Bullous pemphigoid (BP) is a chronic and recurrent bullous disorder that may be associated with the administration of certain drugs. Recently, bullous cutaneous adverse events after immunotherapy (IT) or targeted therapy have been increasingly reported. Here, we report a case of BP in a patient diagnosed with metastatic melanoma after treatment with pembrolizumab, dabrafenib, and trametinib. Histopathological examination showed a subepidermal blister with perivascular lymphocytic and eosinophilic infiltration; the accompanying findings of linear immunoglobulin G and C3 deposition by immunofluorescence microscopy were consistent with BP. Since IT agents may initiate immune dysregulation and pathologic autoantibody production, which are required for the pathogenesis of BP, the lesions were thought to be cutaneous adverse events caused by IT.

Background: Scars in children are highly concerning to most parents who usually seek prompt treatment for these lesions. However, compared with adults, children show a greater tendency to develop hypertrophic scars and a higher likelihood of scar widening with increasing age. Objective: We investigated the role of laser treatment for scars in pediatric patients in view of the fact that this approach is challenging in this age group. Methods: This retrospective study included patients aged ＜17 years who visited the Samsung Medical Center between 2013 and 2018 for scar treatment. Of the 28 children who visited the center during this time, 14 presented within 4 to 5 weeks from scar onset and received laser therapy and 14 presented after 4 to 5 weeks and received topical treatment. The Stony Brook Scar Evaluation Scale (SBSES) was used to assess scar formation. Results: The mean initial SBSES scores were lower in the laser than in the topical group (1.93±0.92 vs. 2.71±0.83, p=0.0363). No intergroup difference was observed in SBSES scores upon treatment completion (4.50±0.94 vs. 4.21±1.19, p=0.4673). Multivariable analysis after adjustment for age, sex, and initial SBSES scores showed that the type (laser vs. topical) of treatment was not significantly associated with an SBSES score=5 or duration of treatment. Conclusion Laser intervention may be useful for scar therapy in children who present early and can receive prompt treatment before scar maturation; however, further studies are warranted to validate our results.

Background: Scars in children are highly concerning to most parents who usually seek prompt treatment for these lesions. However, compared with adults, children show a greater tendency to develop hypertrophic scars and a higher likelihood of scar widening with increasing age. Objective: We investigated the role of laser treatment for scars in pediatric patients in view of the fact that this approach is challenging in this age group. Methods: This retrospective study included patients aged ＜17 years who visited the Samsung Medical Center between 2013 and 2018 for scar treatment. Of the 28 children who visited the center during this time, 14 presented within 4 to 5 weeks from scar onset and received laser therapy and 14 presented after 4 to 5 weeks and received topical treatment. The Stony Brook Scar Evaluation Scale (SBSES) was used to assess scar formation. Results: The mean initial SBSES scores were lower in the laser than in the topical group (1.93±0.92 vs. 2.71±0.83, p=0.0363). No intergroup difference was observed in SBSES scores upon treatment completion (4.50±0.94 vs. 4.21±1.19, p=0.4673). Multivariable analysis after adjustment for age, sex, and initial SBSES scores showed that the type (laser vs. topical) of treatment was not significantly associated with an SBSES score=5 or duration of treatment. Conclusion Laser intervention may be useful for scar therapy in children who present early and can receive prompt treatment before scar maturation; however, further studies are warranted to validate our results.

A 74-year-old male patient was conducted total thyroidectomy with functional neck dissection and final pathologic report confirm occult thyroid carcinoma. Although the frequency of occult thyroid cancer (OTC) has decreased owing to developments in cervical ultrasonography and improved accuracy of histological tests, rare cases are still reported. Due to the decreased frequency of OTC, a benign cervical neck lymph node mass is sometimes diagnosed, which can result in delays to more accurate diagnoses and appropriate treatment. Therefore, we report our case.
Aged ; Diagnosis ; Humans ; Lymph Nodes ; Male ; Neck Dissection ; Neck ; Neoplasm Metastasis ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Ultrasonography

PURPOSE: This study aimed to examine the levels of compassion fatigue/satisfaction, communication efficacy, and job satisfaction among integrated nursing and care services (INCS) units, and to analyze the factors affecting their job satisfaction. METHODS: This descriptive study was conducted between January 1 and February 15, 2019 with 174 nurses working at INCS units. Data were analyzed using independent t-test, one-way ANOVA, Pearson`s correlation coefficient, and hierarchial multiple regression with SPSS/WIN 23.0. RESULTS: Job satisfaction was significantly different according to age, marital status, monthly income, total clinical career, and job position. Job satisfaction was positively correlated with compassion satisfaction (r=.72, p<.001) and communication efficacy (r=.52, p<.001) and showed a negative correlation with compassion fatigue (r=.-25, p<.001). Factors affecting job satisfaction were compassion satisfaction (β=.61, p<.001) and communication efficacy (β=.18, p=.004). Overall, approximately 58.9% of the variability in job satisfaction was explained by these two variables in this study. CONCLUSION Compassion satisfaction has the effect of maintaining an emotional balance in the nurse's interprofessional relationships. High communication efficacy among professionals in the INCS ward is a necessary factor to increase nurses' job satisfaction. These results suggest that programs to improve compassion satisfaction and communication efficacy are needed to enhance nurses' job satisfaction.

PURPOSE: The purpose of this study was to investigate the relationship of sleep quality, lifestyle and successful aging in the elderly. METHODS: The subjects of this study were 125 elderly people, aged 65 years and older, who attended a senior welfare center in Cheongju city, Korea. They completed a structured self-reported questionnaire comprising measures of quality of sleep, lifestyle, and successful aging. Data were analyzed using t-test, ANOVA, Scheffé's test, Pearson's correlation coefficient, and hierarchical linear multiple regression analysis with SPSS/WIN 20.0. RESULTS: Lifestyle showed a positive correlation with the quality of sleep, and successful aging showed a significant positive correlation with quality of sleep and lifestyle. Pin money (β=.32), quality of sleep (β=.20) and lifestyle (β=.55) were strong influential factors in successful aging. Hierarchical multiple regression analysis showed the determinant variables account for 35.9% of the variation in successful aging (F=35.11, p < .001). CONCLUSION: Successful aging depends on controllable factors such as the willingness to change the lifestyle of choosing one's life and how one copes with applying appropriate sleep hygiene. These results suggest that improvement of the quality of sleep and lifestyle will be helpful to the successful aging process.
Aged* ; Aging* ; Chungcheongbuk-do ; Humans ; Hygiene ; Korea ; Life Style*

Compression of the airway is relatively common in pediatric patients, although it is often an unrecognized complication of congenital cardiac and aortic arch anomalies. Aortopexy has been established as a surgical treatment for tracheobronchial obstruction associated with vascular anomaly, aortic arch anomaly, esophageal atresia, and tracheoesophageal fistula. The tissue-to-tissue arch repair technique could result in severe airway complication such as compression of the left main bronchus which was not a problem before the correction. We report three cases of corrective open heart surgery monitored by intraoperative bronchoscopy performed during prebypass, and performed immediately before weaning from bypass, to evaluate tracheobronchial obstruction caused by congenital, complex cardiac anomalies in the operating room.
Airway Obstruction* ; Aorta, Thoracic ; Aortic Coarctation ; Bronchi ; Bronchoscopy* ; Esophageal Atresia ; Humans ; Operating Rooms ; Thoracic Surgery ; Tracheoesophageal Fistula ; Weaning

In 2009, Korea banned the import, transport, and use of asbestos, and the Asbestos Injury Relief Act (AIRA) was promulgated in 2011. Two environmental health centers for asbestos (EHCA), including Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), were adapted to find environmental asbestos-related diseases (ARDs) and to support the purposes of AIRA. EHCA conducted a health impact survey (HIS) on persons who resided or reside near asbestos factories or mines. A total of 13,433 persons have taken screening examinations in PNUYH EHCA, and 623 persons (4.6%) have had secondary examinations. Of the 21,014 persons who had screening examinations in SCHUCH EHCA, 2490 persons (11.8%) had secondary examinations. Some of those who tested positive for ARDs through HISs filed applications for the asbestos victims’ medical pocketbook (AVMP). Approximately 116 and 612 persons received AVMPs as a result of PNUYH and SCHUCH examinees, respectively. EHCAs have conducted HISs, public relations, and education for asbestos victims, ordinary citizens, and physicians. As HISs are based on voluntary participation, they does not monitor high-risk groups. Active surveillance focusing on high-risk groups has been blocked by the personal information protection act. Although important work has been performed in finding environmental asbestos victims and increasing public awareness on asbestos, it is necessary to improve the current system and registration.
Asbestos* ; Busan ; Chungcheongnam-do ; Compensation and Redress ; Computer Security ; Education ; Environmental Health* ; Gyeongsangnam-do ; Humans ; Korea ; Lung Neoplasms ; Mass Screening ; Mesothelioma ; Public Relations

OBJECTIVES: Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress. METHODS: Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor. RESULTS: Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV. CONCLUSIONS: OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.
Aging* ; Cardiovascular Diseases ; Heart Rate* ; Heart* ; Humans ; Leisure Activities ; Male* ; Motor Activity* ; Odds Ratio ; Risk Factors

No abstract available.
Air Pollutants/*toxicity ; Air Pollution/*prevention & control ; *Dust ; *Environmental Exposure ; Humans ; Industrial Waste ; Republic of Korea ; Risk Reduction Behavior