Purpose: This study evaluates the Korean Cancer Study Group Geriatric Score-7 (KG-7) frailty screening tool’s effectiveness in elderly multiple myeloma (MM) patients to prevent under and overtreatment. Materials and Methods: This prospective pilot cohort study included 100 elderly patients aged 70 and older with newly diagnosed MM who had not undergone transplantation from August 2020 to January 2022. Results: The median age was 77 years, and 73.0% of patients were classified at International Staging System stages 2 or 3. Using a 5-point cutoff on the KG-7 index (non-frail, score ≥ 5; frail, score < 5), 31% were categorized as frail. After a median follow-up of 26.8 months, the 3-year overall survival rate was 73.0%. There was no statistically significant association between any frailty index and the risk of death. However, frail patients defined by the simplified frailty index (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.09 to 5.95; p=0.030) and by KG-7 (HR, 2.43; 95% CI, 1.03 to 5.86; p=0.043) had a significantly higher risk of grade 3-4 non-hematologic toxicity, whereas the International Myeloma Working Group definition did not. Over a 24-month tracking period, vulnerability as measured by KG-7 either improved or deteriorated. Conclusion The pilot study, which had a limited number of participants, did not demonstrate KG-7’s effectiveness in predicting survival; however, it successfully predicted severe non-hematologic toxicities. We plan to conduct larger studies in elderly MM patients to determine whether KG-7 can help tailor their treatment regimens.

Background and Objectives: In 2021, biologics were approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) in Korea. However, CRS is a heterogeneous disease, and its characteristics are thought to differ between Western and Korean populations. This study aimed to evaluate the experiences of members of the Korean Rhinologic Society during the first year of biologic usage for the treatment of nasal polyps. Methods: An anonymous survey consisting of 15 items was conducted from November to December 2021. The survey included questions about participant demographics, use of biologics for treating CRSwNP, and expectations regarding the effectiveness of biologics for treating CRSwNP. Results: In total, 44 members participated in the survey. Approximately half of the respondents were in their 40s (50.0%) and had 5–9 years of clinical experience as otorhinolaryngologists (47.7%). The majority of participants held academic positions (95.4%). About half of them worked in Gyeonggi Province. The utilization of biologics did not differ significantly based on clinical experience (p=0.192). When asked about the factors considered for prescribing biologics, the most common reason was recurrence of polyps after surgery (87.2%). The most frequent reason for discontinuing biologics was cost (48.6%). When asked about the extent to which they expected that the availability of biologics for CRSwNP treatment would reduce endoscopic sinus surgery (ESS), 45.5% of members expected a reduction of approximately 10%–29%. In addition, 20.5% expected a reduction of 50% or more. However, 61.4% expected a reduction of less than 10% in primary ESS. In addition, most respondents (93.2%) agreed with the need for Korea-specific guidelines for biologic treatment. Conclusion There are discrepancies between the current guidelines for biologic treatment of CRSwNP and the reality of the situation, highlighting the need for the development of Korea-specific guidelines.

Objectives: . In this study, we review our institutional experience with pediatric laryngomalacia (LM) and report our experiences of patients undergoing supraglottoplasty using the spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) technique. Methods: . The medical records of 29 children with LM who visited Seoul National University Hospital between January 2017 and March 2019 were retrospectively reviewed. Surgical management was performed using the STRIVE Hi technique. Intraoperative findings and postoperative surgical outcomes, including complications and changes in symptoms and weight, were analyzed. Results: . Of the total study population of 29 subjects, 20 (68.9%) were female. The patients were divided according to the Onley classification as follows: type I (n=13, 44.8%), II (n=10, 34.5%), and III (n=6, 20.7%). Twenty-five patients (86.2%) had comorbidities. Seventeen patients (58.6%) underwent microlaryngobronchoscopy under STRIVE Hi anesthesia. Four patients with several desaturation events required rescue oxygenation by intermittent intubation and mask bagging during the STRIVE Hi technique. However, the procedure was completed in all patients without any severe adverse effects. Overall, 15 children (51.7%) underwent supraglottoplasty, of whom 14 (93.3%) showed symptom improvement, and their postoperative weight percentile significantly increased (P=0.026). One patient required tracheostomy immediately after supraglottoplasty due to associated neurological disease. Conclusion . The STRIVE Hi technique is feasible for supraglottoplasty in LM patients, while type III LM patients with micrognathia or glossoptosis may have a higher risk of requiring rescue oxygenation during the STRIVE Hi technique.

Objective: The incidence of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest has increased rapidly over the past 10 years. On the other hand, automated external defibrillators (AEDs) are still only used in a minority of cases. This study investigated the feasibility of mobile video call guidance to facilitate AED use for laypeople. Methods: Ninety laypersons were randomized into three groups: mobile video call guided, voice call guided, and nonguided. The participants were exposed to a simulated cardiac arrest requiring AED use and guided by video call, voice call, or not. The simulation experiments were saved as a video clip, and other researchers blinded to simulation assessed the performance according to a prespecified checklist after the simulations. The performance score and analyzed time intervals from AED arrival to defibrillation in the three groups were compared. Results: The basic characteristics were similar in the three groups. Performance scores in the checklist for using AEDs were higher in the mobile video call guided group, particularly in a category of ‘power on AED’ and ‘correctly attaches pads’ than non-guided groups. The performance scores in the category of ‘safely delivers a shock and resume compression’ were also higher in the mobile video call group. On the other hand, the time interval to defibrillation was significantly longer in the mobile video call group. Conclusion This study showed that mobile video call guidance might be an alternative method for laypeople to facilitate AED use, but further well-designed research will be needed.

Palbociclib, in conjunction with endocrine therapy, has been approved for the treatment of patients with advanced breast cancer. The common hematological toxicities associated with palbociclib are leukopenia and neutropenia. However, hematological malignancies have not been reported for palbociclib treatment. Here, for the first time, we present a case of acute lymphoblastic leukemia that was diagnosed in a patient undergoing treatment with letrozole and palbociclib for metastatic breast cancer. This case emphasizes the need for long term follow up of patients treated with palbociclib.

Purpose: Clinical nurses are the ideal health care providers to advocate for vulnerable and underserved populations such as people with disability. This study aimed to understand factors influencing nursing advocacy for people with disability among clinical nurses. Methods: The subjects of this study were 186 clinical nurses who were working in three hospitals in B and D cities. Self-report questionnaires were used to collect the data. Data were analyzed using IBM SPSS Statistics 25 with descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression analysis. Results: Clinical experience and esthetical nursing competency have positive correlations with nursing advocacy, and optimism-human rights has a negative correlation with nursing advocacy. Factors influencing nursing advocacy for people with disability were identified as patient directivity (β=0.36, p=.001), optimism-human rights (β=-0.18, p=.008) and clinical experience (≥10) (β=0.14, p=.036). The final model consisting of these factors explained 19% of the variance of nursing advocacy (F=14.99, p=.001). Conclusion The findings of this study indicate the importance of developing and implementing nursing interventions that can improve patient directivity and optimism-human rights toward people with disability among clinical nurses. These nursing advocacy interventions can be provided as part of continuing education as well as the nursing curriculum.

PURPOSE: The purpose of this study was to identify the influencing factors on burnout after analyzing the relationship among clinical nurses' various perfectionism and coping styles. METHODS: A descriptive, cross-sectional study was conducted with 200 clinical nurses who had six months or more years of clinical experiences from two general hospitals located in D city. The data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise regression analysis using IBM SPSS statistics 23.0 program. RESULTS: The burnout of clinical nurses was positively correlated with socially prescribed perfectionism and negatively correlated with active coping style. Socially prescribed perfectionism was positively correlated with active coping style and passive coping style. Influencing factors on the burnout of clinical nurses were socially prescribed perfectionism (β=.37), satisfied work unit (β=−.64) and neutral satisfaction of work unit (β=−.27), over 40 years of age (β=−.21), and active coping style (β=−.14). The model consisting of these variables explained 42% of variance of burnout in clinical nurses. CONCLUSION: Based on the findings of this study developing intervention programs that consider influencing factors such as perfectionism and coping styles is needed to reduce the level of burnout of clinical nurses.
Cross-Sectional Studies ; Hospitals, General

PURPOSE: The purpose of this study was to identify the influencing factors on burnout after analyzing the relationship among clinical nurses' various perfectionism and coping styles. METHODS: A descriptive, cross-sectional study was conducted with 200 clinical nurses who had six months or more years of clinical experiences from two general hospitals located in D city. The data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise regression analysis using IBM SPSS statistics 23.0 program. RESULTS: The burnout of clinical nurses was positively correlated with socially prescribed perfectionism and negatively correlated with active coping style. Socially prescribed perfectionism was positively correlated with active coping style and passive coping style. Influencing factors on the burnout of clinical nurses were socially prescribed perfectionism (β=.37), satisfied work unit (β=−.64) and neutral satisfaction of work unit (β=−.27), over 40 years of age (β=−.21), and active coping style (β=−.14). The model consisting of these variables explained 42% of variance of burnout in clinical nurses. CONCLUSION Based on the findings of this study developing intervention programs that consider influencing factors such as perfectionism and coping styles is needed to reduce the level of burnout of clinical nurses.

PURPOSE: The purpose of this study was to investigate the mediating effect of resilience on the relationship between emotional labor and happiness of clinical nurses. METHODS: A descriptive, cross-sectional study was conducted with 224 clinical nurses who had one or more years of clinical experiences from four general hospitals in D city in Korea. Data collected from the survey using self-reported questionnaires were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis using IBM SPSS statistics 21.0 program. RESULTS: There were statistically significant correlations among variables; a negative correlation between happiness and emotional labor, a positive correlation between happiness and resilience, and a negative correlation between emotional labor and resilience. Meanwhile, resilience had a partial mediating effect on the relationship between emotional labor and happiness. That is, resilience can play an important role between emotional labor and happiness of clinical nurses as a mediator. CONCLUSION: Considering the findings of this study, developing programs that can improve resilience of clinical nurses who experience emotional labor are needed to increase their level of happiness.
Cross-Sectional Studies ; Happiness* ; Hospitals, General ; Korea ; Negotiating*

BACKGROUND: Mast cell leukemia (MCL) is the most aggressive form of systemic mastocytosis disorders. Owing to its rarity, neither pathogenesis nor standard treatment is established for this orphan disease. Hence, we tried to treat a patient with MCL based on the exome and transcriptome sequencing results of the patient's own DNA and RNA. METHODS: First, tumor DNA and RNA were extracted from bone marrow at the time of diagnosis. Germline DNA was extracted from the patient's saliva 45 days after induction chemotherapy and used as a control. Then, we performed whole-exome sequencing (WES) using the DNA and whole transcriptome sequencing (WTS) using the RNA. Single nucleotide variants (SNVs) were called using MuTect and GATK. Samtools, FusionMap, and Gene Set Enrichment Analysis were utilized to analyze WTS results. RESULTS: WES and WTS results revealed mutation in KIT S476I. Fusion analysis was performed using WTS data, which suggested a possible RARα-B2M fusion. When RNA expression analysis was performed using WTS data, upregulation of PIK3/AKT pathway, downstream of KIT and mTOR, was observed. Based on our WES and WTS results, we first administered all-trans retinoic acid, then dasatinib, and finally, an mTOR inhibitor. CONCLUSION: We present a case of orphan disease where we used a targeted approach using WES and WTS data of the patient. Even though our treatment was not successful, use of our approach warrants further validation.
Bone Marrow ; Diagnosis ; DNA ; Exome ; Humans ; Precision Medicine ; Induction Chemotherapy ; Leukemia ; Leukemia, Mast-Cell* ; Mast Cells* ; Mastocytosis, Systemic ; Rare Diseases ; RNA ; Saliva ; Transcriptome ; Tretinoin ; Up-Regulation ; Dasatinib