Purpose: This study aimed to provide a systematic review and meta-analysis of research on flipped learning effects applied to university students. Methods: The random effect model was applied to 21 papers to calculate the effect size. To verify the moderation effect, a meta regression analysis and meta ANOVA were performed. Publication bias was verified through a funnel plot, and then an Egger's regression test was conducted. Results: The overall average effect size was .69 (95% CI: .51-.87), showing a median effect size, which was statistically significant. The outcome variables were in the order of learning motivation (Hedges’ g=.83), self-directed learning (Hedges’ g=.78), learning achievement (Hedges’ g=.66), and efficacy (Hedges’ g=.50), which were statistically significant. Conclusion Flipped learning was found to be statistically significant in improving self-directed learning, learning motivation, efficacy, and learning achievement amng university students. It is suggestd that this method be actively applied in university education.

Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.
Neoplasm Metastasis

No abstract available.
Angiomyoma* ; Vulva*

No abstract available.
Angiomyoma* ; Vulva*

Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

The concern about multiple primary cancers has been raised in recent years, but their cause has yet to be elucidated clearly. It has been speculated that many factors may contribute, such as family history, genetic factors, chemotherapy, and radiotherapy.(1) The incidence of multiple primary cancers is estimated to be 13%. However, synchronous multiple primary cancers of the stomach and duodenum are uncommon due to the rarity of duodenal cancer. Duodenal cancer poses diagnostic difficulties because of its rarity, non- specific signs and symptoms, and the fact that duodenum is usually ignored during upper gastrointestinal endoscopy. This 71-year-old female patient was diagnosed with double primary cancer of the stomach and duodenum, which was found by abdominal computed tomography preoperatively, and she underwent a Whipple procedure. The histological diagnosis revealed poorly-differentiated adenocarcinoma in the stomach and moderately-differentiated adenocarcinoma in the duodenum. Here we report a case of synchronous double primary cancer of the stomach and duodenum with a review of the literature.
Adenocarcinoma ; Aged ; Duodenal Neoplasms ; Duodenum ; Endoscopy, Gastrointestinal ; Female ; Humans ; Incidence ; Stomach ; Stomach Neoplasms

Immunohistochemical staining on paraffin sections for S-100 protein improved diagnostic accuracy for melanocytic tumor. But specificity of S-100 protein in the diagnosis of melanocytic tumor is very low, because S-100 protein was also expressed in neurogenic tumor and salivary gland tumor. To investigate a specific tumor marker for the malignant melanoma, immunohistochemical staining for HMB-45 and S-100 protein was performed on the paraffin sections of 25 cases of malignant melanoma and 46 cases of nevi. Positive reaction for HMB-45 and S-100 protein was diffusely identified in the cytoplasm of tumor cells. Positive ratio for HMB-45 was 100% in malignant melanoma, 92% in junctional component of compound nevus and 0% in intradermal nevus. Positive ratio for S-100 protein was 92% in malignant melanoma, 100% in compound nevus and 100% in intradermal nevus. The sensitivity and specificity for HMB-45 in malignant melanoma were 100%, but those for S-100 protein were 92% in sensitivity and 86.7% in specificity. These results indicate that HMB-45 has a high sensitivity and specificity for malignant melanoma cells and it can be quite useful for the histopathological diagnosis of malignant melanoma.
Sensitivity and Specificity ; Tumor Markers, Biological

Mesenteric lymphadenitis due to Yersinia enterocolitica infection is not common in Korea. Although most cases of Yersinia enterocolitica-induced mesenteric adenitis are self limited, cardinal features of Yersinia enterocolitica-induced mesenteric adenitis are so similar to those of acute appendicitis that some of the patients undergo laparotomy with suspected appendicitis. The findings on laparotomy in such patients are usually enlarged mesenteric nodes with a normal or slightly inflamed appendix. Because histologic examination of the removed mesenteric lymph nodes reveals reactive hyperplasia in most cases, it is usually difficult to suspect Yersinia enterocolitica infection on morphology of the resected nodes. But suppurative granulomata of mesenteric lymph nodes, uncommonly encountered in Yersinia enterocolitica infection, strongly suggest yersinial infection. We report a case of mesenteric lymphadenitis in a 10-year-old boy, who underwent laparotomy with suspected acute appendicitis. The removed lymph node showed several suppurative granulomata in the cortex, suggesting yersinial infection. Serologic study confirmed Yersinia enterocolitica serotype O:3 infection.
Appendicitis ; Appendix ; Child ; Humans ; Hyperplasia ; Korea ; Laparotomy ; Lymph Nodes ; Lymphadenitis ; Male ; Mesenteric Lymphadenitis* ; Yemen ; Yersinia enterocolitica* ; Yersinia*

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.
Heel ; Humans ; Infant, Newborn ; Male ; Parturition ; Skin

The most causes of an icteric hepatoma are a late stage hepatocellular carcinoma or intrahepatic cholangiocarcinoma. A hepatocellular carcinoma, causing an obstrucution of the bile duct, rarely results in jaundice. With a late stage hepatocellular carcinoma, the accurate diagnosis and treatment may be difficult. Herein, we report a case of a hepatocellular carcinoma and obstructive jaundice, due to hilar tumor emboli, with a review of the literature.
Bile Ducts ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Diagnosis ; Jaundice* ; Jaundice, Obstructive