The efficacy of hydrocolloid occlusive dressing technique was compared with that of the conventional wet-to-dry gauze dressing technique in decubitus ulcer of stage I and II. Forty-four patients were randomly divided into two treatment groups and each received treatment according to the two different protocols. As a result, 80.8% of the hydrocolloid occlusive dressing group (group 1) and 77.8% of the conventional wet-to-dry gauze dressing group (group 2) healed completely with no statistically significant difference between the two groups. However, the time required for complete healing was shorter in group 1 with 18.9 days compared to 24.3 days in group 2. Ulcer healing speed was also slightly faster in group 1 with 9.1 mm2/day compared to 7.9 mm2/day for group 2. Average treatment time spent by a medical staff member was significantly shorter in group 1 with 20.4 minutes/day compared to 2017 minutes/day in group 2. The hospital cost of the ulcer treatment was higher in group 2 compared to group 1 even without taking into consideration the medical personnel's labor cost. These results indicate that the hydrocolloid occlusive dressing technique offers less time consuming and less expensive method of treatment compared to the conventional technique in stage I andII decubitus ulcers.
Adult ; Aged ; Comparative Study ; Decubitus Ulcer/*therapy ; Female ; Human ; Male ; Middle Age ; *Occlusive Dressings

Purpose: To investigate whether the signal or morphological changes in the adjacent bone or soft tissue after intradiscal electrothermal therapy (IDET) occur due to postprocedural inflammation or infectious spondylodiscitis. Materials and Methods: Ten patients (female:male = 5:5; age range, 18–71 years; mean age: 36.5 years) who underwent lumbar IDET between January 2018 and December 2020 and complained of fever or pain were included in this study. The presence and extent of bone marrow and paraspinal soft tissue signal changes were evaluated using the first follow-up magnetic resonance imaging (MRI) after IDET. Signal changes in the treated discs and the presence and extent of epidural enhancement were evaluated. Additionally, we investigated the presence and margins of subchondral erosions in the vertebral body. Results: Two radiologists analyzed the imaging findings by consensus. Six patients were diagnosed with postprocedural inflammation and four with infectious spondylodiscitis, which was confirmed by specimen culture after surgery. All 10 patients showed signal changes in the bone marrow of the vertebral bodies adjacent to the treated disc. Signal changes in the paraspinal soft tissue were observed in only five patients: three with infectious spondylodiscitis and two with postprocedural inflammation. In six patients with postprocedural inflammation, subchondral erosions had well-defined margins with a sclerotic rim and in four patients with infectious spondylodiscitis, subchondral erosions had ill-defined margins. Epidural enhancement showed an extensive pattern in all cases of infectious spondylodiscitis and localized patterns in cases of postprocedural inflammation. Conclusion MRI or computed tomography findings of well-defined subchondral erosions with a sclerotic rim and more localized signal changes in the paraspinal soft tissue or epidural space might aid in the differentiation of infectious spondylodiscitis and postprocedural inflammation in patients who underwent IDET.

Purpose: This study aimed to evaluate the association of redundant nerve roots of the cauda equina (RNRCEs) with the degree and duration of symptoms in patients with lumbar spinal canal stenosis. Materials and Methods: Between January 2017 and December 2018, 224 patients demonstrating central canal stenosis on lumbar spine MRI were included. Various imaging findings associated with spinal canal stenosis were investigated, as were the presence, level, type, and length of RNRCEs, and the presence of nerve root swelling. Clinically, the degree of symptoms and symptom changes after treatment were investigated. Multinomial logistic regression was used for statistical analysis. Results: RNRCEs were present in 142 patients (63.4%). Most RNRCEs were observed above the level of stenosis (47.3%). RNRCE was associated with the number of stenoses and symptom duration (p < 0.05). The presence, level, type, and length of RNRCE and nerve root swelling significantly affected the severity of symptoms (p < 0.05). The type of treatment influenced symptom changes (p < 0.05). Conclusion The recognition and assessment of RNRCEs on spinal MRI are clinically important because the presence, level, type, and length of a RNRCE may be associated with the degree of symptoms and help predict the clinical outcome according to treatment methods.

Purpose: The purpose of this study was to investigate the levels of fatigue, social support, and burnout among nurses caring for coronavirus disease 2019 (COVID-19) patients, and to identify factors that affect burnout. Methods: Data were collected from 115 nurses who were caring for COVID-19 patients in Gyeonggi Province and Seoul from December 2021 to February 2022. Results: The mean scores for fatigue, social support, and burnout were 63.31 ± 11.48 (of 95), 48.34 ± 6.97 (of 60), and 81.90 ± 15.50 (of 132) points, respectively. The level of burnout of nurses caring for patients with COVID-19 was high. Fatigue (β = .49, p < .001) and social support (β = -.21, p = .012) were significantly associated with burnout. Conclusion Higher levels of fatigue and lower levels of social support were associated with higher levels of burnout. Reducing fatigue among nurses and strengthening their social support can be a strategy to reduce nurse burnout.

To provide high-quality training to residents in a rapidly changing medical environment, it is very important to improve the annual training curriculum centered on competency and ensure that training hospitals maintain an environment suitable for training. The Korean Society of Radiology (KSR) has been steadily improving the training system and has suggested the improvement of the training system by strengthening the competency-based evaluation and faculty development. Currently, KSR was selected for the second annual training curriculum systematization construction project in July 2021, and developed entrustable professional activities, core competencies, and assessment guidelines required by the construction project. Therefore, the development process and assessment guidelines will be introduced to residents and the faculty.

It is the first case that nephrotic syndrome with malignant thymoma reported in Korea. A 56-year-old man have had generalized edema, weight gain, dyspnea, oliguria for 10 days. At that time, a full blown nephrotic syndrome developed, with minimal change glomerulopathy, A mediastinum mass was shown by the chest X-ray. Thymectomy and palliative radiotherapy was done. In the treatment of nephrotic syndrome, firstly diuretics and prednisolone were given. but the response was poor, so additionally cyclophosphamide and azathioprine were given. After 1 year passed, the patient died of the respiratory failure with pulmonary fibrosis of complication of radiotherapy, without improvement in nephrotic syndrome.
Azathioprine ; Cyclophosphamide ; Diuretics ; Dyspnea ; Edema ; Humans ; Korea ; Mediastinum ; Middle Aged ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Oliguria ; Prednisolone ; Pulmonary Fibrosis ; Radiotherapy ; Respiratory Insufficiency ; Thorax ; Thymectomy ; Thymoma* ; Weight Gain

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasms in the same individual. According to the development of new diagnostic techniques and the increase in long-term survivals, reports of multiple primary cancer have been gradually increasing among patients treated for initial cancers. Since Theodor Billroth reported the first three cases of multiple primary cancer in 1889, there have been many reports of multiple primary cancer, with an incidence range in Korea of 0.35~1.84%. In Korea, there have been a few reported cases of triple cancer. Herein, three recently experienced cases of metachronous triple primary cancer are reported.
Humans ; Incidence ; Korea

Most pancreatic pseudocysts are located in or around the pancreas, but they can be found in all the potential spaces around viscera in and outside of the abdominal cavity. The complications of pancreatic pseudocysts are infection, rupture, fistula, obstruction and hemorrhage. However, an upper gastrointestinal bleeding caused by pancreatic pseudocyst is rare. Pseudocysts with complication like hemorrhage require percutaneous, endoscopic or surgical treatment. We report a case of the pancreatic pseudocyst involving duodenal wall with upper gastrointestinal hemorrhage, which was improved by conservative treatment.
Abdominal Cavity ; Duodenum* ; Fistula ; Gastrointestinal Hemorrhage* ; Hemorrhage ; Pancreas ; Pancreatic Pseudocyst* ; Rupture ; Viscera

BACKGROUND/AIMS: Genetic variations of ethanol-metabolizing enzymes can affect alcohol drinking behavior. The aims of this study were to investigate and compare the distributions of these genetic polymorphisms between a healthy control group and a heavy drinker group which included an alcoholic liver cirrhosis group. METHODS: Genotypes of ADH2, ALDH2, CYP2E1, and catalase were identified by polymerase chain reaction and restriction fragment length polymorphism. Genomic DNA was extracted from peripheral leukocytes in 42 healthy controls, 12 heavy drinkers, and 30 alcoholic liver cirrhosis patients. RESULTS: 1) The genotype frequencies of ALDH2 (1*1), ADH2 (1*1), CYP2E1 (c1c1), and catalase1 (TT) were 69%, 55%, 38%, and 12%, respectively in healthy Korean males. 2) There was a significant difference in the distribution of the genetic polymorphism of ALDH2 between the control group and heavy drinker group (12 heavy drinkers and 30 alcoholic liver cirrhosis patients). The genotype frequency of ALDH2 mutant, ALDH2 (1*2) and ALDH2 (2*2) in the heavy drinker group (12%) was significantly lower than that in the control group (30%). 3) We didn't find anyone with ALDH2 homozygote mutant (DD) in the heavy drinker group. 4) There was no significant difference in the distribution of genetic polymorphisms in ADH2, CYP2E1 and catalase1 between the two groups. CONCLUSIONS: These results suggest that the absence of ALDH2 mutant genotype is strongly related to heavy drinking behavior. We can not prove, however, any evidence that the polymorphisms of other ethanol-metabolizing enzymes are associated with the determination of alcohol-drinking behavior.
Adult ; Alcohol Dehydrogenase/*genetics ; Alcohol Drinking ; Alcoholism/enzymology/*genetics ; Aldehyde Dehydrogenase/*genetics ; Cytochrome P-450 CYP2E1/*genetics ; Ethanol/metabolism ; Humans ; Liver Cirrhosis, Alcoholic/enzymology/*genetics ; Male ; Middle Aged ; *Polymorphism, Genetic

Sirenomelia is a lethal congenital malformation characterized by single or fused lower limbs associated with other severe genitourinary and lower gastrointestinal tract anomalies. Associated anomalies include malformation of vertebrae and pelvis, oligohydroamnios, renal agenesis, imperforate anus, internal and external genital anomaly and single umbilical artery. Recently, sirenomelia is diagnosed by ultrasound at first trimester or early second trimester. Termination of pregnancy is recommended as soon as diagnosis is made. We report a case of sirenomelia in a monoamniotic twin gestation detected at IUP at 12 weeks which was maintained till IUP at 37 weeks and delivered by cesarean section. On autopsy, typical finding of sirenomelia was noted, whereas the contralateral twin showed no abnormalities.
Anus, Imperforate ; Autopsy ; Cesarean Section ; Diagnosis ; Ectromelia* ; Female ; Fetus* ; Humans ; Lower Extremity ; Lower Gastrointestinal Tract ; Pelvis ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy, Twin* ; Single Umbilical Artery ; Spine ; Ultrasonography