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

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*

No abstract available.
Lymphangioma* ; Orbit*

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

Purpose: This qualitative study explored nurses' experiences in selecting hospitals within a dual labor market framework. Methods: Focus group interviews were conducted with 18 general nurses, divided into three groups of six, each representing both large and medium-sized hospitals. Results: The analysis revealed two themes, four categories, and nine subcategories, highlighting differences between large and medium-sized hospitals. Nurses who choose large hospitals prioritized "professional development" but faced "struggles to maintain professional identity" while those selecting medium-sized hospitals sought "stability and accessibility" but experienced "crisis of professional identity." Conclusion This study highlights significant differences in the factors influencing nurses' hospital choices based on hospital size. These findings provide foundational data for establishing the Enforcement Decree and Rules of the Nursing Act, emphasizing the importance of developing legal measures to strengthen nurses' professional identity and promote a balanced and sustainable nursing labor market.

Purpose: This qualitative study explored nurses' experiences in selecting hospitals within a dual labor market framework. Methods: Focus group interviews were conducted with 18 general nurses, divided into three groups of six, each representing both large and medium-sized hospitals. Results: The analysis revealed two themes, four categories, and nine subcategories, highlighting differences between large and medium-sized hospitals. Nurses who choose large hospitals prioritized "professional development" but faced "struggles to maintain professional identity" while those selecting medium-sized hospitals sought "stability and accessibility" but experienced "crisis of professional identity." Conclusion This study highlights significant differences in the factors influencing nurses' hospital choices based on hospital size. These findings provide foundational data for establishing the Enforcement Decree and Rules of the Nursing Act, emphasizing the importance of developing legal measures to strengthen nurses' professional identity and promote a balanced and sustainable nursing labor market.

Purpose: This qualitative study explored nurses' experiences in selecting hospitals within a dual labor market framework. Methods: Focus group interviews were conducted with 18 general nurses, divided into three groups of six, each representing both large and medium-sized hospitals. Results: The analysis revealed two themes, four categories, and nine subcategories, highlighting differences between large and medium-sized hospitals. Nurses who choose large hospitals prioritized "professional development" but faced "struggles to maintain professional identity" while those selecting medium-sized hospitals sought "stability and accessibility" but experienced "crisis of professional identity." Conclusion This study highlights significant differences in the factors influencing nurses' hospital choices based on hospital size. These findings provide foundational data for establishing the Enforcement Decree and Rules of the Nursing Act, emphasizing the importance of developing legal measures to strengthen nurses' professional identity and promote a balanced and sustainable nursing labor market.

Purpose: This qualitative study explored nurses' experiences in selecting hospitals within a dual labor market framework. Methods: Focus group interviews were conducted with 18 general nurses, divided into three groups of six, each representing both large and medium-sized hospitals. Results: The analysis revealed two themes, four categories, and nine subcategories, highlighting differences between large and medium-sized hospitals. Nurses who choose large hospitals prioritized "professional development" but faced "struggles to maintain professional identity" while those selecting medium-sized hospitals sought "stability and accessibility" but experienced "crisis of professional identity." Conclusion This study highlights significant differences in the factors influencing nurses' hospital choices based on hospital size. These findings provide foundational data for establishing the Enforcement Decree and Rules of the Nursing Act, emphasizing the importance of developing legal measures to strengthen nurses' professional identity and promote a balanced and sustainable nursing labor market.

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