This study was conducted to confirm the provision standards and appropriateness of functional recovery training services performed on residents in long-term care facilities. Methods: Twenty-eight service providers working in four long-term care facilities applied the functional recovery training services to 63 older residents for 15 days, integrating them with their existing daily tasks. The contents recorded by the service providers on checklists were analyzed, and the experiences of applying functional recovery training services by the service providers were examined through focus group interviews. Results: Training for activities of daily living, excluding bathing, five items such as dressing and undressing are performed 2 to 4 times per day. The duration for one session is approximately 16 minutes for meals, around 10 minutes for bathing, and about 5 to 7 minutes for the remaining activities. Movement and walking training, covering five items like standing, occurs 2 to 3 times per day, with session durations ranging from 3 to 10 minutes. Physical activity training is conducted 1 to 2 times per day, with each session lasting about 5 to 7 minutes. Cognitive activity training is performed 1 to 2 times per day, with each session lasting approximately 4 to 7 minutes. Conclusion: For functional recovery training to be established in long-term care facilities, it is crucial to share an accurate understanding of the concept of training. Prior to the provision of training services, appropriate personnel such as nurses need to comprehensively assess the individuals and plan the training accordingly.

Purpose: Notable effectiveness of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer (BC) has focused pathologists’ attention. We studied the incidence and clinicopathologic characteristics of HER2-low BC, and the effects of immunohistochemistry (IHC) associated factors on HER2 IHC results. Materials and Methods: The Breast Pathology Study Group of the Korean Society of Pathologists conducted a nationwide study using real-world data on HER2 status generated between January 2022 and December 2022. Information on HER2 IHC protocols at each participating institution was also collected. Results: Total 11,416 patients from 25 institutions included in this study. Of these patients, 40.7% (range, 6.0% to 76.3%) were classified as HER2-zero, 41.7% (range, 10.5% to 69.1%) as HER2-low, and 17.5% (range, 6.7% to 34.0%) as HER2-positive. HER2-low tumors were associated with positive estrogen receptor and progesterone receptor statuses (p < 0.001 and p < 0.001, respectively). Antigen retrieval times (≥ 36 minutes vs. < 36 minutes) and antibody incubation times (≥ 12 minutes vs. < 12 minutes) affected on the frequency of HER2 IHC 1+ BC at institutions using the PATHWAY HER2 (4B5) IHC assay and BenchMark XT or Ultra staining instruments. Furthermore, discordant results between core needle biopsy and subsequent resection specimen HER2 statuses were observed in 24.1% (787/3,259) of the patients. Conclusion The overall incidence of HER2-low BC in South Korea concurs with those reported in previously published studies. Significant inter-institutional differences in HER2 IHC protocols were observed, and it may have impact on HER2-low status. Thus, we recommend standardizing HER2 IHC conditions to ensure precise patient selection for targeted therapy.

The greatest advantage of endoscopic submucosal dissection (ESD) in the stomach is that it can be used to perform en bloc resection of a large gastric neoplasm. However, ESD is more technically difficult and more commonly associated with prolonged procedure time and complications than conventional endoscopic mucosal resection. Until now, only a few reports have considered aspiration pneumonia after ESD, which is rare, but can be fatal. We experienced two cases of aspiration pneumonia after ESD with a gastric neoplasm. One was treated by intensive care with mechanical ventilation, and the other by antibiotics only. Prevention is thought to be important for aspiration pneumonia after ESD; therefore, patients at high risk for aspiration pneumonia are urged to take precautions. We considered various factors contributing to aspiration under endoscopy, such as local pharyngeal anesthesia, procedural time, and bleeding.
Anesthesia ; Anti-Bacterial Agents ; Endoscopy ; Hemorrhage ; Humans ; Imidazoles ; Critical Care ; Nitro Compounds ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach ; Stomach Neoplasms

PURPOSE: Intravascular papillary endothelial hyperplasia(IPEH), also known as Masson's pseudoangiosarcoma, is a rare disease which is now considered as a reactive process of the endothelium rather than a benign neoplasm. It can occur in any blood vessels in the body but more common in the head and neck region as a solitary, often tender, bluish or reddish nodule. IPEH is characterized by the development of endothelial-lined papillary projections in a vascular lumen, usually associated with thrombotic material, the endothelial cells in the papillary structures showing only slight atypia and occasional mitotic Figures, the absence of tissue necrosis. METHODS: 8 patients with IPEH were enrolled in the study from 2002 to 2007. All 8 lesions were surgically excised for histopathologic diagnosis. RESULTS: 4 patients were female. The duration of the lesions ranged from 3 months to 15 years. The tumors were first noted between the ages of 20 and 72 years. 4 patients had lesions on the head; 2 on the toe; 1 on the back; and 1 on the finger, respectively. All lesions were solitary, ranged in size from 2mm to 27 mm. There were no recurrences. CONCLUSION: The clinical appearance of IPEH is not specific, presented as a primary neoplasm, and the diagnosis can be established by microscopic examination. Complete surgical excision is the best choice of therapy for patients with IPEH, and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.
Blood Vessels ; Endothelial Cells ; Endothelium ; Female ; Fingers ; Head ; Humans ; Hyperplasia ; Neck ; Necrosis ; Rare Diseases ; Recurrence

Sarcomatoid carcinoma is a rare and occurs mainly in the upper aerodigestive tract such as the oral cavity, esophagus and vocal cords. It is a unique variant of squamous cell carcinoma. We report the case of a patient with spindle cell squamous cell carcinoma involving the mandible. At initial examination, overlying mucosa of that lesion was normal appearance. One week later, that lesion showed ulcerative and bloody change and rapid growth in size. This case showed unpredictable rapid growth although rapid growth in size was suspected of undergoing malignancy.
Carcinoma, Squamous Cell ; Esophagus ; Humans ; Mandible ; Mandibular Neoplasms ; Mouth ; Mucous Membrane ; Ulcer ; Vocal Cords

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.
Adolescent ; Apocrine Glands ; Biopsy, Needle ; Breast ; Dermis ; Epithelium ; Female ; Fibroadenoma ; Follow-Up Studies ; Hair ; Humans ; Lactation ; Milk ; Needles ; Nevus, Pigmented ; Nipples ; Puberty ; Sebaceous Glands

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.
Adolescent ; Apocrine Glands ; Biopsy, Needle ; Breast ; Dermis ; Epithelium ; Female ; Fibroadenoma ; Follow-Up Studies ; Hair ; Humans ; Lactation ; Milk ; Needles ; Nevus, Pigmented ; Nipples ; Puberty ; Sebaceous Glands

PURPOSE: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. METHODS: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. RESULTS: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between 15 x 15 and 25 x 25 cm. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. CONCLUSION: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.
Abdominal Muscles ; Breast ; Breast Neoplasms ; Comorbidity ; Follow-Up Studies ; Humans ; Mastectomy ; Neoplasm Staging ; Skin ; Thoracic Wall ; Thorax ; Tissue Donors

Lymphoepithelial cysts of the pancreas, which are lined by squamous epithelium and surrounded by mature lymphoid tissue, represent a rare clinicopathologic entity of cystic lesions of the pancreas and true pancreatic cysts. Here, we report a case of lymphoepithelial cyst of the pancreas and a review of the related Korean literature. A 58-year-old man presented to our hospital with an asymptomatic pancreatic mass and no remarkable medical history except hypertension. Physical examination and laboratory analyses showed no abnormalities. Ultrasonography (US) revealed a cystic lesion with heterogeneous internal echo within the body of the pancreas, and computed tomography (CT) revealed a low-density lesion (2.3*.5 cm) with well-defined margins and lobulating contour. To further characterize the mass, a biopsy was collected via endoscopic ultrasonography (EUS)-guided fine-needle aspiration. Histological examination revealed fibrous tissue and epithelial cells, but was insufficient for a definitive diagnosis. Laparotomy revealed that the mass was composed of keratinizing squamous epithelial cells surrounded by lymphoid tissue, thereby confirming the diagnosis of lymphoepithelial cyst of the pancreas
Biopsy ; Biopsy, Fine-Needle ; Endosonography ; Epithelial Cells ; Epithelium ; Humans ; Hypertension ; Keratins ; Laparotomy ; Lymphoid Tissue ; Middle Aged ; Pancreas ; Pancreatic Cyst ; Physical Examination

PURPOSE: This study was to identify the perceptions of nursing student on the clinical practice environment and related variables. METHODS: The subjects of this study were 180 nursing students from a college participated in clinical practice at four regional hospitals. Data was collected with the questionnaire tool for the perceptions of clinical practice environment. RESULTS: The students highly satisfied in the major had significantly high perception in innovation, personalization, student involvement, and clinical practice satisfaction. The students with a low level of stress and a clearly named guidance nurse were significantly high in the perceptions of task orientation, innovation, personalization, student involvement, and practice satisfaction. Clinical practice environment variables such as task orientation, innovation, individualization, personalization, student involvement, and practice satisfaction were significantly correlated with each other. In student characteristics, the main variables directly influencing the perceptions of clinical practice environment were religion, the level of stress, and the method of guidance. CONCLUSION: Understanding the students' perspective would be valuable for promoting a positive clinical practice environment. Developing a cooperative system between the college and educational hospitals is necessary for effective clinical practice education
Humans ; Learning ; Orientation ; Students, Nursing ; Surveys and Questionnaires