Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

The authors report the diffusion tensor tractography (DTT) findings of three pediatric patients with gait dysfunction and corticoreticular tract (CRT) disruption. All three patients showed unilateral trunk instability, but they did not show any spasticity or weakness of the distal extremities. Clinical evaluation of trunk instability using a Trunk Control Measurement Scale (TCMS) revealed that the more affected side had a lower score than the contralateral side. DTT showed disrupted CRTs in hemispheres contralateral to the hemiparetic sides, which were associated with unilateral proximal instability, although conventional MRI showed no abnormal lesion explaining the hemiplegic symptom. Compared to the results in age-matched controls, these three patients had decreased values of fractional anisotropy (FA) and tract volumes (TV) of the affected CRTs, and these values were also decreased compared to those in the contralateral side. On the other hand, values of FA and TV of the corticospinal tracts on the ipsilateral and contralateral sides were only marginally different. In conclusion, diffusion tensor imaging can be helpful for investigating the state of the CRT in pediatric patients with trunk instability and gait dysfunction.
Anisotropy ; Diffusion Tensor Imaging ; Diffusion* ; Extremities ; Gait ; Hand ; Humans ; Magnetic Resonance Imaging ; Muscle Spasticity ; Pyramidal Tracts

Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P= 0.027). The overall satisfaction scores did not differ between the two groups (P= 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

Gastric carcinosarcoma is an uncommon biphasic malignant tumor. We report the case of 59-year-old man with a history of melena and dizziness. Endoscopic findings showed a fungating mass that originated from the posterior wall of upper body. Radical total gastrectomy with Roux-en-Y esophagojejunostomy was performed. In the resected specimen, immunohistochemical studies for epithelial and mesenchymal markers showed positive reactions. The mass invaded the submucosa without regional lymph node metastasis. Adjuvant chemotherapy with TS-1 (Taiho Pharmaceutical Co. Ltd, Japan) was performed after surgery despite early clinical stage due to aggressive features of carcinosarcoma.
Carcinosarcoma ; Chemotherapy, Adjuvant ; Dizziness ; Gastrectomy ; Humans ; Lymph Nodes ; Melena ; Middle Aged ; Neoplasm Metastasis ; Pathology ; Prognosis ; Stomach

Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Aging ; Animals ; Apoptosis ; Asian Continental Ancestry Group ; Blood Pressure ; Cell Line ; Cohort Studies ; Gene Expression ; Genome ; Heart ; Humans ; Kidney ; Mice ; Neuroblastoma ; RNA, Messenger ; RNA, Small Interfering ; Transcription Factors ; Veins ; Zinc Fingers

PURPOSE: Antineutrophil cytoplasmic antibody (ANCA) has been identified in various disorders including Wegener's granulomatosis, microscopic polyarteritis and Kawasaki disease. Measuring this antibody has a diagnostic role. It facilitates monitoring disease activity and may also help understand the pathogenesis of the diseases in which it is found. We investigated the correlation between the hematologic findings and ANCA in acute Kawasaki disease and the diagnostic potential of ANCA to predict coronary artery involvement. METHODS: Thirty-eight patients who met the diagnostic criteria for Kawasaki disease were enrolled in this study. We sampled and investigated the hematologic findings and the assay of ANCA before intravenous immunoglobulin treatment and weekly echocardiographs weekly. RESULTS: There was no sexual difference between ANCA positive and negative group. The age in ANCA positive group was significantly lower than in ANCA negative group. Duration of fever before treatment in ANCA positive group were not significantly different from those in ANCA negative group. In ANCA positive group, the mean WBC count and the mean ESRs were higher than in ANCA negative group. There was no relation between ANCA and coronary artery involvement. CONCLUSION: The assays of ANCA in acute Kawasaki disease does not help to predict disease activity and coronary artery involvement.
Antibodies, Antineutrophil Cytoplasmic* ; Coronary Vessels ; Fever ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Wegener Granulomatosis

The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.
Humans ; Retrospective Studies ; Tibia ; Transplants* ; Treatment Outcome