Purpose: This study aimed to investigate burnout and resilience among emergency physicians (EPs) at university teaching hospitals during the coronavirus disease (COVID-19) pandemic. Materials and Methods: In April to May 2021, a survey was administered to 331 and 309 emergency medicine specialists and residents, respectively, from 31 university teaching hospitals in Korea. Data on the respondents’ age, sex, designation, working area, experience with treating COVID-19 patients, and personal experience with COVID-19 were collected. Based on the participants’ characteristics, quality of life (compassion satisfaction, burnout, and secondary traumatic stress), resilience, emotional content, and self-image were analyzed. Results: A total of 247 responses were analyzed. Compared to specialists, compassion satisfaction and resilience in residents were not good, burnout was severe, and emotional content and self-image were less positive. Experiences with treating COVID-19 patients did not cause any difference in quality of life, resilience, emotional content, and self-image among participant subgroups. Personal COVID-19 experiences were associated with poor compassion satisfaction, resilience, less positive emotional content and self-image, and severe burnout. Compassion satisfaction, secondary traumatic stress, and resilience can definitively affect burnout. Conclusion The quality of life and resilience of EPs in university teaching hospitals in Korea during the COVID-19 pandemic have been low. Supportive measures to improve resilience can prevent burnout among emergency staff, particularly residents and EPs, with personal experiences related to COVID-19.

PURPOSE: The purpose of this study is examine the effects of clinical art therapy on self-esteem, anxiety, and pain of pediatric burn patients. METHODS: Hospitalized pediatric patients, age from 6 to 15, at H specialized burn hospital located in Seoul were chosen as subjects for this study. Total 11 people were participated. An experimental group received 8 sessions of a clinical art therapy program, twice a week with each 40 minutes long. As for measurement tools, a Rosenberg Self-Esteem Scale (RSES) and a State Anxiety Inventory for Children (SAIC) were used. And a Visual Analog Scale (VAS) was implemented before and after each session. Also, a Drawing a Person test was analyzed along with individual characteristics. RESULTS: 1) The self-esteem score after art-therapy was improved from 28.1+/-3.4 to 32.9+/-3.1 (P<0.001), 2) The Anxiety score after art-therapy was decrease from 34.6+/-3.7 to 26.8+/-2.8 (P<0.001), 3) Overall 8 sessions of each art-therapy, there were significant reduction in the pain scale score (least squares means: 2.5 (2.1~2.8), P<0.001). CONCLUSION: The study demonstrate positive effects of clinical art therapy on self-esteem, anxiety, and pain of pediatric burn patients.
Anxiety ; Art Therapy ; Burns ; Child ; Humans

Background: Patient safety has a direct impact on the patient’s health and life, so all members of the hospital should consider it first. Patient safety accidents are often occured by organizational problems rather than individual medical personnel. Therefore, effective interprofessional collaboration(IPC) among experts is essential, so interprofessional education(IPE) is considered important. Methods: : A prospective study method of one-group pretest-posttest design was used that provides IPE using active learning-oriented teaching methods for health workers in various occupations of various hospitals, and evaluates self-efficacy, communication confidence, and attitude toward IPE. Results: : 17 trainees from 8 hospitals were evaluated. First, the average of the awareness of patient safety culture was 3.62 points. Next, the score of each indicators increased in the pre-post evaluation. The average of communication confidence was from 3.73 to 3.95 points, self-efficacy was from 3.99 to 4.11 points, and attitude toward IPE was from 4.44 to 4.52 points, but not significant. Conclusions This study would have a great significance in that it was conducted on health workers in various occupations of various hospitals. As a result of a pre and post education survey conducted with trainees, the score was improved in communication confidence, self-efficacy, and attitude toward IPE. It seems to be due to the use of active learning teaching methods, and the active participation of trainees.

We report here on a case of metachronous second primary non-Hodgkin's lymphoma (NHL) that was diagnosed 6 years after performing subtotal gastrectomy for treating early gastric cancer (EGC). The subtype analysis revealed mantle cell lymphoma (MCL) of the blastic variant with a leukemic presentation, which was composed of mixed small and medium-sized cells. The immunohistochemical staining for cyclin-D1 was positive. The cytogenetic study revealed t(4;6). In Korea, the risk of developing a second primary cancer following gastric cancer was reported to be less than 3.4%, and NHL comprised less than 6.3% of this second primary cancer. Furthermore, MCL represents about 2% of all lymphomas in Korea. To the best of our knowledge, this is the first report of metachronous primary MCL with a leukemic presentation following curative resection of EGC.
Cytogenetics ; Gastrectomy ; Humans ; Korea ; Leukemia ; Lymphoma ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Neoplasms, Second Primary ; Stomach Neoplasms

PURPOSE: Although computed tomography (CT) is widely used for diagnosing liver metastasis from colorectal cancer, diagnostic accuracy of CT is not satisfactory. Magnetic resonance (MR) imaging and F-18 FDG PET has been reported to be superior to CT. However, studies on direct comparison of PET and MR are scarce. We compared the diagnostic accuracy of FDG PET and MR in detecting liver metastasis from colorectal cancer. MATERIALS AND METHODS: Among 363 colorectcal cancer patients who underwent F-18 FDG PET (ECAT, Siemens-CTI, Knoxville; Gemini, Philips, Milpitas, U.S.), 26 patients (M:F=17:9, age=62+/-11) underwent MR to evaluate suspicious metastatic liver lesions. Finally, 35 liver lesions detected by CT from 26 patients were enrolled for analysis. PET and MR results were compared with pathologic reports, clinical findings or follow-up results. RESULTS: Of the 35 lesions, 18 lesions (51.4%) were diagnosed as liver metastases, while remaining 17 (48.6%) as benign. The sensitivity and the specificity of PET were 94.4% and 94.1%, respectively, compared to 100% and 82.4% for MR. MR and PET was concordant in 30 lesions (85.7%): 17 metastatic (94.4%) and 13 benign (76.5%) lesions. ROC curve analysis revealed maximal SUV of 3.1 as the optimum standard in differentiating metastatic from benign liver lesions (AUC=0.897, p<0.001, sensitivity 83.3%, specificity 94.1%). For small lesions less than 1cm in diameter (n=20), diagnostic accuracy of PET was comparable to that of MR. CONCLUSION: F-18 FDG PET showed good diagnostic performance in detecting liver metastasis from colorectal cancer, which was comparable to MR.
Colonic Neoplasms ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Liver* ; Neoplasm Metastasis* ; Positron-Emission Tomography ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: We wanted to evaluate the MR findings for differentiating between necrotizing fasciitis (NF) and pyomyositis (PM). MATERIALS AND METHODS: The MR images of 19 patients with surgically confirmed NF (n = 11) and pathologically confirmed PM (n = 8) were retrospectively reviewed with regard to the presence or absence of any MRI finding criteria that could differentiate between them. RESULTS: The patients with NF had a significantly greater prevalence of the following MR findings (p < 0.05): a peripheral band-like hyperintense signal in muscles on fat-suppressed T2-weighted images (73% of the patients with NF vs. 0% of the patients with PM), peripheral band-like contrast enhancement (CE) of muscles (82% vs. 0%, respectively) and thin smooth enhancement of the deep fascia (82% vs. 13%, respectively). The patients with PM had a significantly greater prevalence of the following MRI findings (p < 0.05): a diffuse hyperintense signal in muscles on fat-suppressed T2-weighted images (27% of the patients with NF vs. 100% in the patients with PM), diffuse CE of muscles (18% vs. 100%, respectively), thick irregular enhancement of the deep fascia (0% vs. 75%, respectively) and intramuscular abscess (0% vs. 88%, respectively). For all patients with NF and PM, the superficial fascia and muscle showed hyperintense signals on T2-weighted images and CE was seen on fat-suppressed CE T1-weighted images. The subcutaneous tissue and deep fascia showed hyperintense signals on T2-weighted images and CE was seen in all the patients with NF and in seven (88%) of the eight patients with PM, respectively. CONCLUSION: MR imaging is helpful for differentiating between NF and PM.
Abscess/pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Fascia/pathology ; Fasciitis, Necrotizing/*pathology ; Female ; Humans ; Image Processing, Computer-Assisted ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Pyomyositis/*pathology ; Retrospective Studies ; Young Adult

Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon ; Diverticulum ; Diverticulum, Esophageal ; Duodenum ; Esophagus* ; Granulation Tissue ; Stomach

Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon ; Diverticulum ; Diverticulum, Esophageal ; Duodenum ; Esophagus* ; Granulation Tissue ; Stomach

BACKGROUND: This study aimed to determine the correlation between blood uric acid and homocysteine levels, based on alcohol-related facial flushing. METHODS: Among male adults who visited a health examination center of a university hospital located in Daejeon, Korea, for a personal health examination from March 2013 to February 2014, 702 subjects were analyzed including 401 subjects without alcohol-related facial flushing and 301 with facial flushing. Pearson's correlation and stepwise multivariate linear regression analyses were performed between the log homocysteine levels and other variables including uric acid. RESULTS: Uric acid showed a significant positive correlation with log homocysteine (gamma=0.166, P=0.001) (beta=0.176; P=0.001) in the non-flushing group. In contrast, none of the variables showed any significant correlations with log homocysteine in the flushing group. CONCLUSIONS: Alcohol users not exhibiting alcohol-related facial flushing showed a positive correlation between uric acid and homocysteine levels, whereas those without facial flushing showed no such correlation.
Adult ; Alcohol Drinking ; Flushing* ; Homocysteine* ; Humans ; Korea ; Linear Models ; Male ; Uric Acid*