Ischemic brain hippocampal formation has been developed to understand the relationship between delayed neuronal damage and the expression of NMDA receptor subunits[NR2A, NR2B], MAP2, and NF200 in ttle conditions of hypoxia. Changes of NR subunits[NR2A, 2B], MAP2 6nd NF200 in rat brain postsynaptic density[PSD] after hypoxic injury were investigated through immunoblot analyses. To understand the effect of Ca2+ influx through NMDA receptors on neuronal damage which is manifested by morphological change, cytoskeletal disruption was examined through H & E, toluidine blue and immunohistochemical studies. The expression of NR2B was increased than normal at 30 hours after hypoxia. At this time, the expression of MAP2 and NF200 was markedly decreased and their morphology was more eosinophilic than normal and then became darker with expanded perineuronal space. Irreversible neuronal cell damage in hypoxic hippocampal formation is most prominent in CA3 region of hippocampus and the process is triggered by Ca2+ influx through NR1/MR2B receptor channel at 30 hour after initial hypoxic insult. Ca2+ influx through NR1/MR2B receptor channel may activate intracellular proteases which would degrade cytoskeleton. Proteolysis of cytoskeleton leads to its reorganization and eventually damages normal function of cell membrane which causes neuronal cell death. And, morphological changes of neuronal cells in hypoxic conditions were manifested as red neurons in the stage of reactive change, and as dark neuron in the stage of late hypoxic cell damage.
Animals ; Anoxia* ; Brain ; Cell Death ; Cell Membrane ; Cytoskeleton ; Eosinophils ; Hippocampus* ; N-Methylaspartate ; Neurons ; Peptide Hydrolases ; Proteolysis ; Rats* ; Receptors, N-Methyl-D-Aspartate ; Tolonium Chloride

Cholangiocarcinoma has been associated with various fibrocystic diseases of liver and biliary tract, but cholangiocarcinoma in polycystic liver disease (PLD) was extremely rare. It was reported that the prognosis of cholangiocarcinoma associated PLD was very poor and distant metastases were common. We report a rare case of intrahepatic cholangiocarcinoma associated with PLD in 58- year- old female who presented vague abdominal pain. She had also polycystic kidneys with normal renal function. MRI showed well demonstrated tumor with central scar and a adjacent large cyst in the left lobe of the liver. She underwent extended left lobectomy. On microscopic examination, the tumor was moderately differentiated cholangiocarcinoma having abundant fibrous stroma and necrosis and the adjacent cyst showed focal in situ carcinomatous changes in the lining epithelium.
Abdominal Pain ; Biliary Tract ; Cholangiocarcinoma* ; Cicatrix ; Epithelium ; Female ; Humans ; Liver Diseases* ; Liver* ; Magnetic Resonance Imaging ; Necrosis ; Neoplasm Metastasis ; Polycystic Kidney Diseases ; Prognosis ; Cholangiocarcinoma

OBJECTIVE: To investigate whether a computer-aided diagnosis (CAD) system based on a deep learning framework (deep learning-based CAD) improves the diagnostic performance of radiologists in differentiating between malignant and benign masses on breast ultrasound (US). MATERIALS AND METHODS: B-mode US images were prospectively obtained for 253 breast masses (173 benign, 80 malignant) in 226 consecutive patients. Breast mass US findings were retrospectively analyzed by deep learning-based CAD and four radiologists. In predicting malignancy, the CAD results were dichotomized (possibly benign vs. possibly malignant). The radiologists independently assessed Breast Imaging Reporting and Data System final assessments for two datasets (US images alone or with CAD). For each dataset, the radiologists' final assessments were classified as positive (category 4a or higher) and negative (category 3 or lower). The diagnostic performances of the radiologists for the two datasets (US alone vs. US with CAD) were compared. RESULTS: When the CAD results were added to the US images, the radiologists showed significant improvement in specificity (range of all radiologists for US alone vs. US with CAD: 72.8–92.5% vs. 82.1–93.1%; p < 0.001), accuracy (77.9–88.9% vs. 86.2–90.9%; p = 0.038), and positive predictive value (PPV) (60.2–83.3% vs. 70.4–85.2%; p = 0.001). However, there were no significant changes in sensitivity (81.3–88.8% vs. 86.3–95.0%; p = 0.120) and negative predictive value (91.4–93.5% vs. 92.9–97.3%; p = 0.259). CONCLUSION: Deep learning-based CAD could improve radiologists' diagnostic performance by increasing their specificity, accuracy, and PPV in differentiating between malignant and benign masses on breast US.
Breast ; Dataset ; Diagnosis ; Humans ; Information Systems ; Learning ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Ultrasonography, Mammary

PURPOSE: The purpose of this study was to develop a vital signs e-book for undergraduate student nurses and evaluate the content, system and student satisfaction. METHOD: This study was done in three stages, the development of a vital signs e-book, implementation and evaluation. The subjects were 73 undergraduate student nurses in Y university. RESULT: Thirty one learning objectives were used to create the contents. A set of 5 chapters and 18 subsections were defined after validation from nurse educators. The e-book is available at http://123.134.207.23/ebook/vitalsigns. Analysis of the questionnaires showed a mean score for content, system and students satisfaction of 3.17 +/- .73, 3.11 +/-.79, and 2.96 +/-.74 respectively out of a possible 4 points. CONCLUSION: Nurse educators should provide quality and effective web-based courses that meet undergraduate student nurses' learning needs and they should incorporate web-based learning into traditional teaching to meet the demands of nursing education.
Respiration ; Pulse ; *Physical Examination ; *Internet ; *Education, Nursing ; *Computer-Assisted Instruction

Murine norovirus (MNV) is a non-enveloped virus with a positive-sense RNA genome and causes lethal infection in mice. MNV has been used as a model virus for human norovirus (NV) whose in vitro cell culture system has not been available to date since MNV and NV are genetically related. In this study, the genome replication of MNV was investigated using strand-specific RT-PCR in RAW264.7 cells. Reverse transcription (RT) using a sense primer followed by PCR showed that negative-sense RNAs were first detected in RAW264.7 cells between 6 and 9 [3 and 6] hours post infection (h.p.i.). However, these negative-sense RNAs were not detected when cells were treated with a translation inhibitor cycloheximide. Then, RT with an antisense primer followed by PCR was performed to detect positive-sense RNAs. RT-PCR results revealed that the amount of positive-sense RNAs began to increase from 9 [6] h.p.i., indicating the accumulation of the newly synthesized (+)RNA genome. Furthermore, cycloheximide abrogated the increase of newly made RNAs during MNV infection. In conclusion, strand-specific RT-PCR using a sense or antisense primer, in combination with cycloheximide treatment, enabled us to detect positive-sense and negative-sense RNAs selectively and provided a useful tool to understand the replication cycle of MNV.
Animals ; Cell Culture Techniques ; Cycloheximide ; Genome ; Humans ; Mice ; Norovirus ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; Viruses

No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

BACKGROUND: Immunoglobulin (Ig) gene rearrangement analysis is a useful additional tool to detect clonality of B-lymphoproliferative disease and the method to detect immunoglobulin gene rearrangement is required the high sensitivity and specificity. BIOMED-2 multiplex PCR was designed for the evaluation of molecular clonality of lymphoid lesions. We evaluated the usefulness of the BIOMED-2 multiplex PCR by comparing it with conventional nested PCR. METHODS: Sixteen patients with malignant lymphoma and 5 with reactive lymph nodes were examined to assess the sensitivity, specificity, and accuracy between conventional nested PCR and BIOMED-2. All 3 tests performed using the BIOMED-2 kit for immunoglobulin (Ig) heavy chain (IGH) gene, Igkappa light chain (IGK) gene, and Iglambda light chain (IGL) gene, were used to analyze clonality. RESULTS: Both the methods showed 100% specificity (95% confidence interval, 56.6-100.0). The combination of IGH and IGK BIOMED-2 tests with or without IGL revealed the highest sensitivity (87.5%; range, 64.0-96.5%) and accuracy (90%; range, 0.70-0.97). Compared to the conventional method, the BIOMED-2 test for IGH showed a higher sensitivity (62.5%; range, 38.6-81.5%) and accuracy (71%, 0.50-0.86). CONCLUSIONS: These results suggest that, compared to the conventional method, BIOMED-2 has higher sensitivity and allows for easier interpretation while evaluating the clonality of B-lymphoproliferative disease.
Gene Rearrangement ; Genes, Immunoglobulin ; Hematologic Neoplasms ; Humans ; Immunoglobulins ; Light ; Lymph Nodes ; Lymphoma ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Sensitivity and Specificity

BACKGROUND/AIMS: Quantitation of hepatitis B surface antigen (HBsAg) is an increasingly popular method to determine the treatment response in chronic hepatitis B (CHB) patients. The clinical value of HBsAg level measurement during rescue therapy for lamivudine (LMV)-resistant CHB patients have not been evaluated to date. Therefore, this study investigated the correlation between HBsAg level and treatment response in LMV-resistant CHB patients treated with adefovir (ADV) add-on therapy. METHODS: LMV-resistant CHB patients treated with LMV-ADV combination therapy for over 2 years were included. HBsAg levels were measured at 6 month intervals until 1 year, and annually thereafter. Treatment response was assessed by determining the virological response (VR, undetectable HBV DNA levels) during treatment. RESULTS: Fifty patients were included, of which 40 showed a VR. HBsAg levels were not different significantly at baseline (4.0 vs. 3.6 Log10 IU/mL, P=0.072). However, the HBsAg level decreased after 6 months of treatment in patients with a VR and became different significantly between the groups thereafter (3.9 vs. 3.3 at 6 months, P=0.002; 3.8 vs. 3.2 at 1 year, P=0.004; 3.9 vs. 3.2 at 2 years, P=0.008; 3.7 vs. 3.1 at 3 years, P =0.020). CONCLUSIONS: The HBsAg level at 6 months after treatment can help predict treatment response.
Adenine/*therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Area Under Curve ; DNA, Viral/blood ; Drug Resistance, Viral ; Female ; Hepatitis B Surface Antigens/*blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphates/*therapeutic use ; ROC Curve ; Treatment Outcome

The authors analysed 2,653 cases of transthoracic fine needle aspiration cytology of the lung to evaluate the diagnostic accuracy and its limitation. A comparison was made between the original cytologic and the final histologic diagnoses on 1,149 cases from 1,074 patients. A diagnosis of malignancy was established in 38.3% benign in 48.1%, atypical lesion in 2.3%, and inadequate one in 11.9% of the cases. Statistical data on cytologic diagnoses were as follows; specificity 98.9%: sensitivity of procedure, 76.8%: sensitivity of diagnosis, 95.5%: false positive 5 cases: false negative 18 cases: predictive value for malignancy, 98.8%: predictive value for benign lesion, 79.5%: overall diagnostic efficiency, 87.5%: typing accuracy in malignant tumor, 80%.
Biopsy, Fine-Needle ; Diagnosis ; Diarrhea* ; Hemolytic-Uremic Syndrome* ; Humans ; Lung ; Sensitivity and Specificity

We describe two cases of multiple lymphomatous polyposis in the gastrointestinal tract from the esophagus to the rectum. Clinical findings, histopathologic and immunohistochemical findings in paraffin embedded tissue are discussed. It is important to recognize this rare form of gastrointestinal lymphoma because of the prognostic and therapeutic implications.
Antigens, CD/analysis ; Gastrointestinal Neoplasms/immunology/*pathology ; Humans ; Immunohistochemistry ; Intestinal Polyps/immunology/*pathology ; Lymphoma/immunology/*pathology ; Male ; Middle Aged ; Polyps/immunology/*pathology