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Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.
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PURPOSE: The aim of this study was to explore the nursing needs and satisfaction of pediatric cancer patient families during chemotherapy. METHODS: Data collection was conducted from April to July 2016 using the questionnaire of nursing needs and satisfaction developed by the researchers in 123 families of children who were diagnosed with pediatric cancer and undergoing chemotherapy. The collected data were analyzed by descriptive statistics, t-test, and ANCOVA using the SPSS 22.0 program. RESULTS: Nursing needs and satisfaction were 4.27 ± 0.78 and 4.16 ± 0.57, respectively. Significant differences between nursing need and satisfaction were observed in the educational/informational domain (t=3.94, p=<.001) and community resources nursing domain (t=2.16, p=.032). Also, in terms of general characteristics, the nursing needs were significantly different depending on the elapsed time after diagnosis (t=1.98, p=.049), and the nursing satisfaction was significantly different depending on the type of treatment (F=4.02, p=.009). CONCLUSION: Based on the results of this study, when caring for children who are receiving chemotherapy and their family, it is necessary to develop nursing interventions that meet the individualized nursing needs of those directly and indirectly affected.
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Niño , Humanos , Antineoplásicos , Recolección de Datos , Diagnóstico , Quimioterapia , Evaluación de Necesidades , Enfermería , Enfermería Pediátrica , Satisfacción PersonalRESUMEN
Ischemic monomelic neuropathy (IMN) is recognized as a rare ischemic neuropathy caused by vascular access originating from the brachial artery leading to hemodialysis. IMN is characterized by acute painful muscle weakness shortly after surgery and neuronal axon loss without necrosis of adjacent tissues. In chronic diabetic patients with polyneuropathy, brachial vascular access surgeries include the risk of IMN, necessitating immediate surgical treatment such as banding or ligation. In the above case, we chose to close brachial-cephalic arteriovenous fistula for IMN with no short-term neurologic improvement, however, significant neurological and clinical improvement was observed in long-term follow-up. Here, we present a case of IMN with serial nerve conduction evaluations indicating the improved long-terms outcomes.
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Humanos , Dolor Agudo , Fístula Arteriovenosa , Axones , Arteria Braquial , Estudios de Seguimiento , Isquemia , Ligadura , Debilidad Muscular , Necrosis , Conducción Nerviosa , Neuronas , Polineuropatías , Diálisis RenalRESUMEN
Posthypoxic myoclonus is poorly controlled with current treatments. Based on clinical experience, valproate and benzodiazepines have been used to treat myoclonic seizures. Rarely, some antiepileptic drugs may exacerbate myoclonic seizures. Although lamotrigine is controversial for treatment in myoclonic seizures, we experience a case of posthypoxic myoclonus improved with lamotrigine add-on therapy.
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Anticonvulsivantes , Benzodiazepinas , Mioclonía , Convulsiones , Ácido ValproicoRESUMEN
BACKGROUND AND PURPOSE: Negative findings on diffusion-weighted imaging (DWI) does not exclude the possibility of brainstem infarction, particularly in the acute stage of medullary lesion. Our aim was to investigate the false-negative rate of DWI in patients with acute lateral medullary infarction. METHODS: We applied DWI to 26 patients with a clinical diagnosis of lateral medullary infarction within 72 h of the onset. We assessed relationships between initial DWI findings and time-to-MRI (the time between onset of symptoms and initial DWI), number of clinical symptoms and signs, and final lesion volume. RESULTS: There were 8 cases (31%) of false negatives in the initial DWI results. The occurrence of false-negative DWI findings decreased significantly as the time-to-MRI increased (P=0.014). However, the false-negative rate was not significantly correlated with the number of clinical symptoms and signs or the final lesion volume. CONCLUSIONS: The diagnosis of lateral medullary infarction should not be ruled out on the basis of early negative DWI. To confirm the lesion, follow-up DWI or further MRI should be performed in cases with early negative DWI results
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Humanos , Infartos del Tronco Encefálico , Diagnóstico , Difusión , Estudios de Seguimiento , Infarto , Imagen por Resonancia MagnéticaRESUMEN
Hypereosinophilic syndrome is a rare disease, characterized by hypereosinophilia of the blood and by the presence of varying internal symptoms and neurological signs. We report a 70-year-old woman who was admitted with rapidly progressive cognitive dysfunction, which had begun 10 months earlier. On admission, she had hypereosinophilia with elevated IgE. Following steroid therapy, there was rapid improvement of dementia. Considering the possibility of irreversibility at delayed intervention, the early diagnosis and treatment of dementia due to hypereosinophilic syndrome cannot be overemphasized.
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Anciano , Femenino , Humanos , Demencia , Diagnóstico Precoz , Síndrome Hipereosinofílico , Inmunoglobulina E , Enfermedades RarasRESUMEN
Brain infarction restricted to the unilateral hypothalamus is known to be very rare because of the abundant blood supply from the circle of Willis. We report a case of right hypothalamic infarction. A 63-year-old woman developed hyperphagia, hypersomnolence and hemihyperhidrosis limited to the left half of the face. Brain MRI revealed a high signal intensity at the right anteromedial hypothalamus.
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Femenino , Humanos , Persona de Mediana Edad , Encéfalo , Infarto Encefálico , Círculo Arterial Cerebral , Trastornos de Somnolencia Excesiva , Hiperfagia , Hipotálamo , Infarto , Imagen por Resonancia MagnéticaRESUMEN
OBJECTIVE: To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.
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Humanos , Peso Corporal , Diagnóstico , Electrodiagnóstico , Electromiografía , Ginecología , Histerectomía , Extremidad Inferior , Conducción Nerviosa , Obstetricia , Tempo Operativo , Estudios Retrospectivos , Piel , MusloRESUMEN
Rapid spread of COVID-19 has caused an unprecedented pandemic worldwide, and an inserted furin site in SARS-CoV-2 spike protein (S) may account for increased transmissibility. Plasmin, and other host proteases, may cleave the furin site of SARS-CoV-2 S protein and {gamma} subunits of epithelial sodium channels ({gamma} ENaC), resulting in an increment in virus infectivity and channel activity. As for the importance of ENaC in the regulation of airway surface and alveolar fluid homeostasis, whether SARS-CoV-2 will share and strengthen the cleavage network with ENaC proteins at the single-cell level is urgently worthy of consideration. To address this issue, we analyzed single-cell RNA sequence (scRNA-seq) datasets, and found the PLAU (encoding urokinase plasminogen activator), SCNN1G ({gamma}ENaC), and ACE2 (SARS-CoV-2 receptor) were co-expressed in alveolar epithelial, basal, club, and ciliated epithelial cells. The relative expression level of PLAU, TMPRSS2, and ACE2 were significantly upregulated in severe COVID-19 patients and SARS-CoV-2 infected cell lines using Seurat and DESeq2 R packages. Moreover, the increments in PLAU, FURIN, TMPRSS2, and ACE2 were predominately observed in different epithelial cells and leukocytes. Accordingly, SARS-CoV-2 may share and strengthen the ENaC fibrinolytic proteases network in ACE2 positive airway and alveolar epithelial cells, which may expedite virus infusion into the susceptible cells and bring about ENaC associated edematous respiratory condition.