Purpose: This study aimed to identify the changes in psychological distress and the quality of life in patients with esophageal cancer from pre-surgery to 3 months after surgery. Methods: We enrolled 49 patients scheduled to undergo esophageal surgery at a tertiary hospital in Seoul, South Korea. Patients’ psychological distress and quality of life were assessed using the Korean scales, such as the Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), and an esophageal cancer-specific questionnaire (QLQ-OES18) at pre-surgery, 1 month, and 3 months post-surgery. Results: Moderate-to-severe anxiety was reported in 12.2% of patients at the pre-surgery evaluation, 57.1% of patients at 1 month post-surgery, and 8.2% at 3 months post-surgery. Moderate-to-severe depression was reported in 12.2% of patients at the pre-surgery evaluation, 63.3% at 1 month post-surgery, and 16.3% of patients at 3 months post-surgery. Clinically significant, moderate changes (10~20 points) in physical functioning, insomnia, nausea and vomiting, and dyspnea (per EORTC QLQ-C30) and dysphagia and taste problems (per QLQ-OES18) were reported from pre-surgery to 1 month post-surgery. Conclusion One month after esophageal cancer surgery, patients demonstrated severe psychological distress and worsening quality of life. Nursing intervention is needed to relieve psychological distress and improve the quality of life in patients with esophageal cancer in the 1-month early recovery period.

BACKGROUND: Rapid sequence induction (RSI) is indicated in various situations. Succinylcholine has been the muscle relaxant of choice for RSI, and rocuronium has become an alternative medicine for patients who cannot be administered succinylcholine for various reasons. Although rocuronium has the most rapid onset time among non-depolarizing muscle relaxants, the standard dose of rocuronium (0.6 mg/kg) takes 60 seconds to achieve appropriate muscle relaxation. We evaluated intubating conditions using the "modified timing principle" with rocuronium and succinylcholine. METHODS: In this prospective controlled blinded study, all patients received 1.5 microg/kg fentanyl intravenously with preoxygenation for 2 minutes and were randomized to receive 0.6 mg/kg rocuronium followed by 1.5 mg/kg propofol or 1.5 mg/kg propofol and 1.5 mg/kg succinylcholine. The rocuronium group was intubated just after confirming loss of consciousness, and the succinylcholine group was intubated 1 minute after injecting succinylcholine. Intubation condition, timing of events, and complications were recorded. RESULTS: All patients were successfully intubated in both groups. Apnea time of the rocuronium group (38.5 seconds) was significantly shorter than that in the succinylcholine group (100.7 seconds). No significant differences were observed in loss of consciousness time or intubation time. The succinylcholine group tended to show better intubation conditions, but no significant difference was observed. None of the patients complained awareness of the intubation procedure or had respiratory difficulty during a postoperative interview. CONCLUSIONS: The modified RSI with rocuronium showed shorter intubation sequence, acceptable intubation conditions, and a similar level of complications compared to those of conventional RSI with succinylcholine.
Androstanols ; Apnea ; Complementary Therapies ; Fentanyl ; Humans ; Intubation ; Muscle Relaxation ; Muscles ; Neuromuscular Nondepolarizing Agents ; Propofol ; Prospective Studies ; Succinylcholine ; Unconsciousness

PURPOSE: This study evaluated the effect of loss of interproximal papilla, creating an undercut, on the accuracy of impression materials. MATERIALS AND METHODS: Two addition type silicone impression materials (Extrude(R) Wash, Imprint(TM) II Quick Step Light Body) and one alginate impression material (Cavex Impressional) were used to make impressions of a maxillary master model simulating clinical conditions with or without interproximal papilla. Stone was poured in the impressions and working casts were fabricated. A total of 6 groups with 6 working casts in each group were scanned using 3-dimensional optical scanner. The accuracy of the impressions was assessed by measuring the dimensional changes (DeltaI (%)) of 6 distances on working casts compared to a master model with a 3-dimensional digitizing and inspection software. The data were analyzed by two-way ANOVA (P<.05). RESULTS: Three of 6 distances showed statistically significant differences among the impression materials. Only 1 of 6 distances in alginate impression showed a statistically significant difference between casts with and without interproximal papilla (P=.047). CONCLUSION: The presence of undercut due to loss of interproximal papilla did not significantly influence the dimensional accuracy of addition type silicone and alginate impression materials.
Alginates ; Dental Impression Materials ; Silicone Elastomers

BACKGROUND: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. METHODS: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. RESULTS: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. CONCLUSION: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.
Biomedical Technology ; Chronic Disease ; Classification ; Delivery of Health Care ; Health Expenditures* ; Health Status ; Insurance ; Korea ; National Health Programs* ; Stents

Objectives: ：The turnover rate of mental health workers in community mental health institutes is remarkably high.We explored the mediating effects of perceived work value on the relationship between burnout and turnover intention among mental health professionals working for community mental health centers and addiction centers. Methods: ：A total of 161 mental health workers completed this survey. We administered the Maslach Burnout Inventory-General Survey (MBI-GS) and the Michigan Organizational Assessment Questionnaire (MOAQ) (which explores turnover intention). Perceived work value was assessed using two items of the Scale of Resilience to Burnout.Associations were sought using the t-test, analysis of variance, correlation analyses, and hierarchical regression analyses. Results: ：The burnout level was significantly negatively correlated with perceived work value. Burnout was significantly positively correlated with turnover intention, and perceived work value significantly negatively correlated. Bootstrapping showed that perceived work value partially mediated the relationship between burnout and turnover intention. Conclusion ：Perceived work value may buffer turnover intention caused by burnout. Creation of an environment in which mental health workers feel that their work is valuable is important to prevent resignations.

Periostitis is one of the human diseases commonly encountered in archaeological samples. It is known to be an important health indicator for paleopathologists examining skeletal remains. In our recent study on a Joseon skeletal series (n=101), non-specific, primary periostitis was observed only in five individuals (#4, #29, #137, #175, and #290). Notably, there were no secondary periostitis-suggestive signs (e.g. syphilis), except for those caused by fractures (#33 and #41). As this is the inaugural Korean-skeletal-series report on periostitis, the results presented in these pages should prove significant to interested paleopathologists.
Humans ; Paleopathology ; Periostitis ; Skeleton ; Syphilis

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

A 35-year-old man presented with progressive dyspnea and hemoptysis. His blood pressure was 230/140 mmHg and serum creatinine level was 20.13 mg/dL. Chest radiography and computed tomography revealed pulmonary hemorrhage. His renal function was low, thus emergent renal replacement therapy was required. Malignant hypertension and acute kidney injury were diagnosed, and antihypertensive therapy and hemodialysis started immediately. Renal biopsy was performed to examine the underlying disease. Typical pathological changes of malignant hypertension, fibrinoid necrosis of the afferent arterioles, and proliferative endoarteritis at the interlobular arteries were observed. His renal function improved gradually and pulmonary hemorrhage completely disappeared with administration of antihypertensive agents. Here, we report this rare case of malignant hypertension with pulmonary alveolar hemorrhage and speculate that the hemorrhage may be related to vascular injuries at the alveolar capillary level caused by malignant hypertension.
Acute Kidney Injury ; Adult ; Antihypertensive Agents ; Arteries ; Arterioles ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Dialysis* ; Dyspnea ; Hemoptysis ; Hemorrhage* ; Humans ; Hypertension, Malignant* ; Necrosis ; Pulmonary Alveoli ; Radiography ; Renal Dialysis ; Renal Replacement Therapy ; Thorax ; Vascular System Injuries

Primary malignant melanoma of tbe esophagus is extremely rare and its incidence is below 0.1%. The tumor is polypoid and tend to be large, which is covered with false membrane, friable, hemorrhagic, and necrotic. Hematogenous and lymphogenic metastasis are common. Resection of the tumor with an anastomotic procedure seems to be the treatment of choice, and postoperative irradiation may be useful. But, despite these measures, prognosis is poor, with a 5-year survival of 4.2%. We report a case of 58-year-old man with primary malig- nant melanoma of the epophagus, and review of the literature in presented related studies.
Esophagus* ; Humans ; Incidence ; Intestines* ; Melanoma* ; Membranes ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Stomach*

Hydatid cysts (echinococcosis) are caused by an infestation with larval tapeworms of the genus Echinococcus. The disease is extensively distributed worldwide, and it has been rarely reported in Korea. We describe the cytologic features of a case of hepatic hydatid cyst in a 28-year-old male. Computed tomography revealed a cystic mass in the right lobe of the liver. A right hemihepatectomy was performed. The aspirated fluid from the hepatic cystic mass was clear. The smears showed protoscolices, hooklets, and a laminated membrane.
Biopsy, Fine-Needle ; Cestoda ; Echinococcosis ; Echinococcosis, Hepatic ; Echinococcus ; Humans ; Korea ; Liver ; Male ; Membranes