PURPOSE: beta-human chorionic gonadotropin (beta-hCG) expressing pulmonary carcinoma is very rare, and little is known about this entity. The aim of this study was to find the characteristic clinicopathologic features of beta-hCG expressing pulmonary carcinoma. MATERIALS AND METHODS: Of all 2790 lobectomy specimens of lung excised between January 2006 and December 2010, only six cases of beta-hCG expressing pulmonary carcinoma were identified retrospectively. The cases were classified according to the WHO classification, and clinicopathologic features were investigated. RESULTS: The patients consisted of 4 males and 2 females, and the median age was 64 years. Half of the patients presented with blood tinged sputum or hemoptysis. The median tumor diameter was 4.2 cm. All but one case showed prominent area of hemorrhage and necrosis. All six cases were pleomorphic carcinoma, composed of various types of non-small cell carcinomatous component and giant cell component. All cases showed significant area of beta-hCG positivity, and beta-hCG was usually expressed in the pleomorphic giant cells. CONCLUSION: In pulmonary carcinoma with pleomorphic giant cells, is necessary to check immunohistochemical stain for beta-hCG and to follow up the serum beta-hCG levels, to further establish the concept of beta-hCG expressing pulmonary carcinoma.
Chorion ; Chorionic Gonadotropin ; Female ; Follow-Up Studies ; Giant Cells ; Hemoptysis ; Hemorrhage ; Humans ; Lung ; Male ; Necrosis ; Retrospective Studies ; Sputum ; Tolnaftate

The aim of this study was to examine the roles of care helpers through job analysis. To do this, this study used the Developing A Curriculum Method (DACUM) to classify job content and a multi-dimensional study design was applied to identify roles and create a job description by looking into the appropriateness, significance, frequency, and difficulty of job content as identified through workshops and cross-sectional surveys conducted for appropriateness verification. A total of 418 care helpers working in nursing facilities and community senior service facilities across the country were surveyed. The collected data were analyzed using PASW 18.0 software. Six duties and 18 tasks were identified based on the job model. Most tasks were found to be "important task", scoring 4.0 points or above. Physical care duties, elimination care, position changing and movement assistance, feeding assistance, and safety care were identified as high frequency tasks. The most difficult tasks were emergency prevention, early detection, and speedy reporting. A summary of the job of care helpers is providing physical, emotional, housekeeping, and daily activity assistance to elderly patients with problems in independently undertaking daily activities due to physical or mental causes in long-term care facilities or at the client's home. The results of this study suggest a task-focused examination, optimizing the content of the current standard teaching materials authorized by the Ministry of Health and Welfare while supplementing some content which was identified as task elements but not included in the current teaching materials and fully reflecting the actual frequency and difficulty of tasks.
Aged ; Cross-Sectional Studies ; Curriculum ; Emergencies ; Health Personnel ; Housekeeping ; Humans ; Job Description ; Long-Term Care ; Mortuary Practice ; Teaching Materials

Background/Aims: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. Methods: The studies included in this meta-analysis were selected from Ovid-MEDLINE, OvidEmbase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol.Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications. Results: Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and diseasefree survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postop-erative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). Conclusions The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85–1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77–1.00; 6 studies; I2 = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59–0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilatory support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

Despite the global effort to mitigate the spread, coronavirus disease 2019 (COVID-19) has become a pandemic that took more than 2 million lives. There are numerous ongoing clinical studies aiming to find treatment options and many are being published daily. Some effective treatment options, albeit of variable efficacy, have been discovered. Therefore, it is necessary to develop an evidence-based methodology, to continuously check for new evidence, and to update recommendations accordingly. Here we provide guidelines on pharmaceutical treatment for COVID-19 based on the latest evidence.

Despite the global effort to mitigate the spread, coronavirus disease 2019 (COVID-19) has become a pandemic that took more than 2 million lives. There are numerous ongoing clinical studies aiming to find treatment options and many are being published daily. Some effective treatment options, albeit of variable efficacy, have been discovered. Therefore, it is necessary to develop an evidence-based methodology, to continuously check for new evidence, and to update recommendations accordingly. Here we provide guidelines on pharmaceutical treatment for COVID-19 based on the latest evidence.

Background: In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration. Methods: The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations. Results: An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3–4 months. Conclusion We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media.Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.