Background: To identify work–family balance and level of happiness among married women dental hygienists in Seoul and Gyeonggi Province. The goal of this study is to use the outcome as basic data to determine the compatibility of dental hygienists with work and family, systems, and improvement of happiness levels. Methods: From July 3 to August 10, 2020, 250 dental hygienists in Seoul and Gyeonggi Province were targeted. The questionnaire comprised 65 questions, including general characteristics (perception of work–family balance, perception of work–family balance system, job satisfaction, parenting type, happiness level) whether or not they were implemented. The results were obtained through a self-control questionnaire. Results: The perception of work–family balance was significantly different in job rank and average income, while that of the work– family balance system had significant differences in workplace type, total work experience, current job work experience, childcare system status, and parental leave period. Happiness level and job satisfaction were significantly different in job rank, average income, and childcare system status. Additionally, the perception of work–family balance and that of the work–family balance system showed a positive correlation with job satisfaction and happiness level. Finally, the perception of married women dental hygienists toward work–family compatibility was determined, where the higher the satisfaction with the job, the higher the level of happiness. Conclusion To improve the work–family balance and job satisfaction of dental hygienists and their levels of happiness, changes in social perception and improvement of the working environment such as proper staffing, flexible work systems, and incentive systems should be considered.

Diffuse alveolar hemorrhage (DAH) is a life-threatening condition associated with many disorders. Here, we report a case of 59-year-old female who had diffuse alveolar hemorrhage associated with methimazole. She had been treated with methimazole for two weeks due to the recurrence of Grave's disease, before visiting the emergency room. She had to be intubated on the 3rd day of hospitalization because of unabated massive hemoptysis and rapid progression of diffuse alveolar infiltration on chest radiographs. Since her clinical condition improved substantially after cessation of methimazole and steroid pulse therapy, she was extubated on the 9th day of hospitalization and then discharged. After discharge, DAH did not recur with cessation of steroid and she had radioactive iodine therapy for her Grave's disease. This was a rare and interesting case of life-threatening DAH associated with cytoplasmic-antineutrophil cytoplasmic antibody and methimazole.
Antibodies, Antineutrophil Cytoplasmic* ; Cytoplasm* ; Emergency Service, Hospital ; Female ; Hemoptysis ; Hemorrhage* ; Hospitalization ; Humans ; Iodine ; Methimazole* ; Middle Aged ; Radiography, Thoracic ; Recurrence

OBJECTIVE: To estimate the cardiovascular (CV) and gastrointestinal (GI) risks of etoricoxib in the treatment of osteoarthritis (OA) compared to a placebo and other non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: A systematic review of randomized, controlled trials (RCTs) of etoricoxib were performed. Bayesian network meta-analysis was used over a duration of 12 weeks. The incidence of CV and GI events for a duration ≥26 weeks were also tabulated and presented using descriptive statistics. RESULTS: From this search, 10 studies were identified. Of these, 6 and 5 RCTs that measured the CV and GI events at 12 weeks were included in meta-analysis. They showed that etoricoxib did not increase the CV events compared to the placebo or NSAIDs during the 12 week period (odds ratio [OR]=0.59 compared to celecoxib, OR=0.89 with ibuprofen, OR=0.70 with placebo, and OR=2.16 with naproxen). The risk of GI events was comparable to that of most comparators, with the exception of naproxen, which had a significantly lower risk of GI events (OR=0.18) during the 12 week period. For a duration ≥26 weeks, the incidence of CV and GI events with etoricoxib increased with increasing duration. CONCLUSION: Etoricoxib is an alternative short-term treatment option for OA, showing comparable CV and GI complications to other NSAIDs. Nevertheless, further studies will be needed to elucidate the long-term safety of etoricoxib in the treatment of OA.
Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Celecoxib ; Ibuprofen ; Incidence ; Naproxen ; Osteoarthritis*

Remission is a primary end point of in clinical practice and trials of treatments for rheumatoid arthritis (RA). The 2011 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria were developed to provide a consensus definition of remission. This study aimed to assess the concordance between the new remission criteria and the physician’s clinical judgment of remission and also to identify factors that affect the discordance between these two approaches. A total of 3,209 patients with RA were included from the KORean Observational Study Network for Arthritis (KORONA) database. The frequency of remission was evaluated based on each approach. The agreement between the results was estimated by Cohen's kappa (κ). Patients with remission according to the 2011 ACR/EULAR criteria (i.e. the Boolean criteria) and/or physician judgment (n = 855) were divided into three groups: concordant remission, the Boolean criteria only, and physician judgment only. Multinomial logistic regression analysis was used to identify factors responsible for the assignment of patients with remission to one of the discordant groups rather than the concordant group. The remission rates using the Boolean criteria and physician judgment were 10.5% and 19.9%, respectively. The agreement between two approaches for remission was low (κ = 0.226) and the concordant remission rate was only 5.5% (n = 177). Pain affected classification in both discordant groups, whereas fatigue was associated with remission only by physician clinical judgment. The Boolean criteria were more stringent than clinical judgment. Patient subjective symptoms such as pain and fatigue were associated with discordance between the two approaches.
Arthritis ; Arthritis, Rheumatoid* ; Classification ; Consensus ; Fatigue ; Humans ; Judgment* ; Logistic Models ; Observational Study ; Rheumatic Diseases

Common variable immunodeficiency (CVID) is a heterogeneous group of primary immune deficiencies in adults characterized by hypogammaglobulinemia, recurrent bacterial infections, and a higher incidence of autoimmune diseases. More than 25% of CVID patients also have autoimmune diseases such as autoimmune hemolytic anemia, immune thrombocytopenic purpura, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathogenesis of autoimmunity in CVID remains obscure. We report a 56-year-old woman with CVID and Sjogren's syndrome. In addition to a long history of recurrent upper respiratory infections, acute gastroenteritis, and cellulitis, she has also suffered from persistent xerostomia and xerophthalmia for the past 10 years. Serologic studies revealed hypogammaglobulinemia (low levels of IgG, IgA, and IgM in serum) and the presence of anti-Ro antibodies, and salivary scintigraphy indicated salivary gland involvement. These findings led to a diagnosis of CVID and Sjogren's syndrome, which was treated by monthly intravenous immunoglobulin therapy.
Adult ; Agammaglobulinemia ; Anemia, Hemolytic, Autoimmune ; Antibodies ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Autoimmunity ; Bacterial Infections ; Cellulitis ; Common Variable Immunodeficiency* ; Diagnosis ; Female ; Gastroenteritis ; Humans ; Immunization, Passive ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Lupus Erythematosus, Systemic ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; Radionuclide Imaging ; Respiratory Tract Infections ; Salivary Glands ; Sjogren's Syndrome* ; Xerophthalmia ; Xerostomia

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

BACKGROUND: Gray hair naturally develops in the process of human aging. Many people with gray hair periodically dye their hair. Hair dyeing products are widely used and they can cause adverse effects. Therefore, the user's knowledge and recognition about hair dyeing and related side effects are important. OBJECTIVE: The goal of this study was to lay the foundation for understanding, preventing and treating side effects caused by hair coloring products. METHODS: We conducted a questionnaire survey for adult males and females aged over 20 who had gray hair. A total of 500 subjects were included in this study and statistical analysis was performed. RESULTS: Large numbers of the people who had experience with hair dye (233 out of 319 people, 73.0%) did not know about the exact brand name of the hair dye product that they were using. Of 319 hair dye users, 23.8% (76 out of 319) people stated that they experienced side effects. Despite the occurrence of side effects from hair dyeing products, it seems they did not realize the seriousness of the side effects or the need for treatment. CONCLUSION: It is advisable to introduce a system that enables users to become aware of the ingredients and side effects of hair coloring products and give opportunities for users to become aware of the side effects of hair coloring through education, publicity and publication of an informational booklet.
Adult ; Aged ; Aging ; Androsterone ; Female ; Hair ; Hair Color ; Hair Dyes ; Humans ; Male ; Pamphlets ; Publications ; Surveys and Questionnaires

Dactylitis is a hallmark feature of psoriatic arthritis. It is usually managed with non-steroidal anti-inflammatory drugs and oral corticosteroids. Some cases have been treated successfully with intravenous corticosteroids or some disease-modifying antirheumatic drugs. Recently, inflximab has been reported as an effective treatment for dactylitis that is resistant to conventional treatment. This report describes a 37-year-old man with psoriatic arthritis who had multiple dactylitis on both thumbs and great toes. He was resistant to conventional treatment but was effectively treated with infliximab. This report highlights the effectiveness of infliximab for dactylitis, and the usefulness of blood pool imaging from bone scans as a method for determining treatment response.
Adrenal Cortex Hormones ; Adult ; Antibodies, Monoclonal ; Antirheumatic Agents ; Arthritis, Psoriatic ; Humans ; Thumb ; Toes ; Infliximab

Granulocytic sarcoma is an extramedullary tumor composed of granulocytic precursor cells. It usually presents as a nodular mass in the course of acute myelogenous leukemia. Rarely, the tumor develops in non-hematological conditions or in a patient with complete remission from the acute myelogenous leukemia. In such cases, aleukemic granulocytic sarcoma can be a preceding sign of systemic leukemia or a first sign of hematologic relapse of leukemia. We present an unusual case of multiple granulocytic sarcomas developed in a patient with longstanding complete remission of acute myelogenous leukemia, who has not had bone marrow and peripheral blood involvement for a long time.
Bone Marrow ; Granulocyte Precursor Cells ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Recurrence ; Sarcoma, Myeloid

OBJECTIVE: Pneumomediastinum (PnM), a rare complication of dermatomyositis and polymyositis (DM/PM), is sporadic and has an unclear pathogenesis. PnM is almost always associated with interstitial lung disease (ILD), and is a poor prognostic factor in inflammatory myositis patients. We studied the prevalence of PnM in Korean DM/PM and its clinical significance. METHODS: We retrospectively studied the medical records of 161 patients diagnosed with DM/PM meeting Bohan-Peter's criteria at Hanyang University Hospital for Rheumatic Diseases from 1995 to 2010. We collected following findings; demographic data, diagnosis, lung involvement, cause of death, and duration from diagnosis to death. RESULTS: One hundred nineteen patients (73.9%) were DM and 42 patients (26.1%) were PM. Eighty three patients (51.6%) developed ILD at diagnosis or during follow up. Eighteen patients (11.2%) died because of ILD aggravation, infection, or malignancy. The mean duration from diagnosis to death was 11.5 months, with 10 patients (6.2%) dying from from ILD aggravation but none with spontaneous PnM. 6 patients (3.7%) presented with PnM, and it was associated with ILD worsening in all cases. PnM resolved with O2 inhalation, corticosteroids, and/or immunosuppressive agents after 11 weeks (mean) of therapy. CONCLUSION: PnM is rare but associates with DM and aggravation of ILD. PnM does not usually cause fatalities and can be cured by appropriate therapy.
Adrenal Cortex Hormones ; Cause of Death ; Dermatomyositis ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Mediastinal Emphysema ; Medical Records ; Myositis ; Polymyositis ; Prevalence ; Prognosis ; Retrospective Studies ; Rheumatic Diseases