Retroperitoneal Leiomyoma With Exophytic Growing into the Lesser Sac:A Case Report

Leiomyoma is a common benign tumor of smooth muscle cells that rarely occurs in the retroperitoneum. Here, we report a retroperitoneal leiomyoma with exophytic growing into the lesser sac incidentally diagnosed in a 69-year-old woman. In this case, the retroperitoneal leiomyoma presented as a well-circumscribed mass with heterogeneous signal intensity and mild progressive enhancement on magnetic resonance imaging. Differential image diagnosis of this retroperitoneal leiomyoma from other retroperitoneal tumors was difficult due to an overlap in imaging appearances with other retroperitoneal tumors.

Intrahepatic Bile Duct Dilatation Caused by Pancreatic Pseudocyst: A Case Report

Pancreatic pseudocyst can fistulize to adjacent organs such as stomach, duodenum, colon, and esophagus. Fistula formation with bile duct is rare. Reported cases of biliary involvement of pancreatic pseudocyst include fistula formation between the pancreatic pseudocyst and common bile duct. Intrahepatic bile duct dilatation caused by fistula formation with pancreatic pseudocyst is extremely rare. There are no published reports to the best of our knowledge. Herein, we report a case of intrahepatic bile duct dilatation caused by fistulous communication with a pancreatic pseudocyst. The peripheral intrahepatic bile duct surrounding the pseudocyst was dilated without involving the common bile duct. Magnetic resonance cholangiopancreatography image showed a connection between the pancreatic pseudocyst and dilated intrahepatic bile ducts with a multifocal cystic and beaded appearance.

Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction / 간호행정학회지

PURPOSE: The aim of this study was to identify the relationships between the difficulty of end-of-life care and moral distress, burnout and job satisfaction of nurses working in intensive care units (ICUs). METHODS: This descriptive study was conducted using self-report questionnaires. Participants were nurses who had more than one year of ICU experience and were recruited from three university hospitals (N=168). RESULTS: The mean scores for ICU nurses' difficulty in end-of-life care, moral distress, burnout and job satisfaction were 3.42, 113.88, 3.16 and 2.58 points, respectively. Difficulty in end-of-life care was positively correlated with moral distress (r=.48, p < .001) and burnout (r=.26, p=.001) and was negatively correlated with job satisfaction (r=−.17, p=.024). Difficulties in end-of-life was identified as a predictor of moral distress (β=.44, p < .001), burnout (β=.26, p=.001) and job satisfaction (β=−.18, p=.024). CONCLUSION: The results of this study suggest the following: it is important to have a deep understanding of ICU nurses who experience various difficulties in end-of-life care and to provide realist support for these nurses. And practical efforts by nursing organizations are needed, including support systems and education programs to alleviate ICU nurses' difficulties in end-of-life care.

Newly Graduated Nurses' Job Satisfaction: Comparison with Allied Hospital Professionals, Social Workers, and Elementary School Teachers

PURPOSE: The purposes of this study are to examine differences in job satisfaction among professional groups including nurses, allied hospital professionals, social workers, and elementary school teachers, and to identify specific characteristics of job satisfaction of nurses. METHODS: The study design was a cross-sectional exploratory study using secondary data analysis with the 2009 Graduates Occupational Mobility Survey. The sample was female new graduates. The differences in job satisfaction among professional groups were analyzed using logistic regression (satisfied vs. not satisfied). RESULTS: Overall, 41.5% of nurses, 50.1% of allied hospital professionals, 58.2% of social workers, and 89% of elementary school teachers were satisfied with their job. Nurses were significantly less satisfied than the other professionals in 5 of the 11 job characteristics and had the lowest odds ratio (OR) when compared with elementary school teachers: work content (OR = 0.197, 95% CI [0.128, 0.304]), physical work environment (OR = 0.353, 95% CI [0.236, 0.529]), working hours (OR = 0.054, 95% CI [0.033, 0.088]), personal growth (OR = 0.242, 95% CI [0.160, 0.366]), and autonomy (OR = 0.188, 95% CI [0.123, 0.288]). Work content, physical work environment, interpersonal relationship, advancement system, and autonomy were significantly associated with the overall job satisfaction of nurses. CONCLUSION: Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed.

Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas Adjacent to the Gallbladder with Internally Cooled Electrodes: Assessment of Safety and Therapeutic Efficacy

OBJECTIVE: The objective of this study was to evaluate the safety and therapeutic efficacy of percutaneous radiofrequency (RF) ablation for the treatment of hepatocellular carcinomas (HCCs) adjacent to the gallbladder with the use of internally cooled electrodes. MATERIALS AND METHODS:We retrospectively assessed 45 patients with 46 HCCs (mean size, 2.2 cm) adjacent to the gallbladder ( or =3 cm) and tumor location (a tumor that abutted the gallbladder) were associated with an increased risk of early incomplete treatment. No variable was significantly associated with local tumor progression. CONCLUSION: Percutaneous RF ablation of HCCs adjacent to the gallbladder using an internally cooled electrode is a safe and effective treatment. Significant risk factors that lead to early incomplete treatment include tumor size, tumor location and electrode direction.