Purpose: The efficacy of the Mindful Self-Compassion (MSC) for Healthcare Communities program has not been verified. This study aims to evaluate the feasibility and efficacy of the online MSC for Healthcare Communities program on burnout, stress-related health, and resilience among surgical trainees. Methods: A single-arm pilot study was conducted at a tertiary referral academic hospital in Korea. Surgical trainees were recruited through flyer postings; therefore, a volunteer sample was used. Thus, 15 participants participated, among whom 9 were women and 11 were doctor-residents. The Self-Compassion for Healthcare Communities (SCHC) program was conducted from September to October 2021 via weekly online meetings (1 hour) for 6 weeks. The efficacy of the program was evaluated using validated scales for burnout, stress, anxiety, depression, self-compassion, and resilience before and after the intervention and 1 month later. Results: The results showed significantly reduced burnout, anxiety, and stress scores. After the program, high emotional exhaustion and depersonalization rates decreased, and personal accomplishment increased. Eight participants showed reduced anxiety postintervention, and 9 showed reduced stress. Improvements were observed between pre- and postintervention in resilience, life satisfaction, and common humanity. Changes in self-compassion predicted higher gains in resilience and greater reductions in burnout and stress. Conclusion The SCHC is a feasible and effective program to improve resilience, self-compassion, and life satisfaction and reduce stress, anxiety, depression, and burnout in surgical trainees. This study highlights the need to include specific mental health programs in surgical training to improve trainees’ well-being.

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.
Acromegaly ; Consensus ; Expert Testimony ; Insurance Coverage ; Insurance, Health ; Octreotide ; Somatostatin

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.

PURPOSE: To develop software to measure the shortest radius in curvature of Bruch's membrane from optical coherence tomography (OCT), and then to apply it to various types of eyes. METHODS: Macular OCT images consisting of 12 images of 9 mm radial scans were studied. The horizontal to vertical pixel ratios were changed to 1:1, and Bruch's membrane was marked automatically on each image. Software to measure the radius of Bruch's membrane curvature was developed. The shortest radius on each image was defined as r (mm) and the average r of 12 images was defined as R (mm). The reciprocal of R was multiplied by the constant, 337.5, which was defined as the posterior staphyloma (PS) index. RESULTS: The OCT images of five eyes were analyzed by the software, which could calculate the curvature of Bruch's membrane automatically. The PS indices were 12.7, 23.7, and 66.4 in eyes without refractive error (Case I), in the high myopic group without posterior staphyloma (Case II), and in the high myopic group with posterior staphyloma (Case V), respectively. The PS index gradually increased according to aging in a 37-year-old patient (Case IV) with mild staphyloma from 34.6 to 39.5 over 4 years. CONCLUSIONS: PS index is a novel parameter to reflect the level of posterior staphyloma, but further studies are needed to apply it to clinical patients.
Adult ; Aging ; Bruch Membrane ; Humans ; Myopia ; Radius ; Refractive Errors ; Tomography, Optical Coherence

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.
Acromegaly ; Expert Testimony ; Growth Hormone ; Humans ; Octreotide ; Pituitary Neoplasms ; Somatostatin

PURPOSE: Severe asthma and asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) are difficult to control and are often associated with poor clinical outcomes. However, much is not understood regarding the diagnosis and treatment of severe asthma and ACOS. To evaluate the current perceptions of severe asthma and COPD among asthma and COPD specialists, we designed an e-mail and internet-based questionnaire survey. METHODS: Subjects were selected based on clinical specialty from among the members of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Academy of Tuberculosis and Respiratory Diseases. Of 432 subjects who received an e-mail invitation to the survey, 95 subjects, including 58 allergists and 37 pulmonologists, responded and submitted their answers online. RESULTS: The specialists estimated that the percentage of severe cases among total asthma patients in their practice was 13.9%±11.0%. Asthma aggravation by stepping down treatment was the most common subtype, followed by frequent exacerbation, uncontrolled asthma despite higher treatment steps, and serious exacerbation. ACOS was estimated to account for 20.7% of asthma, 38.0% of severe asthma, and 30.1% of COPD cases. A history of smoking, persistently low forced expiratory volume in 1 second (FEV1), and low FEV1 variation were most frequently classified as the major criteria for the diagnosis of ACOS among asthma patients. Among COPD patients, the highly selected major criteria for ACOS were high FEV1 variation, positive bronchodilator response, a personal history of allergies and positive airway hyperresponsiveness. Allergists and pulmonologists showed different assessments and opinions on asthma phenotyping, percentage, and diagnostic criteria for ACOS. CONCLUSIONS: Specialists had diverse perceptions and clinical practices regarding severe asthma and ACOS patients. This heterogeneity must be considered in future studies and strategy development for severe asthma and ACOS.
Allergy and Immunology ; Asthma* ; Diagnosis ; Electronic Mail ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Lung Diseases, Obstructive ; Population Characteristics ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking ; Specialization* ; Tuberculosis

BACKGROUND: Although many risk factors are known to be associated with poor asthma outcomes in the elderly, the literature on the effect of risk factor control on asthma outcomes in the elderly is very sparse. OBJECTIVE: To evaluate the role of multifaceted interventions in reducing acute exacerbations in elderly asthmatics. METHODS: A total of 100 subjects were randomly selected from our prospective cohort of elderly asthmatics aged 65 years or older and were provided multifaceted intervention for 1 year. Our multifaceted interventions included repeated education on asthma and inhaler technique for patients and their caregivers, provision of an action plan to cope with acute exacerbations, short message service to prevent follow-up losses, and oral replacement of magnesium. The primary outcome was an acute asthma exacerbation rate compared to the previous year. RESULTS: Ninety-two subjects completed this study, although only 58 subjects continued to take magnesium. Compared to the previous year, the acute asthma exacerbation rate showed a significant reduction from 67% to 50% (p = 0001) and significant improvement was observed in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (p = 0.04, p = 0.036 for each). Interestingly, a subgroup analysis revealed that predicted value of FEV1 increased significantly in subjects who continued to take magnesium from 79.6% to 87.1% (p = 0.008). CONCLUSION: To reduce acute exacerbations in elderly asthmatics, a multifaceted approach in increase medical awareness, proficiency and adherence to inhaler, assistance of caregivers and correction of micronutrients deficiency is likely to be effective. In addition, a continuous oral replacement of magnesium may increase FEV1 in elderly asthmatics.
Aged ; Asthma ; Caregivers ; Cohort Studies ; Education ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Magnesium ; Micronutrients ; Nebulizers and Vaporizers ; Prospective Studies ; Risk Factors ; Text Messaging ; Vital Capacity

BACKGROUND/AIMS: The resistance rate of Helicobacter pylori is gradually increasing. We aimed to evaluate the efficacy of levofloxacin-based third-line H. pylori eradication in peptic ulcer disease. METHODS: Between 2002 and 2014, 110 patients in 14 medical centers received levofloxacin-based third-line H. pylori eradication therapy for peptic ulcer disease. Of these, 88 were included in the study; 21 were excluded because of lack of follow-up and one was excluded for poor compliance. Their eradication rates, treatment regimens and durations, and types of peptic ulcers were analyzed. RESULTS: The overall eradiation rate was 71.6%. The adherence rate was 80.0%. All except one received a proton-pump inhibitor, amoxicillin, and levofloxacin. One received a proton-pump inhibitor, amoxicillin, levofloxacin, and clarithromycin, and the eradication was successful. Thirty-one were administered the therapy for 7 days, 25 for 10 days, and 32 for 14 days. No significant differences were observed in the eradication rates between the three groups (7-days, 80.6% vs 10-days, 64.0% vs 14-days, 68.8%, p=0.353). Additionally, no differences were found in the eradiation rates according to the type of peptic ulcer (gastric ulcer, 73.2% vs duodenal/gastroduodenal ulcer, 68.8%, p=0.655). CONCLUSIONS: Levofloxacin-based third-line H. pylori eradication showed efficacy similar to that of previously reported first/second-line therapies.
Amoxicillin ; Clarithromycin ; Compliance ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Levofloxacin ; Peptic Ulcer* ; Ulcer

PURPOSE: The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS: Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posteriorsuperior and lateral-superior direction. RESULTS: The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately 50° posterior-superior and 41° lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION: These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.
Bicuspid ; Cadaver ; Dental Implants ; Tooth ; X-Ray Microtomography

PURPOSE: Inhalant allergen sensitization is one of the major factors involved in the pathogenesis of allergic respiratory diseases. However, the sensitization is determined by interactions between genetic and environmental factors. Thus, testing panels of inhalant allergens may differ among geographical areas. Here we aimed to determine 10 common inhalant allergens in Korean adult patients with suspected respiratory allergies and to examine the variation between different geographical locations. METHODS: A total of 28,954 patient records were retrieved for retrospective analysis, from 12 referral allergy clinics located in 9 different areas. Inclusion criteria were Korean adults (≥18 years old) who underwent the inhalant allergen skin prick test for suspected history of respiratory allergy. The primary outcome was inhalant allergen skin prick response. Demographic and clinical information were also collected. Positive skin prick responses to allergens were defined as allergen-to-histamine wheal ratio ≥1. Based on skin test results, the most prevalent aeroallergens were determined. RESULTS: The overall prevalence of allergic sensitization was 45.3%. Dermatophagoides farinae and Dermatophagoides pteronyssinus were the most commonly sensitized allergens. Other common inhalant allergens were cat epithelium (8.1%), birch (7.7%), mugwort (6.9%), alder (6.7%), hazel (6.7%), beech (6.7%), oak (6.6%), and Tyrophagus putres (6.2%), in decreasing order frequency. These 10 inhalant allergens explained 90% of inhalant allergen sensitization in the study participants. However, distinct patterns of the 10 inhalant sensitization were observed in patients living in Chungnam and Jeju. American cockroach, Gernam cockroach, and Trichophyton metagrophytes were unique in Chungnam. Orchard, Japanese cedar, and Velvet were unique in Jeju. CONCLUSIONS: The present analysis suggests a panel of 10 most common inhalant allergens in Korean adult patients with suspected respiratory allergies, which explained 90% of inhalant allergen sensitization. This panel can be utilized as a practical and convenient tool for primary practice and epidemiological surveys of respiratory allergic diseases.
Adult* ; Allergens ; Alnus ; Animals ; Artemisia ; Betula ; Cats ; Chungcheongnam-do ; Cockroaches ; Cryptomeria ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Epithelium ; Fagus ; Humans ; Hypersensitivity ; Periplaneta ; Prevalence ; Referral and Consultation ; Retrospective Studies* ; Skin ; Skin Tests ; Trichophyton