Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%). Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal cell carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.
Adenocarcinoma ; Bile Ducts ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carcinoma, Adenoid Cystic ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Carcinoma, Small Cell ; Diagnosis ; Diagnosis, Differential ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Hemolytic-Uremic Syndrome* ; Hepatocytes ; Korea ; Liver ; Necrosis ; Pneumococcal Infections* ; Ulnar Nerve

PURPOSE: The purpose of this study was to examine the effects of breathing exercises performed using panflutes in elderly patients undergoing spinal surgery. METHODS: The study design was a nonequivalent control group non-synchronized pre-post test. The study included 24 patients in both the experimental group and the control group. The experimental group completed a daily breathing exercise regimen using panflutes for 30minutes after meals, whereas the control group was provided standard preoperative education, including breathing exercises using incentive spirometers. After the exercise regimen, breathing exercise compliance, pulmonary infections, and life satisfaction were measured in both groups, and the data were analyzed using the SPSS/WIN program. RESULTS: The compliance rate of breathing exercises was significantly higher in the experimental group. The experimental group presented no pulmonary infections in the later period, whereas the control group presented higher pulmonary infection rates in the same period. In addition, the life satisfaction score in the experimental group significantly increased. CONCLUSION: The breathing exercise program using panflutes for elderly patients undergoing spinal surgery enhanced their breathing exercise compliance and their daily life satisfaction in addition to reducing their pulmonary infection rates.
Aged* ; Breathing Exercises ; Compliance* ; Education ; Evaluation Studies as Topic ; Humans ; Meals ; Motivation ; Patient Compliance ; Personal Satisfaction ; Postoperative Complications ; Respiration* ; Work of Breathing

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
Blood Pressure* ; Blood Urea Nitrogen ; Creatinine ; Dialysis ; Dialysis Solutions ; Fasting ; Hemodynamics* ; Humans ; Hypotension ; Incidence* ; Osmolar Concentration ; Potassium ; Renal Dialysis* ; Sensation ; Sodium ; Thirst* ; Ultrafiltration* ; Weight Gain*

The purpose of this study was to evaluate a clinical preventative care program, based on a dental hygiene process (accessment, diagnosis, planning, implementation, evaluation; ADPIE) in a dental clinic, by analyzing patient recognition, knowledge, practice, and satisfaction with respect to oral health. The collected data (in percentages) were analyzed Fisher's exact test and paired t-test using IBM SPSS ver. 21.0 (IBM Co., USA). This study demonstrated a significant difference in oral health knowledge, recognition, and practice before and after the clinical preventive care program (p<0.05). The results were significant in the individual preventive plan within the planning stage, and in the professional teeth cleaning implementation stage (p<0.05). This result can be attributed to the sympathy of the dental hygienist (p<0.05). There was a positive correlation between recommending dental checkups and regular checking of the (r=0.552, p<0.05), undergoing radiography (r=0.434, p<0.01), following an individual preventive plan (r=0.568, p<0.01), undergoing proximal machine teeth cleaning (r=0.437, p<0.05), following tooth brushing instructions (r=0.552, p<0.05), and the evaluation results (r=1.000, p<0.05). Our results demonstrate, that the clinical preventive care program, based on dental hygiene, is an effective program. Given the positive effect of dental revisits and patient recommendations promoting dental hygienists, it is hoped that this preventative program will be widely used.
Dental Clinics ; Dental Hygienists ; Diagnosis ; Hope ; Humans ; Oral Health* ; Oral Hygiene* ; Radiography ; Tooth

Adolescent ; Biomarkers ; Blood Pressure ; Body Image ; Body Mass Index ; Calcium ; Education ; Female ; Food Labeling ; Humans ; Korea ; Nutrition Assessment ; Nutrition Surveys ; Obesity ; Thinness ; Triglycerides ; Waist Circumference ; Weight Loss

BACKGROUND: In the Korean Red Cross Blood Center, ABO blood typing are routinely performed only via red cell grouping at blood donations sites. However, when an error occurs in this process, it is impossible to issue a blood product contrary to the result of the blood type of the Blood Laboratory Center, thereby resulting in delayed supply. Therefore, efforts are needed to reduce typing errors at blood donation sites. METHODS: We analyzed 656,786 donor screenings between January 1, 2016 and December 31, 2016;we also analyzed the statistical data of donor ABO typing between 2013 and 2015. To reduce ABO typing error, we notified and trained nurses at Busan, Gyeongnam, Ulsan, and Daegu-Gyeongbuk Blood centers in June, 2016. We tried to confirm the improvement of ABO typing error at blood donation sites by comparing ABO typing before and after training. For data comparison, chi-square test was conducted (95% confidence interval, 0.05 significant level). RESULTS: The blood typing error rate was significantly lower (P=0.003) four months after training (0.005%) than before training (0.015%), and the blood typing error rate was significantly higher for the first blood donor (P<0.001). CONCLUSION: Educational training for nurses at blood donation sites may be effective in reducing ABO typing error. Continuous and regular training seems to be needed in future to reduce ABO typing error.
Blood Donors* ; Blood Grouping and Crossmatching* ; Busan ; Donor Selection ; Humans ; Red Cross ; Tissue Donors ; Ulsan

No abstract available.
Gestational Trophoblastic Disease*

Special idiopathic female pseudohermaphroditism with urinary tract, m llerian duct, and lower gastrointestinal tract anomalies, in addition to masculinization of the external genitalia, is rare phenomenon. Masculinization of external genitalia and other anomalies occur in the absence of a recognized exposure to androgen or other teratogenic factors. We report a case of a female pseudohermaphroditism with m llerian agenesis, bilateral multicystic dysplastic kidney, urethral agenesis, left double ureter, rectovesical fistula, imperforate anus, single umbilical artery, detected after therapeutic abortion at 23+5 weeks of gestational age. The final diagnosis is based on autopsy.
46, XX Disorders of Sex Development* ; Abortion, Therapeutic ; Anus, Imperforate* ; Autopsy ; Diagnosis ; Female* ; Fistula ; Genitalia ; Gestational Age ; Humans ; Lower Gastrointestinal Tract ; Multicystic Dysplastic Kidney ; Pregnancy ; Single Umbilical Artery ; Ureter ; Urinary Tract*

BACKGROUND: Polymerase chain reacation (PCR)-based methods have been described for rapid detection and identification of Candida spp. Multiplex PCR assay was developed using internal transcribed spacers and topoisomerase II gene for the accurate identification of Candida species. METHODS: We designed Dual Specificity Oligo (DSO) primers for multiplex PCR. Multiplex PCR was followed by agarose gel electrophoresis to test 8 type strains (C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, C. krusei, C. guilliermondii, C. lusitaniae, C. dubliniensis) and 96 clinical isolates (C. albicans 51 isolates, C. parapsilosis 10 isolates, C. glabrata 10 isolates, C. tropicalis 9 isolates, C. krusei 6 isolates, C. guilliermondii 5 isolates, C. lusitaniae 5 isolates) of Candida spp. RESULTS: With multiplex PCR using DSO primers, the eight Candida type strains each could be easily differentiated and all 96 clinical isolates were identified as the same species as were identified by the conventional method. CONCLUSION: Multiplex PCR followed by electrophoresis can be useful for the simple and rapid identification of Candida species in routine laboratories.
Candida* ; DNA Topoisomerases, Type II ; Electrophoresis ; Electrophoresis, Agar Gel ; Multiplex Polymerase Chain Reaction* ; Sensitivity and Specificity

PURPOSE: The purpose of this study was to analyze the prevalence of allergic disease among elementary school students in rural and urban areas. METHODS: In this study, 1,513 elementary students (1,163 in urban areas, 350 in rural areas) were surveyed. Data were analyzed using frequency, percentage of allergic symptoms and chi2 test was used to identify differences in the prevalence of allergic symptoms between urban and rural area students. The SAS program was used in the data analysis. RESULTS: There were significant differences in the prevalence of allergic disease according to whether there was a family member with a prior history of allergy symptoms. 48.7% of surveyed students (49.4% in urban, 46.3% in rural) had allergic symptoms. Allergic rhinitis was the most frequent allergic symptom in both urban and rural students. CONCLUSION: These results suggest that there is a need to prevent and manage allergies among elementary students. The family history should be considered an important factor when a program for allergy prevention and management is developed. Interventions are needed in both areas, especially for students with allergic rhinitis.
Humans ; Hypersensitivity ; Phenothiazines ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Child Health