Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors – integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues – accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach’s α for all the items was .92. Conclusion The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

Purpose: The purpose of this study was to investigate the association between nurses’ positive psychological capital, self-leadership, relational bonds, and organizational commitment, and to identify factors influencing organizational commitment. Methods: The participants in this study were 199 nurses conveniently selected at one general hospital in Seoul. Data collection was conducted between January 1st and March 31st, 2019, and was analyzed using the SPSS/WIN 23.0 program. Results: The mean score for positive psychological capital was 3.31±0.44, for self-leadership, 3.44±0.40, for relational bonds, 3.54±0.79, and for organizational commitment, 3.81±0.76. Positive psychological capital (r=.40, p<.001), self-leadership (r=.33, p<.001) and relational bonds (r=.51, p<.001) showed significant correlation with organizational commitment. Stepwise multiple regression analysis showed that positive psychological capital and relational bonds were included in the factors affecting the organizational commitment of clinical nurses. These variables explained 29.0% of organizational commitment. Conclusion Findings indicate that it is necessary to build effective strategies to enhance positive psychological capital and relational bonds for nurses. Such strategies will result in improved organizational commitment.

Mature cystic teratoma of the ovary is the most commom ovarian germ cell tumor and almost benign. Malignant transformation occurs in less than 2% of benign mature teratoma. Squamous cell carcinoma derived from ectoderm is the most frequent malignancy. Prognosis of squamous cell carcinoma in ovarian mature teratoma is generally poor but there is no consensus on optimal thrapy. We report one case of squamous cell carcinoma arising from mature cystic teratoma with a brief review of the literature.
Carcinoma, Squamous Cell ; Consensus ; Ectoderm ; Female ; Hydronephrosis* ; Neoplasms, Germ Cell and Embryonal ; Neoplasms, Squamous Cell* ; Ovary ; Prognosis ; Teratoma* ; Ureter* ; Ureteral Obstruction*

BACKGROUND AND OBJECTIVES: B-lymphocytes and other phagocytes which infiltrate into inflammatory sites in pathologic condition are able to make reactive oxygen species such as superoxide free radicals (SFRs) which have toxic effects on foreign bodies including bacteria as well as normal eukaryotic cells. To prevent harmful effects of SFRs, eukaryotic cells can produce antioxidant enzymes such as superoxide dismutase (SOD) and catalase. The purpose of this study is to investigate the protective system of pediatric palatine tonsils and adenoids against the SFRs and to evaluate the clinical factors including otitis media with effusion that are related to the expressions and activities of copper zinc superoxide dismutases (CuZnSODs) in these tissues. MATERIALS AND METHOD: Twenty-one children who were operated for enlarged tonsils and adenoid with or without otitis media with effusion (OME) from December 1999 to Feburary 2000 were studied. Physcial fidings were evaluated and history-taking was carried out. RT-PCR and immunohistochemistry stain against CuZnSOD were conducted. RESULTS: Immunohistochemistry showed that CuZnSODs were found in the crypt epithelium, mucous membrane, mantle zone and in the extrafollicular area of pediatric adenoids as well as palatine tonsils. There were significant correlations between the presence of OME, paranasal sinusitis and the expression of CuZnSOD of adenoid (p<0.05), the frequency of tonsillitis, recent tonsillitis and the expression of CuZnSOD of tonsils (p <0.05). CONCLUSION: In pediatric tonsils and adenoids, the mechanism of tissue protection against infection and frequent inflammatory reactions may be closely related to the CuZnSODs expression.
Adenoids* ; B-Lymphocytes ; Bacteria ; Catalase ; Child ; Copper ; Epithelium ; Eukaryotic Cells ; Foreign Bodies ; Free Radicals ; Humans ; Immunohistochemistry ; Mucous Membrane ; Otitis Media with Effusion ; Palatine Tonsil* ; Phagocytes ; Reactive Oxygen Species ; Sinusitis ; Superoxide Dismutase* ; Superoxides* ; Tonsillitis ; Zinc

Cap polyposis is a rare intestinal disease that is characterized by the presence of inflammatory polyps consisting of elongated, tortuous and distended crypts that are covered by a 'cap' of granulation tissue. The pathogenesis and proper treatment of cap polyposis are still unclear. We experienced a case of cap polyposis, that was treated successfully by conservative management without the need for a pharmacotherapy or resection.
Drug Therapy ; Granulation Tissue ; Intestinal Diseases ; Polyps

Cap polyposis is a rare intestinal disease that is characterized by the presence of inflammatory polyps consisting of elongated, tortuous and distended crypts that are covered by a 'cap' of granulation tissue. The pathogenesis and proper treatment of cap polyposis are still unclear. We experienced a case of cap polyposis, that was treated successfully by conservative management without the need for a pharmacotherapy or resection.
Drug Therapy ; Granulation Tissue ; Intestinal Diseases ; Polyps

BACKGROUND: Hypoxia-inducible factor-1alpha (HIF-1alpha) is an intrinsic marker of tumor hypoxia, and this is associated with reduced radiosensitivity. Furthermore, HIF-1alpha can increase a tumor's aggressiveness by promoting neoangiogenesis, cell proliferation and survival, and invasion. METHODS: The expression of HIF-1alpha was was investigated by performing immunohistochemistry on the cervical tissue specimens obtained from 57 patients who had received radiotherapy combined with or without chemotherapy for stages I-III cervical squamous cell carcinoma. The staining results were compared with anemia, the stage, the radiotherapy response and patient survival by univariate and multivariate analysis. RESULTS: In 57 patients, the expression of HIF-1alpha was seen in the tissue specimens of 46 patients (81.7%). Among them, 25 (54.3%), 14 (30.4%), and 7 (15.2%) of the patients' tissue specimens showed weak, moderate and strong expressions, respectively. Six patients had a partial response after radiotherapy. Twelve patients (21.1%) died of cervical cancer. The increased expression of HIF-1alpha was significantly associated (p<0.05) with the disease stage and anemia. There were significant positive correlations between the increased expression of HIF-1alpha and the poor response after radiotherapy and the patients' survival. CONCLUSIONS: The present result suggests that the overexpression of HIF-1alpha in the uterine cervix could be used as a prognostic indicator for the patients treated with radiotherapy.
Anemia ; Anoxia* ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Cervix Uteri* ; Drug Therapy ; Female ; Humans ; Hypoxia-Inducible Factor 1 ; Immunohistochemistry ; Multivariate Analysis ; Radiation Tolerance ; Radiotherapy* ; Uterine Cervical Neoplasms

A NK/T cell lymphoma is highly aggressive lymphoma of a putative NK-cell origin with a predominant extranodal presentation and a rapidly fatal course. CD56 has been reported to be the most reliable marker for a NK/T cell lymphoma. A NK/T cell lymphoma is strongly associated with the Epstein-Barr virus. We report a case of an aggressive NK/T cell lymphoma presenting as a gastric ulcer. A 52-year-old female patient presented with hematochezia and fever. The endoscopic finding showed a gastric ulcer with a recent bleeding stigma. Histologically, the gastric biopsy showed a diffuse infiltration of small or medium sized lymphoma cells with an angiocentric growth pattern and necrosis. The lymphoma cells were CD56+, CD3+, CD20-, which are consistent with a NK/T cell lymphoma. Unfortunately, the patient was discharged without treatment. We report this case with a review of the relevant literature.
Biopsy ; Female ; Fever ; Gastrointestinal Hemorrhage ; Hemorrhage ; Herpesvirus 4, Human ; Humans ; Lymphoma* ; Middle Aged ; Necrosis ; Stomach ; Stomach Ulcer

FA (Fanconi's Anemia) is an autosomal recessive disorder that is characterized by pancytopenia with bone marrow hypoplasia, diverse congenital abnormalities and an increased predisposition towards malignancy. The mainstay of the treatment for these cancers has been surgery, because of the hypersensitive reactions of FA patients to DNA cross- linking agents or radiation. Therefore, there has been no effective therapy for advanced squa mous cell carcinoma. We report here on a patient suffering from advanced multiple squamous cell carcinoma and hepatocellular carcinoma along with an FA, and this patient was treated with gefitinib.
Bone Marrow ; Carcinoma, Hepatocellular* ; Carcinoma, Squamous Cell* ; Congenital Abnormalities ; DNA ; Fanconi Anemia* ; Humans ; Pancytopenia

BACKGROUND: Acinetobacter baumannii, an opportunistic nosocomial pathogen that can cause significant morbidity and mortality, has emerged as a worldwide problem. The aim of this study was to evaluate the risk factors for mortality in patients with A. baumannii bacteremia. MATERIALS AND METHODS: We retrospectively evaluated 118 patients who had A. baumannii bacteremia between July 2003 and December 2011. The aim of this study was to identify the 30-day mortality in patients with A. baumannii bacteremia and relevant risk factors. RESULTS: The bacteremia-related 30-day mortality rate was 34.1%. Univariate analysis revealed that the risk factors for mortality included malignancy, longer hospital stay before bacteremia, intensive care unit (ICU) stay at the time of bacteremia, mechanical ventilation, use of a central venous catheter, unknown origin of bacteremia, bacteremia due to pneumonia, antimicrobial resistance to carbapenems, and elevated Acute Physiology and Chronic Health Evaluation II and Pitt bacteremia scores. Multivariate logistic regression analysis revealed that resistance to carbapenems (odds ratio [OR]: 4.01, 95% confidence interval [CI]: 1.51 to 0.68, P = 0.005), need for mechanical ventilation (OR: 3.97, 95% CI: 1.41 to 11.13, P = 0.005), and presence of malignancy (OR: 4.40, 95% CI: 1.60 to 12.08, P = 0.004) were significantly related to mortality risk. CONCLUSIONS: Risk factors such as resistance to carbapenems, mechanical ventilation, and presence of malignancy were found to be associated with high mortality rates in the patients with A. baumannii bacteremia.
Acinetobacter ; Acinetobacter baumannii ; APACHE ; Bacteremia ; Carbapenems ; Central Venous Catheters ; Humans ; Intensive Care Units ; Length of Stay ; Logistic Models ; Pneumonia ; Respiration, Artificial ; Retrospective Studies ; Risk Factors