Purpose: The aim of this study was to determine the reliability and validity of the metacognition rating scale (MCRS), which is a revised version of the existing metacognition questionnaire (MCQ) with anger and anxiety added. Methods: A survey was conducted on 591 nursing students at colleges in North and South Gyeongsang Provinces, South Korea. The collected data were processed for the reliability and validity of the MCRS through Cronbach’s ⍺ and confirmatory factor analysis using SPSS 26.0. Results: Cronbach’s ⍺ for the reliability of MCRS was calculated at .88, .86, .77, .74, and .66 for five subfactors. Among the five subfactors, the first, second, third, and fifth factors showed high correlation in each of six items. Factor 4 was highly correlated in 5 out of 6 questions. Conclusion The data confirm that the MCQ revised to include anger and anxiety is both reliable and valid for nursing students. Therefore, this scale can be used to identify the maladaptive metacognition of nursing students in stressful situations.

Purpose: The aim of this study was to determine the reliability and validity of the metacognition rating scale (MCRS), which is a revised version of the existing metacognition questionnaire (MCQ) with anger and anxiety added. Methods: A survey was conducted on 591 nursing students at colleges in North and South Gyeongsang Provinces, South Korea. The collected data were processed for the reliability and validity of the MCRS through Cronbach’s ⍺ and confirmatory factor analysis using SPSS 26.0. Results: Cronbach’s ⍺ for the reliability of MCRS was calculated at .88, .86, .77, .74, and .66 for five subfactors. Among the five subfactors, the first, second, third, and fifth factors showed high correlation in each of six items. Factor 4 was highly correlated in 5 out of 6 questions. Conclusion The data confirm that the MCQ revised to include anger and anxiety is both reliable and valid for nursing students. Therefore, this scale can be used to identify the maladaptive metacognition of nursing students in stressful situations.

Purpose: Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management. Methods: A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO. Results: A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases. Conclusion There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.

Stress-induced cardiomyopathy is characterized by reversible systolic dysfunction of the ventricles, usually involving the apical segments. It occurs more commonly in women and is frequently precipitated by emotional or physical stressors. Ever since the first report of typical stress-induced cardiomyopathy-usually known as Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome-was issued, variant forms of stress-induced cardiomyopathy have been reported. We describe a patient who presented with typical ischemic chest pain, but who was found to have an atypical form of stress-induced cardiomyopathy: midventricular ballooning syndrome involving both the left and right ventricles. Transthoracic echocardiography and computed tomography were used in this patient.
Cardiomyopathies ; Chest Pain ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Takotsubo Cardiomyopathy

Purpose: The expression of major histocompatibility complex class I (MHC I) has previously been reported to be negatively associated with estrogen receptor (ER) expression. Furthermore, MHC I expression, level of tumor-infiltrating lymphocytes (TILs), and expression of interferon (IFN) mediator MxA are positively associated with one another in human breast cancers. This study aimed to investigate the mechanisms of association of MHC I with ER and IFN signaling. Materials and Methods: The human leukocyte antigen (HLA)-ABC protein expression was analyzed in breast cancer cell lines. The expressions of HLA-A and MxA mRNAs were analyzed in MCF-7 cells in Gene Expression Omnibus (GEO) data. ER and HLA-ABC expressions, Ki-67 labeling index and TIL levels in tumor tissue were also analyzed in ER+/ human epidermal growth factor receptor 2 (HER2)- breast cancer patients who randomly received either neoadjuvant chemotherapy or estrogen modulator treatment followed by resection. Results: HLA-ABC protein expression was decreased after β-estradiol treatment or hESR-GFP transfection and increased after fulvestrant or IFN-γ treatment in cell lines. In GEO data, HLA-A and MxA expression was increased after ESR1 shRNA transfection. In patients, ER Allred score was significantly lower and the HLA-ABC expression, TIL levels, and Ki-67 were significantly higher in the estrogen modulator treated group than the chemotherapy treated group. Conclusion MHC I expression and TIL levels might be affected by ER pathway modulation and IFN treatment. Further studies elucidating the mechanism of MHC I regulation could suggest a way to boost TIL influx in cancer in a clinical setting.