Decreasing Incidence of Trichophyton mentagrophytes in Korea: Analysis of 6,250 Cases during the Last 21-Year-Period (1992-2012)

Trichophyton mentagrophytes is the second common dermatophyte in Korea. However, few reports have been issued on the epidemiological and mycological characteristics of T. mentagrophytes in Korea based on long-term, large-scale study. The purpose of this study was to elucidate the epidemiological and mycological characteristics of T. mentagrophytes in Korea. During the 21-yr-period from 1992 to 2012, 6,250 patients with T. mentagrophytes were surveyed to determine annual incidence and the distribution of subjects by age, sex, season, involved sites, and place of residence. T. mentagrophytes infections were confirmed by fungal culture. In addition, the colony appearance of T. mentagrophytes was classified as granular, persicolor, powdery, or downy. Epidemiological analysis showed that annual incidence reached a peak in 2005, and then gradually decreased. T. mentagrophytes infection was most common in July, and was found predominantly in middle-aged adults, especially in those in their forties. Mycological analysis showed a powdery colony appearance was the most common, followed by persicolor and granular colonies. Toewebs were most frequently involved. This investigation on T. mentagrophytes provides insights into its incidence and characteristics.

Solitary Splenic Metastasis from Head and Neck Cancer: A Case Report / 대한내과학회지

Solitary splenic metastases from head and neck cancer are rare. We report a 35-year-old male with nasal cavity cancer with metastasis to the cervical lymph nodes. The patient underwent three cycles of induction chemotherapy, followed by left medial maxillectomy with modified radical neck dissection and concurrent chemoradiotherapy with weekly cisplatin. After 7 months of a disease-free interval, positron-emission tomography showed a high uptake in the spleen, and a biopsy confirmed metastatic carcinoma. After four cycles of systemic chemotherapy with docetaxel and cisplatin, laparoscopic splenectomy was performed. This case highlights that solitary splenic metastasis, although rare, may occur with a locoregionally controlled head and neck cancer and could be treated with local and systemic treatment.

Gefitinib Treatment for Pulmonary Sarcomatoid Carcinoma Driven by an EGFR Mutation: Two Cases / 대한내과학회지

Sarcomatoid carcinoma of the lung is defined as a group of poorly differentiated non-small cell carcinomas that contain a component of sarcoma or a sarcoma-like element. Most sarcomatoid carcinomas are known to have a poor prognosis. We describe a 45-year-old female never smoker and 49-year-old female never smoker with sarcomatoid carcinomas of the lung that expressed a specific EGFR mutation: microdeletion of exon 19. Their cancers progressed rapidly, despite appropriate conventional chemotherapy. After they took the EGFR-targeted agent gefitinib, there was a dramatic reduction in tumor size. Sarcomatoid carcinoma of the lung is a rare cancer whose pathogenesis is not well understood. According to these cases, the EGFR mutation could be a driver mutation and the potential therapeutic target of EGFR-targeted agents for sarcomatoid carcinoma in lung cancer patients, especially never smokers.

Development of a Decision Support Computer Program for Pain Management in Institutionalized Patients with Dementia / 기본간호학회지

PURPOSE: The purpose of this study was to develop a computer decision making support system that enables nurses to utilize the computer in selecting the best decision for pain management for patients with dementia institutionalized in nursing homes. METHODS: To formulate the protocol for the management of patients' pain, the researcher analyzed content of interviews with 30 nurses in three nursing homes and an expert group. A decision support computer program was formalized based on existing protocols. To evaluate the effectiveness and applicability of the system, analysis of data on patient pain management and nurse satisfaction with the system were done after the formalized decision support computer program was complete. RESULTS: The decision support computer program for pain management for institutionalized patients with dementia was finalized after adjustments following the evaluation. Nurse satisfaction with the program was moderate. It also provided opportunity to reassess thinking about pain and pain management. CONCLUSIONS: The results indicate that this program provides nurses with useful knowledge for pain management in institutionalized patients with dementia and aids in decision making in nursing practice in nursing home.

Nurses' Perceptions Regarding Sign & Symptom Management in End of Life Care in Nursing Homes / 기본간호학회지

INTRODUCTION: The phenomenon related to sign & symptom management for end of life of the patients is of interest to researchers in nursing society today. This study was conducted to clarify and to conceptualize the factors of sign & symptom management in end of life care though nurses' perceptions on this phenomena. METHODS: The qualitative study method was used to explore the experienced nurses' perceptions related to sign & symptom management in end of life care. It included a field study carried out in South Korea using in-depth interviews with 30 experienced nurses from three nursing home facilities. RESULTS: This study identified the following categories related to end of life care with sub-categories for each category: (1) nurses' modes in identifying the signs related to patients' end of life, (2) nurses' perceived directions on patients' end of life care, (3) nurses' perceived strategies in end of life care and (4) nurses' perceived barriers in end of life care. CONCLUSION: Through this study, characteristics of the way nurses' provide for patients' end of life care are identified, along with how nursing decisions are made to manage the sign & symptom indicating patients' end of life.