The Influence of Dental Hygienists’ Self-Leadership on Organizational Commitment and Quality of Medical Services / 치위생과학회지

Background@#Self-leadership, an action strategy that can maximize individual capabilities, can affect the organizational commitment of dental hygienists and ultimately improve the quality of medical services. This study aims to demonstrate the need for self-leadership and organizational commitment for dental hygienists and develop measures to improve the quality of medical services. @*Methods@#An online survey of dental hygienists working at dental hospitals and clinics in Seoul and Gyeonggi province, Republic of Korea was conducted from March 28 to May 1, 2022. A total of 341 questionnaires were returned and analyzed. The measurement tools were modified and supplemented based on the theories and models developed by Manz for self-leadership, Mowday for organizational commitment, and Cronin and Taylor for medical services. Descriptive statistics, independent t-tests, ANOVA, simple regression, and multiple regression analyses were performed using SPSS 25.0. @*Results@#In leadership education, self-leadership is based on participation experience, the number of participants, and when and where it is received. Organizational commitment comes from participation experience, and the quality of medical services has been found to affect participation experience and location. Self-leadership had an effect on the quality of medical services (β=0.497, t=10.551, p＜0.001; β =0.599, t=13.783, p＜0.001; β=0.353, t=7.601, p＜0.001) and organizational commitment was found to have a mediating effect. @*Conclusion@#Dental hygienists’ self-leadership has a positive effect on the quality of medical services through the formation of appropriate interrelationships within the organization. Therefore, self-leadership programs should be developed, participated in, and promoted to improve the self-leadership of dental hygienists. Moreover, hospitals should improve their environment to provide and improve self-leadership education.

Clinical Characteristics of Peripherally Inserted Central Catheter in Critically Ill Patients

PURPOSE: Ensuring the stability of central venous catheter placement for treating patients hospitalized in an intensive care unit is very important. Although PICC requires an ultrasound and fluoroscopy machine, it is difficult to use a fluoroscopy machine for PICC insertion in the intensive care unit. This study analyzed the cases of the insertion of a PICC under ultrasonic guidance at the bedsides in the intensive care unit to determine the usefulness of PICC in the intensive care unit. METHODS: A retrospective study was conducted on patients hospitalized in the surgical intensive care unit and received PICC using ultrasonography at their bedsides from October 2015 to January 2018. RESULTS: One hundred and twenty patients were collected. The number of successful PICCs stood at 105 patients, which was equal to 87.5%. Among them, 65 and 55 cases had left and right insertion, respectively; the corresponding success rate was 81.8%, and 92.3%. No statistically significant difference in success rates was observed between the left and right, as well as in the success rates depending on the presence of shock, sepsis, acute kidney injury, and mechanical ventilation. In the failed 15 cases, seven cases were due to the course of the procedure and eight cases were confirmed have been malpositioned after insertion. CONCLUSION: PICC at the bedside in an intensive care unit is a safe method for central venous catheterization without severe complications and death. The insertion sites, left or right, are equally acceptable. Further study of the cases of malposition will be necessary.

Association between blood glucose level derived using the oral glucose tolerance test and glycated hemoglobin level

BACKGROUND/AIMS: Glycated hemoglobin (HbA1c) is widely used as a marker of glycemic control. Translation of the HbA1c level to an average blood glucose level is useful because the latter figure is easily understood by patients. We studied the association between blood glucose levels revealed by the oral glucose tolerance test (OGTT) and HbA1c levels in a Korean population. METHODS: A total of 1,000 subjects aged 30 to 64 years from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort were included. Fasting glucose levels, post-load glucose levels at 30, 60, and 120 minutes into the OGTT, and HbA1c levels were measured. RESULTS: Linear regression of HbA1c with mean blood glucose levels derived using the OGTT revealed a significant correlation between these measures (predicted mean glucose [mg/dL] = 49.4 × HbA1c [%] - 149.6; R2 = 0.54, p < 0.001). Our linear regression equation was quite different from that of the Alc-Derived Average Glucose (ADAG) study and Diabetes Control and Complications Trial (DCCT) cohort. CONCLUSIONS: Discrepancies between our results and those of the ADAG study and DCCT cohort may be attributable to differences in the test methods used and the extent of insulin secretion. More studies are needed to evaluate the association between HbA1c and self monitoring blood glucose levels.

Eosinophilic gastroenteritis which leads to mal-absorption and anemia associated with food allergies

Eosinophilic gastroenteritis (EG) is a rare disease characterized by massive eosinophilic infiltration of gastrointestinal tissue, peripheral eosinophilia, and nonspecific gastrointestinal symptoms. The mucosal type of EG commonly presented with malabsorption and anemia. However, the role of food allergy as a stimulus to EG has not yet been clearly defined. A 27-year-old man was referred to the Emergency Department with dyspepsia and leg swelling. The initial laboratory test should as follows: hemoglobin level, 6.4 g/dL; white blood cell count, 7,400/microL with 24.4% of eosinophil fraction; serum total protein, 3.9 g/dL; albumin level, 2.8 g/dL. Gastric endoscopy ruled out gastrointestinal bleeding showed multiple nodular raised lesions on the gastric antrum, which revealed increased eosinophilic infiltration (above 100/high power field). He had experienced nausea whenever eating beef, porks or fish. High serum specific IgE levels to offending foods (beef, 0.82 kU/L; pork, 0.83 kU/L; egg white, 0.40 kU/L; egg yolk, 0.54 kU/L; milk, 0.81 kU/L) were noted. He was instructed strictly to avoid food allergens with oral prednisolone therapy. Approximately 6 months after offending food restriction, the eosinophil count fell down to 400/microL, the hemoglobin level was returned to 11.5 g/dL and the serum albumin level was increased to 4.1 g/dL. We report a case of EG caused by multiple food allergy which leads to malabsorption and iron-deficiency anemia.

A Case of Recurrent Adrenocortical Carcinoma with Stomach Metastasis

Adrenocortical carcinoma (ACC) is a rare disease with poor prognosis. We experienced a case of recurrent ACC with stomach metastasis which had been completely cured a long while ago. A 52-year-old man who presented with right thigh pain was hospitalized. We found a lumbar spine mass on magnetic resonance imaging scan. And this lesion was identified as metastatic adrenocortical carcinoma. The patient had been treated as stage II non-functioning ACC 19 years ago. At that time radical resection and adjuvant chemotherapy were successfully done. And the follow-up evaluation was discontinued, since it had been checked as no evidence of disease (NED) state for 5 years. But this time, there were multiple metastatic sites revealed in positron emission tomography-computed tomography scan including stomach. Therefore, we report a case of ACC herewith that it could be recurred even though long-term NED state was passed after treatment and stomach could be a metastatic site of ACC.

The Change of Frontal Hair Line in Teenagers of Korea / 대한피부과학회지

BACKGROUND: Frontal hair line dose not exist in the same form for a lifetime, and each individual has a different form of frontal hair line. But, the study of the change of the frontal hair line still dose not exist. OBJECTIVE: The objective of this study of the change of frontal hair line was to analyze whether the change of age, puberty, and the family history of androgenic alopecia was related to the change of frontal hair line. METHOD: This study held a survey which consists of male and female students of each class from middle school to high school. In this survey, the shape of frontal hair line was classified into the egg shape, square shape, and M shape. RESULT: 1. When the age increased, the egg shape type of frontal hair line decreased, and the square type of frontal hair line increased. Especially, men were more salient. 2. During puberty, the egg shape type of frontal hair line decreased, and the square shape type of frontal hair line increased. 3. Before puberty, the m shape type of frontal hair line did not exist, but during puberty the M shape type of frontal hair line appeared. 4. Statistically, the family history of androgenic alopecia of the relationship of the change of the egg shape type decreased, the square shape increased. CONCLUSION: This study shows that frontal hair line is related to the change of age, and existence of puberty.

Combination Treatment of LASER and Chemical Peel on Wrinkles / 대한피부과학회지

The presence of facial wrinkles can have a significant effect on a person's self image relating to physical appearance and social acceptance. Many treatment modalities for wrinkle reduction, such as surgical method, injection of Botulinum toxin, chemical peeling, and laser peeling have been developed. The resurfacing carbon dioxide laser has recently proved to be a useful and safe tool in the treatment of facial wrinkles. We have attempted to treat pecular perioral wrinkles using a combination of laser and chemical peeling techniques. This combination treatment has resulted in a good cosmetic appearance. We report and encourage use of this method for wrinkle reduction.

A Clinical Study of 153 Cases of Basal Cell Epithelioma / 대한피부과학회지

BACKGROUND: Clinical features of basal cell epithelioma(BCE) are known to be different according to social and environmental factors. Recently, there have been reports of an increase of BCE in the Chung-Nam area. OBJECTIVE: We evaluated the incidence of tumors, age and sex distribution, and tumor sites. METHODS: Clinical records were reviewed for 153 cases of BCE with a histologically confirmed diagnosis for patients who visited the Department of Dermatology, Chungnam National University Hospital during the 20 years from 1978 to 1997. Pathologic characteristics were also reviewed. RESULTS: The frequency of BCE expressed as a percentage of the total number of new patients increased from 0.10% in 1978 to 0.76% in 1997. The ratio of man to woman with BCE was 1 : 1.1 with a mean age of 61.8 years. Most cases of BCE were on the face (90.8%), especially on the nose (29%). The solid type (66.7%) was the most common pathologic pattern, followed by the adenoid type (9.7%), and the morpheic type (8.6%). The pigmented type of BCE accounted for 41.9%. CONCLUSION: The incidence of BCE has increased during the past 20 years. However, the age of occurrence, common site, and pathologic patterns did not show a significant difference from Caucasians, except for a higher frequency of pigmented type BCE, as can be expected in oriental people.

A Case of Emphysematous Pyelonephritis Recovered by Ureteral Stenting / 대한비뇨기과학회지

A 62-year-old diabetic male was presented with abdominal pain. Six years ago, he had been performed cystectomy with both cutaneous ureterostomy for bladder cancer. After admission, high fever was developed and radiologic findings revealed a calcification occupying the whole left pelvocalyceal system with gas accumulation in parenchyme. We started the intensive cares with fluid therapy, broad-spectrum antibiotics and insulin therapy, but he failed to improve with supportive management. For the decompression we placed initially double-J stent through the left cutaneous ureterostomy instead of percutaneous nephrostomy or nephrectomy. After stenting, postobstructive diuresis was occurred and followed by marked improvement in general condition including vital sign, mental status and laboratory findings. Herein, we report a case of emphysematous pyelonephritis recoverd by ureteral stenting through the cutaneous ureterostomy in a diabetic patient with contralateral atrophic kidney.

Suction Auto Epidermal Graft on Removal of Epidermis of Depigmented Lesion with Radio-frequency Irradiation / 대한피부과학회지

BACKGROUND: Suction auto epidermal graft for the treatment of stable vitiligo has become popular clinically. In general, depigmented epidermis is removed by liquid nitrogen freezing for preparation of the recipient site. There have been some problems with the nitrogen freezing method, uneven repigmentation, appearance of Koebner's phenomenon on normal colored skin around the graft site, scar formation on recipients sites. In our view these resulted in unwanted damage to the dermis and epidermal and skin appendageal melanocytes of normal skin by freezing. OBJECTIVE: To introduce a method to remove the depigmented epidermis of recipient site with minimal unwanted damage to melanocytes and dermal tissue. METHODS: Using Ellman surgitron, irradiation equipment of 3.8MHz frequency the depigmented epidermis was removed with a blade electrode under rated electric power around 10 watts depending on the thickness of the epidermis. Operating mode was fully filtered current for minimal charring and destruction of tissue through pure micro-smooth cutting. RESULTS: In the case of removal of the epidermis with Ellman surgitron, oozing and inflammation decreased markedly compared with those applied with liquid nitrogen. And it was confirmed histopathologically that there was no significant unwanted destruction of healthy tissue. Moreover, the electrode of Ellman surgitron is designed to be apt to trace the margin of depigmented lesion. And Ellman surgitron features a continuously linear intensity setting for precise, predictable control to minimize tissue destruction and charring. So we were able to remove the epidermis of the shallow lesion looking like a pseudopod and of the thinnest part of the body like eyelid also. And we grafted normal epidermis successfully on the depigmented lesion. CONCLUSION: The removal of depigmented epidermis by radio-frequency gave satisfactory results in the suction auto epidermal graft by overcoming the defects shown as depigmented epidermis which were removed by liquid nitrogen freezing. And this method made patients comfortable because of less pain, a one day operation procedure and good results.