Purpose: This study aimed to evaluate the effectiveness of an infection control education (ICE) program based on digital story-telling for new graduate nurses. Methods: From June 2 to July 30, 2022, a total of 58 new graduate nurses (30 and 28 nurses in the experimental and control group, respectively) at a tertiary general hospital in D city were enrolled. The effects were evaluated using a nonequivalent control group, non-synchronized design. The effects of the program were evaluated in terms of awareness of standard precautions, performance of standard precautions, and grit. Results: Statistically significant differences between the two groups were found in the awareness of standard precautions (t=-2.18, p=.034) and the performance of standard precautions (t=-3.27, p=.002). Grit was also significantly higher in the experimental group (t=-4.17, p<.001). Conclusion The development and application of the ICE program effectively improved the awareness of standard precautions, the performance of standard precautions, and grit among new nurses.

Hypereosinophilic syndrome (HES) is characterized by persistent eosinophilia associated with damage to multiple organs. Although the diagnostic criteria for HES include sustained hypereosinophilia for at least 6 months, early initiation of therapy may be recommended in patients exhibiting HES symptoms. Eosinophilic enteritis has been reported as a cause of intussusception in several cases. However, HES as a cause of intussusception has not yet been reported. In the present report, we describe a case of HES that manifested as jejunojejunal intussusception. Although long-standing hypereosinophilia was not confirmed, the patient required eosinophil-lowering therapy for an intestinal obstruction. The patient was treated with systemic corticosteroids, after which the symptoms and multiple organ involvement, including intussusception, improved dramatically, as noted on the radiological investigation. Moreover, surgery was not necessary.
Adrenal Cortex Hormones ; Adult* ; Enteritis ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome* ; Intestinal Obstruction ; Intussusception*

Hypereosinophilic syndrome (HES) is characterized by persistent eosinophilia associated with damage to multiple organs. Although the diagnostic criteria for HES include sustained hypereosinophilia for at least 6 months, early initiation of therapy may be recommended in patients exhibiting HES symptoms. Eosinophilic enteritis has been reported as a cause of intussusception in several cases. However, HES as a cause of intussusception has not yet been reported. In the present report, we describe a case of HES that manifested as jejunojejunal intussusception. Although long-standing hypereosinophilia was not confirmed, the patient required eosinophil-lowering therapy for an intestinal obstruction. The patient was treated with systemic corticosteroids, after which the symptoms and multiple organ involvement, including intussusception, improved dramatically, as noted on the radiological investigation. Moreover, surgery was not necessary.
Adrenal Cortex Hormones ; Adult* ; Enteritis ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome* ; Intestinal Obstruction ; Intussusception*

Background: The risk of secondhand smoke (SHS) is gradually becoming apparent, and as smoking cessation zones are expanding, the exposure to SHS in workplaces, homes, and public places is decreasing. The objective of this study was to evaluate the actual exposure to SHS in nonsmokers. Methods: This study used data from 2008 to 2011 and 2014 to 2018 from the Korean National Health and Nutrition Examination Survey (KNHANES). The urine cotinine concentration values were compared by the geometric mean according to sex, age group, and rurality for non-smokers aged 19 years or older who were tested for urine cotinine. Results: The overall trend of urine cotinine concentration in Korean adult non-smokers have shown a decline since 2011. It gradually decreased from 2.82 ng/mL in 2010 to 0.50 ng/mL in 2016 but slightly increased to 0.79 ng/mL in 2018. Both male and female showed this trend. The decline tended to be lower in those aged 60 years and older, with higher urine cotinine concentrations in the recent 3 years in the rural than in urban residents. Conclusion The urinary cotinine concentration levels in Korean non-smokers increased from 2008 to 2010, then decreased till 2016, but gradually increased thereafter. This is possibly due to limiting the exposure to SHS through expanding the smoking area. Furthermore, a policy to lower the smoking rate with strict implementation and monitoring of the existing policy will be needed.

Background: To assess the clinical efficacy of intravenous immunoglobulin G (IVIG) administration combined with low-dose aspirin in women with unexplained recurrent pregnancy loss (RPL). Methods: We retrospectively analyzed the medical records of patients who had been diagnosed with unexplained RPL and treated with IVIG and low-dose aspirin between January 2000 and March 2020 at Asan Medical Center. We analyzed pregnancy outcomes and their association with the percentage of natural killer (NK) cells. Results: The study analyzed a total of 93 patients and 113 natural and assisted reproductive technology pregnancy cycles. The live birth rate per cycle was 73.5% (83/113), and the term delivery rate was 86.7% (72/83). The live birth rate was high regardless of the type of RPL, method of pregnancy, timing of IVIG treatment, and presence or absence of autoantibodies.In addition, the live birth rate was significantly higher in patients who received IVIG more than once, compared with patients who received IVIG only once (77.8% vs. 42.9%, P = 0.006). There was no significant association between the NK cell counts and live birth rate (65.5% in the group with NK cell < 12%, and 69.7% in that with NK cell ≥ 12%, P = 0.725). Among all patients, 87.6% had no complications, and there were no congenital malformation among newborn babies. Conclusion IVIG combined with low-dose aspirin treatment showed favorable pregnancy outcomes regardless of the patient’s NK cell counts (%).

BACKGROUND: The Htr3a antagonist, ondansetron, has been reported to prolong the QT interval and induce Torsades de pointes in the treatment of postoperative nausea and vomiting. To explore the mechanisms underlying these findings, we examined the effects of ondansetron on the mouse cardiac voltage-gated K⁺ (Kv) channel. METHODS AND RESULTS: Ondansetron increased QT intervals in late pregnant (LP) mice. We measured the Kv channels in freshly isolated left ventricular (LV) myocytes from non-pregnant (NP) and late pregnant (LP) mice, using patch-clamp electrophysiology. Ondansetron blocked Kv current at a dose of 50 µM, and reduced the amplitude of peak current densities in a dose-dependent manner (0, 1, 5, 50 µM), in LP but not in NP mice. In contrast, serotonin and the Htr3 agonist, m-CPBG, increased Kv current densities in NP, but not in LP mice. Interestingly, during pregnancy, serum serotonin levels were markedly increased, suggesting the saturation of the effect of serotonin. Immunostaning data showed that Kv4.3 protein and Htr3a co-localize at the membrane and t-tubule of cardiomyocytes. Moreover, Kv4.3 membrane trafficking was enhanced in response to Htr3a-mediated serotonin stimulation in NP, but not in LP mice. Membrane analysis showed that serotonin enhances Kv4.3 membrane trafficking in NP, but not LP mice. CONCLUSION: Ondansetron reduced Kv current densities, and reduced the Kv4.3 membrane trafficking in LP mouse ventricular cardiomyocytes. This data suggests that QT prolongation by ondansetron is mediated by the reduction of Kv current densities and Kv4.3 membrane trafficking.
Animals ; Electrophysiology ; Membranes ; Mice* ; Muscle Cells* ; Myocytes, Cardiac ; Ondansetron* ; Postoperative Nausea and Vomiting ; Pregnancy ; Serotonin ; Torsades de Pointes

PURPOSE: We investigated the prognostic significance of CD9 expression in tumor cells of patients with invasive lobular carcinoma (ILC). METHODS: CD9 expression was evaluated by immunohistochemistry in 113 ILC tissue samples. Correlation of CD9 expression with the patients' clinicopathological parameters and overall survival was assessed. RESULTS: CD9 expression was detected in 48 (42.5%) ILC patients. However, no significant relation could be determined between CD9 expression and the clinicopathological parameters of the patient including tumor size, lymph node metastasis, lymphovascular invasion, histologic grade, expression of hormone receptors, human epidermal growth factor receptor 2 status, and Ki-67 labeling index. Patients with CD9 expression had worse overall survival (p = 0.051) and disease-free survival (DFS, p = 0.014) compared to patients without CD9 expression. Multivariate analysis revealed that CD9 expression was an independent prognostic factor for DFS (p = 0.049). CONCLUSION: CD9 expression in tumor cells could be a significant prognostic marker in patients with ILC.
Breast Neoplasms ; Carcinoma, Lobular ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Receptor, Epidermal Growth Factor

Clinical outcomes of living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) in patients with multiple myeloma (MM) have not been established in terms of HCC recurrence and MM deterioration after LDLT. A 51-year-old man with chronic hepatitis B was diagnosed with HCC and MM. Since the patient also had decompensated liver cirrhosis (LC), he underwent LDLT prior to autologous peripheral blood stem cell transplantation (PBSCT) to prevent fulminant hepatitis due to HBV reactivation. The patient received Epstein-Barr virus prophylaxis and a triple immunosuppressive regimen of tacrolimus, everolimus, and steroid after LDLT. Autologous PBSCT was performed 7 months after LDLT. He showed a complete response to treatment of MM without post-LT complications or HCC recurrence. In conclusion, LDLT could be adapted for treatment of MM patients with combined HCC and decompensated LC because it is an effective strategy of preventing HBV reactivation and HCC recurrence after induction therapy of MM.
Carcinoma, Hepatocellular* ; Everolimus ; Hepatitis B, Chronic ; Hepatitis* ; Herpesvirus 4, Human ; Humans ; Liver Cirrhosis* ; Liver Transplantation* ; Liver* ; Living Donors* ; Middle Aged ; Multiple Myeloma* ; Peripheral Blood Stem Cell Transplantation ; Recurrence ; Tacrolimus

Epithelioid hemangioendothelioma (EHE) is a rare benign vascular tumor, affecting fewer than one in a million individuals. Spinal EHE is exceptionally rare. This case report presents a case of recurrent spinal EHE, focusing on its clinical manifestation and providing a brief overview of its genetic characteristics. Seven years prior, a patient underwent subtotal resection of a lumbar and retroperitoneal EHE. Due to severe intraoperative bleeding, part of the lumbar spine mass was left unresected and subsequently treated with a moderate dose of radiation therapy. More recently, the patient presented with bilateral lower extremity weakness and urinary incontinence. Imaging studies revealed metastases in the thoracic and sacral bones, along with regrowth in the anterior portion of the previously treated spinal EHE. The patient underwent a series of operations to address both the regrowth and metastases, followed by intensity-modulated radiation therapy to target the remaining tumor tissue while minimizing damage to surrounding structures. Although EHE is generally considered benign, this indolent tumor has a tendency for persistent regrowth and metastasis. This case highlights the importance of radical resection and the potential role of higher radiation doses in preventing recurrence. Molecular testing may aid in achieving an accurate diagnosis and guiding effective treatment strategies.

Epithelioid hemangioendothelioma (EHE) is a rare benign vascular tumor, affecting fewer than one in a million individuals. Spinal EHE is exceptionally rare. This case report presents a case of recurrent spinal EHE, focusing on its clinical manifestation and providing a brief overview of its genetic characteristics. Seven years prior, a patient underwent subtotal resection of a lumbar and retroperitoneal EHE. Due to severe intraoperative bleeding, part of the lumbar spine mass was left unresected and subsequently treated with a moderate dose of radiation therapy. More recently, the patient presented with bilateral lower extremity weakness and urinary incontinence. Imaging studies revealed metastases in the thoracic and sacral bones, along with regrowth in the anterior portion of the previously treated spinal EHE. The patient underwent a series of operations to address both the regrowth and metastases, followed by intensity-modulated radiation therapy to target the remaining tumor tissue while minimizing damage to surrounding structures. Although EHE is generally considered benign, this indolent tumor has a tendency for persistent regrowth and metastasis. This case highlights the importance of radical resection and the potential role of higher radiation doses in preventing recurrence. Molecular testing may aid in achieving an accurate diagnosis and guiding effective treatment strategies.