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: Nursing students are susceptible to medication safety incidents in the neonatal intensive care unit (NICU) related to a lack of communication experience. The purpose of the present study was to investigate the impact of a NICU medication safety simulation (NMSS) focusing on communication clarity, patient hand-off confidence, and patient safety competency in senior-year nursing students. Methods: The study utilized a nonequivalent control group pretest-posttest design. In total, 60 nursing students were assigned to two groups. The experimental group participated in the NMSS, which included three medication error scenarios. Pairs of students completed the scenarios together in 10 to 20 minutes. Data were analyzed using the chi-squared test, independent t test, and ANCOVA. Results: The experimental group showed significant improvements in communication clarity (p=.015), and patient safety competency (p<.001) compared to the control group. Using the pretest values as covariates, patient hand-off confidence scores significantly increased (p=.027). Conclusion Implementing the NMSS focusing on communication in the pediatric nursing curriculum helped students to communicate clearly and concisely about medication errors, and its use is recommended to promote patient safety competency in the NICU.

PURPOSE: In order to evaluate the value of the renal expression of ICAM-1 as a marker of renal injury, we analyzed the relationship between abnormal tubular expression of ICAM-1 and histopathological features and clinical manifestations in children with IgA nephropathy (IgAN). METHODS: The clinical data from 43 patients with IgAN were analyzed retrospectively and compared to the histopathologic subclassification proposed by Haas. ICAM-1 in tubular epithelium was assessed using the LSAB(Labeled streptavidine biotin) kit on the renal biopsy specimens. RESULTS: In 43 patients with primary IgAN, 28 males and 15 females aged 12.2+/-2.2 years were studied. There were no differences of renal tubular expression of ICAM-1 between patients with gross hematuria and without gross hematuria. But renal tubular expression of ICAM-1 in patients with proteinuria was significantly higher than that of in patients without proteinuria(78.72+/-14.19% vs. 55.80+/-32.20%, P<0.05). Renal tubular expression of ICAM-1 was also associated with the severity of histopathological degree using Haas classification method. In subclass I, renal tubular expression of ICAM-1 was significantly lower than those of other subclasses. A significant correlation was found between the tubular expression of ICAM-1 and the total amount of protein in 24 hour collected urine(rs=0.47236, P<0.05). But there were no significant correlations between the renal tubular expression of ICAM-1 and interstitial cellular infiltration, tubular atrophy, and interstitial fibrosis respectively(F=0.89, P>0.05; F=0.31, P>0.05; F=0.21, P>0.05). CONCLUSION: Renal tubular expression of ICAM-1 can be a useful marker of renal injury in children with IgAN.
Atrophy ; Biopsy ; Child* ; Classification ; Epithelium ; Female ; Fibrosis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Intercellular Adhesion Molecule-1* ; Male ; Proteinuria ; Retrospective Studies ; Streptavidin

To establish sperm penetrating assay (SPA) with using cryopreserved hamster oocyte, we performed the stepwise SPA with 1) fresh hamster oocyte and hamster sperm, 2) cryopreserved hamster oocyte and hamster sperm, 3) fresh hamster oocyte and human sperm, and 4) cryopreserved hamster oocyte and human sperm, in 4 cases of male hamster and 12 cases of fertile human. In SPA of hamster sperm with fresh hamster oocyte, the oocyte penetration rate (PR) were 100+0%, and the penetration index(mean penetration per oocyte, PI) was 22.4 +/- 1.8. In SPA of hamster sperm with cryopreserved hamster oocyte, the PR were 100 +/- 0%, and the Pl was 14.1 +/- 2.9 (p<0.01). When the oocytes were examined at 1, 2, 3, and 6 hour post insemination, hamster sperm penetration was 1 hour slower in cryopreserved oocytes than in fresh ones. In SPA of human sperm with fresh hamster oocyte, the PR was 79.5 +/- 10%, and the Pl was 2.78 +/- 2.6. In SPA of hamster sperm with cryopreserved hamster oocyte, the PR was 73.9+/- 16%, and the PI was 2.82 +/- 2.7. There`s no significant difference in SPA using human sperm. These results suggest that them may be some functional damages on cryopreserved oocyte, because Pl of fresh oocytes is higher than that of cryopreserved oocytes. However in sperm of human, it dose not make significant difference in Pl between fresh and cryopreserved oocytes. The SPA using cryopreserved hamster oocyte would appear to have wide application of the evaluation of infertility, the assessment of the treatment of infertility and the experiment in infertility field.
Animals ; Cricetinae* ; Humans ; Infertility ; Insemination ; Male ; Oocytes* ; Sperm-Ovum Interactions* ; Spermatozoa*

OBJECTIVE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC) in a large population.MATERIALS AND METHODS: Cases of 152 biopsy-proven PTMCs from 133 patients who had undergone RFA for PTMC between May 2008 and January 2017 were included in this study. All patients were either of high surgical risk or refused to undergo surgery. They were followed up for at least 6 months after initial RFA. Ultrasonography (US) and computed tomography were performed to evaluate the PTMC and the presence of neck metastasis before treatment. RFA was conducted using an internally cooled thyroid-dedicated electrode system. Follow-up US was performed at 1 week, and 2, 6, and 12 months, after the initial RFA, and then at every 6–12 months. We evaluated serial changes of ablated tumors, newly developed cancers, lymph node (LN) or distant metastasis and complications.RESULTS: Complete disappearance was found in 91.4% (139/152) of ablated tumors. Among the 13 tumors in patients who did not show complete disappearance, no tumor displayed any regrowth of the residual ablated lesion during the follow-up period. The mean follow-up period was 39 months. During the follow-up period, there were no local recurrence, no LN or distant metastasis, and no newly developed thyroid cancers. No patients were referred to surgery. The overall complication rate was 3% (4/133) of patients, including one voice change. There were no life-threatening complications or procedure-related deaths.CONCLUSION: Our results suggest that RFA is an effective and safe option for treating low-risk PTMC patients who are of high surgical risk or refuse surgery.
Catheter Ablation ; Electrodes ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography ; Voice

PURPOSE: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. METHODS: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. CONCLUSION: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health-related quality of life in elders.
Aged ; Chronic Disease ; Humans ; Malnutrition ; Occupations ; Quality of Life ; Surveys and Questionnaires ; Research Design ; Spouses ; Statistics as Topic

PURPOSE: We evaluated the diagnostic value of susceptibility-weighted imaging (SWI) for the detection of developmental venous anomaly (DVA). MATERIALS AND METHODS: Retrospective review of 1068 brain MR examinations found 28 DVAs in 28 patients (2.6%) on contrast-enhanced T1-weighted images. SWI, T2, and FLAIR images of 28 patients with DVA and 28 sex- and age-matched control patients without DVA were analyzed by blinded readers on each type of sequences. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. In cases of discrepancy, two reviewers reached a consensus later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each MR sequence for the detection of DVA were determined. Statistical analysis was performed by using the Mcnemar test. The significance level was p < 0.05. RESULTS: The sensitivity, specificity, PPV, and NPV of SWI for the detection of DVA were 85.7%, 92.9%, 92.3%, and 86.7%, respectively. T2 and FLAIR images showed sensitivity of 35.7% and 35.7%, specificity of 92.9% and 96.4%, PPV of 83.3% and 90.9%, and NPV of 59.1% and 60.0%, respectively. On SWI, the sensitivity and NPV for the detection of DVAs were significantly higher than those of T2 and FLAIR images (p < 0.05). CONCLUSION: SWI was sensitive and specific for the detection of DVA.
Brain ; Consensus ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: This study aimed to uncover the fundamental nature of living alone in female elderly. METHODS: The phenomenological research approach developed by van Manen was adopted. RESULTS: The theme was 'taking a firm stand alone on the edges of life'. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children's filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died. CONCLUSION: A nurse should understand the multifarious aspects of elderly women's life, and then intervene to consolidate their strengths for self-supporting the final years of life.
Adaptation, Psychological ; Aged ; Aged, 80 and over ; Attitude to Death ; Family ; Female ; Health Status ; Humans ; Interviews as Topic ; Life Style ; Loneliness ; *Quality of Life ; Widowhood/*psychology

To compare the stem niche in different culture conditions of limbal epithelial cells, the suspended human limbal epithelial cells (HLECs) were seeded on the 3T3-pretreated plates and the other suspended cells were plated on amniotic membranes (AMs) which were either cryo-preserved or freeze-dried. All were cultured for 10 to 12 days. Reverse transcription-polymerase chain reaction (RT-PCR) for ATP-binding casette, subfamily G, member 2 (ABCG2), p63, cytokeratin 12, and connexin 43 were performed in cultivated HLECs and their expression levels were compared. The mRNA expression of all markers examined showed no statistically significant differences between the cells on cryo-preserved and on freeze-dried AM. The expression of p63 and cytokeratin 12 in cultivated cells on AMs were significantly lower than those in 3T3-cocultured cells on RT-PCR and immunofluorescent staining. Cultivated HLECs on AMs showed reduced proliferation and differentiation while maintaining stem-property regardless of the preservative method of AM.
3T3 Cells ; Animals ; Cell Culture Techniques/*instrumentation/*methods ; Cells, Cultured ; Cytological Techniques ; DNA Primers/chemistry ; Epithelial Cells/*metabolism ; Humans ; Immunohistochemistry/methods ; Keratin-12/metabolism ; Mice ; Models, Biological ; Phosphoproteins/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Stem Cells/cytology ; Trans-Activators/metabolism

BACKGROUND: Spitz nevus and malignant melanoma have common features clinically and histologically, and in some cases it is impossible to distinguish between the two. Heat shock proteins (HSPs) serve to protect cells, and are activated by cell injury. Some HSPs are shown to be elevated in many types of cancers. Previous studies have reported the expression of heat shock protein in association with melanoma; however, a similar relationship with Spitz nevi has never been investigated. OBJECTIVE: This study was designed to measure the expression pattern of HSP 105 in both Spitz nevi and melanomas. METHODS: The specimens of 4 of Spitz nevi and 10 of malignant melanomas were analyzed for heat shock protein 105 expression through immunohistochemical staining. RESULTS: Immunohistochemical examination of HSP 105 showed strong expression in malignant melanoma specimens. On the other hand, weak expression was observed in Spitz nevus specimens. The degree of expression of HSP 105 showed a statistically significant difference (p<0.05). CONCLUSION: These findings provide the possibility of using HSP 105 as a effective marker for differentiating between Spitz nevi and malignant melanomas. In support of this, HSP 105 is considered to be a tumor-associated antigen of malignant melanoma.
Hand ; Heat-Shock Proteins ; Melanoma ; Nevus ; Nevus, Epithelioid and Spindle Cell