[A Case of Resection of a Mucinous Cystic Neoplasm of the Liver].

A 55 -year-old woman presented at our hospital in 2017. In 2014, a large cyst had been detected in her liver by ultrasonography, and she was followed up at a clinic. Abdominal computed tomography(CT)revealed a large multilocular cystic tumor measuring 12 cm in diameter in the left lobe of the liver. Although no solid component was identified in the tumor, the cystic tumor was increasing in size, and the serum level of CA19-9 was elevated. Under a preoperative diagnosis of mucinous cystic neoplasm(MCN)of the liver, we performed extended left liver lobectomy. There were no postoperative complications. Histopathological examination of the resected specimen revealed low-grade intraepithelial neoplasia, and the epithelium covered an ovarian-type stroma. The ovarian-type stromal cells were immunoreactive for estrogen receptor and progesterone receptor. The definitive diagnosis of the tumor was MCN of the liver with low-grade intraepithelial neoplasia. Eight months after the surgery, the patient remains alive without any recurrence.

[Personal resilience and post-traumatic stress symptoms of local government employees: six months after the 2011 magnitude 9.0 East Japan Earthquake].

OBJECTIVES: The Great East Japan Earthquake caused severe infrastructure damage in the Kanto and Tohoku regions, but the psychological stress of public sector employees in the Kanto region where tsunami damage was small has received little attention. This study examined the association between personal resilience and post-traumatic stress symptoms of local government employees in the Kanto region. METHODS: In this cross-sectional study, all employees (N=2,069) of a single municipality in the Kanto region were recruited in September 2011, six months after the earthquake, and 991 completed the questionnaire (response rate, 47.9%). After excluding respondents who had missing values, the data from 825 respondents (607 males and 218 females) were analyzed. Post-traumatic stress symptoms were measured using the Impact Event Scale-Revised. Resilience was measured using the Connor-Davidson Resilience Scale and divided into three groups on the basis of scores; low, moderate, and high. House damage and respondents or their families' experience of injury that were caused by the earthquake were assessed using single-item questions. Participants who reported house damage or injury were defined as being affected. Using multiple logistic regression analysis, the odds ratio of post-traumatic stress symptoms (IES-R score ≥25) was calculated for the upper, middle, and low resilience score groups. RESULTS: Among the respondents, 4.6% experienced injuries within their families, 82.3% reported house damage, and thus 83.3% were affected by the Great East Japan Earthquake. Post-traumatic stress symptoms were significantly higher among the affected group and those with chronic diseases. After adjusting for the demographic and occupational characteristics, the likelihood of post-traumatic stress symptoms was greater in the low resilience group (Odds ratio: 2.10 [95% confidence interval = 1.31-3.37]). A significant negative relationship was observed between resilience and post-traumatic stress symptoms particularly in the affected group. CONCLUSIONS: Low personal resilience predicted post-traumatic stress symptoms among local government employees who experienced some house damage or injury during the Great East Japan Earthquake. This result may indicate that resilience reduces the onset of post-traumatic stress symptoms, even when faced by the difficulties imposed by a natural disaster such as an earthquake.