Histiocytosis X is characterized by aggregates of Langerhans cells with other inflammatory cells. These Langerhans cells are antigen-presenting cells to T lymphocytes and identified by characteristic morphology, ultrastructural demonstration of Birbeck granules and immunologic reactivity with OKT-6 and HLA-DR antibodies. In this report, the tumor arising in a 2-years-old baby was examined byimmunostaining with several macrophage/dendritic cell markers. The main tumor cells showed cytoplasmic and nuclear staining with S-100 protein and ring-like surface and paranuclear staining with PNA. However, they were negative for follicular dendritic cell marker CD21, macrophage markers lysozyme, Mac 387, alpha-1 antitrypsin and CD68, and interdigitating reticulum cell marker ID4 and ID5. These observations demonstrate the usefulness of S-100 protein and PNA for the identification of Langerhans cells in paraffin-embedded tissue.

Congenital hepatic fibrosis is an inherited, congenital disorder of the liver, and is occasionally associated with cystic disease of the liver and kidney. We present a case of congenital hepatic fibrosis with Caroli's disease. A 21-year-old woman had suffered from an episodic fever with headaches for 3 years. In laboratory examination, the liver function test was within the normal limits. Esophageal varix was noted by an endoscopic examination. Hepatosplenomegaly and multiple dilated bile ducts were seen by abdominal CT scanning. An orthotopic whole liver transplantation was done. The liver was fibrotic and enlarged. Multiple cystically dilated intrahepatic ducts were noted. Microscopically, diffuse portal fibrosis and widening with proliferation of bile ductules were seen. Intrahepatic bile ducts were markedly dilated and tortuous. The liver cell cords were well preserved.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Caroli Disease* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Esophageal and Gastric Varices ; Female ; Fever ; Fibrosis* ; Headache ; Humans ; Kidney ; Liver ; Liver Function Tests ; Liver Transplantation ; Tomography, X-Ray Computed ; Young Adult

No abstract available.
Psoriasis

No abstract available.
Knee Joint* ; Knee* ; Torque*

Purpose: The purpose of this study was to identify factors influencing nurses’ performance of care in COVID-19 wards. Methods: The participants were 132 nurses who worked in COVID-19 wards at three hospitals, and were recruited from April 1 to May 31, 2021. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with SPSS/WIN 24.0 program. Results: Nursing performance was significantly and positively correlated with ethical sensitivity (r = .75, p < .001), nursing professionalism (r = .67, p < .001), and social support (r = .67, p < .001). Nursing professionalism was positively correlated with ethical sensitivity (r = .64, p < .001) and social support (r = .55, p < .001). Multiple regression analysis for nursing performance revealed that the most significant factor was ethical sensitivity (β = .47, p < .001). Ethical sensitivity, nursing professionalism, and social support explained 66.0% of total variance in nursing performance. Conclusion Ethical sensitiviy, nursing professionalism, and social support significantly influence nurses’ performace of care in COVID-19 wards. It suggests that intervention programs should be directed at improving nurses’ ethical sensitivity, bolstering social support, and enhancing nursing professionalism.

No abstract available.

No abstract available.

No abstract available.

The authors present a case of macular dystrophy of the cornea which is inherited as a recessive trait. The patient was 43 years old female housewife who had suffered from photophobia, frequent tearing, foreign body sensation and gradually increasing visual dimness since early childhood. Partial penetrating keratoplasty was performed. We had a study of the histopathologic findings for a case of macular dystrophy of the cornea with a brief review of relating literatures.
Adult ; Cornea* ; Female ; Foreign Bodies ; Humans ; Keratoplasty, Penetrating ; Macular Degeneration* ; Photophobia ; Sensation ; Tears

PURPOSE: To obtain guideline of diagnosis and treatment when hyperdeviation associated with intermittent exotropia shows symptoms similar to superior oblique palsy (SOP). METHODS: We reviewed the charts retrospectively in 27 patients showing simulated SOP in intermittent exotropia, in which hyperdeviation in primary gaze and 10PD or more by Bielschowsky head tilt test were present. Overaction of Inferior oblique, (IOOA) dysfunction of superior oblique, and forveal extorsion more than +2 were excluded including reoperation and head tilt history. All patients were undergone horizontal muscle surgery only. The postoperative changes of deviation were analyzed at postoperative one day, one month, six month, and one year. RESULTS: Average amount of distant horizontal deviation in primary gaze was 32.3+/-9.58PD. Hyperdeviation was 3.8+/-2.52PD. Degree of IOOA averaged +1.18 in hypertropic eye, and +1.06 in hypotropic eye. Only 10 patients (37%) had foveal extorsion less than +2 in degree. Average vertical deviation of hypertropic eye side was 12.7+/-2.93PD on head tilt test. After horizontal surgery only, the amount of hyperdeviation decreased to 1.3PD at 1st day. On head tilt test, hyperdeviation was almost eliminated showing 0.6PD on the hypertropic side and 0.1PD on the contralateral eye at one month. All patients were aligned up to the follow-up of one year. CONCLUSIONS: To differentiate simulated SOP from intermittent exotropia with hyperdeviation, none of head tilt history, mild foveal extorsion, mild oblique dysfunction less than +3, double Maddox rod test, and forced duction test are important guidelines. Horizontal muscle surgery is only needed to remove exodeviation and hyperdeviation.
Diagnosis ; Exotropia* ; Follow-Up Studies ; Head ; Humans ; Paralysis* ; Reoperation ; Retrospective Studies