NK/T cell lymphoma is a distinct clinicopathologic entity which is more prevalent in Asia than in America and Europe and is highly associated with Epstein-Barr virus (EBV) infection. Although the clinicopathologic features of the tumor have been clearly defined, genetic changes and roles of virus associated with the development and progression of tumor have not been well studied. In this study, we carried out polymerase chain reaction (PCR) for EBNA-3B, EBNA-3C, and LMP-1 30 bp deletion to investigate EBV subtype and variants in tumor tissue and performed comparative genomic hybridization (CGH) to screen chromosomal imbalances using frozen tissues from 7 patients with nasal-type NK/T cell lymphoma and 1 patient with blastic NK cell lymphoma. Of 6 cases infected with EBV, there were EBV type 1 in six, LMP-1 30 bp deletion variant in four, and LMP-1 40 bp deletion variant in one. Frequent chromosomal imbalances included deletions at 1p31-pter (4), 12q23-q24 (3), and 17p (4), and gains at 2q (5), 10q (3), and 13q34-qter (4). Blastic NK cell lymphoma displayed deletions of 9q, 7q, and 6q, similar to that of nasal-type NK/T-cell lymphoma. With these results, we assumed that candidate genes in these imbalanced chromosomal loci would provide the clue for further molecular studies to identify putative tumor suppressor genes or proto-oncogenes associated with pathogenesis of this neoplasm.
Americas ; Asia ; Comparative Genomic Hybridization* ; Europe ; Genes, Tumor Suppressor ; Genotype* ; Herpesvirus 4, Human* ; Humans ; Killer Cells, Natural ; Lymphoma* ; Polymerase Chain Reaction ; Proto-Oncogenes

PURPOSE: Epstein-Barr virus(EBV) exists in the human population in two genetic forms, usually referred to as type 1 and type 2 which have been defined on the basis of sequence divergence in the EBNA-2 and EBNA-3 family genes. In this study, we were intended to investigate whether the subtypes of EBV in malignant lymphoma in Korea were associated with specific disease entities and geographical distribution. MATERIALS AND METHODS: Biopsy samples obtained from 18 Korean patients with malignant lymphoma including Hodgkin's disease(3 cases), B cell lymphoma(1 case), and NK/T cell lymphoma(14 cases) were analyzed to determine the subtype of EBV infected therein. DNA was extracted from formalin-fixed, paraffin-embeded tissues by ordinary method and specific viral sequences were sought using the polymerase chain reaction(PCR) and Southern blot hybridization assay. Oligonucleotide primers used for examination of EBV strain type were derived from the EBNA-3B and EBNA-3C coding regions. As a control, four cases of reactive hyperplasia were analyzed. RESULTS: The two of four reactive hyperplasia cases were associated with type 1 and the rest of two cases with both types. Among the 18 cases with malignant lymphoma, thirteen cases(72%) had type 1, one(6%) had type 2, and four(22%) had dual infections with both types. In case of NK/T cell lymphoma(14 cases) occupying 78% of 18 biopsy samples, 86%(12 cases) were associated with type 1, 7%(1 case) with type 2, and 7%(1 case) with both types. In case of Hodgkin's disease, all of three cases had both types. B cell lymphoma taking only one case of twenty two cases was determined as type 1. CONCLUSION: These observations indicated that type 1 EBV was predominant in Korean patients with malignant lymphoma, especially NK/T cell lymphoma and showed high frequency of dual viral infections(22%) in Hodgkin's disease as well as in reactive hyperplasia.
Biopsy ; Blotting, Southern ; Clinical Coding ; DNA ; DNA Primers ; Genotype ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; Hyperplasia ; Korea* ; Lymphoma* ; Lymphoma, B-Cell

PURPOSE: This study was conducted to examine the effects of simulation-based education on communication skill and clinical competence in maternity nursing practicum. METHODS: This study used a non-equivalent control pretest-posttest design. The simulation-based education in maternity nursing practicum consisted of two clinical situation scenarios pertaining to patients with normal and high-risk deliveries. The control group consisted of 35 students in 2010 and the experimental group consisted of 35 students in 2009. The experimental group was given the simulation-based education using a high-fidelity patient simulator over 3 sessions, whereas the control group was given a conventional pre-clinical practice orientation before maternity nursing clinical practicum. Data were collected using a questionnaire, which included questions to assess communication skill and clinical competence. Data were analyzed using SPSS/WIN 18.0. RESULTS: Members of the experimental group, who received the simulation-based education, showed significantly higher communication skill and clinical competence scores than the control group (t=-2.39, p = .020; t=-2.71, p = .009). CONCLUSION: The simulation-based education in maternity nursing practicum is effective in promoting communication skill and clinical competence. With application of diverse clinical situation scenarios, it is recommended to develop and apply simulation-based education using a high-fidelity simulator in the area of maternity nursing.
Clinical Competence ; Humans ; Infant, Newborn ; Maternal-Child Nursing ; Orientation ; Patient Simulation ; Pregnancy ; Surveys and Questionnaires ; Students, Nursing

PURPOSE: The purpose of this study was to investigate the final outcomes of magnetic resonance imaging (MRI)-identified additional lesions (MRALs) in breast cancer patients and the role of second-look ultrasound (SLUS) and imaging-guided interventions. METHODS: We analyzed breast cancer patients with MRALs on preoperative MRI between January and June 2012. MRALs were defined as additional lesions suspected on MRI but not suspected on mammograms or ultrasound. The malignancy rate of MRALs, MRI-based Breast Imaging Reporting and Database System (BI-RADS) category, positional relationship with the index cancer, MRI-concordant lesion visibility on SLUS, performance of imaging-guided interventions, and total mastectomy (TM) rates were evaluated for the confirmed lesions. RESULTS: Among the 119 confirmed lesions, SLUS and imaging-guided interventions were performed in 94 (79.0%) and 82 cases (68.9%), respectively. The malignancy rate was 68.1% (81 of 119), and was significantly higher in BI-RADS 4C-5 lesions than in 4A-4B lesions (94.6% vs. 56.1%, P < 0.01) and in ipsilateral same-quadrant lesions than in contralateral lesions (84.2% vs. 33.3%, P < 0.01). The lesion visibility rate on SLUS was 90.4%. The malignancy rate was not significantly different according to lesion visibility on SLUS. The TM rate in the 98 cases with ipsilateral MRALs was 37.8%, while it was significantly lower in patients who underwent an imaging-guided intervention than in those who did not (27.9% vs. 54.1%, P=0.017). CONCLUSION: MRALs show a high probability of malignancy, especially if they are ipsilateral. SLUS and imaging-guided interventions can eliminate many unnecessary TMs.
Breast Neoplasms* ; Breast* ; Humans ; Magnetic Resonance Imaging* ; Mastectomy, Simple ; Ultrasonography*

Oral-facial-digital syndrome type 1 (OFD1), first described by Papillon-Léage in 1954, is transmitted as an X-linked dominant condition and is characterized by a combination of malformations in the face, oral cavity, and digits. Malformations of the brain and polycystic kidney disease are also commonly associated with OFD1. An 11-month-old female presented with multiple tiny whitish papules on her face that had been present since birth. The histopathologic examination was consistent with milium. She also had congenital anomalies, including incomplete cleft palate, bifid tongue, short frenulum, anomalous deformities of both toes, and clino-brachy-syndactyly. Based on the characteristic dysmorphic features of her face, mouth, and hands, a clinical diagnosis of OFD1 was made. Herein, we report a rare case of OFD1 featuring congenital milia, which has not been previously reported in the Korean literature.

PURPOSE: The aim of this study was to analyze the differences in psychosocial adjustment between younger (age< or =50) and older (age>50) breast cancer survivors, and to explore the role of sociodemographic and disease-related variables in predicting psychosocial adjustment between younger and older breast cancer survivors. METHODS: A total of 262 women participated in this study. A self-reported questionnaire, the Psychosocial Adjustment to Illness Scale-Self Report Korean version (PAIS-SR Korean version), was used. Data were analyzed with SAS/WIN 9.1 for descriptive statistics using the t-test, ANOVA, and stepwise multiple regression. RESULTS: The psychosocial adjustment score of younger breast cancer survivors was significantly higher than that of older breast cancer survivors. Significant predictors influencing psychosocial adjustment in younger breast cancer survivors were marital state, menopausal cause, immune therapy, and self-help group, and these predictors account for 48% of the variance in psychosocial adjustment. Significant predictors influencing psychosocial adjustment in older breast cancer survivors were stage of cancer, monthly income, marital state, and menopausal cause. These predictors accounted for 35% of the variance in psychosocial adjustment. CONCLUSION: The findings indicate the importance of counseling and educational programs to improve the psychosocial adjustment according to breast cancer survivors' age.
Breast Neoplasms* ; Counseling ; Female ; Humans ; Self-Help Groups ; Survivors*

Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.
Blotting, Northern ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclin E ; Cyclins* ; Humans ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

Prurigo pigmentosa is a chronic pruritic inflammatory dermaoss characterized by erythematous papules in a reticulated pattern that resolve leaving a reticulated, mottled hyperpigmentation. Most cases have been reported from Japan. Two cases of prurigo pigmentosa have been reported in Korean women. We experienced a casc of prurigo pigmentosa in a Korean man of 20 years of age. Histopathological findings of reddish papule showed exocytosis, sponsiosis, intraepidermal vesicles, hydropic degeneration of basal cells in the epidermis, and hyphohistiocytic infiltration in the upper dermis. Direct irnmunofluorescence was negetive. Therapy with dapsone, 50 mg given daily, resulted in a rerinable regression of the reddish papules. The daily dose of clapsone was reduced to 25mg; however, no new reddish, pruritic papules have appeared.
Dapsone ; Dermis ; Epidermis ; Exocytosis ; Female ; Humans ; Hyperpigmentation ; Japan ; Prurigo*

Intraductal papillary mucinous neoplasm (IPMN) is a recently recognized clinicopathologic entity characterized by dilatation of pancreatic duct filled with copious mucin and papillary ductal epithelial proliferation ranging from simple hyperplasia to invasive carcinoma. The exact clinicopathologic identification of this tumor is important because of favorable prognosis contrast to that of conventional ductal adenocarcinoma. Herein we report a case of surgically resected typical IPMN. A 59-year-old man had a long history of diabetes mellitus with epigastric pain of 4 months duration. Ultrasonography and computed tomographic examination revealed cystic dilatations of main pancreatic duct in the head. The patient underwent total pancreatectomy. The gross appearance showed diffuse dilatation of main pancreatic duct associated with cystic dilatation of subbranches in the uncinate process. Histologic examination revealed diffuse papillary proliferations lined by mucinous epithelium with mild atypism within ectatic ducts. No invasive carcinoma was noted. Histochemically, the papillary epithelium contained mostly neutral and acid sialomucin.
Male ; Humans

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy