Purpose: The purpose of this study was to investigate post-traumatic stress, job stress, fatigue, and social support of nurses in direct care for COVID-19 patients and to identify the factors affecting post-traumatic stress among the nurses. Methods: The participants were 150 nurses from three hospitals. Data were collected from September 11, 2020 to September 21, 2020. The data were analyzed with SPSS/WIN/25.0 program. Results: The mean score of post-traumatic stress was 22.27±15.49 (range 0~88). The percentage of high risk group of post-traumatic stress was 35.3%, risk group was 20.0%, normal group was 44.7%. Post-traumatic stress showed statistically significant differences according to quarantined experience (t=2.15, p=.033), and provision of COVID-19 manual (t=-2.40, p=.026). Post-traumatic stress was positively correlated with job stress (r=.48, p<.001), and fatigue (r=.58, p<.001), and it was negatively correlated with social support (r=-.22, p=.005). Job stress was positively correlated with fatigue (r=.74, p<.001), and it was negatively correlated with social support (r=-.17, p=.030). Fatigue and social support (r=-.17, p=.029) had a negative correlation. The results of regression analysis showed that the factors affecting post-traumatic stress included fatigue (β=.56, p<.001), provision of COVID-19 manual (β=-.24, p<.001), and quarantined experience (β =.18, p=.016) and that the total explanatory power was 42.0%. Conclusion In this study, fatigue, provision of COVID-19 manual, and quarantined experience were found as influential factors of post-traumatic stress among nurses in direct care for COVID-19 patients. Therefore, development of the intervention for reducing the fatigue should consider to prevent post-traumatic stress in nurses. Also, provision of COVID-19 manual for nurses and psychological intervention program for nurses experienced quarantine are necessary.

Purpose: The purpose of this study was to investigate post-traumatic stress, job stress, fatigue, and social support of nurses in direct care for COVID-19 patients and to identify the factors affecting post-traumatic stress among the nurses. Methods: The participants were 150 nurses from three hospitals. Data were collected from September 11, 2020 to September 21, 2020. The data were analyzed with SPSS/WIN/25.0 program. Results: The mean score of post-traumatic stress was 22.27±15.49 (range 0~88). The percentage of high risk group of post-traumatic stress was 35.3%, risk group was 20.0%, normal group was 44.7%. Post-traumatic stress showed statistically significant differences according to quarantined experience (t=2.15, p=.033), and provision of COVID-19 manual (t=-2.40, p=.026). Post-traumatic stress was positively correlated with job stress (r=.48, p<.001), and fatigue (r=.58, p<.001), and it was negatively correlated with social support (r=-.22, p=.005). Job stress was positively correlated with fatigue (r=.74, p<.001), and it was negatively correlated with social support (r=-.17, p=.030). Fatigue and social support (r=-.17, p=.029) had a negative correlation. The results of regression analysis showed that the factors affecting post-traumatic stress included fatigue (β=.56, p<.001), provision of COVID-19 manual (β=-.24, p<.001), and quarantined experience (β =.18, p=.016) and that the total explanatory power was 42.0%. Conclusion In this study, fatigue, provision of COVID-19 manual, and quarantined experience were found as influential factors of post-traumatic stress among nurses in direct care for COVID-19 patients. Therefore, development of the intervention for reducing the fatigue should consider to prevent post-traumatic stress in nurses. Also, provision of COVID-19 manual for nurses and psychological intervention program for nurses experienced quarantine are necessary.

Tumor lysis syndrome is rare in hepatocellular carcinoma (HCC), but it has been reported more frequently recently in response to treatments such as transcatheter arterial chemoembolization (TACE), radiofrequency thermal ablation (RFTA), and sorafenib. Tumor lysis syndrome induced by low-dose steroid appears to be very unusual in HCC. We report a patient with hepatitis-C-related liver cirrhosis and HCC in whom tumor lysis syndrome occurred due to low-dose steroid (10 mg of prednisolone). The patient was a 90-year-old male who presented at the emergency room of our hospital with general weakness and poor oral intake. He had started to take prednisolone to treat adrenal insufficiency 2 days previously. Laboratory results revealed hyperuricemia, hyperphosphatemia, and increased creatinine. These abnormalities fulfilled the criteria in the Cairo-Bishop definition of tumor lysis syndrome. Although the patient received adequate hydration, severe metabolic acidosis and acute kidney injury progressed unabated. He finally developed multiple organ failure, and died 3 days after admission. This was a case of tumor lysis syndrome caused by administration of low-dose steroid in a patient with HCC.
Acute Kidney Injury/pathology ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/*pathology/therapy ; Chemoembolization, Therapeutic ; Creatinine/blood ; Humans ; Liver Neoplasms/*pathology/*therapy ; Male ; Niacinamide/analogs & derivatives/therapeutic use ; Phenylurea Compounds/therapeutic use ; Steroids/adverse effects/therapeutic use ; Tomography, X-Ray Computed ; Tumor Lysis Syndrome/*diagnosis/drug therapy

The most commonly reported sexual problems in diabetic women are sexual arousal disorder and a lack of vaginal lubrication. The aims of this study were to investigate the vaginal structural changes and expressions of TGF-beta1, Ec-NOS and estrogen receptor alphaby histochemistry, immunohistochemistry and Western blot analysis in diabetic and insulin-treated diabetic rats. The mean blood glucose levels were significantly increased in the diabetic rats (453+/-88.4 mg/dL)compared to the control group (79+/-6 mg/dL)and insulin-treated diabetic rats (56.7+/-0.6 mg/dL).The vaginal wall in control rat showed 6~11 layered stratified squamous epithelial lining and submucosal smooth muscle, connective tissue and vasculatures. In diabetic rat, the vaginal epithelium was reduced to 2~6 layers and the submucosal vasculatures were decreased n size and number.Collagen fibers were increased and irregularly distorted arrangement. Insulin-treated diabetic rat showed similar morphologic features as control rat.In diabetic rat, TGF-beta1 expression was upregulated by 1.65 times and Ec-NOS expression was 40% downregulated compared to control and insulin-treated diabetic rats in Western blot analysis. In control and insulin-treated diabetic rats, TGF-beta1 immunoreactivity was detected in fibroblasts and the collagen fibers, Ec-NOS immunoreactivity in the endothelial cells of blood vessels, and estrogen receptor alphaimmunoreactivity in the basal and intermediate cell layers of stratified squamous epithelium, smooth muscle fibers, and nerve fibers. In diabetic rat, expression of TGF-beta1, Ec-NOS, and estrogen receptor alphawas exhibited comparable cellular patterns of labeling, but signal intensity was increased in TGF-beta1 and decreased in Ec-NOS and estrogen receptor alpha. These results suggest that vaginal tissue fibrosis in diabetes mellitus may be caused by altered expression of TGF-beta1, NOS and estrogen. It also mplies that sexual arousal disorder and lack of vaginal lubrication in the diabetic women could be protected or delayed by controlling blood glucose levels.
Animals ; Blood Glucose ; Blood Vessels ; Blotting, Western ; Collagen ; Connective Tissue ; Diabetes Mellitus ; Endothelial Cells ; Epithelium ; Estrogen Receptor alpha ; Estrogens ; Female ; Fibroblasts ; Fibrosis ; Humans ; Immunohistochemistry ; Insulin* ; Lubrication ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide Synthase ; Rats* ; Sexual Dysfunctions, Psychological ; Transforming Growth Factor beta1 ; Vagina*

BACKGROUND/AIMS: Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. METHODS: We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. RESULTS: The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. CONCLUSION: Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.
Abdominal Fat ; Adipose Tissue ; Crohn Disease* ; Diagnosis ; Diagnosis, Differential* ; Humans ; Hypertrophy ; Intra-Abdominal Fat* ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Subcutaneous Fat ; Tomography, X-Ray Computed ; Tuberculosis*

The aim of this study was to examine the relationship of complications related to diverticulitis and visceral obesity. The study was based on a retrospective case note review conducted at the Hanyang University Hospital. Patients were diagnosed with diverticulitis based on clinical symptoms and abdominal computed tomography (CT) findings and divided into two groups: those admitted with complicated diverticulitis and those with a simple diverticulitis episode. We compared the body mass index (BMI) and degree of visceral obesity, measured by abdominal CT. The study included 140 patients, 87 (62.1%) were simple diverticulitis and 53 (37.9%) were complicated diverticulitis. In the complicated diverticulitis group, 9 (6.4%) cases were recurrent, 29 (20.7%) were perforation or abscess patients, and 28 (20%) were patients with systemic inflammatory response syndrome (SIRS). Of the SIRS patients, 13 were involved in other complication groups. When comparing in the two groups, the complicated diverticulitis group had a significantly higher visceral fat area (128.57 cm2 vs 102.80 cm2, P = 0.032) and a higher ratio of visceral fat area/subcutaneous fat area (0.997 vs 0.799, P = 0.014). Visceral obesity is significantly associated with complications of diverticulitis.
Adipose Tissue ; Adult ; Aged ; Body Composition ; Body Mass Index ; Diverticulitis/*complications/pathology ; Female ; Humans ; *Intra-Abdominal Fat ; Lipids/*blood ; Male ; Middle Aged ; Obesity, Abdominal/*complications ; Systemic Inflammatory Response Syndrome