1.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
		                        		
		                        			 Background:
		                        			Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. 
		                        		
		                        			Methods:
		                        			We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. 
		                        		
		                        			Results:
		                        			A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). 
		                        		
		                        			Conclusion
		                        			Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA. 
		                        		
		                        		
		                        		
		                        	
2.A qualitative meta-synthesis of the essence of patient experiences of dialysis
Soyoung JANG ; Eunyoung E. SUH ; Yoonhee SEOK
Journal of Korean Academy of Nursing 2025;55(1):119-136
		                        		
		                        			 Purpose:
		                        			This study aimed to understand the experiences of dialysis and their meaning among patients with chronic kidney disease through a meta-synthesis of the existing literature. Since 2010, the prevalence of end-stage renal disease has doubled in South Korea, which has the sixth-highest incidence worldwide. Although most kidney disease patients undergo dialysis to attenuate disease-related symptoms and prolong their lives, the implications of dialysis on their lives, together with the role played by patients’ significant others, remain underexplored. Similarly, existing research has not considered both patients with hemodialysis and peritoneal dialysis. 
		                        		
		                        			Methods:
		                        			In this meta-synthesis, seven electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, DBpia, KISS, and RISS) were searched for the terms “dialysis” and “qualitative.” Thirty qualitative studies were selected for examination. 
		                        		
		                        			Results:
		                        			The overriding theme observed in the studies was “I do not have much time left.”–navigating the dual realities of one’s limited existence, while other key themes were: (1) the inevitable experience of the troubles of dialysis, (2) life is extended, but deteriorating in every aspect, (3) accepting dialysis with a positive outlook for life, and (4) essential support experienced in an exhausting life. 
		                        		
		                        			Conclusion
		                        			These findings are important for the design and delivery of practical and tailored nursing interventions to help patients overcome the various challenges related to dialysis treatment, and improve their quality of life. 
		                        		
		                        		
		                        		
		                        	
3.A qualitative meta-synthesis of the essence of patient experiences of dialysis
Soyoung JANG ; Eunyoung E. SUH ; Yoonhee SEOK
Journal of Korean Academy of Nursing 2025;55(1):119-136
		                        		
		                        			 Purpose:
		                        			This study aimed to understand the experiences of dialysis and their meaning among patients with chronic kidney disease through a meta-synthesis of the existing literature. Since 2010, the prevalence of end-stage renal disease has doubled in South Korea, which has the sixth-highest incidence worldwide. Although most kidney disease patients undergo dialysis to attenuate disease-related symptoms and prolong their lives, the implications of dialysis on their lives, together with the role played by patients’ significant others, remain underexplored. Similarly, existing research has not considered both patients with hemodialysis and peritoneal dialysis. 
		                        		
		                        			Methods:
		                        			In this meta-synthesis, seven electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, DBpia, KISS, and RISS) were searched for the terms “dialysis” and “qualitative.” Thirty qualitative studies were selected for examination. 
		                        		
		                        			Results:
		                        			The overriding theme observed in the studies was “I do not have much time left.”–navigating the dual realities of one’s limited existence, while other key themes were: (1) the inevitable experience of the troubles of dialysis, (2) life is extended, but deteriorating in every aspect, (3) accepting dialysis with a positive outlook for life, and (4) essential support experienced in an exhausting life. 
		                        		
		                        			Conclusion
		                        			These findings are important for the design and delivery of practical and tailored nursing interventions to help patients overcome the various challenges related to dialysis treatment, and improve their quality of life. 
		                        		
		                        		
		                        		
		                        	
4.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
		                        		
		                        			 Background:
		                        			Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. 
		                        		
		                        			Methods:
		                        			We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. 
		                        		
		                        			Results:
		                        			A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). 
		                        		
		                        			Conclusion
		                        			Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA. 
		                        		
		                        		
		                        		
		                        	
5.A qualitative meta-synthesis of the essence of patient experiences of dialysis
Soyoung JANG ; Eunyoung E. SUH ; Yoonhee SEOK
Journal of Korean Academy of Nursing 2025;55(1):119-136
		                        		
		                        			 Purpose:
		                        			This study aimed to understand the experiences of dialysis and their meaning among patients with chronic kidney disease through a meta-synthesis of the existing literature. Since 2010, the prevalence of end-stage renal disease has doubled in South Korea, which has the sixth-highest incidence worldwide. Although most kidney disease patients undergo dialysis to attenuate disease-related symptoms and prolong their lives, the implications of dialysis on their lives, together with the role played by patients’ significant others, remain underexplored. Similarly, existing research has not considered both patients with hemodialysis and peritoneal dialysis. 
		                        		
		                        			Methods:
		                        			In this meta-synthesis, seven electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, DBpia, KISS, and RISS) were searched for the terms “dialysis” and “qualitative.” Thirty qualitative studies were selected for examination. 
		                        		
		                        			Results:
		                        			The overriding theme observed in the studies was “I do not have much time left.”–navigating the dual realities of one’s limited existence, while other key themes were: (1) the inevitable experience of the troubles of dialysis, (2) life is extended, but deteriorating in every aspect, (3) accepting dialysis with a positive outlook for life, and (4) essential support experienced in an exhausting life. 
		                        		
		                        			Conclusion
		                        			These findings are important for the design and delivery of practical and tailored nursing interventions to help patients overcome the various challenges related to dialysis treatment, and improve their quality of life. 
		                        		
		                        		
		                        		
		                        	
6.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
		                        		
		                        			 Background:
		                        			Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. 
		                        		
		                        			Methods:
		                        			We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. 
		                        		
		                        			Results:
		                        			A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). 
		                        		
		                        			Conclusion
		                        			Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA. 
		                        		
		                        		
		                        		
		                        	
7.A qualitative meta-synthesis of the essence of patient experiences of dialysis
Soyoung JANG ; Eunyoung E. SUH ; Yoonhee SEOK
Journal of Korean Academy of Nursing 2025;55(1):119-136
		                        		
		                        			 Purpose:
		                        			This study aimed to understand the experiences of dialysis and their meaning among patients with chronic kidney disease through a meta-synthesis of the existing literature. Since 2010, the prevalence of end-stage renal disease has doubled in South Korea, which has the sixth-highest incidence worldwide. Although most kidney disease patients undergo dialysis to attenuate disease-related symptoms and prolong their lives, the implications of dialysis on their lives, together with the role played by patients’ significant others, remain underexplored. Similarly, existing research has not considered both patients with hemodialysis and peritoneal dialysis. 
		                        		
		                        			Methods:
		                        			In this meta-synthesis, seven electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, DBpia, KISS, and RISS) were searched for the terms “dialysis” and “qualitative.” Thirty qualitative studies were selected for examination. 
		                        		
		                        			Results:
		                        			The overriding theme observed in the studies was “I do not have much time left.”–navigating the dual realities of one’s limited existence, while other key themes were: (1) the inevitable experience of the troubles of dialysis, (2) life is extended, but deteriorating in every aspect, (3) accepting dialysis with a positive outlook for life, and (4) essential support experienced in an exhausting life. 
		                        		
		                        			Conclusion
		                        			These findings are important for the design and delivery of practical and tailored nursing interventions to help patients overcome the various challenges related to dialysis treatment, and improve their quality of life. 
		                        		
		                        		
		                        		
		                        	
8.Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young HAM ; Seungjae LEE ; Min-Kyung KIM ; Jaehyun JEON ; Eunyoung LEE ; Subin KIM ; Jae-Phil CHOI ; Hee-Chang JANG ; Sang-Won PARK
Journal of Korean Medical Science 2025;40(11):e38-
		                        		
		                        			 Background:
		                        			Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. 
		                        		
		                        			Methods:
		                        			We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. 
		                        		
		                        			Results:
		                        			A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). 
		                        		
		                        			Conclusion
		                        			Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA. 
		                        		
		                        		
		                        		
		                        	
9.Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer
Sun Mi KIM ; Mijung JANG ; Bo La YUN ; Sung Ui SHIN ; Jiwon RIM ; Eunyoung KANG ; Eun-Kyu KIM ; Hee-Chul SHIN ; So Yeon PARK ; Bohyoung KIM
Korean Journal of Radiology 2024;25(2):146-156
		                        		
		                        			 Objective:
		                        			Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017–May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. 
		                        		
		                        			Results:
		                        			The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS–HHUS agreement was 95.9% (236/246; Cohen’s kappa = 0.883). 
		                        		
		                        			Conclusion
		                        			Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS. 
		                        		
		                        		
		                        		
		                        	
10.Short-Term Effectiveness of Oral Nirmatrelvir/Ritonavir Against the SARS-CoV-2 Omicron Variant and Culture-Positive Viral Shedding
Eunyoung LEE ; Sehee PARK ; Jae-Phil CHOI ; Min-Kyung KIM ; Eunmi YANG ; Sin Young HAM ; Seungjae LEE ; Bora LEE ; Jeong-Sun YANG ; Byoung Kwon PARK ; Da Sol KIM ; So-Young LEE ; Joo-Yeon LEE ; Hee-Chang JANG ; Jaehyun JEON ; Sang-Won PARK
Journal of Korean Medical Science 2023;38(8):e59-
		                        		
		                        			 Background:
		                        			Information on the effectiveness of nirmatrelvir/ritonavir against the omicron is limited. The clinical response and viral kinetics to therapy in the real world need to be evaluated. 
		                        		
		                        			Methods:
		                        			Mild to moderate coronavirus disease 2019 (COVID-19) patients with risk factors for severe illness were prospectively enrolled as a treatment group with nirmatrelvir/ritonavir therapy versus a control group with supportive care. Serial viral load and culture from the upper respiratory tract were evaluated for seven days, and clinical responses and adverse reactions were evaluated for 28 days. 
		                        		
		                        			Results:
		                        			A total of 51 patients were analyzed including 40 in the treatment group and 11 in the control group. Faster symptom resolution during hospitalization (P= 0.048) was observed in the treatment group. Only minor adverse reactions were reported in 27.5% of patients. The viral load on Day 7 was lower in the treatment group (P = 0.002). The viral culture showed a positivity of 67.6% (25/37) vs. 100% (6/6) on Day 1, 0% (0/37) vs. 16.7 (1/6) on Day 5, and 0% (0/16) vs. 50.0% (2/4) on Day 7 in the treatment and control groups, respectively. 
		                        		
		                        			Conclusions
		                        			Nirmatrelvir/ritonavir against the omicron was safe and resulted in negative viral culture conversion after Day 5 of treatment with better symptomatic resolution. 
		                        		
		                        		
		                        		
		                        	
            
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