Background: The present study aimed to provide basic data to establish a foundation for efficient operation of the organization by identifying the effects of factors related to moral sensitivity and psychological well-being on job engagement of clinical dental hygienists. Methods: This cross-sectional survey consisted of self-administration questionnaires. After the approval by the Institutional Review Board, a survey was conducted from September 2019 to November 2019, targeting dental hygienists with clinical experience of 1 year or more. A total of 189 questionnaires were analyzed using SPSS 18.0 for Windows. The data were analyzed using average standard deviation, t-test, one-way analysis of variance, Scheffe test, Pearson's correlation analysis, and multiple regression analysis. Results: According to job-related characteristics, higher job engagement was associated with more amount of clinical experience, less turnover intention, higher positions, and occasional job fatigue. Job engagement was improved by increasing moral sensitivity and psychological well-being of clinical dental hygienists. The factors affecting job engagement revealed that along with clinical career, the sub-areas of job engagement, namely turnover intention, moral sensitivity, and psychological well-being had statistically significant influence on job engagement and the explanatory power of the model was approximately 44.8%. Conclusion Joy of working as a clinical dental hygienist, clinical career, turnover intention, moral sensitivity, and psychological well-being were confirmed as influencing factors that affected job engagement of clinical dental hygienists. It is necessary to establish an effective plan to improve job engagement by increasing moral sensitivity and psychological well-being of clinical dental hygienists.

PURPOSE: Incomplete Kawasaki disease (KD) is frequently associated with delayed diagnosis and treatment. Delayed diagnosis leads to increasing risk of coronary artery aneurysm. Anterior uveitis is an important ocular sign of KD. The purpose of this study was to assess differences in laboratory findings, including echocardiographic measurements, clinical characteristics such as fever duration and treatment responses between KD patients with and those without uveitis. METHODS: We conducted a prospective study with 110 KD patients from January 2008 to June 2013. The study group (n=32, KD with uveitis) was compared with the control group (n=78, KD without uveitis). Laboratory data were obtained from each patient including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, and level of alanine aminotransferase, aspartate aminotransferase, serum total protein, albumin, C-reactive protein (CRP), and N-terminal probrain natriuretic peptide (NT-pro BNP). Echocardiographic measurements and intravenous immunoglobulin responses were compared between the two groups. RESULTS: The incidence of uveitis was 29.0%. Neutrophil counts and patient age were higher in the uveitis group than in the control group. ESR and CRP level were slightly increased in the uveitis group compared with the control group, but the difference between the two groups was not significant. No significant differences in coronary arterial complication and treatment responses were observed between the two groups. CONCLUSION: Uveitis is an important ocular sign in the diagnosis of incomplete KD. It is significantly associated with patient age and neutrophil count.
Alanine Transaminase ; Aneurysm ; Aspartate Aminotransferases ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Coronary Vessels ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis* ; Echocardiography ; Fever ; Humans ; Immunoglobulins ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Natriuretic Peptide, Brain ; Neutrophils ; Platelet Count ; Prospective Studies ; Uveitis* ; Uveitis, Anterior

No abstract available.

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

Vitiligo, an autoimmune skin disease, is primarily driven by interferon-γ-CXCL10 signaling involving autoreactive CD8＋ T cells targeting melanocytes. Although the pathogenesis of segmental vitiligo remains unclear, recent insights suggest neural, somatic mosaicism, and microvascular mechanisms as possible explanations. Here, we present a case of a 5-year-old boy with a café au lait macule that transformed into a hypopigmented patch, suggestive of segmental vitiligo. Biopsies showed early vitiligo features in the hypopigmented area, where there was high prevalence of CD8＋ T cells, accompanied by CXCL10 expression. Growing evidence supports the autoimmune basis and cutaneous mosaicism in segmental vitiligo, with this case highlighting the role of vulnerable melanocytes, autoimmune attack, and the abrupt loss of repigmentation post-treatment. This case adds weight to the autoimmune and mosaicism theories in segmental vitiligo pathogenesis.

Gallbladder tumors are rare but aggressive malignancies, often identified incidentally after cholecystectomy. Adenocarcinoma is the most common phenotype, though squamous cell carcinoma is rare, and it ranged as 1–4% of reported gallbladder cancer. Due to the rarity of the disease, early diagnosis is often challenging. One of the uncommon presentations of gallbladder cancer is hepatic abscess, with few cases reported in the literature. This report presents a rare case of an 82-year-old male referred with hepatic abscess. Multiple pathogens were isolated, indicating a superimposed bacterial infection. Upon further investigation, cytology confirmed the presence of a keratinizing squamous carcinoma of gallbladder cancer. This case presents a rare instance of squamous cell gallbladder carcinoma, which is difficult to diagnose, discovered in an elderly patient who presented with a liver abscess accompanied by bacterial infection. It highlights the challenges in diagnosis and treatment, as well as the poor prognosis associated with the condition.

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic

Purpose: We compared cost-effectiveness parameters between inpatient and homebased hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospicepalliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW).Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.