Carcinosarcoma of the esophagus is a rare neoplasm composed of both carcinoma and spindle sarcomatous area. Usually the carcinoma component is a squamous cell carcinoma but rarely adenocarcinoma or undifferentiated carcinoma is found. The histogenesis of the sarcomatous component is still unknown. A case of ulcerated polypoid lesion with a stalk in esophagus was reported. Microscopically it was composed of spindle shaped cells interminled with squamous cell carcinoma and small cell carcinoma nests. No distinct transition between spindle shaped cells and carcinoma are was observed. Immunoreactivity to cytokeratin was observed in both carcinomatous and spindle cell component, but electron microscopic examination failed to demonstrated desmosome or tonofilaments in spindle cells. Undifferentiated small cell nests were reactive to neuron specific enolase and contained membrane bounded secretory granule in electron microscopy.
Adenocarcinoma

PURPOSE: This study was performed to investigate the effects of job embeddedness and nursing professionalism on intent to stay in hospital nurses. METHODS: The study was a cross-sectional survey. Participants were 242 nurses working at four general hospitals in P city of Gyeongbuk Province, Korea. Data were collected from August 29 to September 10, 2016. Structured questionnaires were used and analyzed with the SPSS/PC program. RESULTS: The scores were, for job embeddedness, 3.19 (out of 5.0), nursing professionalism, 3.50 (out of 5.0), and intent to stay, 5.30 (out of 8.0). The three variables were all different according to participants' general characteristics. Factors influencing intent to stay were organization fitness (one of 4 sub-factors of job embeddedness), social recognition (one of 5 sub-factors of nursing professionalism) and age (one of participants' general characteristics). These three variables explained 34% of intent to stay. CONCLUSION: To increase competent career nurses' intent to stay, nursing and hospital managers must develop and implement programs that help improve nurses' organization fitness to adjust well in their organization and healthcare institutions and nursing organizations must continue efforts to raise social recognition of nurses and to improve nurses' working conditions.
Cross-Sectional Studies ; Delivery of Health Care ; Gyeongsangbuk-do ; Hospitals, General ; Korea ; Nursing ; Professionalism

OBJECTIVES: To evaluate the anatomic variations of the paranasal sinuses on computed tomographs. MATERIALS AND METHODS: The author examined the CT images of the paranasal sinuses retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. RESULTS: The highest incidence of anatomic variation of the paranasal sinuses in bilateral structures was agger nasi cell(73.2%), followed by concha bullosa(31.1%), Onodi cell(24.0%), Haller cell(19.8%), maxillary sinus septum(13.0%), paradoxical middle turbinate(2.5%), pneumatized uncinate process(2.0%), and bent uncinate process. The highest incidence of anatomic variation in midline structures was nasal septum deviation(53.2%), followed by nasal septumaerated(29.4%), bulla galli(24.7%) asymmetric intersphenoid septum(22.3%), and nasal septum spur(13.8%). The correlation between anatomic variation and paranasal sinusitis was not found. CONCLUSIONS: The results of this study will aid in the diagnosis and treatment of paranasal sinus diseases, especially in the treatment planning before functional endoscopic surgery.
Anatomic Variation* ; Diagnosis ; Humans ; Incidence ; Jeollabuk-do ; Maxillary Sinus ; Nasal Septum ; Paranasal Sinus Diseases ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis

OBJECTIVES: The purpose of this study was to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). MATERIALS AND METHODS: The author examined the extent and the recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. RESULTS: The most frequently affected sinus was maxillary sinus(82.9%), followed by anterior ethmoid sinus(67.9%), posterior ethmoid sinus(48.9%), frontal sinus(42.0%) and sphenoid sinus(41.4%). The characteristic features of CT images of the sinusitis were sinus opacification(22.4%), mucoperiosteal thickening(34.3%), and polyposis(2.0%). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babbel's classification. They were 1) infundibular(13.0%), 2) ostiomeatal unit(67.4%), 3)sphenoethmoidal recess(13.0%), 4) sinonasal polyposis(9.6%) and 5) unclassifiable patterns(18.0%). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus, both posterior sinuses were 11.4%, 66.8%, 6.3%, respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5%, 79.2%, 45.1% respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows ; normal 70.6% and overriding type 29.4%. The incidences of sphenoid sinus pneumatization were as follows ; normal 56.9% , rudimentary 12.5%, pterygoid recess 22.7%, anterior clinoid recess 2.7%, and both pterygoid and anterior clinoid recess 5.2%. CONCLUSIONS: The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns and the proximity of the important structures to the posterior paranasal sinuses. This result will aid in the interpretation of CT of PNS functionally and systemically.
Anatomic Landmarks ; Carotid Artery, Internal ; Classification ; Ethmoid Sinus ; Humans ; Incidence ; Jeollabuk-do ; Maxillary Nerve ; Optic Nerve ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis* ; Sphenoid Sinus

The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.

The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
Cell Differentiation ; Desmin ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Intestine, Small ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Necrosis ; Neurilemmoma ; Stomach

Background: The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up. Methods: Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61–85 years), and the average follow-up period was 2.2 years (range, 2.0–5.1 years). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications. Results: Significant increases were observed postoperatively in forward flexion (112.0°–162.5°, P<0.01) and internal rotation (from L3 to T12 level, P<0.05). No changes were observed in external rotation (from 43.0° to 45.2°, P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%). Conclusions Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up.Level of evidence: IV.

Background: The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up. Methods: Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61–85 years), and the average follow-up period was 2.2 years (range, 2.0–5.1 years). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications. Results: Significant increases were observed postoperatively in forward flexion (112.0°–162.5°, P<0.01) and internal rotation (from L3 to T12 level, P<0.05). No changes were observed in external rotation (from 43.0° to 45.2°, P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%). Conclusions Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up.Level of evidence: IV.

Background: The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up. Methods: Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61–85 years), and the average follow-up period was 2.2 years (range, 2.0–5.1 years). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications. Results: Significant increases were observed postoperatively in forward flexion (112.0°–162.5°, P<0.01) and internal rotation (from L3 to T12 level, P<0.05). No changes were observed in external rotation (from 43.0° to 45.2°, P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%). Conclusions Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up.Level of evidence: IV.

Background: The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up. Methods: Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61–85 years), and the average follow-up period was 2.2 years (range, 2.0–5.1 years). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications. Results: Significant increases were observed postoperatively in forward flexion (112.0°–162.5°, P<0.01) and internal rotation (from L3 to T12 level, P<0.05). No changes were observed in external rotation (from 43.0° to 45.2°, P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%). Conclusions Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up.Level of evidence: IV.