Salmonella enterica serotype Choleraesuis causes swine paratyphoid, with clinical findings of enterocolitis and septicemia. However, the clinicopathological features of S. Choleraesuis infections in pigs have not been reported in Korea. We describe the pathological findings of two weaned pigs with S. Choleraesuis infections, presenting with diarrhea, cough, and sudden death. Pathological examination indicated severe necrotic colitis in pig 1 and septicemic lesions in pig 2. Multidrug-resistant S. Choleraesuis was isolated from the pigs’ lungs and intestinal contents. Further research is required for the surveillance of S. Choleraesuis infections in pigs and the virulence estimation in the S. Choleraesuis isolates.

BACKGROUND: Previous randomized controlled trials of revascularization for atherosclerotic renal artery stenosis (ARAS) were not successful. We investigated the effects of percutaneous transluminal angioplasty with stent insertion (PTA/S) on kidney function and blood pressure (BP) control in patients with ARAS. METHODS: From 2000 to 2017, 47 subjects who underwent PTA/S for ARAS were identified. A high-risk group was defined, composed of patients having one or more of the following clinical presentations: pulmonary edema, refractory hypertension, and rapid deterioration of kidney function. Subjects who met the criteria of ‘kidney function improvement’ or ‘hypertension improvement’ after PTA/S were classified as responders. RESULTS: Twenty-one (44.7%) subjects were classified into the high-risk group. Two subjects (8.0%) in the low-risk group (n = 25) and 5 subjects (27.8%) in the high-risk group (n = 18) showed improvement in kidney function after PTA/S (P = 0.110). In patients with rapid decline of kidney function, estimated glomerular filtration rate improved from 28 (interquartile range [IQR], 10–45) mL/min/1.73 m² to 41 (IQR, 16–67) mL/min/1.73 m² at 4 months after PTA/S, although the difference was not significant (P = 0.084). Regarding BP control, 9 (36.0%) and 14 (77.8%) subjects showed improvement after PTA/S in the low- (n = 25) and high-risk (n = 18) groups, respectively (P = 0.007). In patients with refractory hypertension, the systolic BP dropped from 157 (IQR, 150–164) mmHg to 140 (IQR, 131–148) mmHg at 4 months after PTA/S (P = 0.005). Twenty-five subjects were defined as responders and comprised a significant proportion of the high-risk group (P = 0.004). CONCLUSION: PTA/S might improve BP control and kidney function in patients with ARAS presenting with high-risk clinical features. The optimal application of PTA/S should be based on individual assessment of the clinical significance of renal artery stenosis.
Angioplasty ; Blood Pressure ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney ; Pulmonary Edema ; Renal Artery Obstruction ; Renal Artery ; Stents

No abstract available.
Humans ; Multiple Myeloma ; Plasma Cells ; Plasma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

PURPOSE: To identify differences in ultrasonography (US) feature, clinical and pathological characteristics including immunohistochemical characteristics between small breast cancer (pathologic size ≤ 5 mm) and large breast cancer (> 5 mm). MATERIALS AND METHODS: A total of 528 invasive breast cancer lesions in 475 patients were included. US features with clinical and pathological characteristics were evaluated according to pathologic size. US Breast Imaging-Reporting and Data System findings and final assessments were recorded for each lesion. Standard references were based on surgical pathologies. RESULTS: Of 528 invasive breast cancer lesions, 62 were small breast cancers. Small breast cancers showed a higher rate of oval, round shape, parallel orientation; circumscribed margin; and iso/solid and cystic echo pattern, with no posterior feature. The final assessment of category 4 was also a dominant factor in small breast cancer. Early stage, asymptomatic state, and extensive ductal carcinoma in situ component were associated with small breast cancers. CONCLUSION Our results show that small breast cancers have less suspicious US features than large breast cancers.

No abstract available.
Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukemia, Myeloid, Acute*

BACKGROUND: The objective of this study was to investigate the frequency and characteristics of HLA-DR⁻/CD34⁻ acute myeloid leukemia (AML) also known as acute promyelocytic leukemia (APL)-like AML. METHODS: This study included 683 newly diagnosed patients with AML. After exclusion of 211 patients with recurrent genetic abnormalities, one with acute panmyelosis with myelofibrosis, two with myeloid leukemia associated with Down syndrome, and two devoid of metaphase cells, we classified the remaining 467 patients as follows: group 1, HLA-DR⁺/CD34⁺ (typical AML); group 2, HLA-DR⁺/CD34⁻ or HLA-DR⁻/CD34⁺; group 3, APL-like AML. RESULTS: Group 1 comprised 294 patients, group 2 comprised 133, and group 3 comprised 40. Therefore, the frequency of APL-like AML among 683 unselected patients with AML was 5.9%. Group 3 patients had significantly higher leukocyte counts and bone marrow (BM) blast percentages, higher frequencies of normal karyotypes and NPM1 mutation, higher fractions of CD33-positive cells, higher concentrations of fibrin degradation products and D-dimers, lower frequencies of complex karyotypes, monosomal karyotypes and poor cytogenetic risk, lower fractions of CD13-positive cells, and lower fibrinogen concentrations, compared with group 1 patients. The values of the BM blast percentage, number of CD33-positive cells, and DIC score of the patients with APL-like AML were intermediate between those of the patients with typical AML and APL. CONCLUSIONS: This study demonstrates that APL-like AML is not uncommon, and it has characteristics distinguishable from those of typical AML. APL-like AML may have some pathophysiological relationships with APL, which need further investigation.
Bone Marrow ; Cytogenetics ; Dacarbazine ; Down Syndrome ; Fibrin Fibrinogen Degradation Products ; Fibrinogen ; HLA-DR Antigens* ; Humans ; Karyotype ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute* ; Leukemia, Promyelocytic, Acute* ; Leukocyte Count ; Metaphase ; Primary Myelofibrosis

OBJECTIVE: This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. METHODS: Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. RESULTS: The average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. CONCLUSION: This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.
Clozapine ; Electroconvulsive Therapy* ; Humans ; Psychopathology ; Retrospective Studies ; Schizophrenia*

PURPOSE: This study was done to investigate new graduate nurses' perceptions of nursing professionalism, job involvement and turnover intention and to identify factors influencing turnover intention in new graduate nurses. METHODS: Participants were 179 new graduate nurses working in general hospitals and small and medium-sized hospitals in Gyungnam province. Data were collected from August 10 to September 16, 2015 through a survey with self-report questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Mean scores were; for nursing professionalism, 3.62±0.73, for job commitment, 3.22±0.89. and for turnover intention, 3.25±0.95. There were significant correlations between nursing professionalism and job involvement (r=.47, p<.001), nursing professionalism and turnover intention (r=-.36, p<.001), job involvement and turnover intention (r=-.46, p<.001). For turnover intention of new graduates 25.1% of the variance was explained by nursing professionalism (β=-.16, p=.034), job involvement (β=-.36, p<.001), and frequency of night shifts (β=.03, p=.022). CONCLUSION: Findings indicate that nursing professionalism and job involvement of new graduate nurses had significant influence on their turnover intention. Therefore, to reduce turnover intention of new graduate nurses, it is necessary to enhance their nursing professionalism and job involvement with organizational supports.
Gyeongsangnam-do ; Hospitals, General ; Intention* ; Nursing* ; Professionalism*

Feline leukemia virus (FeLV) causes a range of neoplastic and degenerative diseases in cats. To obtain a more sensitive and convenient diagnosis of the disease, we prepared monoclonal antibodies specific for the FeLV p27 to develop a rapid diagnostic test with enhanced sensitivity and specificity. Among these antibodies, we identified two clones (hybridomas 8F8B5 and 8G7D1) that specifically bound to FeLV and were very suitable for a diagnostic kit. The affinity constants for 8F8B5 and 8G7D1 were 0.35 x 10(9) and 0.86 x 10(9), respectively. To investigate the diagnostic abilities of the rapid kit using these antibodies, we performed several clinical studies. Assessment of analytical sensitivity revealed that the detection threshold of the rapid diagnostic test was 2 ng/mL for recombinant p27 and 12.5 x 10(4) IU/mL for FeLV. When evaluating 252 cat sera samples, the kit was found to have a kappa value of 0.88 compared to polymerase chain reaction (PCR), indicating a significant correlation between data from the rapid diagnostic test and PCR. Sensitivity and specificity of the kit were 95.2% (20/21) and 98.5% (257/261), respectively. Our results demonstrated that the rapid diagnostic test would be a suitable diagnostic tool for the rapid detection of FeLV infection in cats.
Animals ; Antibodies, Monoclonal/blood ; Cats ; Diagnostic Tests, Routine/*veterinary ; Female ; Gene Products, gag/*blood ; Leukemia Virus, Feline/immunology/*isolation & purification ; Leukemia, Feline/*diagnosis ; Mice, Inbred BALB C ; Sensitivity and Specificity

PURPOSE: In this study, we report on our initial experience using the da Vinci-S® robotic surgical system in performance of laparoscopic adrenalectomy. METHODS: Fifteen patients, 11 with left adrenal tumors and four with right adrenal tumors, underwent robotic adrenalectomies using the lateral transperitoneal approach with the da Vinci-S® surgical system at the Korea University Anam Hospital, Seoul, Korea, between October 2009 and May 2012. RESULTS: The mean age of the patients was 45.5 (22~61) years, and the mean body mass index was 23.81 (18.0~28.57) kg/m². Eleven left adrenalectomies, four for primary aldosteronisms, four for pheochromocytomas, two for primary adrenal Cushing's adenoma, and one for myelolipoma, and four right adrenalectomies, two for the primary adrenal Cushing's adenomas, one for pheochromocytoma, and one for primary aldosteronism, were performed robotically. There was no conversion to traditional laparoscopic or open surgery. The mean size of the tumor was 2.54 (1.0~5.5) cm. The mean operative time was 208.2 (120~320) minutes, and the mean console time was 127.6 (75~212) minutes. No major postoperative morbidity was observed, and the mean length of hospital stay was 5.86 days. CONCLUSION: We found that the robotic systems, with magnified stereoscopic three-dimensional vision, elimination of tremor, and the ability to articulate and rotate the instruments, were ideal surgical tools for operation of adrenal lesion. Robotic adrenalectomy may be a safe and effective alternative to traditional laparoscopic adrenalectomy.
Adenoma ; Adrenalectomy* ; Body Mass Index ; Humans ; Hyperaldosteronism ; Korea ; Length of Stay ; Myelolipoma ; Operative Time ; Pheochromocytoma ; Seoul ; Tremor