BACKGROUND: Axillary osmidrosis is a distressing problem characterized by unpleasant odor, profuse sweating, and occasional wetting of clothes that may handicap those affected both socially and psychologically. A variety of surgical methods have been developed for the treatment of axillary osmidrosis. OBJECTIVE: To introduce the manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver for axillary osmidrosis. METHODS: Twenty-five patients with axillary osmidrosis were treated by the manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver. RESULTS: Twenty-one(84%) patients had good results, four(16%) fair, and none had a poor result or recurrence. Complications included one case of hematoma, two cases of partial skin necrosis. The wound complication rate was 6.0%(3/50) for the axilla and 12%(3/25) for patients. CONCLUSION: The manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver is effective surgical procedure for the treatment of axillary osmidrosis with a low complication rate and recurrence.
Axilla ; Hematoma ; Humans ; Hyperhidrosis* ; Lipectomy* ; Necrosis ; Odors ; Recurrence ; Skin ; Subcutaneous Tissue* ; Sweat ; Sweating ; Wounds and Injuries

PURPOSE: This study was performed to identify the influence of nursing professionalism and campus environment on the perception of ethical sensitivity among nursing students. METHODS: A descriptive survey design was used for this study. The participants were 323 nursing students attending four universities in Busan and Kyungnam. Data collection was conducted from November 25 to December 25, 2017 using a self-report questionnaire. Data were analyzed using a t-test, ANOVA, Scheffe's test, Pearson's correlation coefficients, and stepwise multiple regression. RESULTS: The factors influencing ethical sensitivity of nursing students were identified as professional self-concept (β=.36), nursing role (β=.24), scholarship (β=.17), practicability (β=.17), and propriety (β=-.13). Five factors explained 40.5% of nursing students' ethical sensitivity. CONCLUSION: The results of this study can be used to develop further educational programs on nursing professionalism and campus environments for enhancement of nursing students' ethical sensitivity.
Busan ; Data Collection ; Ethics, Nursing ; Fellowships and Scholarships ; Gyeongsangnam-do ; Humans ; Nursing ; Professionalism ; Students, Nursing

Purpose: This cross-sectional study aimed to evaluate the mediating and moderating effects of resilience in the relationship between experience of workplace bullying and its consequences among hospital nurses. Methods: The participants included 187 registered nurses working in general hospitals or a tertiary hospital in Busan and Gyeongnam Province, South Korea. Data were collected from October 25-November 30, 2019, using structured questionnaires. The moderating effects were examined using stepwise hierarchical multiple regression models. Data were analyzed using the SPSS/WIN 23.0 statistical program. Results: The results demonstrated that resilience had a moderating role in the relationship between experience of workplace bullying and its consequences in hospital nurses (β=.01, p=.024). However, resilience showed no mediating effect. Conclusion To prevent and control workplace bullying, as well as to minimize its negative effects, it is necessary to develop a program that can enhance the resilience of hospital nurses.

Eosinophilic cystitis is a rare inflammatory disease of urinary bladder with unknown etiology. The disease is known to be associated with several different processes such as allergy or injury. Eosinophilic cystitis is similar to interstitial cystitis, vesical tuberculosis and bladder neoplasm in clinical manifestations and should be differentiated from them. A 75 years old male patient underwent TUR-P for benign prostatic hyperplasia. After 2 months, he complained of irritative voiding symptoms. Cystoscopy revealed a polypoid mass, measuring 3 cm in diameter in the right lateral wall of bladder. Pathology of the lesion that was transurethrally resected revealed the diffuse eosinophilic infiltration of the bladder wall without evidence of malignancy.
Aged ; Cystitis* ; Cystitis, Interstitial ; Cystoscopy ; Eosinophils* ; Humans ; Hypersensitivity ; Male ; Pathology ; Prostatic Hyperplasia ; Tuberculosis ; Urinary Bladder ; Urinary Bladder Neoplasms

Transposition of the island pedicle flap is a versatile method of mobilizing tissue from a relatively distant reservoir and moving it across intervening tissue. Advantages are the similar color and texture to those of the affected area, the minimal donor scar, the increased viability with local blood supply, and the potential to camouflage scars into natural skin lines or cosmetic units. In a 73-year-old woman, the lesion of a basal cell carcinoma on her left nasal ala was removed by Mohs micrographic surgery and the resultant defect was reconstructed by transposition of the island pedicle flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that transposition of the island pedicle flap is another alternative for the reconstruction of nasal alar defects.
Aged ; Carcinoma, Basal Cell ; Cicatrix ; Female ; Humans ; Mohs Surgery ; Skin ; Tissue Donors

PURPOSE: To evaluate the effect of instrument aging on optical coherence tomography (OCT) measurements. METHODS: Single eyes of 60 healthy participants (60 eyes) aged 20-30 years were examined twice using a 5-year-old OCT instrument and a new OCT instrument (Carl Zeiss Meditec, Dublin, CA, USA). The measurements and changes in signal strength were investigated using both instruments. RESULTS: The signal strengths of the new and aged instruments were 8.6 ± 0.8 and 5.0 ± 1.0, respectively, which was a statistically significant difference (p < 0.001). In addition, the central macular thicknesses (CMT) of the new and aged instruments were 201.1 ± 16.1 µm and 210.3 ± 16.0 µm, respectively. The thickness was significantly greater using the aged instrument (p < 0.001). Repeated measurements within the same eye were compared, and the difference in CMT was 3.2 using the new instrument and 10.5 using the aged instrument (p < 0.05). The intraclass correlation coefficient (ICC) was compared to evaluate the reproducibility of each instrument. The ICC values of nine areas of Early Treatment Diabetic Retinopathy Study in the aged instrument were 0.371-0.872, indicating low reproducibility. However, the new instrument showed high reproducibility with values of 0.806-0.947. CONCLUSIONS: Higher signal strength and lower CMT were observed using the new instrument compared to the aged instrument. Additionally, there were no differences in signal strength errors between the instruments. However, the error in CMT measured using the new instrument was significantly smaller compared to that using the aged instrument. Therefore, the effect of instrument aging should be accounted for in analyses of OCT measurements.
Aging* ; Child, Preschool ; Diabetic Retinopathy ; Healthy Volunteers ; Humans ; Tomography, Optical Coherence

Background: : In the situation of the national crisis caused by Covid-19, healthcare providers face leadership challenges and professional composure for the benefit of the community. This article aims to find out that self-reflection meditation class for premedical students improves medical leadership and resilience needed for healthcare providers. Methods: : The sample was comprised of 109 premedical students at Pusan National University. We lectured ‘Physicians and leadership’ class focused on self-reflection and meditation for six weeks. We surveyed stress factors, self-reflection, self-esteem, and expectations for life before the class and asked about course satisfaction and changes after the class. A total of 109 questionnaires were retrieved to analyze the data and derive the results of the study. Results: : In the questionnaires about stress factors and self-reflections, grades and exams and questions related to expectations for life recorded the highest average, and negative thinking about self-esteem has the lowest score. In the questionnaire, which asked students to describe their feelings and changes through meditation, most students answered that they could learn to empty negative feelings and be emotionally calm and stable. These were also found in the reflection note analysis. Students experienced ‘self-understanding through deep reflection’ and ‘resolve vague anxiety and fear’ through meditation. This also leads to increase self-awareness and self-satisfaction. Conclusion : Self-reflection meditation class improved emotional and psychological stability for students and fostered self-leadership to drive their lives in the direction they want. This facilitates interpersonal relationships, leadership, and resilience needed as a healthcare provider.

Objective: There is no recommendation for the use of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) who developed cancer. We examined changes in the DMARDs prescription patterns associated with cancer diagnosis in RA patients. Methods: We reviewed the medical records of 2,161 RA patients who visited rheumatology clinic between January 2008 and February 2017 and found 40 patients who developed cancer during RA treatment. In these patients, we examined DMARDs prescription patterns before and right after cancer diagnosis and at recent outpatient clinic visits. Results: Before cancer diagnosis, methotrexate (MTX)-combined conventional synthetic DMARDs (csDMARDs) were most commonly prescribed (22, 55.0%) and biological DMARDs (biologics) in nine patients (22.5%). For cancer treatment, 19 patients received chemotherapy (including adjuvant chemotherapy) and 21 patients had surgery only. Right after cancer diagnosis, changes in the DMARDs prescription patterns were similar in discontinuation (13, 32.5%), switching (14, 35.0%), and maintenance (13, 32.5%). DMARDs were discontinued more frequently in the chemotherapy group (9/19, 47.4%) than the surgery only group (4/2, 19.0%) (p<0.05). Among the 13 patients who discontinued DMARDs, nine (69.2%) resumed DMARDs after a median of 5.5 months (interquartile range [IQR] 2.9, 18.3) due to arthritis flare. At a median of 4.6 years (IQR 3.3, 6.7) after cancer diagnosis, 25 patients were evaluated at recent outpatient clinic visits. Four patients received no DMARD, three MTX monotherapies, 11 csDMARDs combination therapies, and seven biologics. Conclusion A significant number of RA patients who developed cancer during RA treatment were still receiving DMARDs including biologics after cancer diagnosis.

C1q nephropathy is an immune complex glomerulonephritis defined by the presence of mesangial immunoglobins and complement deposits, most notably C1q, and the absence of clinical and laboratory evidence of systemic lupus erythematosus. Most patients with C1q nephropathy present nephrotic-range proteinuria, which has a poor response to steroid. Some patients may experience decreased renal function and progress to end stage renal disease. A 27year-old man presented with proteinuria and decreased mental state. The patient was hypertensive, with a blood pressure of 180/120 mmHg. Serum BUN/creatine was 18/1.8 mg/dL, and urinalysis revealed proteinuria (3+). Brain computed tomography showed right basal ganglial and intraventricular hemorrhage. The patient was treated with craniotomy and hematoma removal, and he also received carvedilol, losartan, nifedipine, and doxazosin for control of BP. Although his mental status recovered and blood pressure was controlled, the patient still showed subnephrotic proteinuria; therefore, renal biopsy was performed. Kidney biopsy showed segmental sclerosis in 3 out of 14 glomeruli, and mesangial C1q immunofluorescence positive staining. Electron microscopic findings revealed electron-dense deposits in the mesangium. The patient was treated with oral prednisolone, and proteinuria was alleviated after 8 weeks and remains in complete remission.
Antigen-Antibody Complex ; Biopsy ; Blood Pressure ; Brain ; Carbazoles ; Complement C1q ; Complement System Proteins ; Craniotomy ; Doxazosin ; Electrons ; Fluorescent Antibody Technique ; Glomerulonephritis ; Glomerulosclerosis, Focal Segmental ; Hematoma ; Hemorrhage ; Humans ; Kidney ; Kidney Failure, Chronic ; Losartan ; Lupus Erythematosus, Systemic ; Nifedipine ; Prednisolone ; Propanolamines ; Proteinuria ; Sclerosis ; Urinalysis

Background: Although data on post-coronavirus disease 2019 (COVID-19) conditions are extensive, the prognostic factors affecting symptom duration in non-hospitalized patients with COVID-19 are currently not well known. We aimed to investigate the various prognostic factors affecting symptom duration among outpatients with COVID-19. Methods: Data were analyzed from 257 patients who were diagnosed with mild COVID-19 and visited the ‘post-COVID-19 outpatient clinic’ between April and December 2022 after a mandatory isolation period. The symptom duration was measured from diagnosis to symptom resolution. Laboratory and pulmonary function test results from their first visit were collected. Results: The mean age of patients was 55.7 years, and the median symptom duration was 57 days. The development of post-COVID-19 conditions (> 12 weeks) were significantly correlated with not using antiviral drugs, leukocytosis (white blood cell > 10,000/µL), lower 25(OH)D 3 levels, forced vital capacity (FVC) < 90% predicted, and presence of dyspnea and anxiety/depression. Additionally, in multivariable Cox regression analysis, not using antiviral drugs, lower 25(OH)D 3 levels, and having dyspnea were poor prognostic factors for longer symptom duration. Particularly, vitamin D deficiency (< 20 ng/mL) and not using antivirals during the acute phase were independent poor prognostic factors for both post-COVID-19 condition and longer symptom duration. Conclusion The non-use of antivirals, lower 25(OH)D 3 levels, leukocytosis, FVC < 90% predicted, and the presence of dyspnea and anxiety/depression symptoms could be useful prognostic factors for predicting post-COVID-19 condition in outpatients with COVID-19. We suggest that the use of antiviral agents during the acute phase and vitamin D supplements might help reduce COVID-19 symptom duration.