions may eontribute to the carcinogenesis of thyroid cancers originated from thyroid follicular cells, and an increased expression of Bcl-x protein may be related to the pathogenesis of medullary carcinoma from parafollicular C cells.
Adenoma ; Autopsy ; bcl-2-Associated X Protein ; bcl-X Protein ; Carcinogenesis ; Carcinoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Cell Death ; Goiter ; Humans ; Membrane Proteins ; Paraffin ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO).METHOD: Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized.RESULTS: The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %.CONCLUSION: The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.
Behavior Control ; Critical Care ; Hospitals, University ; Humans ; Infection Control ; Intensive Care Units ; Intention ; Methods ; Patient Safety

PURPOSE: Lycopene, a carotenoid with anti-oxidant properties, occurs naturally in tomatoes and pink grapefruit. Although the beneficial effects of lycopene on various disorders have been established, little attention has been paid to the possible anti-diabetic effects of lycopene focusing on β-cells. Therefore, this study investigated the potential of lycopene to protect β-cells against apoptosis induced by a cytokine mixture. METHODS: For toxicity experiments, the cells were treated with 0.1 ~ 10 nM of lycopene, and the cell viability in INS-1 cells (a rat β-cell line) was measured using a MTT assay. To induce cytokine toxicity, the cells were treated with a cytokine mixture (20 ng/mL of TNFα+20 ng/mL of IL-1β) for 24 h, and the effects of lycopene (0.1 nM) on the cytokine toxicity were measured using the MTT assay. The expression levels of the apoptotic proteins were analyzed by Western blotting, and the level of intracellular reactive oxidative stress (ROS) was monitored using a DCFDA fluorescent probe. The intracellular ATP levels were determined using a luminescence kit, and mRNA expression of the genes coding for anti-oxidative stress response and mitochondrial function were analyzed by quantitative reverse-transcriptase PCR. RESULTS: Exposure of INS-1 cells to 0.1 nM of lycopene increased the cell viability significantly, and protected the cells from cytokine-induced death. Lycopene upregulated the mRNA and protein expression of B-cell lymphoma-2 (Bcl-2) and reduced the expression of the Bcl-2 associated X (Bax) protein. Lycopene inhibited apoptotic signaling via a reduction of the ROS, and this effect correlated with the upregulation of anti-oxidative stress response genes, such as GCLC, NQO1, and HO-1. Lycopene increased the mRNA expression of mitochondrial function-related genes and increased the cellular ATP level. CONCLUSION: These results suggest that lycopene reduces the level of oxidative stress and improves the mitochondrial function, contributing to the prevention of cytokine-induced β-cell apoptosis. Therefore, lycopene could potentially serve as a preventive and therapeutic agent for the treatment of type 2 diabetes.
Adenosine Triphosphate ; Animals ; Apoptosis* ; B-Lymphocytes ; Blotting, Western ; Cell Survival ; Citrus paradisi ; Clinical Coding ; Luminescence ; Lycopersicon esculentum ; Oxidative Stress ; Polymerase Chain Reaction ; Rats ; RNA, Messenger ; Up-Regulation

Vitamin B12 deficiency anemia is a disorder caused by impaired DNA synthesis. Vitamin B12 binds to the intrinsic factor produced by the parietal cells and is absorbed in the distal ileum. After total gastrectomy, megaloblastic anemia is developed due to the absence or deficiency of the intrinsic factor. Concomitant iron deficiency states such as various malabsorption syndromes and alcoholism induce that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce microblasts and hypochromic microcytic erythrocytes. We experienced a case of Vitamin B12 deficiency anemia with low RBC mean corpuscular volume (MCV) due to combined with iron deficiency anemia in 42 year-old female patient and report the case with literature review.
Adult ; Alcoholism ; Anemia ; Anemia, Iron-Deficiency* ; Anemia, Megaloblastic ; Bone Marrow ; DNA ; Erythrocyte Indices ; Erythrocytes ; Female ; Gastrectomy ; Humans ; Ileum ; Intrinsic Factor ; Iron* ; Malabsorption Syndromes ; Masks ; Rabeprazole ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Anatomic variation in the hepatobiliary tract is relatively common, although bile duct duplication is rare. Detection of biliary tract variation is important because it is closely related to complications such as cholangitis, cholecystitis, pancreatitis, stone formation, and gastrointestinal tract malignancy. Therefore, preoperative imaging and a high index of suspicion are required to make an accurate diagnosis of a biliary tract anomaly. A 44-year-old woman presented with a 2-year history of epigastric pain after eating a meal and gallbladder sludge with chronic cholecystitis. The presumed diagnosis was gallbladder duplication. However, during surgery it was observed that the tubular structure was parallel with the fissure for the ligamentum venosum and ended at the lesser curvature of the stomach. The pathologic diagnosis was bile duct duplication. We report a case of a unique variant of bile duct duplication arising from the hepatic hilum.
Adult ; Anatomic Variation ; Bile ; Bile Ducts ; Biliary Tract ; Biliary Tract Diseases ; Cholangitis ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Digestive System Abnormalities ; Eating ; Female ; Gallbladder ; Gastrointestinal Tract ; Humans ; Meals ; Pancreatitis ; Sewage ; Stomach

RESULTS: The administration of ADLE to HFD-induced diabetic mice reduced the hyperplasia, 4-hydroxynonenal levels, and the number of apoptotic cells while improving the insulin levels compared to the HFD group. Treatment of INS-1 cells with palmitate reduced insulin secretion, which was attenuated by the ADLE treatment. Furthermore, the ADLE treatment prevented palmitate-induced cell death in INS-1 cells and isolated islets by reducing the apoptotic signaling molecules, including cleaved caspase-3 and PARP, and the Bax/Bcl2 ratio. ADLE also reduced the levels of reactive oxygen species generation, lipid accumulation, and nitrite production in palmitate-treated INS-1 cells while increasing the ATP levels. This effect corresponded to the decreased expression of inducible nitric oxide synthase (iNOS) mRNA and protein. CONCLUSIONS ADLE helps prevent lipotoxic beta-cell death in INS-1 cells and HFD-diabetic mice, suggesting that ADLE can be used to prevent or treat beta-cell damage in glucose intolerance during the development of diabetes.

RESULTS: The administration of ADLE to HFD-induced diabetic mice reduced the hyperplasia, 4-hydroxynonenal levels, and the number of apoptotic cells while improving the insulin levels compared to the HFD group. Treatment of INS-1 cells with palmitate reduced insulin secretion, which was attenuated by the ADLE treatment. Furthermore, the ADLE treatment prevented palmitate-induced cell death in INS-1 cells and isolated islets by reducing the apoptotic signaling molecules, including cleaved caspase-3 and PARP, and the Bax/Bcl2 ratio. ADLE also reduced the levels of reactive oxygen species generation, lipid accumulation, and nitrite production in palmitate-treated INS-1 cells while increasing the ATP levels. This effect corresponded to the decreased expression of inducible nitric oxide synthase (iNOS) mRNA and protein. CONCLUSIONS ADLE helps prevent lipotoxic beta-cell death in INS-1 cells and HFD-diabetic mice, suggesting that ADLE can be used to prevent or treat beta-cell damage in glucose intolerance during the development of diabetes.