PURPOSE: The purpose of this study was to define the relationships between job stress, professional self-concept, and job satisfaction among nurses in rehabilitation units and to identify factors that influence job satisfaction. METHODS: This study surveyed 240 nurses working at the rehabilitation units of 10 hospitals located in G City. To collect the data, nurses' job stress, the professional self-concept of nurses instrument (PSCNI), and the Korean-Minnesota Satisfaction Questionnaire (K-MSQ) were used. The data were analyzed through t-tests, ANOVA, Pearson's correlation coefficient, and multiple regression using the SPSS/WIN 18.0 program. RESULTS: The scores for job stress, professional self-concept, and job satisfaction were 3.34+/-0.61, 72.36+/-8.64 and 3.17+/-0.39, respectively. Job satisfaction and job stress showed a low-level negative correlation with statistical significance (r=-.13, p=.042), whereas a medium-level positive correlation was found between job satisfaction and professional self-concept (r=.46, p<.001). Job stress, professional self-concept, total career length and size of working hospital explained approximately 25.8% of job satisfaction (F=17.52, p<.001). CONCLUSION: Considering the results in this study, it is necessary to develop a practical educational program to establish positive professional self-concept for nurses in rehabilitation units. Such efforts must be supported by clinical nursing administrations through policies aimed at reducing job stress and increasing job satisfaction.
Job Satisfaction* ; Nursing ; Surveys and Questionnaires ; Rehabilitation*

PURPOSE: This study aimed to examine the effects of simulation-based education on nursing knowledge, anxiety, and clinical performance ability in nursing students before their first clinical practice. METHODS: Third-year university students who had not yet entered their first clinical practice were recruited to participate in the study. Nineteen students formed the experimental group and participated in simulation-based education for 7 sessions. The 19 students in the control group were provided with clinical practice orientation in the form of traditional lectures. Outcome measures assessed nursing knowledge, clinical practice anxiety, and clinical performance ability. Data were collected before and immediately after the simulation-based education and after six weeks of clinical practice. RESULTS: Nursing knowledge and clinical anxiety were not statistically significant between the groups. However, there was a significant improvement in the clinical performance abilities of the experimental group. Among the subcategories, the ability to apply the nursing process and the ability to educate and cooperate were shown to maintain significant differences from the control group by the end of the six weeks of clinical practice. CONCLUSION: The simulation prior to nursing students’ first clinical practice could be useful to improve clinical performance ability. Nursing educators should consider building programs to reduce anxiety and improve performance ability through simulations.
Anxiety ; Clinical Competence ; Education ; Humans ; Lectures ; Nursing Process ; Nursing ; Outcome Assessment (Health Care) ; Students, Nursing

Purpose: This study aimed to examine the mediating effect of learning immersion in clinical simulations on the relationship between nursing student learning motivation and achievement in clinical simulation. Methods: This study was conducted using a cross-sectional survey with 184 nursing students from two universities who participated in clinical simulation between September and December 2022. The participants completed a self-administered questionnaire, and the collected data were analyzed using independent an independent t-test, Mann–Whitney U-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis to identify the mediating effects of learning immersion on the relationship between nursing student learning motivation and achievement. Results: Among the subvariables of nursing student learning motivation, task value and self-efficacy for learning and performance had a significant effect on learning immersion (respectively, β=.36, p=.001; β =.31, p<.001) and learning achievement (respectively, β=.48, p<.001; β=.38, p<.001). With the input of learning motivation variables, the direct effect of learning immersion on learning achievement was significant (β=.20, p=.003), and the effects of learning motivation and task value and self-efficacy on learning achievement was reduced after controlling for learning immersion, which is a mediating variable (respectively, β=.41, p<.001; β=.32, p<.001). The bootstrapping test to confirm the mediating effect of learning immersion was also significant (task value 95% confidence interval [95% CI], 0.02~0.20; self-efficacy 95% CI, 0.01~0.12). Conclusion The results of this study suggest that simulation educators should consider learners’ motivation and immersion when organizing and operating clinical simulations.

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Cystic hepatocellular carcinoma is unusal, and visualization of the cystic components within hepatic mass lesion have suggested that the lesions were metastatic tumors, primary cystic tumors such as biliary cystadenocarcinoma or cystic papillary cholangiocarcinoma. Although hepatic lesions can be well characterized by noninvasive imaging modalities, findings are often nonspecific. Even for cystic hepatic lesions a considerable diagnostic differential exists. The diagnosis of cystic hepatocellular carcinoma was difficult before the microscopic examination of the biopsy speciemen because of very rare. Then we report an unusual of cystic hepatocellular carcinoma without liver cirrhosis.
Biopsy ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Cystadenocarcinoma ; Diagnosis ; Liver Cirrhosis

Intraductal papillary mucinous neoplasm (IPMN) is a recently recognized clinicopathologic entity characterized by dilatation of pancreatic duct filled with copious mucin and papillary ductal epithelial proliferation ranging from simple hyperplasia to invasive carcinoma. The exact clinicopathologic identification of this tumor is important because of favorable prognosis contrast to that of conventional ductal adenocarcinoma. Herein we report a case of surgically resected typical IPMN. A 59-year-old man had a long history of diabetes mellitus with epigastric pain of 4 months duration. Ultrasonography and computed tomographic examination revealed cystic dilatations of main pancreatic duct in the head. The patient underwent total pancreatectomy. The gross appearance showed diffuse dilatation of main pancreatic duct associated with cystic dilatation of subbranches in the uncinate process. Histologic examination revealed diffuse papillary proliferations lined by mucinous epithelium with mild atypism within ectatic ducts. No invasive carcinoma was noted. Histochemically, the papillary epithelium contained mostly neutral and acid sialomucin.
Male ; Humans

Primary retroperitoneal mucinous tumor is very rare. In the worldwide literature, only 14 cases have been reported. Herein, we report two cases of retroperitoneal mucinous tumor found at laparotomy. The patients were females, aged 24 and 21 years, respectively. They had bilateral normal ovaries. Histologically, one was mucinous cystadenoma and the other showed borderline histology. The connective tissue wall resembling ovarian stroma was noted in one case. The pathogenesis was discussed.
Female ; Humans

Atrial flutter is and infrequent, but potentially unstable tachyarrythmia that occurs in pediatric ages. Transesophageal atrial pacing was used for treatment of 10 episodes of atrial flutter in 7 patients. At the time of atrial flutter conversion, patients were 6 days to 14 years old. 6 patients had associated with congenital heart disease. The atrial cycle length of atrial flutter ranged from 140 to 280 msec with variable atrioventricular conduction. Transesophageal atrial pacing was performed using a bipolar 4 F transesophageal electrode catheter. Atrial flutter conversion was accomplished with stimulation bursts using about 5 seconds of stimuli, 10 msec in duration at 20 to 27 mA. Pacing cycle length was 45 to 110 msec less than the atrial cycle length of tachycardia in 6 episodes. But in a neonate, underdrive pacing converted atrial flutter to sinus rhythm. Conversion attempts were unsuccessful on 2 occasions. Transesophageal atrial pacing is a safe and effective, minimally invasive technique for treatment of atrial flutter in infants and children.
Adolescent ; Atrial Flutter* ; Catheters ; Child* ; Electrodes ; Heart Defects, Congenital ; Humans ; Infant* ; Infant, Newborn ; Tachycardia

PURPOSE: This study was performed to describe the ultrastructure of stromal nerve fibers in central, mid-peripheral, and peripheral parts of the human cornea by flat serial corneal section. METHODS: Seven samples from fresh normal cornea, derived from eyes with retinoblastoma and eyes from eye bank, were processed for transmission electron microscopic examinations. Flat serial sections reaching from mid-epithelium to the anterior stroma were observed. RESULTS: The myelinated and unmyelinated nerve fibers are alternately arranged and run parallel to the stromal collagen fibers at the periphery of the cornea. The main difference between the limbal and the central cornea is the presence of myelinated nerve fibers in the anterior peripheral stroma. The diameter of the unmyelinated nerve fiber measures between 0.25 and 0.63 micrometer in size. The corneal nerve fibers contain vesicles, mitochondria, and glycogen particles. The peripheral nerve fibers contain both clear and dense vesicles. The nerve fiber is separated by an interval of 0.3 micrometer from the cytoplasmic wall of keratocyte at the center of the cornea. CONCLUSIONS: The majority of the corneal nerve fibers can be classified as C-fibers due to their size. The presence of both clear and dense vesicles within the cytoplasm of the periphery of the cornea suggest that a small portion in the peripheral corneal nerve may be originated from the sympathetic nervous system. A close vicinity between the nerve fibers and keratocyte supports that nerve fibers might modulate the release of growth factors in the regulation of stromal and epithelial metabolism.
Collagen ; Cornea ; Cytoplasm ; Eye Banks ; Glycogen ; Humans ; Intercellular Signaling Peptides and Proteins ; Metabolism ; Mitochondria ; Myelin Sheath ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Peripheral Nerves ; Retinoblastoma ; Sympathetic Nervous System