Purpose: This study was performed to explore and describe the overall clinical practice adaptation experiences among nursing students during the COVID-19 pandemic. Methods: This qualitative study applied the grounded theory method by Corbin and Strauss. Data were collected from May to August 2021 through individual in-depth interviews with 14 nursing students from three universities in B metropolitan city. Results: From open coding, 20 sub-categories and 10 categories were identified. Analysis revealed that the core category was the process of “keeping the place of learning while adhering to the restrictions of the era of pandemic” and that it consisted of four phases: confusion, withdrawal, adjustment, and growth. Through this process, participants utilized various action/interactional strategies such as “shifting to positive thinking,” “building a shield to protect oneself,” and “focusing on learning.” The consequences of these strategies were “adapting to the reality of the infectious disease situation” and “strengthening a foothold to grow as a future nurse.” Conclusion An in-depth understanding of nursing students’ experiences of adapting to clinical practice during the COVID-19 pandemic will guide nursing educators to promote effective teaching strategies to better support nursing students in a time of infectious disease crisis.

Acne fulminans shows severe inflammatory changes in acne lesions and is accompanied by systemic symptoms, such as fever and myalgia. Acne fulminans can leave scars, which can profoundly affect patients’ quality of life and require proper treatment. Herein, we present a case of acne fulminans that occurred after COVID-19 vaccination in a 15-year-old male patient. Considering no signs of infection, new drug administration, and immunological factors that can cause acne fulminans other than COVID-19 vaccination and the short time interval between the time of vaccination and the acne fulminans outbreak, acne fulminans is thought to have been caused by COVID-19 vaccination. Oral steroid and isotretinoin treatment was initiated, and 3 months after the treatment, acne lesions recovered to pre-COVID-19 vaccination status, with no exacerbated episode until 6 months follow-up.

PURPOSE: The purpose of this study was to understand the essence and meaning of the experience of cancer patients receiving spiritual nursing. METHODS: Data were collected by in-depth individual interviews with participants from April to June, 2019. Eight patients from a single Christian hospital participated in this study. Cyclical data collection and analysis were conducted by Collaizzi's phenomenological method. RESULTS: The experience of cancer patients receiving spiritual nursing consisted of four themes: strange spiritual nursing faced with longing, unexpected changes in me, spiritual sympathy leading to trust, and transition to spiritual recovery. CONCLUSION: This study provided an in-depth understanding of the changes cancer patients experience through spiritual nursing interventions. Efforts should be made to verify the effectiveness of this study by developing and applying education programs that can enhance the spiritual nursing capabilities of nurses to better approach cancer patients.
Data Collection ; Education ; Hospitals, General ; Humans ; Methods ; Nursing Care ; Nursing ; Qualitative Research ; Spirituality

BACKGROUND: Traditionally, interferon-gamma (IFN-gamma) was regarded as a pro-inflammatory cytokine, however, recent reports suggested role of IFN-gamma in immune tolerance. In our previous report, we could induce tolerance to male antigen (HY) just by male islet transplantation in wild type C57BL/6 mice without any immunological intervention. We tried to investigate the influence of IFN-gamma deficiency on tolerance induction by male islet transplantation. METHODS: To examine the immunogenicity of male tissue in the absence of IFN-gamma, we transplanted male IFN-gamma knock-out (KO) skin to female IFN-gamma KO mice. Next, we analyzed male IFN-gamma KO islet to streptozotocin-induced diabetic female IFN-gamma KO mice. And, we checked the functionality of grafted islet by graft removal and insulin staining. RESULTS: As our previous results in wild type C57BL/6 mice, female IFN-gamma KO mice rejected male IFN-gamma KO skin within 29 days, and did not reject male IFN-gamma KO islet. The maintenance of normal blood glucose level was dependent on the presence of grafted male islet. And the male islet recipient did not reject 2nd challenge of male islet graft also. CONCLUSION: Deficiency of IFN-gamma does not have influence on the result of male skin graft and male islet transplantation. Conclusively, male islet transplantation induced T cell tolerance is not dependent on the presence of IFN-gamma.
Animals ; Blood Glucose ; Female ; Humans ; Immune Tolerance ; Insulin ; Interferon-gamma ; Islets of Langerhans Transplantation ; Male ; Mice ; Skin ; Transplants

Choledochoscopic lithotomy with the aid of electrohydraulic lithotripsy ( EHL ) was performed in 12 patients at the Department of Surgery, College of Medicine, the Catholic University of Korea, St. Vincent Hospital between January 1996 and March 1998. This retrospective analysis include 4 patients with common bile duct (CBD) stones, 5 patients with intrahepatic duct (IHD) stones, and 3 patients with CBD & IHD stones. The male to female ratio was 1 to 2. The peak incidence of age was the fifty. As a route for the choledochoscopy, a T-tube tract was used in 9 patients, while percutaneous biliary drainage followed by dilatation of the tract was established in 3 patients. The largest stones measured 22mm (by 5mm), the average is 10.3mm. Average number of session which performed for IHD stones was 3.7, while that of CBD stones was 2.7. Complete removal of the stones was achieved in 7 of 12 patients. Retained stones of CBD were removed completely in all cases. We could not removed retained stones completely in cases of multiple, impacted stones in peripheral ducts, associated stricture and acute angulation of IHD & CHD which choledochoscopic manipulation make difficult. Minor complications were bleeding from the bile duct mucosa in 1 patient and postprocedure chills and fever in 1 patient. In conclusion, choledochoscopic lithotomy with electrohydraulic lithotripsy is efficient and will be useful to remove biliary calculi in patients who have poor surgical risks.
Bile Ducts* ; Bile* ; Chills ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Fever ; Gallstones ; Hemorrhage ; Humans ; Incidence ; Korea ; Lithotripsy* ; Male ; Mucous Membrane ; Retrospective Studies

BACKGROUND/AIMS: Diagnostic or thepapeutic endoscopic retrograde cholangiopancreatography (ERCP) is the mainstream for the pancreaticobiliary disease. However, the ERCP related complications are serious and sometimes fatal to the patients. We have reviewed our experiences of the operative management for the ERCP injury. METHODS: Medical records of 13 patients who underwent laparotomic surgical intervention for various ERCP injuries from March 1996 to August 2002 at Department of Surgery, the Catholic University of Korea were reviewed. RESULTS: The age range of the patients was from 28 to 85 years. There were 5 females and 8 males. 6 patients showed the duodenal perforations and 4 patients suffered from bleedings around the ampulla of Vater. One of the 4 bleeding patients had huge expanding submucosal hematomas throughout the entire duodenum. We found massive retroperitoneal extraluminal air density in one patient but we could not find any leakage of the contrast media during the upper gastrointestinal series, however, this patient complained aggravated peritoneal irritation sign, so we explored the abdomen. Most of the patients had free abdominal or retroperitoneal air shadows (n=7) on plain chest or abdominal X-ray. We diagnosed the uncontrolled bleeding from the sphincterotomy site using the gastroduodenal fiberscopes in 3 patients. On the computed tomogaphic images, one patient showed a huge duodenal hematoma, another one had a retroperitoneal fluid collection and another one revealed a retroperitoneal air shadow. One patient showed aggravated pancreatitis on the serial CT scan and finally the patient developed a hemorrhagic necrotizing pancreatitis, then we explored the abdomen and tried peripancreatic drainage but we lost the patient in 19 postoperative day due to sepsis. The other 12 patients survived by the various surgical procedures. For the 6 patients, we performed duodenotomic sphincteroplasty, tube duodenostomy and biliary drainage with T-tube. One patient survived with Whipple's procedure, one patient improved by the pyloric exclusion and one patient cured with the duodenal diverticulization. Other procedures were primary repair of the duodenum, transduodenal sphincteroplasty and just cholecystectomy and T-tube choledochostomy. CONCLUSION: There was tendency to uneventful improvement of patients by the early detection and urgent laparotomic surgical intervention of the ERCP complication.
Abdomen ; Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholecystectomy ; Choledochostomy ; Contrast Media ; Drainage ; Duodenostomy ; Duodenum ; Female ; Hematoma ; Hemorrhage ; Humans ; Korea ; Male ; Medical Records ; Pancreatitis ; Sepsis ; Sphincterotomy, Transhepatic ; Thorax ; Tomography, X-Ray Computed

PURPOSE: We have summarized the experience of our institution related to what treatment has been performed in patients with pancreatic fistula and their outcome.METHODS: Seventy-eight pancreatico-enteric anastomosis failure (PEAF) patients of 403 pancreaticoduodenectomy (PD) were included for this retrospective study. PEAF was defined by the presence of rich amylase (over 10,000 IU/L) in drainage fluid at postoperative day 5 to 7 and radiographic demonstration of the anastomotic breakdown and associated local fluid collection. The management was analyzed by observation group (O group), intervention (I group) and surgery group (S group).RESULTS: Preoperative clinical status of the PEAF group and non-PEAF group was similar. Bile duct cancer was the highest risk subgroup of the PEAF (P=0.001) and the pancreatic adenocarcinoma showed the least risk for the PEAF (P<0.001). Among the 78 PEAF patients, 50 were managed as a conservative treatment, 15 patients were received radiologic intervention and 13 patients performed rescue surgery. Among these three subgroups, there was no statistical significance in the patient's demographics, clinical status, surgical factors and disease nature. However, mortality was significantly higher in the S group (P<0.001). The mortality cases were developed one and six patients in O and S group, respectively. Surgical procedures in S group were completion total pancreatectomy with or without splenectomy (n=12) and pancreatectomy preserving spleen in four (28.6%). Pancreaticogastrostomy repair and Roux-en-Y pancreaticojejunostomy reconstruction were performed each case, respectively.CONCLUSION: Proper drainage catheter indwelling during the PD or postoperative radiological intervention can effectively manage the PEAF without surgical interventional treatment.
Adenocarcinoma ; Amylases ; Bile Duct Neoplasms ; Catheters ; Demography ; Drainage ; Humans ; Mortality ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Retrospective Studies ; Spleen ; Splenectomy

Background: /Aim: Cancer-associated fibroblasts (CAFs) play an immunosuppressive role in the tumor microenvironment (TME) of human cancers; however, their characteristics and role in hepatocellular carcinoma (HCC) remain to be elucidated. Methods: Nine tumor and surrounding liver tissue samples from patients with HCC who underwent surgery were used to isolate patient-derived CAFs. Cell morphology was observed using an optical microscope after culture, and cell phenotypes were evaluated using flow cytometry and immunoblotting. Cytokines secreted by CAFs into culture medium were quantified using a multiplex cytokine assay. Results: CAFs were abundant in the TME of HCC and were adjacent to immune cells. After culture, the CAFs and non-tumor fibroblasts exhibited spindle shapes. We observed a robust expression of alpha-smooth muscle actin and fibroblast activation protein in CAFs, whereas alpha-fetoprotein, epithelial cell adhesion molecule, platelet/endothelial cell adhesion molecule-1, and E-cadherin were not expressed in CAFs. Furthermore, CAFs showed high secretion of various cytokines, namely C-X-C motif chemokine ligand 12, interleukin (IL)-6, IL-8, and C-C motif chemokine ligand 2. Conclusions CAFs are abundant in the TME of HCC and play a crucial role in tumor progression. These fibroblasts secrete cytokines that promote tumor growth and metastasis.