Background: This study was conducted to compare the job stress, resilience, and burnout levels of small and medium-sized hospital nurses working at National safety hospitals and coronavirus disease-19 (COVID-19) dedicated hospitals, and to identify influencing factors on burnout. Methods: This study was a cross-sectional study and research participants were nurses at small and medium-sized hospitals working at National safety hospitals and COVID-19 dedicated hospitals. Data from 292 nurses collected using a structured questionnaires from April 1 to 30, 2020 were used. Data was analyzed using multiple regression analyses. Results: As a result of this study, there was a significant difference in stress on job demand and job resources of nurses working at National safety hospital type B and COVID-19 dedicated Hospital. There was no difference in job stress and resilience of nurses among types of hospitals. As a result of multiple regression, stress to job demands and resilience were factors influencing the level of exhaustion of nurses. Stress to job demands and job resources and resilience were factors influencing the level of disengagement of nurses. Conclusions Considering the results of this study, it is suggested to introduce strategies to reduce nurses’ job stress and burnout caused by COVID-19.

The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multiple-trauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and anti-thrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.
Abdominal Pain ; Aged ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Brain ; Coma ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Drainage ; Emergencies ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Iliac Artery ; Multiple Trauma ; Shock ; Sleep Stages ; Subarachnoid Hemorrhage, Traumatic* ; Tomography, X-Ray Computed ; Vital Signs

Purpose: To compare the vessel density (VD) and foveal avascular zone (FAZ) area using four different optical coherence tomography angiography (OCTA) images. Methods: This prospective study analyzed the OCTA images of consecutive healthy subjects using Plex-Elite (Carl Zeiss), DRI OCT-1 Atlantis (Topcon), AngioPlex (Carl Zeiss), and Spectralis OCTA (Heidelberg Engineering). The VD and FAZ areas were calculated using the OCTA images with a 3 x 3 mm2 volume scan pattern centered on the fovea. Results: The VD (%) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were different using the four devices: Plex-Elite (42.17 ± 2.79, 43.71 ± 2.36), DRI OCT-1 Atlantis (28.70 ± 2.87, 30.27 ± 3.02), AngioPlex (28.32 ± 6.68, 33.33 ± 5.44), and Spectralis OCTA (27.86 ± 4.13, 28.54 ± 3.14), respectively; p < 0.001). The FAZ area (mm2) of the SCP and DCP were different using the four devices: Plex-Elite (0.276 ± 0.097, 0.340 ± 0.100), DRI OCT-1 Atlantis (0.281 ± 0.102, 0.354 ± 0.119), AngioPlex (0.269 ± 0.099, 0.422 ± 0.120), and Spectralis OCTA (0.272 ± 0.079, 0.298 ± 0.106), respectively; p < 0.001). The VD of the SCP and DCP had no significant correlation using the four devices (all, p > 0.05), but the FAZ area had positive correlations using the four devices (all, p < 0.001). Conclusions The four OCTA devices provided different VD and FAZ areas, so these differences should be considered in analyzing OCTA images.

Larvae, nymphs, and adult stages of 3 species of ixodid ticks were collected by tick drag methods in Seoul during June-October 2013, and their infection status with severe fever with thrombocytopenia syndrome (SFTS) virus was examined using RT-PCR. During the period, 732 Haemaphysalis longicornis, 62 Haemaphysalis flava, and 2 Ixodes nipponensis specimens were collected. Among the specimens of H. longicornis, the number of female adults, male adults, nymphs, and larvae were 53, 11, 240, and 446, respectively. Ticks were grouped into 63 pools according to the collection site, species, and developmental stage, and assayed for SFTS virus. None of the pools of ticks were found to be positive for SFTS virus gene.
Animals ; Female ; Fever/virology ; Humans ; Ixodidae/*classification/*virology ; Larva/pathogenicity ; Male ; Phlebotomus Fever/virology ; Phlebovirus/*isolation & purification ; Republic of Korea ; Thrombocytopenia/virology ; Tick Infestations/*virology

The prevalence of human astroviruses was tested in patients with acute gastroenteritis by using conventional duplex reverse transcription (RT)-PCR and electrophoresis. Diarrheal fecal samples were collected from 9,597 patients at local hospitals in Seoul. The prevalence of astroviruses was 1.0% (94/9,597 patients; mostly infants), and that of sapoviruses was 0.1% (14/9,597 patients). Age- and gender-wise analyses were carried out on 29 astrovirus-positive patients having complete information on file regarding their age, gender, and other particulars. The results were higher in patients of ages 0 to 14 yr, and 69.0% of the astrovirus-positive patients were females, of which 69.2% were infants (0 to 12 months), and 61.5% were 1-4 yr old. Notably, in the case of 5 to 78-yr-old acute gastroenteritis patients, 100% were females.
Acute Disease ; Adolescent ; Adult ; Age Factors ; Aged ; Astroviridae Infections/complications/*epidemiology/virology ; Child ; Child, Preschool ; DNA, Viral/analysis ; Feces/virology ; Female ; Gastroenteritis/complications/*diagnosis ; Humans ; Infant ; Male ; Mamastrovirus/genetics/*isolation & purification ; Middle Aged ; Prevalence ; Reverse Transcriptase Polymerase Chain Reaction ; Sapovirus/genetics/isolation & purification ; Sex Factors ; Young Adult

BACKGROUND: Viruses that cause acute respiratory infection include adenovirus (ADV), respiratory syncytial virus A and B (RSV(A), RSV(B)), influenza virus A and B (FluA, FluB), parainfluenza virus 1, 2 and 3 (PIV1, PIV2, PIV3), human metapneumovirus (hMPV), human coronavirus (hCoV), human rhinovirus (hRV), and enterovirus, among others. METHODS: Viral incidence was evaluated in acute respiratory patients in Seoul, Korea from 2010 to 2012. A total of 2,544 oropharyngeal swab specimens were tested by real-time polymerase chain reaction (PCR) methods. RNA viruses (hRV, PIV, RSV, hCoV, and hMPV) and DNA viruses (ADV and bocavirus) were detected using the one-step reverse transcriptase PCR (RT-PCR) premix kit (SolGent, Korea) from January 2010 to June 2011, and using the real-time PCR kit (Kogenebiotech, Korea) from July 2011 to December 2012. RESULTS: Thirty-two percent (813/2,544) of specimens were positive; 31.9% (294/923) in 2010, 31.4% (232/738) in 2011, and 32.5% (287/883) in 2012. The most frequently isolated virus was hRV (40.7%, 331/813), followed by ADV (23.9%, 194/813), RSV (14.1%, 115/813), PIV (12.3%, 100/813), and hCoV (8.7%, 71/813). PIV1 was the most commonly isolated PIV, followed by PIV3 and PIV2, respectively. hCo OC43 was the most commonly isolated hCoV, followed by hCoV NL63 and hCoV 229E, respectively. CONCLUSION: Information on respiratory viruses circulating in Seoul, Korea over the last three years will be helpful in the management of acute respiratory infections, and for larger-scale epidemiological studies.

During the course of evaluation and management of neck masses, consideration for Immunoglobulin G4-related disease (IgG4-RD) should be given. IgG4-RD is relatively a new growing entity of immune-mediated origin, characterized by a mass-forming lesion, the infiltration of IgG4-positive plasma cells and occasionally elevated serum IgG4. The most common manifestations are parotid and lacrimal swelling, lymphadenopathy and autoimmune pancreatitis. A previously healthy 72-year-old man was referred to our clinic with a 2-month history of left cervical lymph node enlargement without systemic manifestations . A cervical lymph node biopsy was planned because of elevated serum IgG4 levels. Pathological findings showed prominent infiltration of IgG4-postive plasma cells in the lymph node. After steroid therapy, a computed tomography scan revealed a decrease in the cervical lymph node size. This case illustrates the importance of including IgG4-RD in the differential diagnosis of a cervical lymph node enlargement.
Aged ; Biopsy ; Diagnosis, Differential ; Humans ; Immunoglobulin G ; Immunoglobulins ; Lymph Nodes* ; Lymphatic Diseases* ; Neck ; Pancreatitis ; Plasma Cells

PURPOSE: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. MATERIALS AND METHODS: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. RESULTS: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P=0.03, the THW group; P=0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0< or =5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. CONCLUSION: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.
Humans ; Multivariate Analysis ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyrotropin Alfa

PURPOSE: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and METHODS: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). RESULTS: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: 2.9+/-1.4, group 2: 1.5+/-0.6). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. CONCLUSION: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.
Carcinoma ; Humans ; Lung ; Lung Diseases, Interstitial ; Lung Neoplasms ; Retrospective Studies ; Thorax

Renal cell carcinoma is a rare metastatic malignant neoplasm of the paranasal sinus. The clinical picture and radiologic findings might sometimes be insufficient to suspect metastatic renal cell carcinoma. Therefore, the definite diagnosis should be made according to the result of intraoperative biopsy. Recently, tyrosine kinase inhibitor, sunitinib, is considered as an effective agent in the treatment of metastatic renal cell carcinoma. We report a case of 69-year-old patient with metastatic renal cell carcinoma of the right maxillary sinus with accompanying fungal sinusitis. After 6 times of chemotherapy with sunitinib malate, there was no sign of recurrence or local advancement of the tumor during the 1-year follow-up period.
Aged ; Biopsy ; Carcinoma, Renal Cell ; Follow-Up Studies ; Humans ; Indoles ; Maxillary Sinus ; Maxillary Sinus Neoplasms ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Pyrroles ; Recurrence ; Sinusitis ; Tyrosine