Gorham-Stout syndrome is a rare bone disorder characterized by progressive massive osteolysis and proliferation of vascular and lymphatic vessels. A 15-year-old boy was initially diagnosed with Gorham-Stout at the age of 8 years based on clinical and radiological findings. Following diagnosis, he was treated with pamidronate, interferon alfa, propranolol, oral corticosteroids, and sirolimus. He developed proteinuria at the age of 15 and progressed into the nephrotic range 2 years later. A renal biopsy revealed focal segmental glomerulosclerosis, not otherwise specified variant. The sequential increase in proteinuria associated with medications suggested that the focal segmental glomerulosclerosis may be caused by pamidronate and sirolimus, but cannot completely rule out the possibility of kidney involvement of GSS itself.

PURPOSE: The purpose of this study was to investigate relationships among intention of retention, nursing organizational culture, empowering leadership and organizational socialization of new graduate nurses, and identify factors affecting intent to stay. METHODS: Data were collected from 184 new nurses who were graduated in 2017 and are now working in three tertiary hospitals. The relationship among the variables was analyzed with Pearson coefficient correlations and factors affecting intention of retention were identified by using multiple linear regression analysis. RESULTS: The mean score for intention of retention was 5.23±1.25 (out of 8). Intent to stay had positive relationships with innovation-oriented culture, relation-oriented culture, task-oriented culture, empowerment leadership, organizational socialization. Factors influencing intent to stay were ‘motivation for selection of nursing (β=.19, p<.001)’, ‘organizational commitment (β=.45, p<.001)’, ‘job identity (β=.18, p=.005)’, and ‘interpersonal relationship of personal characteristics (β=.16, p=.005)’ in organizational socialization, and ‘coaching (β=.29, p=.001)’, and ‘showing concerning (β=−.19, p=.036)’ by empowering leadership. These factors explained 53.0% of the variance in intention of retention (F=35.96, p<.001). CONCLUSION Focusing on the factors of influence derived from this study, relevant institutions and nursing organizations require the creation of a work environment and leadership to increase the retention of new graduate nurses.

PURPOSE: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). METHODS: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. RESULTS: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. CONCLUSION: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.
Atmosphere ; Education, Nursing ; Korea ; Learning ; Nursing ; Preceptorship ; Reproducibility of Results ; Statistics as Topic ; Weights and Measures

PURPOSE: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). METHODS: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. RESULTS: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. CONCLUSION The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

A 65-year-old male was referred to our hospital for evaluation of a right pleural effusion. Thoracic computed tomography (CT) revealed a huge central mass with right hilar and subcarinal lymph node conglomerates. An endobronchial mass was incidentally found in the right upper lobe bronchus, and endobronchial ultrasound-guided transbronchial needle biopsy of the mediastinal lymph nodes was thus also performed at the time of bronchoscopy. The two biopsies revealed squamous cell carcinoma and diffuse large B-cell lymphoma (DLBCL), respectively. As the pathology of the mediastinal lymph nodes was unknown, the lung cancer could not be accurately staged. Thus, we treated the DLBCL; follow-up positron emission tomography/CT after two cycles of chemotherapy showed that the conglomerate mass had disappeared but the right upper lobe lesion remained. Lung cancer staging thus became more accurate and radical treatment could be considered. To the best of our knowledge, this is the first report of a co-existing squamous cell carcinoma of the lung and DLBCL of the intrapulmonary lymph nodes.
Aged ; B-Lymphocytes* ; Biopsy ; Biopsy, Needle ; Bronchi ; Bronchoscopy ; Carcinoma, Squamous Cell* ; Drug Therapy ; Electrons ; Epithelial Cells* ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell* ; Male ; Mediastinum ; Pathology ; Pleural Effusion

Solid pseudo-papillary neoplasm (SPN) of pancreas is a rare epithelial neoplasm of pancreas with a low malignant potential, occurs most commonly in young females. Here, we report a rare case of woman who has severe hepatomegaly due to multiple hepatic metastases of SPN of pancreas. At the time of diagnosis, a SPN was detected at only pancreas and there was no evidence of metastasis. So, she received subtotal pancreatectomy and total splenectomy. After 2 years of follow up, multiple small hepatic metastases were presented. In spite of three times of radiofrequency ablation, the burden of hepatic metastasis has increased continuously and multiple intra-abdominal lymph nodes metastases were detected, and ascites and peripheral edema occurred. However, because of benign feature of SPN and extremely rare incidence of recurrence and metastasis, there is no specific treatment guideline for metastatic SPN. Through multidisciplinary care service, we planned to do radiotherapy followed by a transarterial chemoembolization (TACE). But the patient could not have a scheduled radiation therapy due to deterioration of liver function. So changing the strategy of treatment, followed by TACEs were done alone. Although the size of SPN is not reduced, the extent of SPN and complication of SPN (ascites, peripheral edema, abdominal pain and so on) are being controlled.
Abdominal Pain ; Ascites ; Catheter Ablation ; Diagnosis ; Edema ; Female ; Follow-Up Studies ; Hepatomegaly ; Humans ; Incidence ; Liver ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Pancreas ; Pancreatectomy ; Radiotherapy ; Recurrence ; Splenectomy

BACKGROUND: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness. CASE PRESENTATION: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids. CONCLUSIONS: Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.
Aged ; Argyria* ; Basement Membrane ; Biopsy ; Diagnosis, Differential ; Eating ; Emergency Service, Hospital ; Female ; Fever ; Forehead ; Humans ; Muscle Weakness* ; Muscles ; Muscular Diseases ; Myofibrils ; Myositis ; Neural Conduction ; Nose ; Pathology ; Pigmentation Disorders ; Polyneuropathies ; Pyelonephritis ; Rehabilitation ; Silver ; Skin ; Skin Pigmentation ; Steroids ; Sweat Glands ; Thigh

No abstract available.
Macular Edema*

PURPOSE: To report our results on urinary continence after bladder neck preservation (BNP) and posterior urethral reconstruction (PUR) during robot-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: Data from 107 patients who underwent RALP were compared on the basis of whether the patients underwent BNP and PUR, BNP only, or the standard technique (ST). In group A (n=31 patients), ST was performed by using Ven velthoven continuous suturing for urethrovesical anastomosis. In group B (n=28 patients), ST with only PUR was performed. In group C (n=48 patients), both the BNP and PUR techniques were used. "Recovery of continence" was defined as the use of 1 pad (50 ml) or less within 24 hours. RESULTS: The three groups were comparable in terms of patient demographics. The mean operative time and the mean blood loss decreased significantly from group A to group C (p=0.021 for mean operative time and p=0.004 for the mean blood loss). Mean catheterization time was 8.9, 7.8, and 7.1 days in each group (p=0.047). Early return of urinary continence at 3 months was observed in group B (89.2%) and group C (90.6%) compared with group A (71%). However, continence at 6 months was comparable in the 3 groups (87.5% in group A, 92.8% in group B, and 92.3% in group C). Rates of positive surgical margins decreased from 30.2% in group A to 20% in group B and 12% in group C. CONCLUSIONS: BNP and PUR during RALP showed a favorable impact on the early postoperative recovery of continence while not affecting positive surgical margins.
Catheterization ; Catheters ; Demography ; Humans ; Neck ; Operative Time ; Prostatectomy ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Incontinence

No abstract available.