Adenoma malignum (minimal deviation adenocarcinoma) is an extremely well-differentiated adenocarcinoma of uterine cervix. Despite its benign histological appearance, this tumor is thought to be malignant and has a poor prognosis. Because Pap smear and punch biopsy have low sensitivity, accurate diagnosis of the tumor may be difficult. If it is diagnosed, it must be treated same as in cervical cancer. We presented one case of preoperatively diagnosed adenoma malignum by deep cone biposy with a brief review of literature.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Diagnosis ; Female ; Prognosis ; Uterine Cervical Neoplasms

PURPOSE: To present a case report of fungal keratitis related to prolonged overnight use of orthokeratology contact lenses. METHODS: A 13 year-old girl presented with a corneal ulcer in her left eye refractory to antibacterial medication. She had a history of wearing orthokeratology contact lenses overnight for seven months. RESULTS: The organism Aspergillus was isolated by corneal scraping, the contact lens itself, and from the storage case. The patient was treated with topical fluconazole and Natamycin pimaricin in addition to oral itraconazole, resulting in a resolution of the ocular lesion. CONCLUSIONS: The risk of fungal infection as a potential complication of the use of overnight orthkeratology contact lenses should be considered when using these lenses.
Aspergillus ; Contact Lenses ; Corneal Dystrophies, Hereditary ; Corneal Ulcer ; Eye ; Fluconazole ; Humans ; Itraconazole ; Keratitis ; Keratomileusis, Laser In Situ ; Natamycin

OBJECTIVE: To examine the pattern of gestational weight gain using maternal characteristics and pregnancy outcomes. METHODS: We used maternal weight data from 1,825 women who had noncomplicated pregnancy between Jan. 2002 and Aug. 2009. The rate of maternal weight gain in each trimester, the associations between gestational weight gain per trimester and maternal characteristics and pregnancy outcomes, and the relationship between maternal characteristics and trimester weight gain were analyzed. RESULTS: The average rate of weight gain (kg/week) was lowest during the first trimester (0.06+/-0.30), peaked during the second trimester (0.52+/-0.23), and slowed slightly in the third trimester (0.47+/-0.23). With the exception of infant sex, all six maternal characteristics and pregnancy outcomes included in the multivariate analyses (parity, maternal age, height, BMI, preeclampsia, gestational DM) were associated significantly with maternal weight gain in at least one trimester. The important maternal predictors of weight gain per trimester were prepregnancy BMI, height and age in the first trimester; prepregnacy BMI, parity and height in the second; and height, age and parity in the third. CONCLUSION: The pattern of gestational weight gain is associated with a number of maternal characteristics and pregnancy outcomes, and these relationships vary according to which trimester is being examined.
Female ; Humans ; Infant ; Maternal Age ; Multivariate Analysis ; Parity ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Weight Gain

Calcification most frequently occurs in the rotator cuff insertion of the shoulder. However, calcification is known to develop in any joint, including the hip, knee, wrist and elbow. Around the knee joint, it usually occurs in the areas such as the quadriceps femoris muscle, the popliteus muscle and the medial collateral ligament with a history of trauma. But the occurrence of calcification in the lateral collateral ligament is very rare. We herein report on one case of the calcification that developed in the lateral collateral ligament, and this was treated by excision of the calcified materials and repair of the ligament. We also present the magnetic resonance imaging findings of this case.
Collateral Ligaments ; Elbow ; Hip ; Joints ; Knee ; Knee Joint ; Ligaments ; Magnetic Resonance Imaging ; Muscles ; Quadriceps Muscle ; Rotator Cuff ; Shoulder ; Wrist

PURPOSE: The purpose of this study was to investigate the wage structure of hospital nurses in Korea and to analyze the factors that determine the level of nurses' wages. METHODS: First, a mobile survey on nurses' wages was conducted with a total of 3,742 nurses working in hospitals. A literature review was also done. Second, a regression model was applied to analyze the determinants of nurses' wages. RESULTS: The average monthly wage of 3,742 nurses based on the survey was KRW 3,588,000 and the standardized monthly income of 3,742 nurses was estimated to be KRW 3,364,000 as of the end of 2018. The results of regression analysis(R2=61.7%) showed that gender, nursing experience, designated night duty, ownership, and number of beds were statistically significant variables for nurses' wages at 1% significance level. The monthly wage of nurses working in total nursing care wards was not significantly different from those working in other wards at 5% significance level. CONCLUSION The substantial difference in nurses' wages according to job career, hospital size, region, etc may result in the low proportion of nurses with more than three to five years of service experience and the high turnover of less-experienced workers. Consideration should be given to adjust the gap in wage level and a standard nurse wage system could be effective measures.

Purpose: The purpose of this study is to develop a nursing salary guideline for Korean hospitals. Methods: Literature review and a mobile survey were conducted regarding staff nurses’ salary. Regression analysis and simulation model were applied to develop the nurses’ salary guideline. Results: The United Kingdom, Australia, and Germany have standard salary guidelines which demonstrated the standard salary of nurses. These were determined mainly by nursing experience and expertise. The results of the mobile survey indicated that the maximum to minimum ratio of the salary was as high as 4.5 among staff nurses working in Korean hospitals. Two models (exponential and linear) for a standard nursing salary guideline were developed and the simulation results demonstrated an improved salary structure for staff nurses. Conclusion This developed salary guideline for staff nurses is recommended to be applied in Korean hospitals which provide total nursing care services.

Neural stem cells (NSCs) have the ability to self-renew and differentiate into neurons, oligodendrocytes, and astrocytes. Highly dynamic nature of NSC differentiation requires the intimate involvement of catabolic processes such as autophagy. Autophagy is a major intracellular degradation pathway necessary for cellular homeostasis and remodeling. Autophagy is important for mammalian development and its role in neurogenesis has recently drawn much attention. However, little is known about how autophagy is associated with differentiation of NSCs into other neural lineages. Here, we report that autophagy plays a critical role in differentiation of adult rat hippocampal neural stem (HCN) cells into astrocytes. During differentiation, autophagy flux peaked at early time points, and remained high. Pharmacological or genetic suppression of autophagy by stable knockdown of Atg7, LC3 or CRISPR-Cas9-mediated knockout (KO) of p62 impaired astrogenesis, while reintroduction of p62 recovered astrogenesis in p62 KO HCN cells. Taken together, our findings suggest that autophagy plays a key role in astrogenesis in adult NSCs.
Adult Stem Cells ; Adult ; Animals ; Astrocytes ; Autophagy ; Cell Differentiation ; Homeostasis ; Humans ; Neural Stem Cells ; Neurogenesis ; Neurons ; Oligodendroglia ; Rats ; Suppression, Genetic

Background: As an instrument for measuring body composition in experimental animals, dual energy X-ray absorptiometry (DXA) is ideal for accuracy, cost, and measurement efficiency. However, there is too little insight into the effectiveness of the various aspects of applying DXA to experimental animals. We investigated whether to compare and verify the precision and accuracy of DXA and nuclear magnetic resonance (NMR) animal body composition analyzers. Methods: We used 30 Institution of Cancer Research mice in the study. First, in order to evaluate the reproducibility of DXA and NMR, we did repeated measurements by repositioning each mouse in anesthesia and euthanasia states. Subsequently, the accuracy of each device was evaluated by comparing the weight measured before the experiment, the weight of the tissue extracted from the mice after the experiment, and the measured DXA and NMR. In addition, when measuring the body composition of animals, we compared the time and the measurable body composition parameters and summarized the advantages and disadvantages of the 2 devices. Results: Compared to NMR, DXA had the advantage of a fast measurement of bone composition and rapid image analysis. In addition, DXA showed a higher correlation (>95%) with fat mass, lean mass baseline than did NMR (>85%). Conclusions In conclusion, DXA was confirmed to have higher precision and measurement accuracy than did NMR. Therefore, DXA is an effective method for evaluating the body composition of experimental animals.

Objective: : Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. Methods: : Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained preand postoperatively and compared between those with and without postoperative complications. Results: : Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. Conclusion : The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.

Objective: : Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. Methods: : Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained preand postoperatively and compared between those with and without postoperative complications. Results: : Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. Conclusion : The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.