Analysis of the Effect of the Size of the Medial Femoral Condyle and Medial Tibial Condyle on the Tear of Medial Meniscus Posterior Horn Root / 대한정형외과학회잡지

Purpose@#Many studies have been conducted on the cause of the medial meniscus posterior horn root (MMPHR) tears. A previous study reported that the relatively large size of the medial femoral condyle (MFC) compared to the size of the medial tibial condyle (MTC) could cause a tear of the MMPHR. The authors conducted a study to confirm that this was correct. @*Materials and Methods@#Patients who underwent magnetic resonance imaging of the knee at our Hospital from March 2011 to April 2019 were divided into a group with a tear of MMPHR and a control group without a tear. The size (MFC, MTC) and relative size ratio of the MFC and the MTC (MFC/MTC) were measured and compared to determine if there was any correlation with the tear of MMPHR. @*Results@#The mean MFC size of the 175 patients with MMPHR tear was 24.6±2.1 mm (0°), 23.5±2.1 mm (30°), 24.1±2.2 mm (60°), and the mean MTC size was 28.2±2.2 mm. The mean size of the MFC of the 147 control subjects was 25.2±2.4 mm (0°), 23.9±2.3 mm (30°), and 24.5±2.6 mm (60°), and the mean size of the MTC was 29.0±2.6 mm. The mean ratios (MFC/MTC) of the 175 patients with MMPHR tears were 0.87±0.05 (0°), 0.83±0.04 (30°), and 0.85±0.05 (60°) for each location. The corresponding mean ratios (MFC/MTC) of the 147 control subjects were 0.87±0.05 (0°), 0.83±0.04 (30°), and 0.85±0.05 (60°). There was no significant difference between the patient group and the control group. @*Conclusion@#The size and relative ratio of MFC and MTC do not appear to be related to a tear of the MMPHR.

Medial Patellofemoral Ligament Reconstruction Using Adjustable Tensioning under Arthroscopic Visualization Provides Satisfactory Radiographic and Clinical Outcomes / 대한스포츠의학회지

Purpose@#Recurrent patellar dislocation required a surgical reconstruction of medial patellofemoral ligament (MPFL) in many cases. During MPFL reconstruction, over-tension of medial construct altered the patellofemoral kinematics which may result in pain, patellofemoral joint degeneration, or graft failure. Thus, it is important to confirm appropriate tension intraoperatively. The purpose of this study was to evaluate the clinical and radiographic outcomes of MPFL reconstruction with use of an adjustable tensioning under arthroscopic direct visualization of patellofemoral joint. @*Methods@#This retrospective study included 11 MPFL reconstructions (nine patients) from 2013 to 2020. All the patients received the same surgical procedures by a single surgeon. Final graft tension was determined after confirming patellar position to the trochlear groove at 60° knee flexion under arthroscopic exam. Patient demographics, pre- and postoperative radiographic results including congruence angle and Insall-Salvati ratio, and clinical outcomes were compared. @*Results@#The congruence angle was significantly changed from 32.8°±21.1° preoperatively to 8.4°±11.5° postoperatively (p=0.003), and the Insall-Salvati ratio was 1.16°±0.15° and 1.10°±0.13° respectively (p=0.02). Clinical scores were significantly improved between pre- and postoperatively; Kujala score (33.2±18.3 to 88.8±4.7, p=0.04), Lysholm score (30.2±15 to 79.0±5.2, p=0.005), and Tegner level (2.2±1.1 to 4.4±1.7, p=0.04). There was no recurrence of patellar dislocation. @*Conclusion@#MPFL reconstruction using adjustable tensioning under arthroscopic direct visualization could obtain satisfactory outcomes after surgery.

Hemodialysis facility star rating affects mortality in chronic hemodialysis patients: a longitudinal observational cohort study

Many countries have their own hemodialysis (HD) quality assurance programs and star rating systems for HD facilities. However, the effects of HD quality assurance programs on patient mortality are not well understood. Therefore, in the present study, the effects of the Korean HD facility star rating on patient mortality in maintenance HD patients were evaluated. Methods: This longitudinal, observational cohort study included 35,271 patients receiving HD treatment from 741 facilities. The fivestar ratings of HD facilities were determined based on HD quality assessment data from 2015, which includes 12 quality measures in structural, procedural, and outcome domains. The patients were grouped into high (three to five stars) and low (one or two stars) groups based on HD facility star rating. Cox proportional hazards model was used to evaluate the effects of star rating on patient mortality during the mean follow-up duration of 3 years. Results: The patient ratio between high and low HD facility star rating groups was 82.0% vs. 18.0%. The patients in the low star rating group showed lower single-pool Kt/V and higher calcium and phosphorus levels compared with subjects in the high star rating group. After adjusting for sociodemographic and clinical parameters, the HD facility star rating independently increased the mortality risk (hazard ratio, 1.11; 95% confidence interval, 1.04–1.18; p = 0.002). Conclusion: The HD facilities with low star rating showed higher patient mortality.

Rapidly growing juvenile xanthogranuloma in an adult: a case report

Juvenile xanthogranuloma is a benign tumor made up of non-Langerhans histiocytes that predominantly occurs in infancy and early childhood. Juvenile xanthogranuloma can be differentiated from xanthoma by the distribution of the lesions and the absence of lipid abnormalities. It usually develops on the trunk and upper and lower extremities. Histologically, xanthogranulomas show a mixed cellular dermal infiltration with histiocytes, lymphocytes, eosinophils and Touton-type multinucleated giant cells. Classically, juvenile xanthogranuloma is a disease that largely affects infants and children. We describe a rare case of juvenile xanthogranuloma that suddenly developed in the axillary region of a male adult.

Changes in Stress, Occupational Stress, and Subjective Health Problems of Novice Female Nurses: Secondary Data Analysis

Purpose@#This study aimed to examine the changes in stress, occupational stress, and subjective health problems of novice female nurses within the first 18 months of work. @*Methods@#This was a longitudinal study conducted with a secondary data analysis based on the Shift Work Nurse’s Health and Turnover (SWNHT) study. The participants were 178 female novice nurses who participated in all 3 data collection activities (on the first day of orientation before ward placement [T0], 6 months after work [T1], and 18 months after work [T2]). The stress, occupational stress, 8 subjective health problems (upper musculoskeletal pain, leg/foot discomfort, depression, anxiety or emotional disorder, sleep disturbance, headache, gastrointestinal disorder, menstrual disorder, and others), and the greatest health problem during the study period were measured, respectively. Data were analyzed using SPSS 26.0 to obtain descriptive statistics. @*Results@#The subjective health of novice female nurses were found to be poor at T1 compared to T0 on both physical (upper musculoskeletal pain, leg/foot discomfort, and sleep disturbance) and psychological health problems (depression and stress). However, the psychological health problems of the participants were alleviated at T2 whereas; physical health problems persisted until T2. @*Conclusion@#Novice nurses had poor health problems 6 months after work. Sleep disturbance and musculoskeletal pain persisted although other health problems such as depression and stress were alleviated over the period. Strategies to prevent and manage different health problems of novice female nurses at different work duration are urgently needed.

Factors Associated with Post-Traumatic Growth in Patients with Breast Cancer Based on a Model of Post-Traumatic Growth

Purpose@#The study was to identify factors associated with post-traumatic growth (PTG) in patients with breast cancer based on Tedeschi and Calhoun’s model of PTG. @*Methods@#The participants were 150 patients who were diagnosed with breast cancer at C University Hospital and were undergoing treatment or attending regular follow-up visits after the completion of all treatments. Data were collected using structured self-administered questionnaires from January 20, 2021, to February 24, 2021. The data were analyzed through linear multiple regression. @*Results@#Factors associated with PTG were resilience (β=.51, p<.001), social support (β=.25, p<.001), and deliberate rumination (β=.14, p=.030), and these variables explained 45.0% of PTG. @*Conclusion@#Resilience was included in this study instead of self-exposure in Tedeschi and Calhoun’s PTG model. Oncology nurses should actively intervene to increase personal resilience, to strengthen social support systems, and to encourage patients to perceive breast cancer occurrence as a meaningful event since breast cancer patients can experience PTG throughout the entire period of treatment and post-treatment.A revised model should be validated in future studies.

A Case of Neuromyelitis Optica Spectrum Disorder of a Patient Who Present for Fungal Sinusitis / 대한이비인후과학회지

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system, characterized by repeatedly invading the brain, optic nerve, or spinal cord. In 2004, when a disease-specific antibody (aquaporin-4-immunoglobulin G) was discovered in the serum of an optic neuromyelitis patient, it was thought to be a separated disease from multiple sclerosis. Since 2004, however, the concept of the disease has been expanded to include NMO spectrum disorder (NMOSD). We experienced a rare case of NMOSD in a patient who presented with left visual disturbance and underwent endoscopic sinus surgery because of acute fungal sinusitis. We report this case with a review of the literature.

Closed extensor tendon rupture caused by Kienböck disease: a case report

Kienböck disease, a rare disease that can cause chronic pain and motor dysfunction, occurs due to avascular necrosis of the lunate bone, which leads to dislocation of the carpal bone. Among various other etiologies, Kienböck disease can cause closed tendon rupture of the finger. In this report, we introduce a case of total rupture of the second extensor digitorum communis and the extensor indicis proprius tendons caused by undiagnosed Kienböck disease in an elderly female patient.

Clinical Outcome Study after External Approach Septoplasty / 대한이비인후과학회지

Background and Objectives@#This study aims to investigate the indications of external approach septoplasty and improvement in subjective symptoms and objective parameters in patients who underwent external approach septoplasty to correct septal deviation with various types of deformities. @*Subjects and Methods@#Thirty-one patients who underwent external approach septoplasty from October 2014 to January 2019 were classified by direction, location, and degree of nasal septal deviation, septal shape and surgical techniques. Through acoustic rhinometry, the minimum cross-sectional area and nasal volume were measured before and after surgery. To evaluate the improvement in symptoms, the Nasal Obstruction Symptom Evaluation (NOSE) survey and nasal congestion visual analogue scale (VAS) were also measured. @*Results@#We found significant correlations between: the direction and degree of nasal septal deviation; the location and degree of nasal septal deviation; septal shape and location of the nasal septal deviation; septal shape and surgical techniques; and the degree of nasal septal deviation and presence of spreader grafts. The NOSE scale following external approach septoplasty improved from 14.7±4.4 to 3.1±3.2 (p<0.001), while the VAS score improved from 7.2±2.3 to 1.2±1.4 (p<0.001). Also, acoustic rhinometry showed that the minimum cross-sectional area and nasal volume at the convex side of nasal cavity significantly increased after surgery. @*Conclusion@#The external approach septoplasty is a surgical technique that is effective not only in improving subjective symptoms, but also in improving objective parameters. External approach septoplasty could be used in case of caudal and/or dorsal nasal septal deviation.

Iatrogenic Spark Burn Injury to the Chest From a Transcutaneous Pacing Patch

Iatrogenic electrical burns that occur from the use of a defibrillator, a paddle-type cardiac shock device, have been reported in various forms. Electrical burns are usually conducted directly through the skin and are more damaging than scald burns or contact burns. A transcutaneous cardiac pacing device is a patch-type cardiac shock device that automatically delivers a shock when an abnormal heart rhythm is detected. We introduce a unique case of iatrogenic electrical burns caused by the transcutaneous pacing patch of a cardiac shock device. Electrical energy was converted into a spark due to foreign bodies deposited around the patch, resulting in damage to the peripheral area of the skin.

Knowledge Structure of Chronic Obstructive Pulmonary Disease Health Information on HealthRelated Websites and Patients’ Needs in the Literature Using Text Network Analysis

Purpose@#The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD). @*Methods@#Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis. @*Results@#The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management. @*Conclusion@#The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients’ needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.

Rapid Differentiation of Human Embryonic Stem Cells into Testosterone-Producing Leydig Cell-Like Cells In vitro

BACKGROUND@#Leydig cells (LCs) are testicular somatic cells that are the major producers of testosterone in males.Testosterone is essential for male physiology and reproduction. Reduced testosterone levels lead to hypogonadism and are associated with diverse pathologies, such as neuronal dysfunction, cardiovascular disease, and metabolic syndrome. LC transplantation is a promising therapy for hypogonadism; however, the number of LCs in the testis is very rare and they do not proliferate In vitro. Therefore, there is a need for an alternative source of LCs. @*METHODS@#To develop a safer, simple, and rapid strategy to generate human LC-like cells (LLCs) from stem cells, we first performed preliminary tests under different conditions for the induction of LLCs from human CD34/CD73 double positive-testis-derived stem cells (HTSCs). Based on the embryological sequence of events, we suggested a 3-step strategy for the differentiation of human ESCs into LLCs. We generated the mesendoderm in the first stage and intermediate mesoderm (IM) in the second stage and optimized the conditions for differentiation of IM into LLCs by comparing the secreted testosterone levels of each group. @*RESULTS@#HTSCs and human embryonic stem cells can be directly differentiated into LLCs by defined molecular compounds within a short period. Human ESC-derived LLCs can secrete testosterone and express steroidogenic markers. @*CONCLUSION@#We developed a rapid and efficient protocol for the production of LLCs from stem cells using defined molecular compounds. These findings provide a new therapeutic cell source for male hypogonadism.

Clinical outcomes among hemodialysis patients with atrial fibrillation: a Korean nationwide population-based study

Background@#The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. @*Methods@#In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. @*Results@#Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222–1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225–1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050–2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075–2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. @*Conclusion@#This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.

Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy

Purpose@#The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. @*Methods@#The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. @*Conclusion@#The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

Rapid Differentiation of Human Embryonic Stem Cells into Testosterone-Producing Leydig Cell-Like Cells In vitro

BACKGROUND@#Leydig cells (LCs) are testicular somatic cells that are the major producers of testosterone in males.Testosterone is essential for male physiology and reproduction. Reduced testosterone levels lead to hypogonadism and are associated with diverse pathologies, such as neuronal dysfunction, cardiovascular disease, and metabolic syndrome. LC transplantation is a promising therapy for hypogonadism; however, the number of LCs in the testis is very rare and they do not proliferate In vitro. Therefore, there is a need for an alternative source of LCs. @*METHODS@#To develop a safer, simple, and rapid strategy to generate human LC-like cells (LLCs) from stem cells, we first performed preliminary tests under different conditions for the induction of LLCs from human CD34/CD73 double positive-testis-derived stem cells (HTSCs). Based on the embryological sequence of events, we suggested a 3-step strategy for the differentiation of human ESCs into LLCs. We generated the mesendoderm in the first stage and intermediate mesoderm (IM) in the second stage and optimized the conditions for differentiation of IM into LLCs by comparing the secreted testosterone levels of each group. @*RESULTS@#HTSCs and human embryonic stem cells can be directly differentiated into LLCs by defined molecular compounds within a short period. Human ESC-derived LLCs can secrete testosterone and express steroidogenic markers. @*CONCLUSION@#We developed a rapid and efficient protocol for the production of LLCs from stem cells using defined molecular compounds. These findings provide a new therapeutic cell source for male hypogonadism.

Clinical outcomes among hemodialysis patients with atrial fibrillation: a Korean nationwide population-based study

Background@#The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. @*Methods@#In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. @*Results@#Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222–1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225–1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050–2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075–2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. @*Conclusion@#This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.

Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy

Purpose@#The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. @*Methods@#The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. @*Conclusion@#The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

A propeller superficial transverse cervical artery perforator flap for defect coverage of the submental area: a case report

Reconstruction of submental defects is a challenge that needs to be approached carefully, since many important anatomical structures are located in this small space. Both aesthetic and functional outcomes should be considered during reconstruction. In this report, we describe a case where a superficial branch of the transverse cervical artery (STCA) perforator propeller flap was applied for coverage of the submental area. An 85-year-old woman presented with a 3-cm ovoid mass on her submental area. We covered the large submental defect with a STCA rotational flap in a 180° propeller pattern. The flap survived well without any complications at 1 year of follow-up. A STCA propeller flap is a useful surgical option in reconstruction for defect coverage of the submental area.

Factors Affecting Preventive Behavior related to Tuberculosis among University Students in Korea: Focused on Knowledge, Attitude and Optimistic Bias related to Tuberculosis / 기본간호학회지

Purpose@#The purpose of this study was to identify factors affecting preventive behavior related to tuberculosis (TB). The focus was on knowledge, attitude and optimistic bias related to tuberculosis among university students in Korea. @*Methods@#A descriptive cross-sectional study was conducted with 255 students from 6 universities in 6 regions in Korea. Data were collected using a structured questionnaire online. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression. @*Results@#The level for scores on preventive behavior for TB was slightly good, knowledge related to TB was moderate, and attitude was good. There was a slight optimistic bias. Knowledge and attitude related to TB were positively correlated with preventive behavior for TB. The factors affecting preventive behavior for TB were attitude (β=.36,p<.001), knowledge related to TB (β=.13, p=.025). The explanatory power of these variables was 26.1% (F=10.98,p<.001). @*Conclusion@#Findings suggest that knowledge and attitude related to TB are major factors influencing preventive behavior for TB. In order to improve preventive behavior for TB, it is necessary to establish effective educational strategies and TB information media utilization that firmly enhance attitude and improve knowledge related to TB in university students in Korea.

Inflammatory Myofibroblastic Tumor of Nasal Septum after Septoplasty: A Case Report

Inflammatory myofibroblastic tumor is an uncommon tumor composed of myoblasts and various types of inflammatory infiltrates. Inflammatory myofibroblastic tumor is most common in the lungs but can be rarely found in the nasal cavity. Inflammatory myofibroblastic tumor is a rare entity that represents a diverse histologic pattern that can mimic malignant tumors. We report a case of inflammatory myofibroblastic tumor of the nasal septum in a 45-year-old man who presented with a tumor-like lesion of the nasal septum after two rounds of septoplasty.