No abstract available.
Carcinoma, Squamous Cell* ; Teratoma*

Adenomyoepithelioma (AME) is a rare breast lesion with balanced proliferation of both epithelial and myoepithelial cells. Patients usually present with a solitary mass without pain and nipple discharge. Although the tumor is generally considered benign, it has potential for local recurrence, metastasis, or malignant change. Approximately 150 cases have been reported in the medical literature, of which 40 cases were malignant or potentially malignant. But among them, elastographic findings have been reported in only two cases and still remain unclear. Herein, we now present a case of breast AME with emphasis on elastography.
Adenomyoepithelioma ; Breast Neoplasms ; Breast ; Elasticity Imaging Techniques ; Humans ; Neoplasm Metastasis ; Nipples ; Recurrence ; Ultrasonography

FLASH radiotherapy (FLASH RT) is a technique to deliver ultra-high dose rate in a fraction of a second. Evidence from experimental animal models suggest that FLASH RT spares various normal tissues including the lung, gastrointestinal track, and brain from radiation-induced toxicity (a phenomenon known as FLASH effect), which is otherwise commonly observed with conventional dose rate RT. However, it is not simply the ultra-high dose rate alone that brings the FLASH effect. Multiple parameters such as instantaneous dose rate, pulse size, pulse repetition frequency, and the total duration of exposure all need to be carefully optimized simultaneously. Furthermore it is critical to validate FLASH effects in an in vivo experimental model system. The exact molecular mechanism responsible for this FLASH effect is not yet understood although a number of hypotheses have been proposed including oxygen depletion and less reactive oxygen species (ROS) production by FLASH RT, and enhanced ability of normal tissues to handle ROS and labile iron pool compared to tumors. In this review, we briefly overview the process of ionization event and history of radiotherapy and fractionation of ionizing radiation. We also highlight some of the latest FLASH RT reviews and results with a special interest to neurocognitive protection in rodent model with whole brain irradiation. Lastly we discuss some of the issues remain to be answered with FLASH RT including undefined molecular mechanism, lack of standardized parameters, low penetration depth for electron beam, and tumor hypoxia still being a major hurdle for local control. Nevertheless, researchers are close to having all answers to the issues that we have raised, hence we believe that advancement of FLASH RT will be made more quickly than one can anticipate.

PURPOSE: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX) for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. METHODS: Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. RESULTS: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students' performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. CONCLUSION: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
Checklist ; *Clinical Competence ; Communication ; Comprehension ; *Education, Medical, Undergraduate ; Educational Measurement/*standards ; Humans ; Medical History Taking ; Medical Records ; Observer Variation ; Physical Examination ; Physician-Patient Relations ; *Problem-Based Learning ; Reproducibility of Results ; Republic of Korea ; *Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; *Thinking ; Universities

PURPOSE: Helicopter parenting is an emerging concept as a way of rearing adolescents and adult children. However, helicopter parenting from a nursing perspective has not been elucidated. Therefore, we undertook a concept analysis to understand the attributes, antecedents and consequences of helicopter parenting in the context of nursing. METHODS: Using Rodgers' evolutionary concept analysis, we analyzed literature on helicopter parenting to discover critical attributes, antecedents, and consequences of this phenomenon. Data were collected from seven electronic search engines. Twelve studies matching inclusion criteria were reviewed RESULTS: Three core attributes of helicopter parenting were hovering, highly deep involvement, and proxy decision making. The antecedents and consequences were retrieved from three important domains including social, parent, and child aspects. Surrogate terms were black hawk, hummingbird, and hovercraft parenting, and related terms were stealth fighter and Kamikaze parenting. CONCLUSION: Based on the results of this study, helicopter parenting has both positive and negative effects on both children and parents. To enhance the positive effects, measurement tools for helicopter parenting and nursing interventions on parenting need to be developed.
Adolescent ; Adult Children ; Aircraft* ; Child ; Concept Formation ; Decision Making ; Family Relations ; Hawks ; Humans ; Nursing ; Parenting* ; Parents* ; Proxy ; Search Engine

BACKGROUND: We evaluated a rapid screening kit for the detection of hepatitis surface antigen (HBsAg) and antibody (anti-HBs) using an immunochromatographic method. MATERIALS AND METHODS: We selected 499 serum specimens for the evaluation. Each specimen was tested by enzyme immunoassay (EIA; Cobas Core, Roche, Switzerland), reverse passive hemagglutination (RPHA; Serodia HBs, Asan, Korea) for HBsAg, passive hemagglutination (PHA; Serodia Anti-HBs, Asan, Korea) for anti-HBs, and with the Genedia HBsAg and Anti-HBs Rapid (Green Cross Corp., Korea) kits. Results of each assay were compared with those of the EIA. RESULTS: The sensitivities and specificities of the Genedia HBsAg Rapid kit were 98.0% and 100%, and those for the Genedia Anti-HBs Rapid kit were 95.3% and 98.0%, respectively. These were higher than those for RPHA (96.0% and 100%), and PHA (83.2% and 96.0%). Concordance rates between EIA and Genedia HBsAg Rapid, Genedia Anti-HBs Rapid, RPHA, and PHA were 98.8%, 96.4%, 97.6%, and 88.4%, respectively. Extending the incubation time from the recommended 30 minutes to 2 hours increased the sensitivities of the Genedia kits. CONCLUSION: The Genedia HBsAg and Anti-HBs Rapid kits are simple, sensitive, and inexpensive assays suitable for screening or use in emergency situations.
Antigens, Surface ; Chungcheongnam-do ; Emergencies ; Hemagglutination ; Hepatitis ; Hepatitis B Surface Antigens* ; Immunoenzyme Techniques ; Mass Screening*

Henoch-Schonlein purpura(HSP) is a systemic small vessel vasculitis characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. The characteristic rash of HSP consists of palpable purpura on the buttocks and lower extremities. Bullous lesions often appear in adults with HSP, whereas they are very rare in children with HSP. In this case report, the patient presented with arthralgia and abdominal pain and had hemorrhagic bullae as a prominent manifestation of the disease. The skin biopsy of the patient revealed typical leukocytoclastic vasculitis of dermal vessels and prominent IgA and fibrinogen deposits on capillary walls by direct immunofluorescence. We confirmed the diagnosis of HSP and observed improvement of clinical symptoms and signs within a few days after corticosteroid treatment. We therefore report a case with a review of the literature.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Biopsy ; Blister ; Buttocks ; Capillaries ; Child* ; Diagnosis ; Exanthema ; Fibrinogen ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin A ; Lower Extremity ; Nephritis ; Purpura ; Purpura, Schoenlein-Henoch* ; Skin ; Vasculitis

OBJECTIVE: The HPV vaccination target adolescents, and may be influenced by opinion of parents and other family member. For implementation of HPV vaccine, we measured knowledge of HPV infection and acceptability of vaccination among adults in Korea. METHODS: From August 2006 to November 2007, we provided a written questionnaire to females (above 19 years- olds) who visited Il-sin Christian hospital for prenatal care or gynecological examination. The questionnaire was built using elements of The Health Belief Model. We measured (1) awareness of HPV (2) perceived susceptibility (3) perceived seriousness (4) perceived benefit of vaccination (5) perceived barriers (6) cues to action. RESULTS: Total 975 females answered the questionnaire, and the mean age was 40 years. Only 23.8% knew the fact cervical cancer is related to HPV infection. 78.3% of respondents were willing to accept HPV vaccination after they understood HPV vaccination can prevent cervical cancer. Financial burden and possible side effect were barriers to vaccination. CONCLUSIONS: Despite of low awareness of HPV infection, most (78.3%) adults favored having HPV vaccination. But the vaccine was more likely to be accepted if it is recommended by a physician and reasonably priced.
Adolescent ; Adult ; Cues ; Surveys and Questionnaires ; Female ; Gynecological Examination ; Humans ; Korea ; Papillomavirus Infections ; Parents ; Prenatal Care ; Uterine Cervical Neoplasms ; Vaccination