PURPOSE: This study was to examine the effects of 3 domains of continuing education (CE) for healthcare managers. METHODS: A group of 20 healthcare managers, attending 3 levels of CE, were the subjects. The data were collected by structured questionnaires before and after each education. The data were analyzed by Friedman test, Wilcoxon Signed Ranked Test, and Bonferroni correction. RESULTS: After completing CE, there was significant improvement on the scores of knowledge, attitude, and skills. CONCLUSION: This study suggests that CE for healthcare managers is an effective strategy to promote the competency of healthcare managers, who take care of the chronically ill patients.
Chronic Disease ; Delivery of Health Care ; Education, Continuing ; Humans ; Surveys and Questionnaires

Extraskeletal chondromas are relatively uncommon benign cartilaginous tumors of the soft tissue and well known to pose a considerable diagnostic problem because of histological variations including the immature appearance of their tumor cells. Recently, we have experienced a case of extraskeletal chondroma mimicking benign chondroblastoma. The patient was a 47-year-old woman who complained of a painful subcutaneous swelling on the radial aspect of 4th proximal interphalangeal (PIP) joint in the left hand for 6 months. Radiologic examination of the 4th finger revealed a 1cm-sized soft tissue mass. Histologically, the tumor was characterized by a lobulated mass which was composed of dense proliferation of chondroblast-like cells admixed with a few multinucleated giant cells of osteoclastic type. However, there were focal areas of typical chondroma which showed lace-like intense calcification around the differentiated chondrocytes.
Chondroblastoma ; Chondrocytes ; Chondroma* ; Female ; Fingers ; Giant Cells ; Hand ; Humans ; Joints ; Middle Aged ; Osteoclasts

Purpose: The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD). Methods: Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis. Results: The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management. Conclusion The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients’ needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.

Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.

Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.

Purpose: This study aimed to identify the factors associated with chemotherapy-induced neutropenia (CIN) in diffuse large B-cell lymphoma (DLBCL) patients undergoing combination chemotherapy. Methods: A total of 111 patients with DLBCL participated in this study at C University Hospital. The CIN group consisted of patients with an absolute neutrophil count (ANC) lower than 1,000 cells/μL. Clinical factors, the level of depression, and the level of healthy lifestyle were measured on the chemotherapy administration day, and the ANC was measured on the next follow-up day. Results: Binary logistic regression analysis showed that the factors associated with CIN in DLBCL were the presence of B symptoms at diagnosis (β=4.69) and low-risk CIN regimen (β=0.10) among clinical factors, and the level of healthy lifestyle (β=0.17). Conclusion Oncology nurses have to focus on the patients vulnerable to CIN having B symptoms at diagnosis, receiving a low-risk CIN regimen, and showing non-adherence to healthy lifestyle practice. Administration of granulocyte colony-stimulating factor can be considered for the patients receiving low-risk CIN regimen to reduce CIN. Education programs including healthy lifestyle practice to improve the immune system should be applied to the DLBCL patients.

Purpose: Improving survival and health-related quality of life (HRQOL), along with symptom relief, is important for the treatment of metastatic breast cancer (MBC). This study measured HRQOL and analyzed its influence on sociodemographic and clinical factors in patients with MBC. Methods: We interviewed 298 patients with MBC to investigate their sociodemographic characteristics and HRQOL by using EuroQol-5D-5L (EQ-5D) between September and October 2014. We also reviewed medical records to examine the clinical condition of the patients, including disease progression, adverse events, treatments, chronic disease, and metastatic areas. The distribution of the EQ-5D index was compared between different clinical conditions by using the Kruskal-Wallis test. We also conducted multiple regression analyses to identify the factors affecting HRQOL in patients with MBC. Results: The mean EQ-5D index was 0.79 for all patients surveyed. The mean EQ-5D index score was significantly lower in patients in the progressed state than in those in the progression-free survival state (0.73 vs. 0.80, p = 0.0002). The HRQOL of patients treated with chemotherapy alone was significantly lower than that of patients treated with hormonal or targeted therapy (0.76 vs. 0.82 or 0.85; p = 0.0020). Regression analysis revealed that the clinical factors associated with lower HRQOL were progressed state, chemotherapy, and adverse events, such as hair loss or stomatitis. Finally, young age, high income, and employment were the sociodemographic factors that were positively associated with better HRQOL. Conclusion This study provides new information on the health utility of MBC patients on the basis of various patient characteristics and offers insights that can assist medical professionals in treating patients with MBC and help policymakers implement cancer strategies. Further research is needed to reflect the changing environment of cancer treatment and enrich available evidence.

During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.
Female ; Humans ; Infant* ; Meningioma* ; Scalp*

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

BACKGROUND AND PURPOSE: There have been a few national population-based epidemiological studies of myasthenia gravis (MG) with wide variation of incidence and prevalence rates worldwide. Herein we report the first nationwide population-based epidemiological study of MG in Korea. METHODS: We attempted to estimate the incidence and prevalence rates of MG using the Korean National Health Insurance claims database for 2010 to 2013. Cases with MG were defined as those having claim records with a principal diagnosis of MG and the prescription of acetylcholinesterase inhibitors or immunosuppressive agents including corticosteroids and azathioprine within 2 years after the diagnosis. The year 2010 was set as a washout period, such that patients were defined as incident cases if their first records of MG were observed in 2011. RESULTS: In 2011 there were 1,236 incident cases, and the standardized incidence rate was 2.44 per 100,000 person-years. The standardized prevalence rates were 9.67 and 10.66 per 100,000 persons in 2010 and 2011, respectively. The incidence and prevalence rates peaked in the elderly population aged 60 to 69 years for both sexes. CONCLUSIONS: This is one of the largest national population-based epidemiological studies of MG, and it has confirmed the high incidence and prevalence rates of MG in the elderly population of South Korea.
Adrenal Cortex Hormones ; Aged ; Azathioprine ; Cholinesterase Inhibitors ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Humans ; Immunosuppressive Agents ; Incidence* ; Korea* ; Myasthenia Gravis* ; National Health Programs* ; Prescriptions ; Prevalence*