We report a case of secretory carcinoma with axillary lymph node metastasis in a 21-year old woman. She was aware of a mass in her breast for 10 years and noticed a rapid growth of the preexisting mass during the last years. Histologically, the tumor was composed of micropapillary and microcystic or cribriform glandular structures which contained eosinophilic, mucinous, intraluminal secretions. The center had a dense hyalinized strama with a solid infiltrative growth of tumor cells with intracytoplasmic secretory vacuoles at the periphery. In addition, marked intraductal papillary epithelial proliferations were present at the superficial portions of the tumor near the nipple. Prognostic factors and their relationship to juvenile papillomatosis are discussed with a review of the literature.
Female ; Humans ; Neoplasm Metastasis ; Breast Neoplasms

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Some circadian rhythms can become disorganized due to rotating shift work. This lack of organization, termed desynchronization, can produce a group of symptoms such as insomnia, GI disturbance and fatigue among many rotating shift workers. The magnitude of these symptoms are influenced by personal and environmental factors and the patterns of shift work. This study was carried out to investigate the subjective symptoms related to rotational schedules of shift work after personal and environmental factors adjusted. 182 male workers in rapidly rotating shift system and 86 male workers in weekly rotating shift system were conducted the questionnaire on personal factors and subjective sleep, GI and fatigue symptoms. Major findings obtained from this study are as follows: 1. The symptoms of 'feeling tired at work' and 'being irritable' were more frequent in weekly rotating shift workers(P<0.05), and the mean of symptom score was significantly higher in weekly rotating shift workers(P<0.01). 2. According to 6 hours of sleeping which is a definite elevation point of fatigue, there was not a significant difference between two groups in sleeping hours. Among workers in rapidly rotating shift system, the mean of symptom score was significantly higher in workers of less than 6 hours of sleeping(P<0.05), but it was not different among weekly rotating shift workers. 3. The symptoms of GI disturbance were more frequent in weekly rotating shift workers but statistically mot significant. 4. The positive rate of mental and physical fatigue symptoms were significantly higher in weekly rotating shift workers(P<0.01) and mental and physical fatigue symptoms were more frequent in them(P<0.01). 5. After the effect of the factors that were significantly different between two groups by X2-test were controlled, the mean score of sleep disturbance was significantly higher in weekly rotating shift workers(P<0.01) and mental physical fatigue symptoms were more frequent in them(P<0.01). Based on these study results, subjective symptoms were more common in the weekly rotating shift workers. In future, medical examination and laboratory test will be also administered to evaluate a more accurate health outcomes and the review of current shift schedules will be required.
Appointments and Schedules ; Circadian Rhythm ; Fatigue ; Humans ; Male ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

One author's affiliation is misspelled in original article.

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

No abstract available.
Coronary Vessels* ; Pulmonary Artery*

Tumoral calcinosis is an uncommon disease, characterized by deposits of large, calcified soft tissue masses around major joints in children and young adults. The causes of the lesion have not yet been established, but are presumed an inborn error of metabolism of phosphorus. It has been recommanded medical treatment or surgical excision, but recurrence of the lesion is frequent. We report a case of young female patient who presented with tumoral calcinosis at the age of 10 years.
Calcinosis* ; Child ; Female ; Humans ; Joints ; Knee Joint* ; Knee* ; Metabolism ; Phosphorus ; Recurrence ; Young Adult

PURPOSE: The purpose of this study was to confirm the influence of hematoonchology unit nurses' positive psychological capital and death awareness on their terminal care performance. METHODS: This descriptive study data were collected from self-reported questionnaire filled by 127 oncology nurses at a tertiary hospital in Seoul, Korea. The variables were positive psychological capital, death awareness, and terminal care performance. Data were analyzed using SPSS version 22.0 software. RESULTS: The participants scored 3.93±0.83 on positive psychological capital, 3.68±0.99 on death awareness and 2.86±0.65 on terminal care performance. The three variables were positively correlated. The factors affecting the nurses' terminal care performance were hope and resilience in the subcategory of positive psychological capital and experience of death of family members, relatives or friends within the past year; The explanatory power was 32.1%. CONCLUSION: It is necessary to develop educational programs to foster hope, resilience, etc. in hematooncology unit nurses to improve their quality of terminal care performance.
Friends ; Hope ; Humans ; Korea ; Resilience, Psychological ; Seoul ; Terminal Care ; Tertiary Care Centers

Purpose: This study aimed to define coaching in nursing clearly and elucidate its essential role within the context of contemporary nursing education in clinical settings. Methods: A concept analysis was conducted using Rodgers’ evolutionary method. Literature was extracted from databases such as Web of Science, Medline (PubMed) and CINAHL. Results: Results of analysis led to the development of an operational definition of coaching in nursing characterized as an educational approach focusing on nursing tasks. Coaching in nursing is a systematic and formalized process that can enhance the learning experience through interactive engagement rather than direct instruction. The analysis identified five core attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive. Conclusion The purpose of this concept analysis was to propose a comprehensive definition of coaching in nursing that could align with its theoretical foundation within modern nursing practice. Using Rodgers' evolutionary concept analysis method, related terms, attributes, antecedents, and outcomes were identified, culminating in a detailed definition. This concept analysis provides a contemporary definition of coaching in nursing, clarifying its meaning, ensuring applicability, and offering guidance for future research, education, and clinical practice.

Purpose: This study aimed to define coaching in nursing clearly and elucidate its essential role within the context of contemporary nursing education in clinical settings. Methods: A concept analysis was conducted using Rodgers’ evolutionary method. Literature was extracted from databases such as Web of Science, Medline (PubMed) and CINAHL. Results: Results of analysis led to the development of an operational definition of coaching in nursing characterized as an educational approach focusing on nursing tasks. Coaching in nursing is a systematic and formalized process that can enhance the learning experience through interactive engagement rather than direct instruction. The analysis identified five core attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive. Conclusion The purpose of this concept analysis was to propose a comprehensive definition of coaching in nursing that could align with its theoretical foundation within modern nursing practice. Using Rodgers' evolutionary concept analysis method, related terms, attributes, antecedents, and outcomes were identified, culminating in a detailed definition. This concept analysis provides a contemporary definition of coaching in nursing, clarifying its meaning, ensuring applicability, and offering guidance for future research, education, and clinical practice.