Objective: Coronavirus disease-2019 (COVID-19) had a significant impact on the mental health of healthcare workers. Related assessments should be included in plans for future pandemics. We investigated the connections between grief, viral anxiety, depression, and preoccupation in the context of COVID-19 in healthcare workers, to determine which factors will need to be incorporated. Methods: A total of 267 healthcare workers who had experienced the death of at least one patient during the COVID-19 pandemic were asked to respond to questionnaires assessing grief, viral anxiety, depression, loneliness, and preoccupation with COVID-19, based on their emotional state during the 2 weeks immediately after the death. Multivariate linear regression, causal mediation analysis and structural equation modeling were used to examine the psychological processes underlying grief. Results: Linear regression showed that viral anxiety (β=0.287, 95% confidence interval [CI]: 0.235–0.338, p<0.001) and depression (β= 0.157, 95% CI: 0.073–0.241, p<0.001) had independent associations with preoccupation with COVID-19. Causal mediation analysis revealed that both viral anxiety (proportion mediated: 0.51, 95% CI: 0.37–0.66, p<0.001) and depression (proportion mediated: 0.77, 95% CI: 0.50–1.08, p<0.001) were mediators between grief and preoccupation with COVID-19. In a structural equation model, viral anxiety and depression mediated most of the effects of grief on preoccupation with COVID-19, and loneliness was a mediator between grief and depression. Conclusion Contingency plans for the next pandemic are being formulated. Effective measures to protect the mental health of healthcare workers should be included, and such measures should consist of assessments for grief, viral anxiety, depression, and loneliness.

Objective: Coronavirus disease-2019 (COVID-19) had a significant impact on the mental health of healthcare workers. Related assessments should be included in plans for future pandemics. We investigated the connections between grief, viral anxiety, depression, and preoccupation in the context of COVID-19 in healthcare workers, to determine which factors will need to be incorporated. Methods: A total of 267 healthcare workers who had experienced the death of at least one patient during the COVID-19 pandemic were asked to respond to questionnaires assessing grief, viral anxiety, depression, loneliness, and preoccupation with COVID-19, based on their emotional state during the 2 weeks immediately after the death. Multivariate linear regression, causal mediation analysis and structural equation modeling were used to examine the psychological processes underlying grief. Results: Linear regression showed that viral anxiety (β=0.287, 95% confidence interval [CI]: 0.235–0.338, p<0.001) and depression (β= 0.157, 95% CI: 0.073–0.241, p<0.001) had independent associations with preoccupation with COVID-19. Causal mediation analysis revealed that both viral anxiety (proportion mediated: 0.51, 95% CI: 0.37–0.66, p<0.001) and depression (proportion mediated: 0.77, 95% CI: 0.50–1.08, p<0.001) were mediators between grief and preoccupation with COVID-19. In a structural equation model, viral anxiety and depression mediated most of the effects of grief on preoccupation with COVID-19, and loneliness was a mediator between grief and depression. Conclusion Contingency plans for the next pandemic are being formulated. Effective measures to protect the mental health of healthcare workers should be included, and such measures should consist of assessments for grief, viral anxiety, depression, and loneliness.

Objective: Coronavirus disease-2019 (COVID-19) had a significant impact on the mental health of healthcare workers. Related assessments should be included in plans for future pandemics. We investigated the connections between grief, viral anxiety, depression, and preoccupation in the context of COVID-19 in healthcare workers, to determine which factors will need to be incorporated. Methods: A total of 267 healthcare workers who had experienced the death of at least one patient during the COVID-19 pandemic were asked to respond to questionnaires assessing grief, viral anxiety, depression, loneliness, and preoccupation with COVID-19, based on their emotional state during the 2 weeks immediately after the death. Multivariate linear regression, causal mediation analysis and structural equation modeling were used to examine the psychological processes underlying grief. Results: Linear regression showed that viral anxiety (β=0.287, 95% confidence interval [CI]: 0.235–0.338, p<0.001) and depression (β= 0.157, 95% CI: 0.073–0.241, p<0.001) had independent associations with preoccupation with COVID-19. Causal mediation analysis revealed that both viral anxiety (proportion mediated: 0.51, 95% CI: 0.37–0.66, p<0.001) and depression (proportion mediated: 0.77, 95% CI: 0.50–1.08, p<0.001) were mediators between grief and preoccupation with COVID-19. In a structural equation model, viral anxiety and depression mediated most of the effects of grief on preoccupation with COVID-19, and loneliness was a mediator between grief and depression. Conclusion Contingency plans for the next pandemic are being formulated. Effective measures to protect the mental health of healthcare workers should be included, and such measures should consist of assessments for grief, viral anxiety, depression, and loneliness.

Objective: Coronavirus disease-2019 (COVID-19) had a significant impact on the mental health of healthcare workers. Related assessments should be included in plans for future pandemics. We investigated the connections between grief, viral anxiety, depression, and preoccupation in the context of COVID-19 in healthcare workers, to determine which factors will need to be incorporated. Methods: A total of 267 healthcare workers who had experienced the death of at least one patient during the COVID-19 pandemic were asked to respond to questionnaires assessing grief, viral anxiety, depression, loneliness, and preoccupation with COVID-19, based on their emotional state during the 2 weeks immediately after the death. Multivariate linear regression, causal mediation analysis and structural equation modeling were used to examine the psychological processes underlying grief. Results: Linear regression showed that viral anxiety (β=0.287, 95% confidence interval [CI]: 0.235–0.338, p<0.001) and depression (β= 0.157, 95% CI: 0.073–0.241, p<0.001) had independent associations with preoccupation with COVID-19. Causal mediation analysis revealed that both viral anxiety (proportion mediated: 0.51, 95% CI: 0.37–0.66, p<0.001) and depression (proportion mediated: 0.77, 95% CI: 0.50–1.08, p<0.001) were mediators between grief and preoccupation with COVID-19. In a structural equation model, viral anxiety and depression mediated most of the effects of grief on preoccupation with COVID-19, and loneliness was a mediator between grief and depression. Conclusion Contingency plans for the next pandemic are being formulated. Effective measures to protect the mental health of healthcare workers should be included, and such measures should consist of assessments for grief, viral anxiety, depression, and loneliness.

No abstract available.
Amyloidosis* ; Heart* ; Stem Cell Transplantation* ; Stem Cells*

Primary lymphoma of the urinary bladder is rare, comprising 0.2% of extranodal lymphomas. The predominant subtype of mucosa-associated lymphoid tissue (MALT) is extranodal marginal zone lymphoma. We report a case of MALT lymphoma of the urinary bladder in a 53-year-old female patient presenting with a five-year history of persistent hematuria and urinary frequency. A cystoscopy revealed multiple nodular lesions at the posterior wall and trigone of the bladder. The tissue obtained by cold-cup biopsy revealed lymphoid infiltration consistent with low-grade MALT lymphoma. Image studies revealed that the tumor originated from the urinary bladder and there was no evidence of metastases. The patient was positive for a rapid urease test. Because of the relationship between gastric MALT lymphoma and Helicobacter pylori, the patient was treated with antibiotics to eradicate Helicobacter pylori. The lymphoma subsequently disappeared and the patient has remained in persistent complete remission for eight years.
Anti-Bacterial Agents ; Biopsy ; Cystoscopy ; Female ; Helicobacter pylori* ; Hematuria ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Neoplasm Metastasis ; Urease ; Urinary Bladder*

Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma. Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis. Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM. However, no cases of acromegaly accompanied with MM have been reported in Asia to date. We here report the case of a 58-year-old woman with acromegaly accompanied with MM who presented with longstanding acromegalic manifestations resulting from a GH-secreting pituitary adenoma and also exhibited anemia, a reversed albumin/globulin ratio, and plasmacytosis on bone marrow examination. Because IGF-1 has been suggested to play an important role in the development and progression of MM, the patient promptly underwent surgical removal of the pituitary adenoma via a transsphenoidal approach. Since there is currently no consensus on therapeutic guidelines and suggested prognosis for MM with acromegaly, long-term follow-up of such cases is needed.
Acromegaly* ; Anemia ; Apoptosis ; Asia ; Bone Marrow Examination ; Cell Proliferation ; Consensus ; Female ; Growth Hormone ; Growth Hormone-Secreting Pituitary Adenoma ; Humans ; Insulin-Like Growth Factor I ; Middle Aged ; Mortality ; Multiple Myeloma* ; Neoplasms, Plasma Cell ; Pituitary Neoplasms ; Prognosis

BACKGROUND: Multicentric Castleman's disease (CD) is commonly associated with poor prognosis, and well-known prognostic factors are scarce. We performed a retrospective analysis to define the clinical features and prognostic factors for patients with multicentric CD. METHODS: Between 1990 and 2013, 32 patients with multicentric CD were identified from the database of the Asan Medical Center, Seoul, Korea. Clinicopathologic data were collected by reviewing the medical records. With the exclusion of 4 patients because of unknown human immunodeficiency virus infection status, 28 human immunodeficiency virus-negative patients with multicentric CD were included in this analysis. RESULTS: Most of the patients were male (76%) and had a median age of 54 years. Hyaline vascular variant was the most common subtype (N=11, 39%). Hepatosplenomegaly (61%), fever (39%), edema (29%), and ascites (18%) were the most frequently reported symptoms and signs at diagnosis. With a median follow-up of 67 months, the 5-year overall survival (OS) was 77%. Patients with extravascular fluid accumulation (i.e., peripheral edema, ascites, and/or pleural effusions) were significantly associated with a poor survival rate (5-year OS, 94% vs. 56%; P=0.04). The extent of disease involvement was also a significant prognostic factor (5-year OS, 91% for involvement on a single side vs. 73% on both sides of the diaphragm; P=0.03). Other clinicopathologic factors were not significantly associated with patient survival. CONCLUSION: Our findings suggest that the hyaline vascular variant is not a rare subtype of multicentric CD. Extravascular fluid accumulation and disseminated disease involvement seem to be significant prognostic factors.
Ascites ; Chungcheongnam-do ; Diagnosis ; Diaphragm ; Edema ; Fever ; Follow-Up Studies ; Giant Lymph Node Hyperplasia* ; HIV ; Humans ; Hyalin ; Korea ; Male ; Medical Records ; Prognosis ; Retrospective Studies ; Seoul ; Survival Rate

Background: The equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient. Objectives: The objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds. Methods: In this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured. Results: The mean H:W in Jeju horses was significantly lower than that in Thoroughbreds.The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds. Conclusions In this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.

A seven-month pregnant four-year-old Thoroughbred mare with colic weighing 600 kg was referred to the Jeju National University Equine Hospital. A physical examination and ultrasound suggested epiploic foramen entrapment. The patient underwent ileum resection and end-to-side jejunocecostomy. After surgery, the horse showed a consistent pain when introduced to feeding. A repeat laparotomy was performed to enlarge the stoma size with side-to-side jejunocecostomy. The repeat laparotomy was successful, and the mare gave birth uneventfully. This report describes a case of small intestinal epiploic foramen entrapment and the clinical outcomes of the 2 consecutive laparotomies a Thoroughbred mare in late gestation.