Myxofibrosarcomas (MFSs), which consist of multiple nodules with a variable cellular population in a myxoid matrix, are primarily located in subcutaneous tissue. Pleomorphic hyalinizing angiectatic tumors (PHATs) are rare soft-tissue tumors characterized by a proliferation of highly pleomorphic spindle or polygonal cells and abundant ectatic blood vessels in cellular or myxoid stroma. We present here an unusual case of a high-grade MFS with a PHAT-like appearance. A 67-year-old man presented with an asymptomatic subcutaneous mass in the right forearm. The tumor had myxoid, hypo-, and hypercellular areas with highly pleomorphic spindle or polygonal tumor cells that showed frequent mitoses and nuclear pseudoinclusions. Foci of punctuate necrosis and inflammatory infiltration were present throughout the tumor, and abundant ectatic, thick-walled vessels containing blood clots were noted. The tumor cells were immunohistochemically positive for vimentin but negative for CD34, S-100 protein, smooth muscle actin, desmin, and bcl-2.
Actins ; Aged ; Blood Vessels ; Desmin ; Forearm ; Humans ; Hyalin ; Mitosis ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Sarcoma ; Subcutaneous Tissue ; Vimentin

PURPOSE: The purpose of this study was to investigate the relation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. METHODS: Data were collected from 543 students by means of self reported questionnaires about satisfaction in major, career decision-making self-efficacy and career identity from November 26 to 30, 2012. RESULTS: The average score of satisfaction in major, career decision-making self-efficacy and career identity of nursing students was 3.56 on a 5 point-scale, 3.28 on a 5 point-scale, and 2.65 on a 4 point-scale respectively. There were significant correlation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. Career identity could be explained 26.2% by satisfaction in major, career decision-making self-efficacy, admission motivation, and school grade. CONCLUSION: Career identity was correlated with satisfaction in major and career decision-making self-efficacy in nursing students. Therefore, it is necessary to develop an effective intervention program to improve nursing students's satisfaction in major, career decision-making self-efficacy and career identity.
Humans ; Motivation ; Nursing ; Surveys and Questionnaires ; Self Report ; Students, Nursing*

BACKGROUND: This study aimed to examine (1) the patterns of online health information search with respect to seeking and scanning, and (2) how online search, along with eHealth literacy, predicts perceived information usefulness in the context of diet and weight control. METHODS: Online survey was conducted with 299 adults from the consumer panel recruited for the purpose of quality assessment of the Korean National Health Information Portal in 2016. We conducted paired sample t-test and multiple logistic regression to address the research questions. Data analysis was performed using IBM SPSS Statistics ver. 24.0 (IBM Corp., Armonk, NY, USA) and SAS ver. 9.3 (SAS Institute Inc., Cary, NC, USA). RESULTS: Of the respondents, 38.8% were ‘high seek-high scanners,’ 35.8% were ‘low seek-low scanners,’ 13.0% were ‘high seek-low scanners,’ and 12.4% were ‘low seek-high scanners.’ eHealth literacy was a significant, positive predictor of online information scanning (odds ratio [OR], 2.46; 95% confidence interval [CI], 1.41–4.29), but not for online information seeking (OR, 1.75; 95% CI, 1.00–3.05). With respect to perceived usefulness of online information seeking, online seeking (OR, 4.90; 95% CI, 2.19–11.00) and eHealth literacy (OR, 2.30; 95% CI, 1.11–4.75) were significant predictors. Perceived usefulness of online scanning had a significant association with online scanning (OR, 2.38; 95% CI, 1.08–5.22), but not with eHealth literacy. CONCLUSION: To increase the effectiveness of the health policy for online information search and related outcomes in the context of diet and weight control, it is important to develop education programs promoting eHealth literacy.
Adult ; Diet ; Education ; Health Policy ; Humans ; Information Seeking Behavior ; Literacy ; Logistic Models ; Statistics as Topic ; Surveys and Questionnaires ; Telemedicine ; Weight Loss

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
Blood Pressure* ; Blood Urea Nitrogen ; Creatinine ; Dialysis ; Dialysis Solutions ; Fasting ; Hemodynamics* ; Humans ; Hypotension ; Incidence* ; Osmolar Concentration ; Potassium ; Renal Dialysis* ; Sensation ; Sodium ; Thirst* ; Ultrafiltration* ; Weight Gain*

BACKGROUD: The purpose of our study was to evaluate the usefulness of the ictal semiology, interictal and ictal electro-encephalography(EEG), brain magnetic resonance imaging(MRI), interictal and ictal single photon emission computed tomography(SPECT), positron emission tomography(PET) and neuropsychometry for localization or lateralization of the ictal onset zone, and analyze the result of surgical treatment. METHODS: We evaluated 13 children with intractable temporal lobe epilepsy, who are diagnosed at children's hospital of Seoul National University, from January 1995 to August 1996. The ictal onset zone was determined by ictal semiology, electrophysiologic study, structural and functional neuroimaging, and neuropsychometry. RESULTS: 1) Ictal semiology : Sixty-nine% of the studied children had change of consciousness, 62% had automatism, 31% had aura, 23% had contralateral versive movement, and 23% had contralateral dystonic posturing. Secondarily generalized seizure occured in 38% of them. 2) Interictal EEG showed localized or lateralized value in 8 cases(62%). In interictal EEG, 12 cases(92%) showed epileptiform discharges on the ipsilateral temporal lobe. 3) Magnetic resonance imaging revealed ipsilateral temporal lobe lesion in 8 cases(62%). Interictal SPECT was performed in 6 cases, only one of them had decreased cerebral blood flow on the ipsilateral temporal lobe. Ictal SECT was done in all, 8 cases(67%) had localized or lateralized value. PET was performed in 11 cases, 8 cases(73%) of them had localized or lateralized value. 4) Neuropsychometry was performed in 7 cases, 6 cases(86%) of them had localized or lateralized value. 5) Nine patients underwent epileptic surgery, 6 of them had class I outcome and each one of the rest had class II, class III and class IV. CONCLUSIONS: Electroencephalography, neuropsychometry, MRI, ictal SPECT, and PET are valuable for localization and lateralization of the ictal onset zone, but interictal SPECT is valuless. The outcome after surgery is relatively good, but more extensive study including patient's social, cognitive and emotional status will be necessary.
Automatism ; Brain ; Child* ; Consciousness ; Electroencephalography ; Electrons ; Epilepsy ; Epilepsy, Temporal Lobe* ; Functional Neuroimaging ; Humans ; Magnetic Resonance Imaging ; Seizures ; Seoul ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Gestational Trophoblastic Disease*

BACKGROUND: Quyyumi et al described circadian variation of ischemic eletrocardio-graphic changes and heart rate in patients with and without significant coronary disease in 1985. Rocco et al also described circadian variation of transient myocaldial ischemia in patients with coronary artery disease. They also noted an increse in ischemic eletrocardiographic abnormalities in the morning hours.In recent years the important of circadian variation of cardiovascular phenomena has generated a great deal of interest. Such phonomena include the occurrence of ischemia in patients with both chronic stable angina and variant angina, myocaldial infarction, sudden cardiac death, ventricular arrhythmia and platelet aggregability. METHOD: To examine whether a significant circadain variation of transient myocardial ischemia exists and to better understand the character of such variation, 35 patients with againa pectoris(15 patients treated with nitrate and/or caclcum channel blocker and 20 patients without treatment) underwent 24 hours ambulatory monitoring of ischemic ST segment changes during daily life. RESULT: Only 21% of the episodes of ST depression were accompanied by chest pain. While 79% were asymptomatic. A significant circadian increase in ischemic activity was found with 44% of episodes and 40% of total ischemic time in not treated group, and 52% of episodes and 56% of total ischemic time in treated group, occuring between 6 A.M. to 12 P.M.(P<0.05 respectively) When the distribution of ischemic episodes was corrected for the variable time of waking, the peak ischemic activity was occuring in the 1st and 2nd hours after rising. There were no significant differences in heart rate at onset and heart rate at 1 min before onset. CONCLUSION: Is summary, transient myocardial ischemia in the absence of pain was more common and there were a significant circadian variation of transient myocardial ischemia with peak activity in the morning. In addition most of transient myocardial were not preceded by a rise in heart rate.
Angina, Stable ; Arrhythmias, Cardiac ; Blood Platelets ; Chest Pain ; Coronary Artery Disease ; Coronary Disease ; Death, Sudden, Cardiac ; Depression ; Heart Rate ; Humans ; Infarction ; Ischemia ; Monitoring, Ambulatory ; Myocardial Ischemia*

BACKGROUND: The purpose of this study is to investigate the effects of volume and concentration in a constant dose of subarachnoid bupivacaine on the extent and duration of sensory and motor blocks. METHODS: Forty parturients scheduled for cesarean section were randomly assigned to two groups for spinal anesthesia. In group 1, 3.5 ml of hyperbaric 0.25% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected into the subarachnoid space; in group 2, 1.75 ml of hyperbaric 0.5% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected. Dural punctures were performed at the L3-L4 or L2-L3 interspaces with a 25 gauge needle in the sitting position after which the patients were turned to the supine horizontal position. The level and extent of the sensory and motor block were measured at 3, 5, 10, and 15 minutes. The onset, duration and regression of sensory and motor blocks were studied. RESULTS: There were no significant differences between two groups in the level and extent of sensory and motor blocks. From onset time to maximal sensory block took 12.1 +/- 3.0 min in group 1, and 13.3 +/- 3.7 min in group 2, and from onset time to complete motor block took 10.2 +/- 2.7 min in group 1 and 11.4 +/-2.6 min in group 2. There was no significant difference in the time taken to complete the regression of seosory block, and the complete resolution of the motor block. CONCLUSIONS: A constant 8.75 mg dose of subarachnoid hyperbaric bupivacaine produced, in all groups, a similar, statistically insisnificant, level and extent of sensory and motor block, in spite of different volumes and concentrations.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Needles ; Pregnancy ; Punctures ; Subarachnoid Space

BACKGROUND: The purpose of this study is to investigate the effects of volume and concentration in a constant dose of subarachnoid bupivacaine on the extent and duration of sensory and motor blocks. METHODS: Forty parturients scheduled for cesarean section were randomly assigned to two groups for spinal anesthesia. In group 1, 3.5 ml of hyperbaric 0.25% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected into the subarachnoid space; in group 2, 1.75 ml of hyperbaric 0.5% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected. Dural punctures were performed at the L3-L4 or L2-L3 interspaces with a 25 gauge needle in the sitting position after which the patients were turned to the supine horizontal position. The level and extent of the sensory and motor block were measured at 3, 5, 10, and 15 minutes. The onset, duration and regression of sensory and motor blocks were studied. RESULTS: There were no significant differences between two groups in the level and extent of sensory and motor blocks. From onset time to maximal sensory block took 12.1 +/- 3.0 min in group 1, and 13.3 +/- 3.7 min in group 2, and from onset time to complete motor block took 10.2 +/- 2.7 min in group 1 and 11.4 +/-2.6 min in group 2. There was no significant difference in the time taken to complete the regression of seosory block, and the complete resolution of the motor block. CONCLUSIONS: A constant 8.75 mg dose of subarachnoid hyperbaric bupivacaine produced, in all groups, a similar, statistically insisnificant, level and extent of sensory and motor block, in spite of different volumes and concentrations.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Needles ; Pregnancy ; Punctures ; Subarachnoid Space

No abstract available.
Membranes* ; Pregnancy* ; Rupture*