Glycogen storage disease (GSD) type V, also known as McArdle’s disease, is an autosomal recessive genetic disease caused by a mutation of the PYGM gene related to the synthesis of the myophosphorylase enzyme. Here, we presented the case of an 83-year-old woman who was admitted for progressively worsening weakness of her legs due to rhabdomyolysis after a COVID-19 vaccination. In the muscle biopsy, myopathy with subsarcolemmal glycogen accumulation was revealed and she was diagnosed with a mild form of GSD type V. Although COVID-19 vaccines are generally safe and encouraged for everyone, adverse events following COVID-19 vaccinations are increasing. We should pay attention to the side effects of COVID-19 vaccination including rhabdomyolysis.

A 70-year-old female was referred for brown-to-gray colored papules and nodules on her lower legs. She had been diagnosed with diffuse large B-cell lymphoma (DLBCL) in her stomach, and myelodysplastic syndrome (MDS) by bone marrow biopsy. Three years after complete remission of DLBCL, she experienced DLBCL recurrence in her small bowel and was hospitalized. MDS had been stationary, but during the treatment of DLBCL, her laboratory findings suggested signs of leukemia. Bone marrow biopsy was done, and acute monoblastic leukemia (AMoL) was diagnosed. After 1 cycle of chemotherapy for AMoL, skin lesions developed, and her skin biopsy showed cutaneous T-cell lymphoma (CTCL). Terminal deoxynucleotidyl transferase staining and CD123 staining were negative, and bone marrow re-biopsy conducted after the skin lesion developed still showed monoblastic proliferation. Whether the CTCL represented with an AMoL lineage switch could not be completely proved due to the absence of molecular or clonal marker evaluations, but the possibility of coexistence of three different malignancies was higher. During treatment, a neutropenic fever developed, and the patient died due to sepsis. We herein report a rare case of CTCL accompanied by AmoL and DLBCL.

PURPOSE: This study was conducted to compare internal marketing, job satisfaction and customer orientation between nurses in small-medium hospitals and nurses in general hospitals. METHOD: The participants were 470 nurses were working in 8 small-medium hospitals and 5 general hospitals. Data were collected with structured questionnaires in July, 2010, and analyzed using descriptive statistics, chi2-test, MANCOVA, t-test, One-way ANOVA, and Scheffe test with PASW (SPSS) 18.0 program. RESULTS: There was no significant difference between small-medium hospital nurses and general hospital nurses in internal marketing and customer orientation. But nurses in small-medium hospitals had higher levels of job satisfaction than general hospital nurses. CONCLUSIONS: These findings demonstrate the necessity of developing programs that will help to improve job satisfaction in nurses.
Hospitals, General ; Job Satisfaction ; Marketing ; Orientation ; Surveys and Questionnaires

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*

Objectives: This study examined the nutritional status according to frailty status in the elderly at home. Methods: The participants were a total of 76 elderly at home living in Seo-gu, Gwangju, Korea. The nutritional status and frailty status were analyzed using the Nutrition Quotient for Elderly (NQ-E) and the Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight Scale (K-FRAIL), respectively. Results: The distribution of frailty status was robust (17.1%), pre-frailty (38.2%) and frailty (44.7%), and its distribution was significantly different in genders, age groups and the number of medications. The mean NQ-E score was 47.0 for total subjects, indicating a low grade. The scores of balance, diversity and dietary behavior factors were within the low grade, while the score of the moderation factor was within the medium-high grade. According to the frailty status, pre-frailty and frailty showed significantly higher scores for sugar-added beverages intake in the moderation constructs than robust. Robust showed significantly higher scores for the exercise hours and perception level for one’s health than pre-frailty and frailty. Conclusions These results suggest that nutrition status is associated with frailty status.Regular nutrition education and visiting nutrition service should be established to improve the balance and diversity of food intake and improve the dietary behavior of the elderly at home.

Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ 2 -test, Fisher’s exact test, t-test, Wilcoxon signed-rank test, and Mann– Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students’ clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

Cerebral white matter tracts are altered by a brain tumor. We report a case of gliomatosis cerebri where the diffusion tensor fiber tract passes through the tumor.
Brain Neoplasms ; Diffusion Magnetic Resonance Imaging ; Diffusion* ; Neoplasms, Neuroepithelial*

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.
Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Chromatin ; Diagnosis ; Financing, Organized ; Humans ; Lymphoma ; Neoplasm Metastasis ; Pleural Effusion ; Skin ; Small Cell Lung Carcinoma

Purpose: This study was conducted to evaluate clinical usefulness by evaluating the marginal bone resorption and survival rate of an implant with a taper straight type SLA surface domestically available on the market recently. Materials and methods: 40 implants satisfying the including criteria were observed for one year of 125 implants of 83 adult men and women who had KISPLANT® implanted from August 2016 to December 2019 at the Department of Periodontology, Chonnam National University Dental Hospital. The marginal bone level was measured on periapical radiographs taken initially and 1 year later and we analyzed implant survival and success rates. A t-test was used for the analysis of the association between the marginal bone resorption and the severity of periodontitis, supportive periodontal therapy, the inserted site, the cause of extraction, immediate placement, and systemic disease. Results: After 1 year of loading, the mesial bone resorption was 0.74 ± 1.07 mm, and the distal bone resorption was 0.53 ± 1.04 mm. The marginal bone resorption of 2 mm or more occurred at 3 implants out of 40 implants after 1 year, so the success rate of implant was 92.5% and survival rate was 100%. There was a significant difference in mesial marginal bone resorption according to the inserted site and no significant differences were found between marginal bone resorption and the other factors. Conclusion As a result of marginal bone resorption, success rate, and survival rate in this study, we found little marginal bone resorption and high survival and success rate. It can be concluded that they represent excellent clinical results.