Lymphadenitis due to toxoplasma infection is not uncommon and should be considered in the diagnosis of unexplained lymphadenopathy at all sites, especially at the cervical region. We report four cases of toxoplasmosis diagnosed by cytologic, histologic and serologic tests. Fine needle aspiration cytologic diagnosis can help the diagnosis of toxoplasma lymphadenitis and eliminate unnecessary hospitalization or surgery.
Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Hospitalization ; Lymphadenitis ; Lymphatic Diseases ; Mass Screening* ; Serologic Tests ; Toxoplasma ; Toxoplasmosis*

PURPOSE: The purpose of this study was to evaluate the clinicopathological features and immunohistochemical features of gastrointestinal stromal tumor (GIST), and specifically the expressions of platelet derived growth factor receptor A (PDGFRA), protein kinase C theta (PKC theta), discovered on GIST-1 (DOG-1), p16 and p27. MATERIALS AND METHODS: Total 118 patients who underwent surgical resection for GIST at our institution between Jan 1997 and Dec 2007 were retrospectively studied. Immunohistochemical staining for c-kit, PDGFRA, PKC-theta, DOG-1, p16 and p27 was performed on a tissue microarray of the 118 GIST. The clinicopathologic parameters, the disease-free survival (DFS) and the overall survival rate were analyzed along with immunohistochemistry. RESULTS: The immunohistochemical stains for c-kit, CD34, PKC-theta, PDGFRA, DOG-1, p16 and p27 were positive in 89.8%, 72.0%, 56.8%, 94.9%, 90.7%, 69.5% and 44.1% of the tumor samples, respectively. The immunohistochemical expression of c-kit was strongly correlated with PKC-theta (p=0.000), DOG-1 (p=0.000) and CD34 (p=0.002). The DFS rate was significantly decreased for the patients with peritoneal GIST, high risk GIST, > or =10 cm-sized GIST, > or =10 mitoses/50 high power fields (HPFs) and p16 positivity (p=0.001, p=0.004, p=0.001, p=0.003 and p=0.028). GISTs > or =10 cm, epithelioid tumor cell type, and c-kit, and DOG-1 negativity were significantly associated with shorter period of overall survival (p=0.048, p=0.006, p=0.000 and p=0.000). CONCLUSION: The expression of p16 and no expression of c-kit and DOG-1 in GISTs, as well as peritoneal tumor site, high risk group, large tumor size, epithelioid tumor cell type and numerous mitoses, may be potentially prognostic factors for predicting worse outcome for patients who suffer from GIST.
Coloring Agents ; Disease-Free Survival ; Gastrointestinal Stromal Tumors ; Humans ; Immunohistochemistry ; Mitosis ; Prognosis ; Protein Kinase C ; Receptors, Platelet-Derived Growth Factor ; Retrospective Studies ; Survival Rate

We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors’ positions.

BACKGROUND: This study evaluated potential correlations between the allele burden of the Janus kinase 2 (JAK2) V617F mutation and clinicohematologic characteristics in patients with myeloproliferative neoplasms (MPN). METHODS: Clinical and hematologic features were reviewed for 103 MPN patients, including patients with polycythemia vera (PV, 22 patients), essential thrombocythemia (ET, 64 patients), and primary myelofibrosis (PMF, 17 patients). JAK2 V617F allele status and allele burdens were measured by allele-specific PCR and pyrosequencing, respectively. RESULTS: The JAK2 V617F mutation was detected in 95.5%, 68.8%, and 52.9% of PV, ET, and PMF patients, respectively. JAK2 V617F-positive ET patients were significantly older and exhibited higher neutrophil fractions, a higher frequency of thrombotic events, and a higher myelofibrosis rate than JAK2 V617F-negative patients (P <0.05). PV patients carried the highest mean T allele burden (66.0%+/-24.9%) compared with ET (40.5%+/-25.2%) and PMF patients (31.5%+/-37.0%) (P =0.00). No significant correlations were detected between V617F allele burden and patient age, white blood cell count, Hb, Hct, or the platelet count for PV, ET, or PMF patients. ET patients with organomegaly had a higher JAK2 V617F allele burden (53.4%+/-23.7%) than patients without organomegaly (35.6%+/-24.3%) (P =0.03). CONCLUSIONS: The JAK2 V617F mutational status and its allele burden correlate with the clinicohematologic phenotypes of ET patients, including older age, higher neutrophil count, and greater rates of organomegaly, thrombotic events, and myelofibrosis. For PV and PMF patients, larger-scale studies involving more MPN patients are needed.

Ganglioneuroma is the most differentiated tumor of neural crest origin and rarely arises in the adrenal gland. Ganglioneuroma is typically known to be benign, but very rarely can metastasize to distant sites. We report a case of a 31-year-old man with a huge adrenal mass with hepatic metastases.
Adrenal Glands ; Adult ; Ganglioneuroma ; Humans ; Neoplasm Metastasis ; Neural Crest

PURPOSE: In order to assess the usefulness of serum ferritin as a marker of disease activity and prognostic factor in pediatric malignancy, serum ferritin levels were measured. METHODS: Peripheral blood samplings for ferritin level were made at presentation, in remission following therapy, and in relapse in 95 children with malignancy admitted to the Department of Pediatrics, Kosin University Gospel Hospital between January, 1986 and August, 1995. The patients were comprised of 35 acute lymphoblastic leukemia(ALL), 17 acute myelogenous leukemia(AML), 20 non- Hodgkin's lymphoma(NHL) and 23 neuroblastoma(NB). RESULTS: The mean values of serum ferritin at presentation were 465.3+/-53.9 ng/mL in ALL, 468.9+/-69.4 ng/mL in AML, 274.1+/-69.2 ng/mL in NHL and 337.3+/-64.4 ng/mL in NB. Those values were increased significantly compared to the mean of 20 control children(69.5+/-12.9 ng/mL). The mean values of serum ferritin concentration in remission stage(first, second, and third remission) tend to be lower compared to those in the active stage(at presentation, first relapse and second relapse). But these differences reached a statistical significance only in patients with ALL when the mean values of the active stage were compared to those checked in the remission stage over 12 months(P= 0.0002). Comparison of overall survival according to initial serum ferritin levels(below and above 200 ng/mL) did not show any significant difference in ALL, AML and NHL. However, there was a borderline relationship in NB(relative risk 3.12, P=0.06). CONCLUSION: The study showed that normalization of serum ferritin levels were found in ALL who had continuous, complete remission for more than 12 months. And patients with lower serum ferritin levels were not associated with better survival except in patients with NB in which the lower ferritin group showed borderline significance.
Child ; Ferritins* ; Humans ; Leukemia ; Lymphoma ; Neuroblastoma ; Pediatrics ; Prognosis ; Recurrence

Herein, a case of nabothian cysts, extending into the deep cervical wall is reported. The radiologic and clinical examinations were suggestive of adenoma malignum. The cysts were incidentally found in a 42 year-old woman with abnormal uterine bleeding of about ten days duration. The patient underwent a total abdominal hysterectomy. A gross examination of the cervix revealed multiple mucin-filled cysts that extended almost to the serosa. On microscopic examination, the cysts were lined by columnar to flattened endocervical type cells, which are usually found in nabothian cysts. No atypical features or mitotic activity were noted. A deep nabothian cyst is a rare benign lesion of the cervix that should be distinguished from a cystically dilated adenoma malignum.
Adenocarcinoma ; Adenoma ; Adult ; Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Serous Membrane ; Uterine Hemorrhage

PURPOSE: The purpose of this study were to identify the influential factors of bullying of intensive care nurses and to suggest a final structural model based on identified relationships between nursing organizational culture, authentic leadership, self-esteem, and bullying in the workplace. METHODS: Data were collected from 221 nurses at intensive care units in eight general hospitals using structured questionnaires and analyzed by structural equation modeling. RESULTS: In this study, the average of bullying in the workplace was 1.34±0.40, nursing organizational culture was 3.31±0.47, self-esteem was 2.79±0.44, and authentic leadership was 3.61±0.60. The factors affecting nursing organizational culture were authentic leadership (β=.54, p<.001) and self-esteem (β=.24, p=.002) that had direct positive effects on the nursing organizational culture. The nursing organizational culture had also a direct effect on reducing workplace bullying (β=−.45, p<.001). Authentic leadership (β=−.24, p=.004) and self-esteem (β=−.11, p=.004) had indirect effects on workplace bullying, which was mediated by the nursing organizational culture. CONCLUSION To understand and reduce workplace bullying, evaluating a nursing organizational culture should be preceded. Based on the finding of this study, an intervention for increasing authentic leadership and self-esteem of nurses can positively help to create the nursing organizational culture and then reduce workplace bullying.

Psoriasis is one of the most common inflammatory skin disorders, with a global prevalence of 2% – 3%. It is an autoimmune skin disorder characterized by excessive generation of plaques on the skin with typical long-lasting red, itchy, and scaly lesions. In this study, we aimed to elucidate the anti-psoriatic effect of the methanolic extract of Persicaria senticosa (PS), a bioactive edible plant extract used in traditional medicine, using a mouse model of imiquimod (IMQ)-induced psoriasis. The daily topical application of IMQ could induce human psoriasis-like lesion. The extract ameliorated IMQ-induced psoriasis. Furthermore, hematoxylin and eosin staining and the Psoriasis Area and Severity Index (PASI) scores indicated that topical application of PS led to an improvement in erythema, scaling, and thickness scores of the mouse dorsal skin and a considerable decrease in the epidermal thickness of the ear and dorsal skin in the IMQ-induced psoriatic mouse model. We also studied the effect of PS on the proliferation of keratinocytes using HaCaT cells. The extract inhibited cell proliferation and IL-6 and pSTAT3 expression induced by M5 cocktail (comprising interleukin [IL]-1α, IL-17A, IL-22, oncostatin M, and tumor necrosis factor-α) in HaCaT cells. Thus, PS might serve as a potential therapeutic agent for the treatment of psoriasis.

Invasive micropapillary carcinoma (IMPCa) is a rare variant of invasive ductal carcinoma of the breast. This variant is associated with a set of peculiar cytological findings and aggressive biological behaviors. In most reported cases, IMPCa has involved massive axillary lymph node metastases at the time of diagnosis. We experienced four cases of cytological features of IMPCa, all of which were verified by histological examination. Fine needle aspiration cytology (FNAC) revealed malignant epithelial cells, which formed small, oval to angulated papillary clusters, which lacked central fibrovascular cores. The histological findings of the four cases revealed both pure and mixed forms of IMPCa, composed of cohesive malignant epithelial cells, surrounded by distinctive clear spaces and separated by thin fibrous septa. All patients evidenced axillary lymph node metastases at the time of diagnosis. It is important to identify the peculiar cytological findings which would differentiate IMPCa from other diseases.
Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Epithelial Cells ; Humans ; Lymph Nodes ; Neoplasm Metastasis