Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor consisting of distinctive perivascular epithelioid cells, and is commonly detected in the uterus. The liver is an uncommon site for primary PEComa. In this study, we report a case of primary hepatic PEComa in a 36-year-old woman. Upon gross examination, the tumor was a well-defined, brownish solid mass, measuring 6.5x5.2x4.5 cm. Microscopically, the tumor consisted largely of epithelioid cells and some spindle cells with a clear to eosinophilic cytoplasm and a rich network of delicate capillaries in the stroma. With the exception of their relatively large size and microscopically sinusoidal infiltrative growth pattern, all other histopathologic features of the tumor were consistent with their being benign. The tumor cells were positive for human melanoma black-45 and smooth muscle actin, and negative for cytokeratin-cocktail and c-kit.
Actins ; Adult ; Capillaries ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Female ; Humans ; Liver ; Melanoma ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms ; Uterus

Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor consisting of distinctive perivascular epithelioid cells, and is commonly detected in the uterus. The liver is an uncommon site for primary PEComa. In this study, we report a case of primary hepatic PEComa in a 36-year-old woman. Upon gross examination, the tumor was a well-defined, brownish solid mass, measuring 6.5x5.2x4.5 cm. Microscopically, the tumor consisted largely of epithelioid cells and some spindle cells with a clear to eosinophilic cytoplasm and a rich network of delicate capillaries in the stroma. With the exception of their relatively large size and microscopically sinusoidal infiltrative growth pattern, all other histopathologic features of the tumor were consistent with their being benign. The tumor cells were positive for human melanoma black-45 and smooth muscle actin, and negative for cytokeratin-cocktail and c-kit.
Actins ; Adult ; Capillaries ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Female ; Humans ; Liver ; Melanoma ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms ; Uterus

No abstract available.
Lymphangioma* ; Orbit*

PURPOSE: The purpose of this study was to review the resilience of elderly patients of gastric cancer, their self-efficacy, family support, spiritual well-being and depression. METHODS: The subjects were 100 patients who were 65 years old or older who had been admitted to the surgical department at K University Hospital in B City. Data were collected from August 10 to September 2, 2016. RESULTS: Resilience of patients showed significant correlations with the degree of self-efficacy r=.51 (p<.001), the degree of family support r=.47 (p<.001), the degree of spiritual well-being r=.59 (p<.001), the degree of depression r=.34 (p<.001). The factor that affected resilience most was spiritual well-being (β=.35), followed by self-efficacy (β=.21), monthly average income (β=.20), family support (β=.18), and experienced symptoms (β=.15). The overall explanatory power was 47.4%. CONCLUSION: The degree of resilience in elderly patients of gastric cancer was higher when self-efficacy, family support and spiritual well-being were higher. To improve the resilience of elderly patients of gastric cancer, the development and application of a nursing intervention program that take these variables into account is needed.
Aged* ; Depression ; Humans ; Nursing ; Spirituality ; Stomach Neoplasms*

Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes 5-HT2A and alpha1 adrenergic receptors. Compared with SSRIs nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. 1) Nefazodone, as a 5-HT2A antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. The case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.
Constipation ; Diarrhea ; Dizziness ; Drug Interactions ; Hallucinations ; Humans ; Mouth ; Norepinephrine ; Psychotropic Drugs ; Receptors, Adrenergic ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

In this study the effect of insulin and aminoguanidine on the expression of iNOS and the development of insulitis in the multiple low dose streptozotocin (SZ) induced diabetic (LDSD) mice was evaluated. Eighty mice (Charles-River CD-1 mice) were divided into four groups. Group I received SZ for five days. Group II received SZ for five days and was followed by insulin treatment. Group III received SZ for five days and was followed by aminoguanidine treatment. Group IV was normal control group. The blood glucose level and body weight were measured weekly. On the 35th day, pancreat ic sections were observed to evaluate the frequency and the severity of insulitis in addition to the immunohistochemical expression of iNOS in the pancreatic islets. Blood glucose levels of group IV were significantly lower than other experimental groups on the 21st, 28th, and 35th day. The difference in blood glucose levels was not statistically significant. Incidence of the insulitis was lower in group II than in groups I and III. The severity of insulitis correlated with the increase in blood glucose level only in group II. The expression of iNOS was more pronounced in group I than in groups II and III. Aminoguanidine did not inhibit development of the insulitis but decreased expression of iNOS in the pancreatic islets. Therefore it is speculated that iNOS production is one of the factors and other pathogenetic mechanisms might be involved in the development of insulitis.
Animals ; Blood Glucose ; Body Weight ; Incidence ; Insulin* ; Islets of Langerhans ; Mice* ; Nitric Oxide Synthase Type II* ; Streptozocin

An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

No abstract available.
Carcinoma, Basal Cell ; Nose

The study aimed to compare the whitening efficacy of a strip and gel containing 2.9% hydrogen peroxide, using a tooth whitening light activator. The whitening effect was compared through in vitro and in vivo studies. In the in vitro study, we used stained hydroxyapatite (HAP) specimens as artificial teeth. HAP specimens were made using HAP powder and polyvinyl alcohol solution, and stained by modified Stookey's method. A whitening gel and whitening strip were applied to the respective specimens for 20 minutes, with a light activator. The color changes were measured using a colorimeter. In the in vivo study, one group (test 1) used the gel with a light activator and the other group (test 2) used a strip with the same activator for 15 minutes a day, for four consecutive days. An organoleptic evaluation using a Vita shade guide and instrumental evaluation using a Shade eye-NCC (Shofu Co., Japan) were performed. The color change values (ΔE*) in the in vitro study revealed the strip with the light activator to be more effective than the gel with the same activator (p<0.001). In the in vivo study, even though there was no significant difference between the groups with respect to the ΔE*, using either the Shade eye-NCC or the Vita shade guide, the change in yellowness (Δb*) was statistically significant (p=0.024). In conclusion, test 2 group that used 2.9% hydrogen peroxide strip with a light activator, showed a tendency towards increased whitening than test 1 group that used the gel with the same activator; however further studies are needed to validate the above finding.
Durapatite ; Hydrogen Peroxide ; In Vitro Techniques ; Methods ; Polyvinyl Alcohol ; Sensation ; Tooth Bleaching* ; Tooth* ; Tooth, Artificial

BACKGROUND: There is an increasing need for the development of in vitro models capable of substituting for animals in cutaneous irritancy studies. Until now, various culture models have been developed, including skin organ cultures, conventional and air-exposed cell cultures. The air-exposed culture forms a multilayered epidermis showing an overall structure which resembles that of a native epidermis. The presence of a coherent stratum corneum layer in these cultures permits the application of potential irritants at the concentrations and formulations which are applied in vivo. Recently, a new human skin recombinant, made of human keratinocytes cultured on de-epidermized dermis with fibroblast-populated collagen matrix, has been developed and appears to represent a better skin equivalent model than previous models. OBJECTIVE: In the present study, monolayer-cultured human keratinocytes and the new human skin recombinants were evaluated for the test models of various skin irritants. METHODS: The extent of skin irritancy induced after application of 3 different irritants (sodium lauryl sulfate, methyl paraben, and polyethylene glycol-400) was evaluated on the basis of (1) MTT assay, (2) neutral red uptake assay, (3) LDH release, and (4) release of IL-1 alpha. In the human skin recombinants, morphological perturbations and changes in the expression of differentiation-specific protein markers (keratin 1, involucrin, filaggrin, and loricrin) were also evaluated. To determine the difference between in vivo and in vitro models for the detection of irritancy, a patch test was performed on 11 normal human volunteers with various concentrations of the different irritants RESULTS: The results of the present study show that irritant cytotoxicity correlates well with irritant concentration in both monolayer-cultured human keratinocytes and the new human skin recombinant. The new human skin recombinant is superior to monolayer culture as an in vitro model for skin irritancy screening in that the concentrations of test irritants are the same as in vivo. With the human skin recombinant, morphological changes were observed according to the irritant concentration. CONCLUSION: The new human skin recombinant can be used as an alternative to animals for skin irritancy screening.
Animals ; Cell Culture Techniques ; Collagen ; Dermis ; Epidermis ; Healthy Volunteers ; Humans* ; Interleukin-1alpha ; Irritants ; Keratinocytes ; Mass Screening ; Neutral Red ; Organ Culture Techniques ; Patch Tests ; Polyethylene ; Skin*