OBJECTIVES: The purpose of this study was to evaluate the effects of emotional labor on burnout, turnover intention, and job satisfaction. METHODS: Dental hygienists were surveyed over a period of 13 days during March, 2013. Data from the completed questionnaires (N=202) were analyzed using the t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression. RESULTS: Higher levels of emotional labor resulted in higher levels of burnout and turnover intention, as well as lower levels of job satisfaction. The variable showing the largest mediating effect between emotional labor and burnout was emotional intelligence. Supervisor support had the largest mediating effect between emotional labor and turnover intention, as well as emotional labor and job satisfaction. CONCLUSIONS: To reduce the negative effects caused by emotional labor, it is necessary to foster the development of emotional intelligence and self-efficacy of employees. Employers' efforts to improve supervisor and colleague support for the employees should be made to reduce such negative effects.
Dental Hygienists* ; Emotional Intelligence ; Humans ; Intention* ; Job Satisfaction* ; Negotiating ; Surveys and Questionnaires

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy.Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy.Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

BACKGROUND: Next-generation sequencing is increasingly used for taxonomic identification of pathogenic bacterial isolates. We evaluated the performance of a newly introduced whole genome-based bacterial identification system, TrueBac ID (ChunLab Inc., Seoul, Korea), using clinical isolates that were not identified by three matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems and 16S rRNA gene sequencing. METHODS: Thirty-six bacterial isolates were selected from a university-affiliated hospital and a commercial clinical laboratory. Species was identified by three MALDI-TOF MS systems: Bruker Biotyper MS (Bruker Daltonics, Billerica, MA, USA), VITEK MS (bioMérieux, Marcy l'Étoile, France), and ASTA MicroIDSys (ASTA Inc., Suwon, Korea). Whole genome sequencing was conducted using the Illumina MiSeq system (Illumina, San Diego, CA, USA), and genome-based identification was performed using the TrueBac ID cloud system (www.truebacid.com). RESULTS: TrueBac ID assigned 94% (34/36) of the isolates to known (N=25) or novel (N=4) species, genomospecies (N=3), or species group (N=2). The remaining two were identified at the genus level. CONCLUSIONS: TrueBac ID successfully identified the majority of isolates that MALDI-TOF MS failed to identify. Genome-based identification can be a useful tool in clinical laboratories, with its superior accuracy and database-driven operations.
Genes, rRNA ; Genome ; Gyeonggi-do ; Mass Spectrometry ; Seoul

Objectives: Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). Methods: We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. Results: After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. Conclusions This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.

Background: There have been many epidemiologic studies on community-acquired pneumonia (CAP) among children, most of which had substantial limitations. This study investigated the etiologic distribution and clinical characteristics of CAP in Korean children for 5 years before the coronavirus disease 2019 (COVID-19) pandemic. Methods: A retrospective analysis of children hospitalized for CAP at 4 referral hospitals during 2015-2020 was performed. Cases in which bronchiolitis was suspected or pulmonary infiltration was not evident on chest radiography (CXR) were excluded. Viruses and atypical bacteria were defined as detected when positive in the polymerase chain reaction test performed for respiratory specimens. Serologic testing result for Mycoplasma pneumoniae was incorporated with strict interpretation. Pyogenic bacteria were included only when cultured in blood, pleural fluid, or bronchoalveolar lavage, but those cultured in endotracheal aspirate or sputum when the case was clinically evident bacterial pneumonia were also included. Results: A total of 2,864 cases of suspected pneumonia were selected by diagnosis code and CXR findings. Medical chart and CXR review excluded nosocomial pneumonia and cases without evident infiltration, resulting in 517 (18.1%) CAP cases among 489 children.Regarding clinical symptoms, high fever was present in 59.4% and dyspnea in 19.9% of cases.Respiratory support was required for 29.2% of patients, including mechanical ventilation for 3.9%. Pathogens were detected in 49.9% of cases, with viruses in 32.3%, atypical bacteria in 17.8%, and pyogenic bacteria in 2.3% of cases. As single pathogens, M. pneumoniae (16.8%) and respiratory syncytial virus (RSV, 13.7%) were the most common. Parenteral β-lactam and macrolide antibiotics were administered in 81.6% and 50.7% of cases, respectively. A total of 12 (2.3%) cases resulted in poor outcomes, including 3 deaths. Conclusion M. pneumoniae and RSV were the most commonly detected pathogens of pediatric CAP, which was selected by strict clinical and radiologic criteria. It is necessary to carefully decide whether to use parenteral antibiotics based on the epidemiology and clinical features of CAP in children.

PURPOSE: Despite the ready availability of pneumococcal vaccine, vaccination rates are quite low in South Korea. This study was designed to assess perceptions and awareness about pneumococcal vaccines among subjects at risk and find strategies to increases vaccine coverage rates. MATERIALS AND METHODS: A cross sectional, community-based survey was conducted to assess perceptions about the pneumococcal vaccine at a local public health center. In a tertiary hospital, an outpatient-based pneumococcal vaccine campaign was carried out for the elderly and individuals with chronic co-morbidities from May to July of 2007. RESULTS: Based on the survey, only 7.6% were ever informed about pneumococcal vaccination. The coverage rates of the pneumococcal vaccine before and after the hospital campaign showed an increased annual rate from 3.39% to 5.91%. The most common reason for vaccination was "doctor's advice" (53.3%). As for the reasons for not receiving vaccination, about 75% of high risk patients were not aware of the pneumococcal vaccine, which was the most important barrier to vaccination. Negative clinician's attitude was the second most common cause of non-vaccination. CONCLUSION: Annual outpatient-based campaigns early in the influenza season may improve pneumococcal vaccine coverage rates. Doctor's advice was the most important encouraging factor for vaccination.
Aged ; Aged, 80 and over ; *Ambulatory Care ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Immunization Programs ; Male ; Patients/*psychology ; Physicians/*psychology ; *Pneumococcal Vaccines ; Republic of Korea ; Vaccination/*psychology

A 31-year-old woman was referred to our hospital and diagnosed as overlap syndrome with systemic lupus erythematosus and dermatomyositis. After completing the fourth cycle of intravenous immunoglobulin therapy, the patient developed acute confusional state with the Glasgow Coma Scale of 7. Considering the lack of response to high dose corticosteroid therapy (methylprednisolone 1 g per day for 3 days), rituximab (500 mg per week) was administered twice. The next day after the administration of the first dose of rituximab, the level of consciousness started to improve and 15 days after rituximab, mental status was fully recovered. The proportion of CD19+ B cells started to decrease within 1 week after the administration of rituximab and remained depleted for 14 weeks. There was also a gradual decrease in serum CD40 and CD80 concentration measured by ELISA up to 4 months. This case suggests the effect of rituximab for the treatment of neuropsychiatric lupus.
Female ; Humans

Plasma cell granuloma, a form of inflammatory pseudotumor, is a rare nonneoplastic lesion that is characterized by cellular proliferation composed predominantly of polyclonal plasma cells with other inflammatory cells in fibrovascular background. We have experienced an unusual case of plasma cell granuloma of skull that developed in a patient with systemic lupus erythematosus (SLE). A 42-year-old female diagnosed with SLE 13 years ago has complained of palpable scalp mass and headache beginning ten days previously. A brain magnetic resonance imaging showed intensely enhanced soft tissue mass with focal bone defect in right parietal bone and whole body positron emission tomography suggested high possibility of malignancy. Surgical tumor removal was performed. Biopsy specimen revealed inflammatory proliferation predominantly with mature plasma cells which were determined to be polyclonal in immunostaining. Currently, 4 months after surgery, the patient are on regular follow-up with oral medications (prednisolone, hydroxychloroquine) for SLE without evidence of recurrence.
Adult ; Biopsy ; Brain ; Cell Proliferation ; Female ; Follow-Up Studies ; Granuloma, Plasma Cell* ; Headache ; Humans ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Parietal Bone ; Plasma Cells* ; Plasma* ; Positron-Emission Tomography ; Recurrence ; Scalp ; Skull*

Sjogren's syndrome is a hererogenous autoimmune disease characterized by progressive destruction of the exocrine glands and accompanied by a variety of autoimmune phenomena. Sjogren's syndrome patients can develop symptoms of ocular and oral dryness as well as extraglandular complications including central and peripheral nervous system disease. Sometimes neuropathy precedes the diagnosis of Sjogren's syndrome. Adiets syndrome is characterized by tonic pupil and the absence of tendon reflex. Sweating abnormality and chronic peripheral polyneuropathy can also be present. We report a case of primary Sjogren's syndrome preceded by Adie's syndrome with peripheral neuropathy. A 26-year-old woman was admitted for photophobia and paresthesia. On examination, her pupils were anisocoric and did not react to light but constricted promptly to pilocarpin. Sensation decreased on her left side of body and deep' tendon reflexes were absent. Biopsy of minor salivary gland demonstrated infiltration by lymphocyte consistent with Sjogren's syndrome, but Schirmer test was negative. So she was diagnosed as Adie's syndrome with peripheral neuropathy. Five month later she complained of dry eye and dizziness. Rose bengal staining was positive. Sjogren's syndrome was diagnosed and she was discharged with local therapy for the sicca symptoms.
Adie Syndrome* ; Adult ; Autoimmune Diseases ; Biopsy ; Diagnosis ; Dizziness ; Exocrine Glands ; Female ; Humans ; Lymphocytes ; Paresthesia ; Peripheral Nervous System Diseases ; Photophobia ; Polyneuropathies ; Pupil ; Reflex, Stretch ; Rose Bengal ; Salivary Glands, Minor ; Sensation ; Sjogren's Syndrome* ; Sweat ; Sweating ; Tonic Pupil