A case of malignant mixed mesodermal tumor (MMMT) developed after radiation therapy for a uterine cervix cancer is described. The patient was a 62-year-old female at the time of diagnosis of stage Ib squamous cell carcinoma of the cervix and a total of 12,000 rads of x-ray was administered on the pelvic area. Five years later she manifested vaginal spotting and rectal pain. Endometial curettage and biopsy revealed carcinosarcoma. Radical hysterectomy was done and a 5x3x2 cm sized polypoid mass was noted in the uterine cavity. Microscopically, the tumor showed intimate admixture of adenocarcinomatous and sarcomatous areas. The sarcomatous stroma was composed of compactly arranged atypical spindle cells with frequent mitoses, merging into a loosely textured reticular areas and abundant amount of heterologous elements such as skeletal muscle and cartilage. The rhabdomyosarcomatous element was confirmed by PTAH staining and immunohistochemical staining for myoglobin and desmin. Multiple metastases to the liver, lung, and lymph nodes appeared within one year of total abdominal hysterectomy and bilateral salpingo-oophorectomy. In spite of palliative radiotherapy, she expired one month later.
Female ; Humans ; Biopsy ; Neoplasm Metastasis

Purpose: The purpose of this study was to identify the influence of emotional labor and work-life balance on the organizational commitment of nurses in comprehensive nursing care service wards. Methods: A cross-sectional descriptive study was designed. Data collection was conducted for a total of 171 nurses in comprehensive nursing care service wards in two H university hospitals in Gyeonggi-do. Data were collected from March 5 to 30, 2021 using questionnaires on topics including emotional labor, work-life balance, organizational commitment, and general characteristics. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Pearson’s correlation analysis, and hierarchical regression analysis. Results: Organizational commitment was influenced by working experience in current unit, future work plan, emotional modulation efforts in profession, patient-focused emotional suppression, and work-life balance. Conclusion The findings of this study suggest that in order to increase organizational commitment, it is important to support organizational efforts and systems such as an emotional management program that can strengthen the positive aspects of emotional labor, and leisure activities and childcare support programs that can improve work-life balance.

OBJECTIVE: Recently some behavioral features and affective traits are considered important for the phenotype of obsessive-compulsive disorder (OCD). The purpose of this study was to assess some specific behavioral, temperamental, emotional features of OCD patients and to investigate if there is any change in patterns of temperament-character after 4-month pharmacotherapy. METHODS: Fifty-six patients with OCD and 70 normal controls were enrolled in this study. Four self-report questionnaires were employed to assess temperamental characteristics and affective traits: The behavioral inhibition system and behavioral activation system scale, the Baratt impulsiveness scale, state-trait anger expression inventory, emotional intelligence inventory. Among 56 OCD patients, 21 subjects started pharmacotherapy and 4 months later, they repeated 4 self-report tests as the same above and Yale-Brown obsessive compulsive scale (Y-BOCS). And then we investigated the changes from initial results. RESULTS: Patients with OCD showed significantly greater expression of behavioral inhibition system (p<0.0001), more cognitive impulsiveness (p<0.0001), motor impulsiveness (p=0.0067) and increased level of state anger (p<0.0001), trait anger (p<0.0001) than healthy controls. Compared to the controls, the OCD patients also expressed significantly lower level of emotional intelligence for using to facilitate thinking (p<0.0001) and managing emotions (p<0.0001). After 4-month pharmacotherapy for 21 OCD patients, Y-BOCS scores significantly decreased while self-report tests showed no meaningful differences from baseline assessments. CONCLUSION: Our results suggest that patients with OCD may have some differences in behavioral and affective tendencies including behavioral inhibition, impulsiveness, anger experiences, and emotional patterns. And short term pharmacotherapy during 4 months improved the severity of obsessive-compulsive symptoms but didn't influence these traits. These results provide some perspectives about possible vulnerability or trait markers of OCD. Further research is needed to examine the effects of long term treatment and other investigation might be helpful to assess the relationships between these behavioral and affective aspects and clinical phenotypes of OCD.
Anger ; Emotional Intelligence ; Humans ; Obsessive-Compulsive Disorder ; Phenotype ; Surveys and Questionnaires ; Temperament ; Thinking

We report a case of a full-term neonate with persistent pulmonary hypertension who developed asphyxia after birth and was treated with iloprost. The neonate had persistent hypoxia and did not respond to supportive treatment. Because inhaled nitric oxide (iNO) was not available in our hospital, inhaled iloprost was administered via an endotracheal tube. This resulted in an immediate elevation of oxygen saturation. Echocardiography revealed the conversion of the right-to-left ductal shunt to the left-to-right one and a decrease of the right ventricular pressure. The use of inhaled iloprost did not cause any significant side effects. Here, we describe our experience where iloprost was used in a neonate with persistent pulmonary hypertension because the standard therapy with inhaled nitric oxide was not available.
Anoxia ; Asphyxia ; Echocardiography ; Female ; Humans ; Hypertension, Pulmonary ; Iloprost ; Infant, Newborn ; Nitric Oxide ; Oxygen ; Parturition ; Persistent Fetal Circulation Syndrome ; Ventricular Pressure

OBJECTIVE: We performed immunohistochemistry for the evaluation of follicle stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR) expression in the ovarian tumors and examined the blood level of the gonadotropins in ovarian cancer patients to investigate ovarian carcinogenesis process related to gonadotropins. METHODS: Between January 2002 and July 2003, 25 patients with ovarian tumors were treated in the Hallym University Sacred Heart Hospital. 25 ovarian tumors including 7 borderline tumors, 1 sex cord stromal tumor, 1 germ cell tumor, and 16 carcinomas were examined for FSHR, LHR expression by immunohistochemistry. Serum gonadotropins were collected from 13 cases of 25 ovarian tumors who were not taking hormones at the time of blood collection. RESULTS: Followings are results summarized. 1. Mean FSH levels were lower among cases compared with controls. LH levels were lower among cases than controls, but the difference was not statistically significant. 2. The steady decline of FSHR, LHR expression from borderline tumor (86%, 100%) to carcinoma (56%, 43%) is observed. 3. Patients showing significant gonadotropins receptors expression showed lower serum FSH and LH levels when compared with patients with no detectable gonadotropins receptors. CONCLUSION: The presence of FSHR, LHR in ovarian tumors provide additional evidence supporting the relation of gonadotropins and ovarian carcinogenesis. But, this study did not support the hypothesis that pituitary goandotropins increase the risk of ovarian cancer. The decline of receptor expression from borderline tumors to carcinoma suggests that FSH, LH may be needed in early ovarian cancer development. If further studies of gonadal peptides and gonadotropins are done, we can suggest the cut-off value of gonadotropins on ovarian carcinogenesis.
Carcinogenesis ; Gonadotropins* ; Gonads ; Heart ; Humans ; Immunohistochemistry ; Neoplasms, Germ Cell and Embryonal ; Ovarian Neoplasms* ; Peptides ; Receptors, FSH ; Receptors, Gonadotropin ; Receptors, LH ; Sex Cord-Gonadal Stromal Tumors

OBJECTIVE: We investigated whether the insemination method (in vitro fertilization [IVF] or intracytoplasmic sperm injection [ICSI]) affected morphokinetic events and abnormal cleavage events in embryonic development. METHODS: A total of 1,830 normal fertilized embryos were obtained from 272 IVF and ICSI cycles that underwent ovum retrieval culture using a time-lapse system (Embryoscope) from June 2013 to March 2015. All embryos were investigated by a detailed time-lapse analysis that measured the developmental events in the hours after IVF or ICSI insemination. RESULTS: No significant differences were observed between the two groups regarding clinical outcomes (p>0.05). ICSI-derived embryos showed significantly faster morphokinetics than those derived from conventional IVF, from the time to pronuclear fading to the time to 6 cells (p<0.05). However, no significant differences were found from the time to 7 cells to the time to expanded blastocyst (p>0.05). There were no differences in abnormal cleavage events between the two groups (p>0.05); they showed the same rates of direct cleavage from 1 to 3 cells, 2 multinucleated cells, 2 uneven cells, and reverse cleavage. CONCLUSION: The morphokinetics of embryo development was found to vary between IVF- and ICSI-fertilized oocytes, at least until the 6-cell stage. However, these differences did not affect the clinical outcomes of the embryo. Additionally, no significant differences in abnormal cleavage events were found according to the fertilization method.
Blastocyst ; Embryonic Development* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Humans* ; In Vitro Techniques* ; Insemination ; Methods ; Oocytes* ; Ovum ; Pregnancy ; Sperm Injections, Intracytoplasmic ; Spermatozoa* ; Time-Lapse Imaging

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially fatal drug-induced systemic hypersensitivity response characterized by erythematous eruption, fever, leukocytosis with eosinophilia, and internal organ involvement. Antitubercular agents are potential causative agents for DRESS syndrome but difficult to verify as a culprit drug, since antitubercular agents are coadministered as a combination regimen. A 42-year-old female with endobronchial tuberculosis was diagnosed with DRESS syndrome after 4-week treatment of isoniazid, rifampicin, ethambutol, and pyrazinamide with prednisolone 50 mg. All the antitubercular agents were stopped and replaced with levofloxacin, cycloserine, p-aminosalicylic acid, and kanamycin. However, severe exacerbation of DRESS syndrome compelled the patient to discontinue the administration of the second-line antitubercular agents. Two months later, the patient underwent a patch test for all the antitubercular agents which had been used, and the results showed positivity to isoniazid and cycloserine. We report a rare case of DRESS syndrome that reacted to cycloserine as well as isoniazid. Development of coreactivity to other drugs should be differentiated with a flare-up reaction in the management of DRESS syndrome.
Adult ; Aminosalicylic Acid ; Antitubercular Agents ; Cycloserine ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Ethambutol ; Female ; Fever ; Humans ; Hypersensitivity ; Isoniazid ; Kanamycin ; Leukocytosis ; Levofloxacin ; Patch Tests ; Prednisolone ; Pyrazinamide ; Rifampin ; Tuberculosis

BACKGROUND: The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures. METHODS: An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate. RESULTS: The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; P<0.001), vertebral fracture (OR 0.55; P<0.001) and non-vertebral fracture (OR 0.73; P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; P=0.127). CONCLUSIONS: This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
Diphosphonates* ; Etidronic Acid ; Humans ; Meta-Analysis as Topic ; Osteoporosis ; Osteoporotic Fractures* ; Risk Reduction Behavior

In this paper, some parts of Fig. 1 and dose information of methylprednisolone on page 113 were misprinted.

Intussusception is a rare disease in adults. A demonstrable etiology is found in approximately 85% of all cases, and approximately 40% of them are caused by malignant tumors. A 65-year-old patient visited the outpatient department with mild abdominal pain without other symptoms. The initial laboratory test and simple X-ray showed normal findings. CT revealed intussusception in the ileocecal area. The initial colonoscopic biopsy revealed atypical cells. Follow up colonoscopy showed spontaneous reduction of the intussusception. Diffuse large B-cell lymphoma was suspected in the second colonoscopic biopsy. An elective operation was performed. This case reports a case of a spontaneous reduction of adult intussusception with a brief review of literature.
Abdominal Pain ; Adult ; Aged ; Biopsy ; Colonoscopy ; Follow-Up Studies ; Humans ; Immunoproliferative Small Intestinal Disease ; Intussusception ; Lymphoma ; Lymphoma, B-Cell ; Outpatients ; Rare Diseases