Purpose: : This study is descriptive research investigating the effects of incivility, job stress, and resilience experienced by emergency room nurses on turnover intention. The study will identify the degree of incivility experienced by emergency room nurses and provide data to improve and cope with the impolite situations in emergency room. Methods: : Participants were 203 nurses in the emergency departments of 10 hospitals. The data were analyzed using the SPSS Statistics 24.0 program with descriptive statistics, independent t-test, one-way ANOVA, Scheffé test and Pearson’s correlation coefficients and stepwise multiple regression analysis. Results: : Turnover intention had significant positive correlations with job stress and incivility from various sources including patients and their caregivers, doctors, supervisors, and coworkers. In contrast, turnover intention had a significant negative correlation with resilience. The most influencing factor for increasing turnover intention was nursing job dissatisfaction, followed by neutral job satisfaction, job stress, not wanting to work in the ER, unmarried marital status, and incivility from coworkers. The total explanatory power of these factors was 36.3%. Conclusion : This study indicates that the less incivility experience among the emergency room nurses is associated with less job stress and lower turnover intention. Therefore, nursing organizations must establish specific support strategies to reduce incivility and job stress experienced by emergency room nurses and minimize their turnover intention.

We investigated the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for restaging of treated uterine cervix squamous cell cancer with tumor maker elevation that was not explained by other conventional evaluation. We enrolled 32 cases who underwent PET/CT for the restaging of treated cervical cancer with tumor marker elevation that was not explained by recent conventional evaluation. All enrolled cases had squamous cell carcinoma. Increased tumor markers included squamous cell carcinoma antigen (SCC Ag) and carcinoembryonic antigen (CEA). PET/CT findings were determined by pathologic confirmation or clinical follow-up. We compared PET/CT accuracy and clinical parameters including normalization of tumor markers in both the SCC Ag elevation group and the CEA elevation group. The sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT in detecting recurrence were 100%, 83.3%, 82.4%, and 100%, respectively. Accuracy was significantly different between the SCC Ag elevation group and the CEA elevation group (p=0.0169). PET/CT with SCC Ag elevation was more accurate (100%) than PET/CT with CEA elevation (66.7%). Normalization of tumor markers was observed more often in the SCC Ag elevation group than in the CEA elevation group (p=0.0429). PET/CT showed high negative predictive value and sensitivity in the restaging of cervical cancer with unexplained tumor marker elevation. PET/CT was more accurate in patients with SCC Ag elevation than in those with CEA elevation.
Antigens, Neoplasm ; Carcinoembryonic Antigen ; Carcinoma, Squamous Cell ; Cervix Uteri ; Electrons ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Neoplasms, Squamous Cell ; Positron-Emission Tomography and Computed Tomography ; Recurrence ; Sensitivity and Specificity ; Serpins ; Biomarkers, Tumor ; Uterine Cervical Neoplasms

Tetrofosmin is a ligand that forms a lipophilic, cationic complex with Tc-99m.1) Tc-99m tetrofosmin was developed as a myocardial perfusion imaging agent and also used to depict tumors.1-3) Mediastinal tumors is also detected by Tc-99m tetrofosmin.2-5) We report a case of extracardiac mediastinal activity detected by Tc-99m tetrofosmin scintigraphy, which revealed thymoma.
Myocardial Perfusion Imaging ; Thymoma ; Tomography, Emission-Computed, Single-Photon

PURPOSE: There are few recent data regarding allergic sensitization of atopic dermatitis (AD) in Korea. The aim of this study was to investigate patterns of sensitization according to age and gender in children with AD. METHODS: This retrospective study included 4,661 children with AD from 1998 to 2014. The serum specific IgE (sIgE) levels to egg white (EW), cow's milk (CM), peanut, wheat, soybean, buckwheat, tree nuts, crustaceans, meat, and house dust mites (HDMs) were reviewed. AD was categorized into the extrinsic (ADe) and intrinsic type (ADi) according to the presence or absence of sensitization. The proportion of patients with sIgE to EW or CM greater than the previously reported diagnostic decision point (DDP) was determined. RESULTS: A total of 4,661 children (2,843 boys and 1,818 girls) were collected. We identified 1,857 of 2,663 children (69.7%) with the ADe type and 806 of 2,663 children (30.3%) with the ADi type. The sensitization rates increased with age (P<0.001). EW (59.3%) was the most commonly sensitized food, followed by CM (46.6%), peanut (32.2%), wheat (31.5%), soybean (28.1%), and buckwheat (23.7%). The most commonly sensitized food groups were tree nuts (56.7%) and crustaceans (28.3%). The rate of sensitization to HDMs was 40.1%. In addition, 11.1% and 7.5% of children had levels of sIgE to EW and CM, respectively, higher than the DDP. CONCLUSION: The incidence of ADe among children with AD was 69.7% and increased with age. The most commonly sensitized food allergen was EW, followed by CM and peanut.
Arachis ; Child* ; Dermatitis, Atopic* ; Egg White ; Fagopyrum ; Humans ; Immunoglobulin E ; Incidence ; Korea ; Meat ; Milk ; Nuts ; Pyroglyphidae ; Retrospective Studies ; Soybeans ; Trees ; Triticum

A 75-year-old man with non-small cell lung cancer (NSCLC) underwent F-18 fluorodeoxyglucose (FDG) PET/CT for staging. PET/CT showed distant metastases to intra-abdominal lymph nodes (LNs) as well as bilateral mediastinal LNs (stage IV). He underwent PET/CT (restaging PET/CT) 1 week after the completion of first-line chemotherapy (docetaxel + carboplatin). It showed markedly increased FDG uptake in primary tumor, whereas tumor size decreased significantly, compared to prior PET/CT. This lesion was aggravated on follow-up CT 3 months after the completion of chemotherapy. Although there are several reports that FDG PET has potential to evaluate early response to chemotherapy and prognosis, there are a few cases to show mismatch between FDG uptake and size on PET/CT. Thus we report a case of NSCLC showed increased FDG uptake of primary tumor while decreased tumor size on restaging PET/CT.
Aged ; Carcinoma, Non-Small-Cell Lung ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Ectopic thyroid is not common disease and double ectopic thyroid is rare. Until January of 2008, dual ectopic thyroid has been reported only 23 cases in international literatures. Tc-99m sodium pertechnetate scan is playing an important role in the diagnosis of ectopic thyroid. In most of the cases, dual lingual thyroid tissues could be detected as two radiotracer uptake foci. We report a case of dual lingual thyroid mimicking mono-lingual thyroid in the anterior view of thyroid scan. Lateral view helped in this case to detect the dual lingual thyroid. With lateral view, the anatomical position and relationship could be examined in more detail.
Lingual Thyroid ; Sodium ; Sodium Pertechnetate Tc 99m ; Thyroid Dysgenesis ; Thyroid Gland

Juvenile dermatomyositis is a common inflammatory muscle disease of childhood, characterized by weakness in proximal muscles and specific skin rash. In case of juvenile dermatomyositis without characteristic clinical features, non-invasive imaging tools such as (99m)Tc-HDP three-phase bone scan are very helpful in diagnostic workup of myopathies. We report a case of 13-year old female with juvenile dermatomyositis, in which (99m)Tc-HDP three-phase bone scan was useful in diagnosis and assessing therapy response.
Dermatomyositis ; Exanthema ; Female ; Humans ; Muscles ; Muscular Diseases ; Myositis

We aimed to determine the changes in 18F-fluorodeoxyglucose (FDG) uptake in the spinal cord on two serial positron emission tomography/computed tomography (PET/CT) scans in a healthy population. We retrospectively enrolled healthy people who underwent PET/CT twice for cancer screening. We excluded those who had degenerative vertebral disease, neurologic disease, or a history of a vertebral operation. The standardized uptake value (SUVmax) of the spinal cord of each mid-vertebral body was obtained by drawing a region of interest on an axial image of PET/CT. For analysis, the cord-to-background ratio (CTB) was used (CTB=SUVmax of each level/SUVmax of L5 level). Differences in pattern, sex, age, and intervals of the two serial PET/CT scans were analyzed. A total of 60 PET/CT images of 30 people were analyzed. The mean interval between the two PET/CT imaging studies was 2.80+/-0.94 years. On the follow-up PET/CT, significant change was shown only at the level of the C6 and T10 vertebrae (p<0.005). Mean CTB showed a decreasing pattern from cervical to lumbar vertebrae. There were two peaks at the lower cervical level (C4-6) and at the lower thoracic level (T12). Neither sex nor age significantly affected CTB. The FDG uptake of the spinal cord changed significantly on follow-up PET/CT only at the level of the C6 and T10 vertebrae. This finding is valuable as a baseline reference in the follow-up of metabolic changes in the spinal cord.
Early Detection of Cancer ; Electrons ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Lumbar Vertebrae ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Spinal Cord ; Spine

Wilson disease (WD) is a relatively common genetic hepatic disease in children and is characterized by excessive copper accumulation, predominantly in the liver and brain. It is an autosomal recessive disease caused by an ATP7B mutation that causes brain degeneration and is potentially fatal if diagnosed late or untreated. In the early phase of WD, its initial presentation may include mild hepatic involvement. WD may be overlooked as a cause of liver disease due to severe obesity but should not be excluded from differential diagnosis. We report a case of WD with severe obesity and fatty liver diagnosed in the early phase by targeted gene panel sequencing and review the endocrine problems associated with WD. Early suspicion of WD is important for good prognosis.

Coffin-Lowry syndrome (CLS, OMIM # 303600) is a rare X-linked disorder caused by mutations in RPS6KA3. CLS is characterized by facial dysmorphism, digit abnormalities, developmental delays, growth retardation, and progressive skeletal changes in male patients. Females with CLS are variably affected, complicating diagnosis. Here, we describe the clinical and molecular findings in a female Korean child with CLS and review the associated literature. A 5-year-old girl presented with short stature and developmental delays. She had a coarse facial appearance characterized by a prominent forehead, hypertelorism, thick lips, and hypodontia. She also had puffy tapering fingers and pectus excavatum. We performed exome sequencing and identified a novel, likely pathogenic, heterozygous variant, c.326_338delinsCTCGAGAC (p.Val109Alafs*10), in RPS6KA3 (NM_004586.2). This is the first Korean female genetically diagnosed with CLS. In contrast to the delayed bone age reported in previous studies, our patient showed advanced bone age and central precocious puberty. CLS should be considered as a differential diagnosis of short stature, tapering fingers, and developmental delay. We suggest that molecular techniques can be a useful tool for diagnosis of rare disorders such as CLS because such conditions are not simple, and the associated spectrum of phenotypes can vary.