Simultaneous development of adenocarcinoma and gastrointestinal stromal tumor (GIST) in the stomach: case report

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal stromal tumors (GISTs) and adenocarcinoma are distinct neoplasms originating from different cell layers. Approximately 20% of patients with GIST develop other cancers.</p> <p>Case presentation</p> <p>We report a case of the coexistence of adenocarcinoma and gastrointestinal stromal tumor (GIST). Gastric endoscopy showed the ulcerated tumor with bleeding along the lesser curvature of the proximal stomach and a submucosal nodule that measured about 3 cm in diameter in the lower part of the stomach body. Their pathological examination showed gastric cancer (poorly differentiated diffuse adenocarcinoma) and GIST (low-risk category). Further, immunohistochemical staining for C-kit and CD34 was positive, while that for SMA and S-100 was negative.</p> <p>Conclusion</p> <p>Although it is not easy to speculate on the coexistence of adenocarcinoma and GIST, pre-and post-operative diagnoses may be essential, and such cancer development is not considered to be unusual.</p

Impact of genetic alterations on central nervous system progression of primary vitreoretinal lymphoma

Primary vitreoretinal lymphoma (PVRL) is a rare malignant lymphoma subtype with an unfavorable prognosis due to frequent central nervous system (CNS) progression. Thus, identifying factors associated with CNS progression is essential for improving the prognosis of PVRL patients. Accordingly, we conducted a comprehensive genetic analysis using archived vitreous humor samples of 36 PVRL patients diagnosed and treated at our institution and retrospectively examined the relationship between genetic alterations and CNS progression. Whole-exome sequencing (n = 2) and amplicon sequencing using a custom panel of 107 lymphomagenesis-related genes (n = 34) were performed to assess mutations and copy number alterations. The median number of pathogenic genetic alterations per case was 12 (range: 0– 22). Pathogenic genetic alterations of CDKN2A, MYD88, CDKN2B, PRDM1, PIM1, ETV6, CD79B, and IGLL5, as well as aberrant somatic hypermutations, were frequently detected. The frequency of ETV6 loss and PRDM1 alteration (mutation and loss) was 23% and 49%, respectively. Multivariate analysis revealed ETV6 loss (hazard ratio [HR]: 3.26, 95% confidence interval [CI]: 1.08–9.85) and PRDM1 alteration (HR: 2.52, 95% CI: 1.03–6.16) as candidate risk factors associated with CNS progression of PVRL. Moreover, these two genetic factors defined slow-, intermediate-, and rapid-progression groups (0, 1, and 2 factors, respectively), and the median period to CNS progression differed significantly among them (52 vs. 33 vs. 20 months, respectively). Our findings suggest that genetic factors predict the CNS progression of PVRL effectively, and the genetics-based CNS progression model might lead to stratification of treatment

精神看護における看護技術研究の傾向と今後の課題

本研究の目的は精神科で実践される看護技術についての国内の先行研究を分析し、そこから見えてくる傾向と今後の課題を明らかにすることである。精神科の看護技術に関する14の先行研究を分析した結果、精神科における看護技術の定義や概念は記されておらず、研究者ごとの解釈で看護技術を検討していた。今後の課題としては概念構築のために、1人の患者が入院から退院して、安定した地域生活の定着後のある時期までの期間を縦断的に追跡していく研究が必要である。もしくは、疾患の種類や病期、患者の属性等を統一した研究成果を蓄積し、その成果を体系化していくことが実現可能な研究デザインである。今後、精神障害者の社会復帰や自立、エンパワメントを目指す看護技術が特に重要になってくることが考えられる。よって、これまでの研究には含まれていなかった就労支援や余暇活動の充実の視点も含めていくことが必要である

重度認知症高齢者に対する熟練看護師の実践行動

　熟練看護師の重度認知症高齢者に対する実践知から導き出された実践行動を４つのスキルから明らかにするため、半構成的面接を行いカテゴリー化を実施した。その結果、ヒューマンスキルでは、高齢者の想いを傾聴し重度認知症高齢者が他者と良い人間関係を維持できるよう努めていた。テクニカルスキルでは、多くを行動・心理症状への実践行動が占め、熟練看護師はこれまでのキャリアの発達段階で獲得したスキルを活かし、行動・心理症状や安全管理を大切にする実践行動へ繋げていた。メタ認知スキルでは、熟練看護師自身の実践行動について振り返り、次の実践行動へ繋げていた。コンセプチュアルスキルでは、重度認知症高齢者や家族の困難な状況に対して、問題解決やビジョン立案のスキルを発揮し実践行動へ繋げていた。これら重度認知症高齢者への実践行動は、熟練看護師自身の実践行動を振り返る省察の繰り返しによる継続性によってもたらされたものと考える

「待遇コミュニケーション」における「勧め」表現に関する一考察

departmental bulletin pape

「待遇理解」の諸相 -「表現行為」における「適切さ」との関連について-

departmental bulletin pape

Reduction in the short-circuit current density of silicon heterojunction photovoltaic modules subjected to potential-induced degradation tests

This letter deals with the potential-induced degradation (PID) of silicon heterojunction(SHJ) photovoltaic (PV) modules. After rapid indoor PID tests applying a voltage of −1000 V at 85 ◦C, the modules exhibited a significant reduction in short-circuit current density (J_). On the other hand, the dark current density–voltage characteristics of the modules were intact after the PID tests, indicating that the reduction in J_ is attributed not to carrier recombination but to optical loss. A degraded module slightly recovered its performance loss upon applying a positive bias but complete recovery was not observed, showing that the PID of SHJ PV modules is not reversible. A module with an ionomer encapsulant showed high PID resistance, revealing that the degradation of SHJ PV modules can be prevented by the use of ionomer encapsulants

Influence of backsheet materials on potential-induced degradation in n-type crystalline-silicon photovoltaic cell modules

We investigated the influence of backsheet materials on potential-induced degradation (PID) in n-type crystalline-silicon (c-Si) photovoltaic (PV) cell modules. Silicon heterojunction PV cell modules and rear-emitter n-type c-Si PV cell modules were fabricated by using aluminum backsheets composed of poly ethylene terephthalate (PET)/aluminum/PET as well as typical backsheets. PID tests of the modules were performed by applying a negative bias in a dry environment (<2% relative humidity). Regardless of the types of cells, the modules with the aluminum backsheets showed smaller degradation. This indicates that aluminum backsheets reduce PID effects, and to alter backsheets may be a potential measure to reduce PID

Influence of emitter position of silicon heterojunction photovoltaic solar cell modules on their potential-induced degradation behaviors

Potential-induced degradation (PID)-test results of modules fabricated from the rear- and front-emitter silicon heterojunction (SHJ) solar cells were compared to clarify the influence of the emitter position of SHJ photovoltaic (PV) cell modules on their PID behaviors. The PID tests were performed by applying a bias of −2000 V to the shorted interconnector ribbons from the front surface of the cover glass, at 85 °C. In the initial stage, both modules showed the same degradation characterized by a reduction in the short-circuit current density (J_). After the firststage degradation, the rear-emitter SHJ PV modules exhibited subsequent degradation characterized by a significant reduction in the J_ and open-circuit voltage (V_), due to the enhancement of the minority-carrier recombination in the front surface region of the n-type crystalline silicon base. The front-emitter SHJ PV modules, on the other hand, showed a reduction in the fill factor (FF), in addition to moderate reductions in J_ and V_. The FF reduction of the front-emitter SHJ PV modules is considered to be caused by the enhancement of the recombination in the front surface region of the n-type crystalline-silicon base as the region corresponds to the pn junction interface of the front-emitter configuration. The moderate reductions in both J_ and V_ may be due to further progression of the first-stage degradation. These findings are essential for understanding the mechanism of PID in SHJ PV cell modules