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

BACKGROUND: Idiopathic left ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation that is sensitive to verapamil is electrophysiologically distinct arrhythmia entity but descriptions in pediatric ages are infrequent. This study attempted to describe the clinical presentation and dignostic clues from the surface ECG in children with idiopathic left venteicular tachycardia. METHODS: We retrospectively reviewed the medical records, electrocardiograms, Holter recordings, echocardiographic reports of 10 children with idiopathic left ventricular tachycardia who have been managed at Sejong General Hospital and Asan Medical Center, Seoul, Korea from January 1991 to July 1996. Follow-up periods are 2 months to 5 years(mean=26 months). RESULTS: 1) Age of tachycardia onset was 8 months to 14 years(median=4.3 years). In 3 children tachycardia began from infancy. The main complaint in older children was palpitation and chest discomfort but young childen complained abdominal pain during tachycardia attack. Tachycardia was paroxysmal and sustained. Tachycardia responded to intravenous use of verapamil in 9 patients and was controlled by chronic verapamil medication in 6 patients. 2 patients were well without medication. Radiofrequency catheter ablation was done in an adolescent patient successfully. 2) In sinus rhythm, surface ECG showed normal QRS axis and normal QRS morphologies in all patients. During ventricular tachycardia, the heart rate was 183 to 270 beats/min. The taxhycardia of RBBB morphology was observed in all patients. The mean QRS duration was 109+-12ms and the QRS axis was -50* to -90*. Themean RS interval was 60+-12ms. AVdissociation was found on surface RCG in all patients and confirmed in 4 patients by transesophageal ECG. We tried rapid transesophageal atrial pacing in 3 patients and could induce and terminate the ventricular tachycardia. CONCLUSIONS: Idiopathic left ventricular tachycaedia is rare in childhood and is seen from infancy. Idiopathic left ventricular tachycardia is generally benign but occasionally causesmyocardial dysfunction. Idiopathic ventricular tachycardia with a QRS pattern of right bundle branch block amd left axis deviation that is sensitive to verapamil in children should not be confused with supraventricular tachycardia with aberrancy and most helpful diagnostic clue is AV dissociation in surface ECG.
Abdominal Pain ; Adolescent ; Arrhythmias, Cardiac ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Child ; Chungcheongnam-do ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Hospitals, General ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular* ; Thorax ; Verapamil

OBJECTIVE: Recently, microdissection of tissue sections has been used increasingly for the isolation of morphologically identified homogeneous cell populations, thus overcoming the obstacle of tissue complexity for the analysis cell-specific expression of macromolecules. The aim of the present study was to establish the minimal conditions required for the RNA extraction and amplification from the cells captured by the laser captured microdissection. METHODS: Mouse ovaries were fixed and cut into serial sections (7 micrometer thickness). Oocytes were captured by laser captured microdissection (LCM) method by using PixCell IITM system. The frozen sections were fixed in 70% ethanol and stained with hematoxylin and eosin, while the paraffin sections were stained with Multiple stain. Sections were dehydrated in graded alcohols followed by xylene and air-dried for 20 min prior to LCM. All reactions were performed in ribonuclease free solutions to prevent RNA degradation. After LCM, total RNA extraction from the captured oocytes was performed using the guanidinium isothiocyanate (GITC) solution, and subsequently evaluated by reverse transcriptase -polymerase chain reaction (RT-PCR) for glyceraldehyde-3-phosphate-dehydrogenase (GAPDH). RESULTS: With the frozen sections, detection of the GAPDH mRNA expression in the number of captured 25 oocytes were not repeatable, but the expression was always detectable from 50 oocytes. With 25 oocytes, at least 27 PCR cycles were required, whereas with 50 oocytes, 21 cycles were enough to detect GAPDH expression. Amount of the primary cDNA required for RT-PCR was reduced down to at least 0.25 microl with 50 oocytes, thus the resting 19.75 microl cDNA can be used for the testing other interested gene expression. Tissue-to-slide, tissue-to-tissue forces were very high in the paraffin sections, thus the greater number of cell procurement was required than the frozen sections. CONCLUSION: We have described a method for analyzing gene expression at the RNA level with the homogeneously microdissected cells from the small amount of tissues with complexity. We found that LCM coupled with RT-PCR could detect housekeeping gene expression in 50 oocytes captured. This technique can be easily applied for the study of gene expression with the small amount of tissues.
Alcohols ; Animals ; DNA, Complementary ; Eosine Yellowish-(YS) ; Ethanol ; Female ; Frozen Sections ; Gene Expression* ; Genes, Essential ; Guanidine ; Hematoxylin ; Mice ; Microdissection* ; Oocytes* ; Ovary ; Paraffin ; Polymerase Chain Reaction ; Ribonucleases ; RNA Stability ; RNA* ; RNA, Messenger ; RNA-Directed DNA Polymerase ; Xylenes

PURPOSE: The purpose of this study was to identify the influencing factors on maternal role adjustment among the primiparous women in the first year after childbirth. METHODS: The study subjects were 210 healthy primiparous women who have delivered at one of four women's health hospitals and revisited the out-patient department for the routine check-up and baby's vaccination during the first year after childbirth. Data were collected by a self-report questionnaire which consisted of general characteristics, maternal role adjustment, spousal rearing support, childcare stress, and postpartum depression. Collected data were analyzed by using the SPSS Win 18.0 program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient and multiple regression. RESULTS: The maternal role adjustment was significantly correlated with spousal rearing support (r=.649, p<.001), childcare stress (r=-.596, p<.001), postpartum depression (r=-.569, p<.001), and subjective health condition (r=.204, p=.003). The multiple regression analysis showed that the maternal role adjustment were significantly affected by spousal rearing support (t=6.542, p<.001). childcare stress (t=-3.268, p=.001), and postpartum depression (t=-2.238, p=.018). CONCLUSION: From these results, it is concluded that the nursing intervention for enhancing spousal support in childcare and decreasing the childcare stress and depression should be developed for improving maternal role adjustment in the first time mother, especially within one year after childbirth.
Depression ; Depression, Postpartum ; Diagnostic Self Evaluation ; Female ; Humans ; Maternal Behavior ; Mothers ; Nursing ; Outpatients ; Parity ; Parturition* ; Vaccination ; Women's Health

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