Purpose: This study aimed to examine the effects of nurses' job esteem and positive psychological capital on their intention to stay and to investigate the mediating effect of organizational commitment in these relationships. Methods: A cross-sectional survey was conducted among 107 nurses employed at two general hospitals in Daejeon and Sejong, South Korea, between March and June 2023. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson's correlation coefficients, hierarchical multiple regression, and PROCESS macro (Model 4) with bootstrapping. Results: Nurses' intention to stay was positively correlated with job esteem (r=.52, p<.001), positive psychological capital (r=.47, p<.001), and organizational commitment (r=.60, p<.001). After controlling for gender and total clinical experience, job esteem, positive psychological capital, and organizational commitment explained 48.0% of the adjusted variance in intention to stay (adjusted R2 =.48), with organizational commitment being the strongest predictor. Mediation analysis showed that job esteem had a significant indirect effect on intention to stay through organizational commitment, while its direct effect was not significant, indicating full mediation. In contrast, positive psychological capital did not show a significant indirect effect through organizational commitment but had a significant direct effect on intention to stay. Conclusion These findings suggest that job esteem influences intention to stay primarily through organizational commitment, whereas positive psychological capital exerts a direct effect. Therefore, nurse retention strategies should prioritize organizational interventions that strengthen organizational commitment, along with efforts to enhance job esteem.

Objective: The efficacy of routine inferior vena cava (IVC) filter placement during catheterdirected thrombolysis (CDT) or pharmacomechanical thrombectomy (PMT) for iliofemoral deep vein thrombosis (IF-DVT) remains controversial. This study aimed to evaluate whether routine IVC filter placement improves prevention of pulmonary thromboembolism (PTE) or recurrent venous thromboembolism (VTE) in this population. Methods: We retrospectively reviewed adults with acute IF-DVT treated with CDT/PMT (March 2021–February 2025) and compared outcomes between a filter group (n=17) and no-filter group (n=21). All patients received six months of oral anticoagulation. The primary outcome was incident PTE within six months. Secondary endpoints included the 6-month composite of recurrent VTE (recurrent deep vein thrombosis and/or PTE), inferior vena cava thrombosis, and target-limb stent occlusion. Results: Baseline limb laterality, thrombus extent, and concomitant PTE were similar. Primary outcome: PTE at six months—0/17 (0%) in the filter group vs 1/21 (4.8%) in the nofilter group (p>0.999). Secondary outcomes: recurrent DVT—3/17 (18%) vs 1/21 (4.8%) (p=0.307); IVC thrombosis—1/17 (5.9%) vs 0/21 (0%) (p=0.447); stent occlusion—1/17 (5.9%) vs 2/21 (9.5%) (p>0.999). Event-free survival also did not differ (log-rank p=0.43).Beyond six months, long-term composite events were infrequent with no significant differences. Conclusion In anticoagulated patients undergoing CDT/PMT for acute IF-DVT, routine prophylactic IVC filter placement did not improve short- or long-term outcomes, including prevention of PTE. These data support a selective, rapid-retrieval strategy for highembolic-risk scenarios.

Objective: This study aimed to evaluate the clinical utility of intraoperative venography in image-guided chemoport insertion, with a focus on catheter tip positioning and procedural safety. Methods: We retrospectively reviewed 270 patients who underwent chemoport insertion via the internal jugular vein between July 2020 and April 2024. Intraoperative venography was used to localize the SVC–RA junction. Patient demographics, catheter tip location, complications, and clinical outcomes were analyzed. Results: Venous stenosis was detected in 9.5% of patients without prior central catheterization and in 23.5% of those with a history of prior access; the difference was not statistically significant (p=0.065). Two cases of severe stenosis required balloon angioplasty before chemoport insertion. Although all catheter tips were positioned intraoperatively within 2 cm below the SVC–RA junction, only 61.5% remained in the intended location on postoperative chest x-ray. Superior migration occurred in 65.2% and inferior in 20.4%, but differences between planned and postoperative catheter tip positions were not significantly associated with complications (p=0.613). Left-sided insertions required significantly longer catheters than right-sided ones (p<0.001), while height, weight, and BMI were not predictive of catheter length. Conclusion Intraoperative venography can be a useful tool for guiding chemoport insertion, as well as for identifying and managing venous stenosis.

An internal hernia is defined as the protrusion of an internal organ through a defect in the abdominal cavity. Broad ligament hernia (BLH) is an extremely rare type of internal hernia that is difficult to diagnose preoperatively because the symptoms are nonspecific. However, early diagnosis is crucial, and early surgery is required to reduce complications such as strangulation. Laparoscopy has the advantage of enabling simultaneous diagnosis and treatment of BLH. With the advancement of the laparoscopic techniques, several cases of laparoscopic treatment of BLH have been reported. Nevertheless, open surgery is primarily performed in patients requiring bowel resection. We present a case of laparoscopic surgery for a strangulated internal hernia through a broad ligament defect. We successfully resected the strangulated small intestine and closed the defect of the broad ligament laparoscopically with a minor incision.

These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.

Pulmonary embolism (PE) that occurs in patients with severe chronic obstructive pulmonary disease (COPD) can often result in acute exacerbation. Immediate intervention for them is required to prevent acute exacerbations and reduce mortality. A 72-year-old man with severe COPD developed deep vein thrombosis with PE and worsened despite anticoagulant therapy and mechanical ventilation. Thrombolysis was contraindicated due to a history of gastric bleeding 3 weeks ago. He had a pulmonary embolism severity index (PESI) score of 272, placing him in the very high-risk group, with a 30-day mortality rate of 10.0%–24.5%. Mechanical thrombectomy was performed using AngioJet® Solent catheter to remove the thrombus obstructing the right middle and lower lobe pulmonary arteries. The patient improved without complications and was discharged. PE in severe COPD requires immediate intervention due to the higher severity of symptoms compared to the general population, and the use of AngioJet ® Solent catheter may be an effectively alternative modality of treatment.

Coffin-Lowry syndrome (CLS, OMIM # 303600) is a rare X-linked disorder caused by mutations in RPS6KA3. CLS is characterized by facial dysmorphism, digit abnormalities, developmental delays, growth retardation, and progressive skeletal changes in male patients. Females with CLS are variably affected, complicating diagnosis. Here, we describe the clinical and molecular findings in a female Korean child with CLS and review the associated literature. A 5-year-old girl presented with short stature and developmental delays. She had a coarse facial appearance characterized by a prominent forehead, hypertelorism, thick lips, and hypodontia. She also had puffy tapering fingers and pectus excavatum. We performed exome sequencing and identified a novel, likely pathogenic, heterozygous variant, c.326_338delinsCTCGAGAC (p.Val109Alafs*10), in RPS6KA3 (NM_004586.2). This is the first Korean female genetically diagnosed with CLS. In contrast to the delayed bone age reported in previous studies, our patient showed advanced bone age and central precocious puberty. CLS should be considered as a differential diagnosis of short stature, tapering fingers, and developmental delay. We suggest that molecular techniques can be a useful tool for diagnosis of rare disorders such as CLS because such conditions are not simple, and the associated spectrum of phenotypes can vary.

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines for AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and a systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.

A 25-year-old woman was referred for discomfort when breathing through her left nose. The patient had undergone augmentation rhinoplasty 5 years ago, after which hypertrophic scarring occurred in the left nostril. Several corticosteroid injections were administered as the first line of treatment, but with no symptom improvement. Therefore, we proceeded with surgical scar removal, with the use of a nasal conformer. However, scarring in the left nostril recurred. Accordingly, we proceeded with further surgical treatment using the scar folding technique. After scar folding, neither scarring nor nostril stenosis recurred during 1 year of postoperative follow-up. To summarize, herein, we report a case of hypertrophic scarring in the nostril that was successfully treated with the scar folding technique.

The coronavirus disease 2019 (COVID-19) pandemic is one of the most consequential global health crises in over a century. Since its discovery in 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to mutate into different variants and sublineages, rendering previously potent treatments and vaccines ineffective. With significant strides in clinical and pharmaceutical research, different therapeutic strategies continue to be developed. The currently available treatments can be broadly classified based on their potential targets and molecular mechanisms. Antiviral agents function by disrupting different stages of SARS-CoV-2 infection, while immune-based treatments mainly act on the human inflammatory response responsible for disease severity. In this review, we discuss some of the current treatments for COVID-19, their mode of actions, and their efficacy against variants of concern. This review highlights the need to constantly evaluate COVID-19 treatment strategies to protect high risk populations and fill in the gaps left by vaccination.