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

No Abstract Available.
HIV-1* ; Transcription Factors*

Purpose: The purpose of this study is to identify the educational needs of a severe trauma treatment simulation program based on mixed reality which combines element of both virtual reality and augmented reality. Methods: Focus group interviews were conducted with ten military hospital nurses on February 4 and 5, 2021. The collected data were analyzed using a qualitative content analysis. As a framework for data analysis, the educational needs were clustered into the following four categories: teaching contents, teaching methods, teaching evaluation, and teaching environment. Results: The educational needs for each category that emerged were as follows: three subcategories including “realistic education reflecting actual clinical practice” and “motivating education” for teaching contents; five subcategories including “team-based education,” “repeated education that acts as embodied learning,” and “stepwise education” for teaching methods; six subcategories including “debriefing through video conferences,” “team evaluation and evaluator in charge of the team,” “combination of knowledge and practice evaluation” for teaching evaluation; six subcategories including “securing safety,” “similar settings to real clinical environments,” “securing of convenience and accessibility for learners,” and “operating as continuing education” for teaching environment. Conclusion The findings of this study can provide a guide for the development and operation of a severe trauma treatment simulation program based on mixed reality. Moreover, it suggests that research to identify the educational needs of various learners should be conducted.

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

PURPOSE: We evaluated the risk factors and related results of residual diplopia and enophthalmos in patients who had orbital wall fracture repair. METHODS: 50 patients with orbital wall fracture who were followed up for at least 6 months postoperatively were included in this study. We analyzed effects of the patient age, timing of surgery, size and location of fracture on development of postoperative diplopia and enophthalmos. RESULTS: 32 patients had diplopia and 16 patients had enophthalmos greater than 2 mm. Among 32 patients with preoperative diplopia, 9 patients experienced postoperative diplopia. Among 16 patients with preoperative enophthalmos, 5 patients experienced postoperative enophthalmos. Delayed timing of surgery was a significant factor for development of postoperative diplopia and enophthalmos. Age of the patients and fracture size were not significant factors for development of postoperative diplopia and enophthalmos. CONCLUSIONS: Early surgical repair of orbital wall fractures decreases the incidence of residual diplopia and enophthalmos. Preoperative assessment of multiple variables could help to achieve cosmetical and functional better results.
Diplopia* ; Enophthalmos* ; Humans ; Incidence ; Orbit* ; Risk Factors

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

PURPOSE: To assess the role of MRI in the diagnosis of uterine anomaly. MATERIAL AND METHODS: MRI(n:15), hysterosalpingography(n:7) and ultrasonography(n:7) were performed in 15 patients with suspected MullerJan duct anomaly. Nine cases were proved by operation and six cases were diagnoed with imaging and clinical findings. According to Buttram and Gibbons modified classification, the anomalies were 4 cases of class I, 2 cases of class III, one case of class IV, and 8 cases of class V. RESULTS: MRI enabled accurate diagnoses of anomalies in all cases, but HSG and USG showed wrong diagnoses in 3 of 7 cases and in 1 of 7 cases. CONCLUSION: MRI, especially T2-weighted images parallel to long axis of uterine corpus, was very useful in diagnosis of the Mullerian duct anomaly, because it could depict exactly the external fundal contour, intercornual distance, septum, transverse vaginal septum, and associated abnormalities such as hematocolpos and hematometra.
Axis, Cervical Vertebra ; Classification ; Diagnosis ; Female ; Hematocolpos ; Hematometra ; Humans ; Hylobates ; Magnetic Resonance Imaging*

No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: To evaluate MR characteristics of periosteal reactions and subperiosteal abscesses in osteomyelitis as compared with radiographs. MATERIALS AND METHODS: We retrospectively reviewed 28 patients(18 males, 10 females) with osteomyelitis. Nineteen patients underwent MR imaging with 0.5 T. We analyzed for morphologic patterns, intervals of appearance and disappearance of periosteal reactions after symptom onset. Twenty-three patients were confirmed by surgery and 5 patients by the radiologic findings, clinical and laboratory data. RESULTS: Periosteal reaction appeared as low signal intensity arc on the T1- and T2-weighted axial images. In 3-7 days after symptom onset, periosteal reactions and subperiosteal abscesses were noted on MR imaging, and only two of eleven patients were noted in radiographs. Periosteal reactions of 8-14 days after symptom onset were demonstrated in all of 13 patient on MR, and 9 on plain radiographs. All patients with 2 weeks after symptom onset showed perioste.al reaction in plain film and MR. The periosteal reactions persisted until approximately 2 to 3 months after treatment on follow up radiographs. CONCLUSION: Periosteal reactions in osteomyelitis are detected on the MR imaging earlier than plain film. MR is valuable in detecting subperiosteal abscess which is not appecent in simple radiographs. Periosteal reactions can be seen on MR in 3 days after symptom onset and persist for 2-3 months after treatment.
Abscess ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Male ; Osteomyelitis* ; Retrospective Studies

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.
Carcinoma, Basal Cell* ; Eccrine Porocarcinoma* ; Humans ; Male ; Middle Aged