Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.
Adult ; Back Pain ; Bone Marrow ; Breast ; Cytoplasm ; Drug Therapy ; Female ; Humans ; Leukemia ; Leukemia, Plasma Cell* ; Ovary ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Spine

OBJECTIVE: This study was performed to investigate the role of matrix-metalloproteinases(MMP-2,9) and tissue inhibitor of matrix-metalloproteinase(TIMP-2) in tumor metastasis and to correlate the expression of MMP-2,9 and TIMP-2 in cervical carcinomas. METHODS: We have performed immunohistochemical staining of MMP-2,9 and TIMP-2 on 35 patients of cervical carcinomas who were treated by radical hysterectomy between 1995.1.-1996.12. using paraffin-embeded tissue specimens. RESULTS: The lymph node metastasis and lymphvascular invasion groups showed a significantly higher rate of MMP-2 (50.7% vs 37.1%, 51.2% vs 37.5%) (p<0.05). And the lymphvascular invasion group showed a significantly higher rate of expression of MMP-9 (46.6% vs 29.8%) (p<0.05). But, the lymph node metastasis and lymphvascular invasion groups showed a significantly lower rate of expression of TIMP-2 (14.2% vs 36.5%, 11.2% vs 37.3%) (p<0.05). CONCLUSION: Lymph node metastasis and/or lymphvascular invasion of cervical carcinoma were related high percentages of MMP-2,9 and low percentages of TIMP-2 expression. These data suggest that the expression of MMPs and TIMPs are closely correlated with the progression of cervical carcinoma. To determine the ratio of cells expressing MMPs and TIMPs are strongly correlated with clinical outcome requires further study.
Humans ; Hysterectomy ; Lymph Nodes ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Tissue Inhibitor of Metalloproteinase-2

Purpose: This study aimed to develop a Core Competency Scale for clinical nursing student educators. Methods: In this study, we constructed a conceptual framework, selected initial items, verified the content validity, conducted two rounds of Delphi expert consultation, selected secondary and tertiary items, and extracted the final items. The study included 242 clinical educators for nursing students. Item analysis, factor analysis, criterion validity, and internal consistency were used for the data analyses. Results: For the final scale, 35 items were selected and 5 factors were categorized, which together explain 61.7% of the total variance. The factors were education and evaluation, research and cooperation, ethical/legal principles, presenting leadership, and clinical practice. The scores for the scale significantly correlated with the teaching efficacy scale for clinical nursing instructors. The Cronbach’s alpha coefficient for the 35 items was .96. Conclusion The findings of this study demonstrated that the core competency scale has good validity and reliability. This scale can be used to assess the competency of clinical educators for nursing students; hence, it will help in evaluating the relationship between the skills of clinical educators for nursing students and the self-efficacy of those students.

No abstract available.
Amniocentesis* ; Cytogenetics*

Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells that have overtly malignant cytologic features. It is a very rare disease and theoretically, it can present de novo or progress from an antecedent Langerhans cell histiocytosis (LCH). However, to our knowledge, LCS arising from an antecedent LCH has not been reported on. We present here a case of LCS arising from a pulmonary LCH. A 34 yr-old man who was a smoker, had a fever and a chronic cough. Computed tomographic (CT) scan revealed multiple tiny nodules in both lungs. The thoracoscopic lung biopsy revealed LCH. The patient quit smoking, but he received no other specific treatment. One year later, the follow up chest CT scan showed a 4 cm-sized mass in the left lower lobe of the lung. A lobectomy was then performed. Microscopic examination of the mass revealed an infiltrative proliferation of large cells that had malignant cytologic features. Immunohistochemical stains showed a strong reactivity for S-100 and CD68, and a focal reactivity for CD1a. We think this is the first case of LCS arising from LCH.
Tomography, X-Ray Computed ; Sarcoma/*pathology ; S100 Proteins/biosynthesis ; Radiography, Thoracic ; Pancreatic Neoplasms/*pathology ; Male ; Langerhans Cells/*pathology ; Immunohistochemistry ; Humans ; Histiocytosis, Langerhans-Cell/diagnosis/*pathology ; Gene Expression Regulation, Neoplastic ; Antigens, Differentiation, Myelomonocytic/biosynthesis ; Antigens, CD1/biosynthesis ; Antigens, CD/biosynthesis ; Adult

PURPOSE: The objective of the present study was to determine whether fermentation can increase the protective effects of blueberry liquid in a high-fat diet-induced obese mice model. METHODS: Male C57BL/6J mice were fed a high-fat diet (HD, 60% fat, w/w,), HD supplemented with 10 ml/kg BW/day of blueberry liquid (BHD, blueberry high-fat diet), or HD supplemented with 10 ml/kg BW/day of fermented blueberry liquid (FBHD, fermented blueberry high-fat diet) for 10 weeks. RESULTS: There were significant decreases in the body, epididymal adipose tissue, and liver weights of blueberry-fed groups compared to HD, whereas there were no significant differences in food intake among the groups. Furthermore, blueberry liquid groups, especially fermented blueberry liquid, significantly attenuated the contents of hepatic triglycerides and total cholesterol induced by HD. Serum LDL-cholesterol was significantly lower in the BHD and FBHD-fed groups, whereas FBHD significantly increased the serum HDL-cholesterol level compared to the control. Concentrations of aspartate transaminase, alanine transaminase, and leptins in serum were also reduced by blueberry liquid supplementation. The mRNA expression of hepatic acetyl CoA carboxylase was significantly reduced in both the BHD and FBHD groups compared to HD. Furthermore, FBHD altered the mRNA expression level of hepatic lipolysis genes. CONCLUSION: In conclusion, these results suggest that blueberry, especially fermented blueberry liquid, may improve obesity-related abnormalities.
Acetyl-CoA Carboxylase ; Adipose Tissue ; Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Blueberry Plant* ; Cholesterol ; Diet, High-Fat ; Eating ; Fermentation ; Humans ; Leptin ; Lipolysis ; Liver ; Male ; Mice* ; Mice, Obese ; RNA, Messenger ; Triglycerides ; Weights and Measures

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

Thymoma is the most common neoplasm of the anterior mediastinum and has malignant potential. Germ cell tumors (GCTs) found in the anterior mediastinum are usually benign, and malignant GCTs, such as seminomas, are rare. Histologically, mediastinal seminoma is indistinguishable from testicular seminoma except for site-associated morphological features such as lymphoid follicular hyperplasia. Therefore, excluding metastasis is very important. Recently, we treated a young adult patient with multiple thymic masses that occurred simultaneously. The patient underwent a thymectomy for the removal of the mediastinal masses, one of which was diagnosed as type B2 invasive thymoma, and two of which were diagnosed as primary mediastinal seminomas with massive follicular hyperplasia. The patient received adjuvant chemotherapy after surgical resection. To our knowledge, this is the first description of a thymoma and a mediastinal seminoma occurring simultaneously in the thymus. We present this case along with a literature review.

Waldenstr's macroglobulinemia is a slowly progressing disease characterized by proliferation of small lymphocytes, plasmacytoid lymphocytes and plasma cells in the bone marrow with increased serum monoclonal IgM. Since 1944, only a few cases of Waldenstr's macroglobulinemia with pulmonary involvement have been described. We experienced a case of Waldenstr's macroglobulinemia with pulmonary involvement. The patient was 66-year-old male complaining dyspnea. His cytological finding of pleural fluid aspirates revealed many plasmacytoid lymphocytes. Serum electrophoresis showed the sharp M-peak in the gamma globulin region, which was identified as a IgM, kappa type by immunofixation. Bone marrow findings showed small lymphocytic and plasmacytoid lymphocytic infiltration.
Aged ; Bone Marrow ; Dyspnea ; Electrophoresis ; gamma-Globulins ; Humans ; Immunoglobulin M ; Lymphocytes ; Male ; Plasma Cells ; Waldenstrom Macroglobulinemia*

OBJECTIVE: To compare the effect of radio frequency ablation (RFA) on the dimensions of radio frequency coagulation necrosis in a rabbit lung using a wet electrode in monopolar mode with that in dual electrode bipolar mode at different infusion rates (15 mm/hr versus 30 ml/hr) and saline concentrations (0.9% normal versus 5.8% hypertonic saline) . MATERIALS AND METHODS: Fifty ablation zones (one ablation zone in each rabbit) were produced in 50 rabbits using one or two 16-guage wet electrodes with a 1-cm active tip. The RFA system used in the monopolar and dual electrode wet bipolar RFA consisted of a 375-kHz generator (Elektrotom HiTT 106, Berchtold, Medizinelektronik, Germany). The power used was 30 watts and the exposure time was 5 minutes. The rabbits were assigned to one of five groups. Group A (n = 10) was infused with 0.9% NaCl used at a rate of 30 ml/hr in a monopolar mode. Groups B (n = 10) and C (n = 10) were infused with 0.9% NaCl at a rate of 15 and 30 ml/hr, respectively in dual electrode bipolar mode; groups D (n = 10) and E (n = 10) were infused with 5.8% NaCl at a rate of 15 and 30 ml/hr, respectively in a dual electrode bipolar mode. The dimensions of the ablation zones in the gross specimens from the groups were compared using one-way analysis of variance by means of the Scheffe test (post-hoc testing). RESULTS: The mean largest diameter of the ablation zones was larger in dual electrode bipolar mode (30.9+/-4.4 mm) than in monopolar mode (22.5+/-3.5 mm). The mean smallest diameter of the ablation zones was larger in dual electrode bipolar mode (22.3+/-2.5 mm) than in monopolar mode (19.5+/-3.5 mm). There were significant differences in the largest and smallest dimension between the monopolar (group A) and dual electrode wet bipolar mode (groups B-E). In dual electrode bipolar mode, the mean largest diameter of the ablation zones was larger at an infusion rate of 15 ml/hr (34.2+/-4.0 mm) than at 30 ml/hr (27.6+/-0.1 mm), and the mean smallest diameter of the ablation zones was larger at an infusion rate of 15 ml/hr (27.2+/-7.5 mm) than at an infusion rate of 30 ml/hr (24+/-2.9 mm). CONCLUSION: Using a wet electrode, dual electrode bipolar RFA can create a larger ablation zone more efficiently than monopolar RFA.
Sodium Chloride/administration & dosage ; Rabbits ; Pulmonary Alveoli/pathology ; Necrosis ; Lung Neoplasms/surgery ; Equipment Design ; *Electrodes ; Catheter Ablation/*instrumentation/methods ; Animals