No abstract available.
Epidemiology*

Cyclic Neutropenia is a benign, unusual hematologic disorder characterized by regularly recurring episodes of severe neutropenia occurring approximately every 21 days. Beside neutrophils, monocytes, lymphocytes, platelets and reticulocytes all cycle with strict periodicity suggest that this disease should be viewed as cyclic hematopoiesis, not merely as cyclic neutropenia. During neutropenic periods, patients regularly experience aphthous stomatitis, fever, malaise, cervical lymphadenitis, cutaneous infections and occasional pneumonia and otitis media. The exact cause of cyclic neutropenia is unknown. But it is strongly suggested that cyclic neurtopenia is due to an abnormality in the regulation of early hematopoietic precursor cells. We have documented a case of cyclic neutropenia for a period of 2.5 years in a 11 year-old boy who had suffered from recurrent fever, stomatitis, gingival swelling, cervical lymphadenitis and skin infections at 3 weeks intervals since 5 years of age. A brief review of the related literatures is presented.
Child ; Fever ; Hematopoiesis ; Humans ; Lymphadenitis ; Lymphocytes ; Male ; Monocytes ; Neutropenia* ; Neutrophils ; Otitis Media ; Periodicity ; Pneumonia ; Reticulocytes ; Skin ; Stomatitis ; Stomatitis, Aphthous

Histologic, immunohistochemical and ultrastructural studies were performed on 6 cases of undifferentiated thyroid carcinoma to study the histogenesis of the undifferentiated thyroid carcinoma, to determine the most useful markers for diagnosing these tumors and to investigate the nature of osteoclast-like giant cells rarely observed in these tumors. For the immuno-histochemical study, a panel of antibodies to epithelial (cocktailed keratin, low molecular weight keratin, CEA), mesenchymal(vimentin, desmin, actin, FVIIIRAg) endocrine(calcitonin, chromogranin), lymphocytic(LCA), histiocytic(alpha-l-ACT, alpha-1-AT, lysozyme, CD68), and Schwann cell(S-100 protein) markers were used. The following results were obtained; 1) Well differentiated carcinoma was associated with 2 cases of spindle cell type and 1 case of giant cell type of undifferentiated thyroid carcinoma and a transitional zone between the well differentiated and undifferentiated lesions was observed. 2) All of the examined cases expressed keratin, and 3 tumors expressed CEA. 3) All the mesenchymal markers, LCA, S-100 protein, calcitonin, and chromogranin were not expressed. Vimentin was coexpressed with keratin in 4 cases. 4) Osteoclast-like giant cells were observed in 1 case of spindle cell type. They expressed CD68 but not keratin. 5) Ultrastructural study revealed the desmosomes between the tumor cells and non-neoplastic, follicular, thyroid epithelial cells. The above results indicate that undifferentiated thyroid carcinoma originates from follicular epithelial cell, keratin is the most useful marker for diagnosis of this tumor, and the osteoclast-like giant cells are histiocytic in nature and reactive, rather than neoplastic.

Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens

BACKGROUND: Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-small cell lung cancer to get evaluate its clinical implication. METHODS: Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish peroxidase complex in the formalin-fixed, paraffin-embedded tissue 4 µm section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. RESULTS: Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in turmor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the correlated between survivin expression and p53 expression, but found none. CONCLUSION: We confirmed the tumor specific expression of survivin in non-small cell lung cancer But this pression was not correlated with clinical parameters as well as histlogy, tumor stage recurrence, and sur rate. Also it ws not statistically correlated with the expression of p53.
Adult ; Apoptosis ; Blotting, Western ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Cell Line ; Horseradish Peroxidase ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins* ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis ; Recurrence

PURPOSE: The purpose of the non-equivalent control group pretest-posttest study was to test the effects of self-directed nursing practice using peer-tutoring, on the level of confidence, performance and learning satisfaction of nursing students in practicing core nursing skills. METHODS: The data were collected from 80 junior nursing students at a nursing college in Daejeon before and after 3 weeks of intervention on practicing six core nursing skills, according to the highest order of priority. The subjects were divided into the peer-tutoring practice group (PTPG, n=40) and the lecturer-guided practice group (LGPG, n=40). The data were analyzed using mean, frequency, and t-test. RESULTS: The PTPG scored statistically higher than the LGPG on the performance of ‘indwelling urinary catheterization’ and ‘wearing protection equipment while entering quarantine room & disposing waste’ The PTPG scored statistically higher than the LGPG on the confidence of ‘indwelling urinary catheterization’ and ‘inserting intravenous catheterization’. The PTPG scored statistically higher on learning satisfaction than LGPG. CONCLUSION: The results showed that self-directed nursing practice using peer-tutoring could be effective for nursing students in improving proficiency in core nursing skills and might be applied to core nursing skills training.
Clinical Competence ; Humans ; Learning* ; Nursing* ; Quarantine ; Students, Nursing*

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion:These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.

BACKGROUND: Dendritic cell (DC)-based cancer immunotherapy is studied for several years. However, it is mainly derived from autologous PBMC or leukapheresis from patient, which has limitations about yield and ability of DC production according to individual status. In order to solve these problems, inquiries about allogeneic DCs are performed but there are no preclinical trial answers for effect or toxicity of allogeneic DC to use for clinical trial. In this study, we compared the anti-tumor effect of allogeneic and autologous DCs from mouse bone marrow stem cells in mouse metastatic melanoma model. METHODS: B16F10 melanoma cells (5 x 10(4)/mouse) were injected intravenously into the C57BL/6 mouse. Therapeutic DCs were differentiated from autologous (C57BL/6: CDC) or allogeneic (B6C3F1: BDC) bone marrow stem cells with GM-CSF, SCF and IL-4 for 13days and pulsed with B16F10 tumor cell lysate (Blys) for 18hrs. DC intra-peritoneal injections began on the 8th day after the tumor cell injection by twice with one week interval. RESULTS: Anti-tumor response was observed by DC treatment without any toxicity especially in allogeneic DC treated mice (tumor burden score: 2.667+/-0.184, 2.500+/-0.463, 2.000+/-0.286, 1.500+/-0.286, 1.667+/-0.297 for saline, CDC/unpulsed-DC: U-DC, CDC/Blys-DC, BDC/U-DC and BDC/Blys-DC, respectively). IFN-gamma secretion was significantly increased in allogeneic DC group stimulated with B16F10 cell lysate (2,643.3+/-5,89.7, 8,561.5+/-2,204.9. 6,901.2+/-141.1 pg/1 x 10(6) cells for saline, BDC/U-DC and BDC/Blys-DC, respectively) with increased NK cell activity. CONCLUSION: Conclusively, promising data was obtained that allogeneic DC can be used for DC-based cancer immunotherapy.
Animals ; Bone Marrow ; Dendritic Cells ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Interleukin-4 ; Killer Cells, Natural ; Leukapheresis ; Melanoma* ; Mice ; Neoplasm Metastasis* ; Stem Cells

Myelodysplastic syndromes (MDS) are a group of refractory anemias resulting from a clonal stem cell disorder often associated with cytogenetic abnormalities. There is increasing recognition of immunological abnormalities in patients with MDS, including defective B- and T-cell function, hyper- or hypogammaglobulinemia and monoclonal gammopathy. MDS have been associated with Sjogren's syndrome, polymyalgia rheumatica, relapsing polychondritis and systemic lupus erythematosus. Although there may be various rheumatologic features, including acute arthritis in MDS, chronic inflammatory arthritis is uncommonly combined. There have been a few reports that described cases of rheumatoid arthritis (RA) concurrent with MDS, but advanced rheumatoid arthritis with typical joint deformities has rarely been reported. We report a case of rheumatoid arthritis with atlantoaxial subluxation combined with refractory anemia in a 31-year-old woman.
Adult ; Arthritis, Rheumatoid/radiography ; Arthritis, Rheumatoid/pathology ; Arthritis, Rheumatoid/complications* ; Arthritis, Rheumatoid/blood ; Case Report ; Female ; Follow-Up Studies ; Human ; Myelodysplastic Syndromes/pathology ; Myelodysplastic Syndromes/complications* ; Myelodysplastic Syndromes/blood