Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: Bone metastasis (BM) adversely affects the prognosis of gastric cancer (GC). We investigated molecular features and immune microenvironment that characterize GC with BM compared to GC without BM. Materials and Methods: Targeted DNA and whole transcriptome sequencing were performed using formalin-fixed paraffin-embedded primary tumor tissues (gastrectomy specimens) of 50 GC cases with distant metastases (14 with BM and 36 without BM). In addition, immunohistochemistry (IHC) for mucin-12 and multiplex IHC for immune cell markers were performed. Results: Most GC cases with BM had a histologic type of poorly cohesive carcinoma and showed worse overall survival (OS) than GC without BM (p < 0.05). GC with BM tended to have higher mutation rates in TP53, KDR, APC, KDM5A, and RHOA than GC without BM. Chief cell-enriched genes (PGA3, PGC, and LIPF), MUC12, MFSD4A, TSPAN7, and TRIM50 were upregulated in GC with BM compared to GC without BM, which was correlated with poor OS (p < 0.05). However, the expression of SERPINA6, SLC30A2, PMAIP1, and ITIH2 were downregulated in GC with BM. GC with BM was associated with PIK3/AKT/mTOR pathway activation, whereas GC without BM showed the opposite effect. The densities of helper, cytotoxic, and regulatory T cells did not differ between the two groups, whereas the densities of macrophages were lower in GC with BM (p < 0.05). Conclusion GC with BM had different gene mutation and expression profiles than GC without BM, and had more genetic alterations associated with a poor prognosis.

Background/Aims: The recent update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added normal growth in children as an intermediate target in Crohn’s disease and ulcerative colitis. We aimed to investigate factors associated with reaching midparental height (MPH) in patients diagnosed with inflammatory bowel disease in childhood and the adolescent period. Methods: This multicenter retrospective observational study included pediatric patients with inflammatory bowel disease that had reached adult height. Factors associated with reaching MPH were investigated by logistic regression analyses. Results: A total of 166 patients were included in this study (128 Crohn’s disease and 38 ulcerative colitis). Among them, 54.2% (90/166) had reached their MPH. Multivariable logistic regression analysis revealed that height Z-score at diagnosis and MPH Z-score were independently associated with reaching MPH (odds ratio [OR], 8.45; 95% confidence interval [CI], 4.44 to 17.90;p<0.001 and OR, 0.11; 95% CI, 0.04 to 0.24; p<0.001, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level of "height Z-score at diagnosis minus MPH Z-score" that was associated with reaching MPH was –0.01 with an area under the curve of 0.889 (95% CI [0.835 to 0.944], sensitivity 88.9%, specificity 84.2%, positive predictive value 87.0%, negative predictive value 86.5%, p<0.001). Conclusions Height Z-score at diagnosis and MPH Z-score were the only factors associated with reaching MPH. Efforts should be made to restore growth in pediatric patients who present with a negative “height Z-score at diagnosis minus MPH Z-score.”

Background/Aims: The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn’s disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods: This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results: A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

Psoriasis is a common chronic inflammatory disease in which keratinocytes proliferate abnormally due to excessive immune action. Psoriasis can be associated with various comorbidities and has a significant impact on health-related quality of life. Although many systemic treatments, including biologic agents, have been developed, topical treatment remains the main option for psoriasis management. Consequently, there is an urgent need to develop topical treatments with minimal side effects and high efficacy. Mesenchymal stem cells (MSCs) exhibit excellent immune regulation, anti-inflammatory activities, and therapeutic effects, and MSC-derived extracellular vesicles (EVs) can serve as crucial mediators of functional transfer from MSCs. Therefore, this study aimed to develop a safe and easy-to-use emulsion cream for treating psoriasis using MSC conditioned media (CM) containing EVs. We developed an enhanced Wharton’s jelly MSC (WJ-MSC) culture method through a three-dimensional (3D) culture containing exogenous transforming growth factor-β3. Using the 3D culture system, we obtained CM from WJ-MSCs, which yielded a higher EV production compared to that of conventional WJ-MSC culture methods, and investigated the effect of EV-enriched 3D-WJMSC-CM cream on psoriasis-related inflammation. Administration of the EV-enriched 3D-WJ-MSC-CM cream significantly reduced erythema, thickness, and scaling of skin lesions, alleviated imiquimod-induced psoriasiform lesions in mice, and ameliorated histopathological changes in mouse skin. The upregulated mRNA expression of inflammatory cytokines, including IL-17a, IL-22, IL-23, and IL-36, decreased in the lesions. In conclusion, we present here a new topical treatment for psoriasis using an MSC EV-enriched cream.

Background: Recent global trends indicate a rise in pediatric obesity, reflecting patterns also observed in South Korea. Given its significant impact on chronic disease prevalence in adulthood, pediatric obesity poses potential societal challenges. For pediatric obesityrelated prevention or management programs in community level to operate effectively, there needs to be a clear understanding of barriers and facilitators of the programs. This study aims to establish a foundation for policy implementation, contributing to pediatric obesity prevention and management (POPM) in Korea. Methods: A survey was conducted among program providers involved in domestic POPM programs. A total of 577 individuals completed the survey, including those working in elementary and middle schools (n = 508) and public health centers (n = 69) nationwide. The questionnaire comprised 67 questions covering characteristics of respondents, purpose and contents of POPM programs, measurement of program outcome, level of inter- and intrainstitutional linkage, difficulties in operating programs and factors that facilitate programs.A 5-point Likert scale was used for most questions. Descriptive statistics was employed to analyze characteristics of respondents in POPM programs. The level of linkage in POPM programs was assessed using perceived importance and actual degree of linkage. The difficulties in operating POPM programs were analyzed based on agreement responses, and facilitating factors of program activation were analyzed based on importance responses. Results: The domestic POPM program showed low actual linkage compared to its perceived importance, both between institutions and among professions within institutions.Difficulties in operating the program included securing availability of students, encouraging participation of reluctant students and development of new programs. The survey suggested that schools require support from parents, guardians and family members, while public health centers need professional providers to facilitate such programs. Conclusion The study highlights the urgent need for strategies to address pediatric obesity in South Korea. Weak institutional linkages hinder effective programs. Challenges include student availability, participation, and the need for innovative programs. New approaches to build partnerships in harmony among institutions are necessary. Implementing findings into policy can help prevent obesity in Korean children and adolescents.

Voice rehabilitation after total laryngopharyngoesophagectomy is a significant challenge, especially when accompanied by gastric pull-up reconstruction. In 2021, a study revealed that tracheoesophageal puncture is also safe and feasible option for voice rehabilitation in patients who underwent gastric pull-up surgery. Here, we report for the first time in South Korea a case that represents an instance of voice prosthesis insertion after gastric pull-up surgery. The case demonstrates the feasibility and safety of voice prosthesis insertion in patients who undergo total laryngopharyngoesophagectomy and gastric pull-up surgery, providing evidence that voice prosthesis insertion is achievable and can be performed in the outpatient setting using transnasal esophagoscopy.

Retrograde cricopharyngeus dysfunction (R-CPD) is a new syndrome first described in 2019 by Bastian. It is characterized by an inability to belch, along with associated symptoms such as loud gurgling noises, chest and abdominal pain/distention, and excessive flatulence. The cause of R-CPD is not yet clearly understood, but it is believed to be related to the dysfunction of the cricopharyngeus muscle. In Korea, R-CPD is not well understood yet and consequently, there is no available treatment for this condition to date. Here, we aim to report two cases of diagnosing and treating patients with R-CPD for the first time in Korea using botulinum toxin injection under local anesthesia.