Subcutaneous panniculitis-like T-cell lymphoma (SPLTCL) which is similar to lobular panniculitis is a subtype of skin lymphoma that is characterized by pleomorphic T cells and benign macrophages. The simultaneous presence of hemophagocytic lymphohistiocytosis (HLH) is the most important and adverse prognostic factor in SPLTCL. SPLTCL is a rare disease with no well-established standard treatment. We report a child with SPLTCL and HLH, who were successfully treated with the modified NHL (non-Hodgkin lymphoma)-BFM(Berlin-Frankfurt-Münster)-90 and HLH-2004 protocols. Patient had persistent fever and subcutaneous masses. SPLTCL with HLH was diagnosed by immunohistochemistry, radiology and laboratory results. SPLTCL with HLH has shown high mortality when treated with a combination of intensive anticancer drugs. Thus, we first administered dexamethasone and etoposide. After this, when we used the modified protocol of NHL-BFM-90 and HLH-2004, patient showed complete resolution of the subcutaneous masses and features of HLH, except for persistent hyperferritinemia. We tried etanercept to reduce high serum ferritin with some effects. In children with diagnosis of SPLTCL with HLH, initiation of immediate and appropriate treatment affects prognosis. Thus, prompt initiation of the agents that can simultaneously control underlying disease as well as secondary HLH could have lead to successful results.

Background: Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases. Methods: We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response. Results: We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19.In the absence of precise manuals or designated consultancies, the participants’ confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others’ passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation. Conclusion The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.

Background: Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases. Methods: We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response. Results: We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19.In the absence of precise manuals or designated consultancies, the participants’ confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others’ passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation. Conclusion The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.

Background: Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases. Methods: We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response. Results: We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19.In the absence of precise manuals or designated consultancies, the participants’ confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others’ passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation. Conclusion The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.

Background: Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases. Methods: We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response. Results: We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19.In the absence of precise manuals or designated consultancies, the participants’ confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others’ passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation. Conclusion The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.
Clinical Coding ; Korea* ; Mortality* ; Quality of Health Care ; Risk Adjustment

The feasibility of virtual otoscopy (VO) imaging was evaluated in five dogs with experimentally induced otitis media, two control dogs, and two canine patients with otitis media. VO images of the tympanic cavity and ossicles were generated with commercially available software using raw computed tomography (CT) data. Eight out of 10 ears inoculated with pathogen exhibited obvious clinical signs associated with otitis externa. CT images revealed soft tissue density material occupying the tympanic bulla compatible with otitis media in three dogs with experimentally induced otitis media and two patients. No remarkable features were observed on the radiographs. Four different VO views (ear canal, tympanic bulla, eustachian tube, and ossicular chain) were created. Promontory, cochlea window, tympanic, and septum bulla as well as ossicles were easily and clearly distinguished except for the incus and stapes of the clinical patients. VO images were not more suitable than images created with conventional CT for accurately diagnosing otitis media in this study. However, it appears that VO could be more feasible for assessing the complex structure of the inner ear in dogs with fluid-filled tympanic cavities since fluid accumulation within the tympanic bulla did not affect the evaluation of bony tissue in the middle ear on VO images.
Animals ; Blister ; Cochlea ; Dogs ; Ear ; Ear, Inner ; Ear, Middle ; Eustachian Tube ; Incus ; Otitis Externa ; Otitis Media ; Otoscopy ; Stapes

BACKGROUND: This study aimed to understand and explore perception of healthy adults and chronically ill adults on health and health-related quality of life (HRQoL). METHODS: Data were collected by open questions using a focus group discussion for healthy adults (N=6) and in-depth interviews for chronically ill adults (N=6). Previously developed 34 HRQoL items also were offered and participants were asked to select the five most important HRQoL items among them. RESULTS: Findings were elicited along the following themes: health, HRQoL, health maintenance strategies, and elements affecting health. The definition on "being healthy" by healthy participants had a variety of standards and required several conditions to be fulfilled. Whereas chronically ill adults have more flexible perception about the coexistence of health and disease. Health dimensions were thought to affect each other, and physical and mental health dimension were selected as the most important items. As for the five most important HRQoL items, both group participants selected mental health dimension than physical or social health dimensions. Health maintenance strategies were similar in both groups except more healthcare service use in chronically ill adults. CONCLUSIONS: This study shows the difference of perception on health and HRQoL between health group and disease group in Korea. It can be used for developing the HRQoL assessment tool reflecting the perception of Korean people.
Adult ; Chronic Disease ; Delivery of Health Care ; Focus Groups* ; Humans ; Korea ; Mental Health ; Quality of Life*

Summary measures of population health (SMPHs) have been used to estimate the burden of diseases. Among various type of SMPHs, disability adjusted life year (DALY) and healthy life expectancy (HALE) have been calculated in the global and national burden of disease studies. In order to calculate DALY and HALE, disability weight is an essential element. Disability weights quantify the level of disability for health states or diseases and have values between 0 (full health) to 1 (being dead). In this study, we reviewed the main disability weights studies and determined their meaning and limitations. Furthermore, we provided the whole process of typical disability weight study and reviewed key issues as follows: health state or disease description development, panel composition, valuation method, validation of disability weight, cross-cultural variability in health state or disease, and so on. The results from this study will be helpful to conduct future disability weight studies for adapting disability weights and developing new methodologies.
Life Expectancy ; Quality-Adjusted Life Years ; Weights and Measures

Maternal and child health is an important issue throughout the world. Given their impact on maternal and child health, nutritional issues need to be carefully addressed. Accordingly, the effect of maternal, child, and nutritional disorders on disability-adjusted life years (DALYs) should be calculated. The present study used DALYs to estimate the burden of disease of maternal, neonatal, and nutritional disorders in the Korean population in 2012. For this purpose, we used claim data of the Korean National Health Insurance Service, DisMod II, and death data of the Statistics Korea and adhered to incidence-based DALY estimation methodology. The total DALYs per 100,000 population were 376 in maternal disorders, 64 in neonatal disorders, and 58 in nutritional deficiencies. The leading causes of DALYs were abortion in maternal disorders, preterm birth complications in neonatal disorders, and iron-deficiency anemia in nutritional deficiencies. Our findings shed light on the considerable burden of maternal, neonatal, and nutritional conditions, emphasizing the need for health care policies that can reduce morbidity and mortality.
Anemia, Iron-Deficiency ; Child ; Child Health ; Delivery of Health Care ; Humans ; Korea* ; Malnutrition ; Mortality ; National Health Programs ; Nutrition Disorders* ; Premature Birth