PURPOSE: Nurses experience burnout related to various factors. For this descriptive research job stress, compassion satisfaction, and compassion fatigue were examined as to their relationship to burnout in nurses from children's hospital. METHODS: The participants were 305 nurses working in children's hospital. Self-report questionnaires were used to measure job stress, compassion satisfaction, compassion fatigue and burnout. RESULTS: Nurses in children's hospital experienced a greater than moderate degree of job stress, compassion satisfaction, compassion fatigue and burnout, whereas differences existed according to general characteristics. Job stress, compassion fatigue and burnout showed a significant positive correlation and results of compassion fatigue and burnout were similar. Also, job stress, compassion satisfaction and compassion fatigue were associated with burnout in nurses working in children's hospital. CONCLUSION: Findings indicate that as longer work experience is accompanied by higher job stress and burnout, it is necessary to develop intervention programs to reduce burnout among career nurses exposed to greater job stress in children's hospital.
Compassion Fatigue* ; Empathy*

BACKGROUND: Long-term use of topical steroids for inflammatory skin diseases can induce complications, and efforts to find a better treatment are being continued. Peroxisome proliferator activated receptor alpha (PPARalpha) suppresses the skin's inflammatory reaction, maintains the homeostasis of the skin, and plays an important role in skin barrier function. OBJECTIVE: This study analyzed the effects of a skin moisturizer containing PPARalpha activator on various inflammatory skin diseases causing facial erythema and evaluated the observed improvements. METHODS: The PPARa activator used for this study is composed of supercritical extracts from Euryale ferox, Euphorbia lathyris, and Rosa multiflora, which showed significant effects in the transactivation assay compared to Wy14643. Moisturizer containing PPARalpha was applied to the faces of 31 patients with symmetric facial erythema, with PPARalpha applied on one-half of the face and a control moisturizer on the other half of the face twice a day for 2 weeks. The percentage of erythema index, erythema index, skin hydration, and transepidermal water loss was checked to evaluate treatment effect. Both patients and clinicians each assessed the improvement of erythema on both sides of a patient's face. RESULTS: Moisturizer containing PPARalpha agonist significantly improved erythema index measured with Mexameter MX18(R) and percentage of erythema index by polarization color imaging system (DermaVision-PRO(R)) (p<0.05). However, there was no significant improvement in skin hydration and transepidermal water loss. Improvement of erythema was also shown on both the patient and clinician graded assessments. CONCLUSION: Topical PPARalpha agonist applied during clinical practice was relatively safe and effective. This can be applied clinically to various inflammatory skin diseases causing erythema.
Erythema* ; Euphorbia ; Homeostasis ; Humans ; PPAR alpha* ; Rosa ; Skin ; Skin Diseases ; Steroids ; Transcriptional Activation

OBJECTIVE: To assess the current practice patterns of radiologists who perform transthoracic needle biopsy (TNB). MATERIALS AND METHODS: An email survey of 71 questions on TNB was sent to 240 members of the Korean Society of Thoracic Radiology. The answers to multiple-choice questions (n = 56) were analyzed. RESULTS: Of 60 respondents, 45% had 10 or more years of experience in chest radiology, and 70% had 5 or more years of experience in TNB. For the question on the most frequently used diagnostic method for lesions with high probability of being resectable-stage lung cancer, 70% of respondents answered that TNB is initially used, with or without bronchoscopy. In patients at high-risk of TNB-related complications, the proportion of the respondents who consistently declined TNB was only 5%. The number of rebiopsies was said to be increased; molecular analysis for an established target therapy (43.6%) and clinical trial of a new drug (28.2%) were the two most common reasons for it. The most popular needle type was the coaxial cutting needle (55%), and the popular guiding modality was conventional computed tomography (CT) (56.7%). In addition, 15% of respondents have encountered air embolism. CONCLUSION: Despite high variation in how TNB is being performed in Korea, some patterns were noted. It is common for patients with resectable-stage lung cancer to undergo TNB prior to surgery. Rebiopsy is now more common than before, with personalized medicine as the most important reason for it. The most popular type of needle is the coaxial system; the most popular modality for guidance is still CT.
Biopsy, Needle* ; Bronchoscopy ; Electronic Mail ; Embolism, Air ; Humans ; Korea ; Lung Neoplasms ; Methods ; Needles* ; Precision Medicine ; Surveys and Questionnaires ; Thorax

Purpose: Interleukin (IL)-17A has been suggested to play a role in the growth and organization of thrombi. We examined whether IL-17A plays a role in the early stages of thrombosis and whether there are sex differences in the effects of IL-17A. Materials and Methods: We performed a blinded, randomized, placebo-controlled study to compare time to thrombotic occlusion and sex differences therein between mice treated with IL-17A and those treated with saline using a ferric chloride-induced model. We also assessed thrombus histology, blood coagulation, and plasma levels of coagulation factors. Results: Time to occlusion values did not differ between the IL-17A group and the control group (94.6±86.9 sec vs. 121.0±84.4 sec, p=0.238). However, it was significantly shorter in the IL-17A group of female mice (74.6±57.2 sec vs. 130.0±76.2 sec, p=0.032). In rotational thromboelastometry, the IL-17A group exhibited increased maximum clot firmness (71.3±4.5 mm vs. 66.7±4.7 mm, p=0.038) and greater amplitude at 30 min (69.7±5.2 mm vs. 64.5±5.3 mm, p=0.040) than the control group. In Western blotting, the IL-17A group showed higher levels of coagulation factor XIII (2.2±1.5 vs. 1.0±0.9, p=0.008), monocyte chemoattractant protein-1 (1.6±0.6 vs. 1.0±0.4, p=0.023), and tissue factor (1.5±0.6 vs. 1.0±0.5, p=0.003). Conclusion IL-17A plays a role in the initial st ages of arterial thrombosis in mice. Coagulation factors and monocyte chemoattractant protein-1 may be associated with IL-17A-mediated thrombosis.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic disease and a potentially life‐threatening systemic necrotizing vasculitis predominantly affecting small vessels. Herein, we describe a 47-year-old man with EGPA misdiagnosed as non-ST-segment elevation myocardial infarction. He presented to the Emergency Department with indigestion and diarrhea. He had been diagnosed with asthma and chronic rhinosinusitis 3 years earlier and was taking antibiotics due to worsening sinusitis. In laboratory tests, peripheral blood eosinophils, serum creatinine, and serum troponin were elevated to 4,641 cells/μL, 13.40 ng/mL, and 1.26 ng/ mL, respectively. Electrocardiography showed ST-segment depression on the inferior wall, and echocardiography indicated an ischemic insult in the right coronary artery territory. A non-ST-segment elevation myocardial infarction as well as antibiotic-associated diarrhea, eosinophilia and acute kidney injury was initially suspected. However, fever persisted and eosinophilia worsened despite cessation of antibiotics after admission. There was no significant stenosis of the coronary arteries on coronary angiography. Meanwhile, abdominal computed tomography suggested medical renal disease, and magnetic resonance imaging showed late gadolinium enhancement at the mid wall and the subepicardial area in the left ventricle of the heart. As a workup for eosinophilia, serum anti-MPO was measured and turned out to be positive. A kidney biopsy was performed, which yielded membranous nephropathy superimposed on antineutrophil cytoplasmic antibodies-mediated crescent formation. He was diagnosed as EGPA with cardiac and renal involvement, and received systemic steroid, cyclophosphamide, and plasmapheresis. Then, peripheral eosinophil counts and renal function were normalized. He is now in clinical remission even after stopping the use of steroids and immunosuppressive agents.

Background: In February 2020, as coronavirus disease 2019 (COVID-19) spread rapidly in Daegu, South Korea, students in that region experienced many emotional difficulties. In this study, we analyzed the stress and emotional crisis experienced by students during the COVID-19 pandemic, its causative factors, and the factors that affect negative emotions. Methods: We identified the demographic information related to the experiences of unbearable stress and emotional crisis and their causal factors at three points in time: before the pandemic, during its peak, and at the time of the survey (2–3 months after the peak). In addition, we analyzed the factors related to depression and anxiety experienced by students during the COVID-19 pandemic. The Korean version of the Patient Health Questionnaire 9 and the Korean version of the Generalized Anxiety Disorder 7 was used to assess for depressive and anxiety symptoms in the subject students, respectively. Results: A total of 8,177 students participated in the analysis, with 4,072 boys (49.8%), 4,105 girls (50.2%), and 4,463 middle school students (54.6%) and 3,177 high school students (45.4%). The percentage of students who experienced unbearable stress was 9% before the COVID-19 pandemic, increased to 16% at the peak of the COVID-19 pandemic, then decreased to 12.7% at the time of the survey. Stress was experienced more by girls (18.1% versus 13.8% in boys; χ2 = 28.159, P < 0.001) and high school students (19.0% versus 13.5% in middle school students; χ2 = 45.437, P < 0.001). Overall, 7.6% experienced emotional crises during the COVID-19 pandemic, which was more prevalent in girls (10.1% versus 5.2% in boys; χ2 = 71.025, P < 0.001) and in high school students (8.8% versus 6.7% in middle school students; χ2 = 12.996, P < 0.001). Depression and anxiety was seen in 19.8% and 12.3% of students during the COVID-19 pandemic, respectively. The risk factors for depression and anxiety included unbearable stress before the COVID-19 pandemic (P < 0.001), mental health (P = 0.044), and age (P = 0.040), whereas resilience was identified as a protective factor for depression and anxiety (P = 0.001). Conclusion Students in Daegu experienced lots of mental difficulties since the COVID-19 pandemic. It will be necessary to improve stress management and resilience to improve students' mental health in disasters such as the COVID-19 pandemic.

This study aimed to develop docetaxel (DTX) loaded poly(lactic-coglycolic acid) (PLGA) nanoparticles (DTX-NPs) and to evaluate the different pharmacological sensitivity of NPs to MCF-7 and MDA-MB-231 breast cancer cells. NPs containing DTX or coumarin-6 were prepared by the nanoprecipitation method using PLGA as a polymer and d-α-tocopherol polyethylene glycol 1000 succinate (TPGS) as a surfactant. The physicochemical properties of NPs were characterized. In vitro anticancer effect and cellular uptake were evaluated in breast cancer cells. The particle size and zeta potential of the DTX-NPs were 160.5 ± 3.0 nm and –26.7 ± 0.46 mV, respectively. The encapsulation efficiency and drug loading were 81.3 ± 1.85% and 10.6 ± 0.24%, respectively. The In vitro release of DTX from the DTX-NPs was sustained at pH 7.4 containing 0.5% Tween 80. The viability of MDA-MB-231 and MCF-7 cells with DTX-NPs was 37.5 ± 0.5% and 30.3 ± 1.13%, respectively. The IC 50 values of DTX-NPs were 3.92- and 6.75-fold lower than that of DTX for MDA-MB-231 cells and MCF-7 cells, respectively. The cellular uptake of coumarin-6-loaded PLGA-NPs in MCF-7 cells was significantly higher than that in MDA-MB-231 cells. The pharmacological sensitivity in breast cancer cells was higher on MCF-7 cells than on MDA-MB-231 cells. In conclusion, we successfully developed DTX-NPs that showed a great potential for the controlled release of DTX. DTX-NPs are an effective formulation for improving anticancer effect in breast cancer cells.

This study aimed to develop docetaxel (DTX) loaded poly(lactic-coglycolic acid) (PLGA) nanoparticles (DTX-NPs) and to evaluate the different pharmacological sensitivity of NPs to MCF-7 and MDA-MB-231 breast cancer cells. NPs containing DTX or coumarin-6 were prepared by the nanoprecipitation method using PLGA as a polymer and d-α-tocopherol polyethylene glycol 1000 succinate (TPGS) as a surfactant. The physicochemical properties of NPs were characterized. In vitro anticancer effect and cellular uptake were evaluated in breast cancer cells. The particle size and zeta potential of the DTX-NPs were 160.5 ± 3.0 nm and –26.7 ± 0.46 mV, respectively. The encapsulation efficiency and drug loading were 81.3 ± 1.85% and 10.6 ± 0.24%, respectively. The In vitro release of DTX from the DTX-NPs was sustained at pH 7.4 containing 0.5% Tween 80. The viability of MDA-MB-231 and MCF-7 cells with DTX-NPs was 37.5 ± 0.5% and 30.3 ± 1.13%, respectively. The IC 50 values of DTX-NPs were 3.92- and 6.75-fold lower than that of DTX for MDA-MB-231 cells and MCF-7 cells, respectively. The cellular uptake of coumarin-6-loaded PLGA-NPs in MCF-7 cells was significantly higher than that in MDA-MB-231 cells. The pharmacological sensitivity in breast cancer cells was higher on MCF-7 cells than on MDA-MB-231 cells. In conclusion, we successfully developed DTX-NPs that showed a great potential for the controlled release of DTX. DTX-NPs are an effective formulation for improving anticancer effect in breast cancer cells.