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

OBJECTIVES: School refusal can result from various causes; temperament, familial influences, and school experiences have been identified. This study was to compare family, school and psychological functioning in school-refusing adolescents and non-refusing ones. METHODS: Twenty-four school refusing outpatients aged 13-17 years were evaluated from May, 1998 to January, 1999. They completed self-report questionnaires, including Parent Bonding Instrument, Family Environment Scale, Index of Marital Satisfaction, Scales for School-related Distress, Center-for Epidemiological Studies-Depression, The Failure and Criticism Factor of Fear Survey Schedule from Children-revised. Their scores were compared with nonrefusers. RESULTS: The results were as follows: 1) School refusers perceived their family as more independence and achievement-oriented than nonrefusers. 2) School refusers did not differ significantly from nonrefusers in school-related distress. 3) School refusers had more depression than nonrefusers. 4) School refusers claimed more fear of having to go to school, and having to stay after school than nonrefusers. On the other hand, nonrefusers expressed greater apprehension about situations such as Being called on by the teacher, Getting poor grades, Failing a test, and Taking a test. CONCLUSION: The results suggested two postulated mechanisms of school refusals (overprotection and demanding of independence of parents) and possible causes of each result were discussed.
Adolescent* ; Appointments and Schedules ; Depression ; Disulfiram ; Hand ; Humans ; Outpatients ; Parents ; Surveys and Questionnaires ; Temperament ; Weights and Measures

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

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

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

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

PURPOSE: Although advances in neonatal intensive care have led to improved survival of very low birth weight(VLBW) infants, nosocomial sepsis continues to be an important cause of morbidity and death among these infants. Our study was carried out to estimate the incidence of nosocomial sepsis and to identify the attributable risk factors for sepsis. METHODS: The results of blood cultures taken from 182 infants with their birth weights less than 1,500 gram who were admitted to the NICU at Samsung Medical Center from October 1994 to December 1997 were retrospectively reviewed. A multiple logistic regression was performed to identify which factors were independently associated with sepsis. RESULTS: Of 166 infants who survived beyond 3 days, 57(34.3%) had nosocomial sepsis(positive blood culture at age greater than 3 days and antibiotic therapy for more than 5 days). The incidence of nosocomial sepsis was 1.8/100 hospital days and the interval between admission and onset of sepsis was 18.4+17.8 days(meanSD). Coagulase negative staphylococci(35.3%) were the most common organism in nosocomial sepsis. On multiple logistic regression analysis, several risk factors appeared to be independently associated with sepsis. The risk of nosocomial sepsis rose with decreasing gestational age, with increasing ventilator duration, UAC(umbilical venous catheter) duration, PCVC(percutanous central venous catheter) duration, nasal prong duration. And infants with nosocomial sepsis were more likely to be outborn, resuscitated at delivery room and to have bronchopulmonary dysplasia. CONCLUSION: Directing quality improvement efforts toward decreasing exposure to invasive vascular catheter and reducing ventilator days may decrease the incidence of nosocomial sepsis in VLBW infants.
Birth Weight ; Bronchopulmonary Dysplasia ; Coagulase ; Delivery Rooms ; Gestational Age ; Humans ; Incidence* ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Parturition ; Quality Improvement ; Retrospective Studies ; Risk Factors* ; Sepsis* ; Vascular Access Devices ; Ventilators, Mechanical

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