Inherited platelet disorders (IPDs) can cause mucocutaneous bleeding due to impaired primary hemostatic function of platelets, thrombocytopenia, or both. Recent advances in molecular technology can help identify many genes related to platelet biology, control the overall steps of megakaryopoiesis, and cause IPD. In this article, currently available laboratory tools for diagnosing IPDs with the characteristic laboratory features of each IPD are reviewed, and a general diagnostic approach for the evaluation of IPD patients is presented.

Purpose: This study compared health behaviors and health-related clinical characteristics between individuals with normal glucose levels without diabetes and those with undiagnosed diabetes. Factors that were associated with undiagnosed diabetes were identified by sex. Methods: This was an observational study with a cross-sectional design based on data from the eighth Korea National Health and Nutrition Examination Survey, which used a stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors and clinical characteristics to identify risk factors for undiagnosed diabetes. Results: The overall prevalence of undiagnosed diabetes was 5.2% (weighted %, n = 700, p < .001). Among individuals with undiagnosed diabetes, 58.3% were men. Univariate logistic regression for undiagnosed diabetes identified sex, age, house income, educational level, and triglycerides as influencing factors. In multiple logistic regression by sex, the factors associated with undiagnosed diabetes in men were age, perceived health status, a diagnosis of angina, and triglycerides. Conclusion Strategies should be targeted to improve health behaviors and clinical characteristics for those in specific age groups, men in bad perceived health status, women with high systolic blood pressure, and high triglycerides. Moreover, healthcare providers should understand the barriers to health behaviors and health-related quality of life to effectively deliver healthcare services.

PURPOSE: The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea. METHODS: This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis. RESULTS: New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses. CONCLUSION: Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.
Geography ; Gyeonggi-do ; Health Care Rationing ; Human Migration ; Insurance, Health ; Korea ; Logistic Models ; Ownership ; Personnel Turnover ; Seoul

Purpose: The objectives of this study were to categorize the conflict management types of preceptor nurses and determine the effects of these types on preceptors’ role perception and core competencies. Methods: Data was collected from 192 preceptor nurses with at least two years experiences in general hospitals, from July 1 to July 31, 2022. Conflict management type, preceptor role perception, and core competency were investigated using structured instruments. The data was analyzed using K-means cluster analysis, Independent samples t-test, One-way ANOVA with Scheffé‘s test, and multiple regression analysis. Results: The conflict management types were categorized into four types; comprehensive type (cluster 1), integrating, obliging, compromising type (cluster 2), undifferentiated type (cluster 3) and obliging, avoiding type (cluster 4). The effect of conflict management types on preceptors’ role recognition occurred in the following order of cluster 2 (integrating/obliging/compromising type), cluster 1 (comprehensive type), and cluster 4 (obliging/avoiding type). Next, cluster 1 (comprehensive type), cluster 2 (integrating/obliging/compromising type), and cluster 4 (obliging/avoiding type) were shown in the order of the impact on the core competencies of the preceptor. Conclusion When preceptor nurses use a mixture of various attributes of conflict management evenly, they have been shown to demonstrate effective preceptor role recognition and core competencies. Therefore, it is proposed that future development of conflict management training programs for preceptor nurses should begin with identifying their conflict management type, followed by creating a program that addresses any deficiencies.

Purpose: s: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-testpost-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome. Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.
Adult ; Hepatitis B, Chronic/complications ; Humans ; Liver Cirrhosis/etiology/*therapy ; *Liver Transplantation ; Male ; Mesenteric Veins/*ultrasonography

A 67-year-old woman with a history of subtotal parathyroidectomy, distal pancreatectomy, and total splenectomy 23 years prior underwent surgical gastric resection for neuroendocrine tumors of the stomach and duodenum. Meticulous examination of the entire stomach and duodenum revealed multiple scattered, minute neuroendocrine tumors. To the best of our knowledge, this is the first case report of a patient diagnosed with gastroduodenal neuroendocrine tumors associated with multiple endocrine neoplasia type 1 (MEN 1) in whom complete histologic mapping of the whole gastrectomy specimen was performed. The presence of MEN 1–associated neuroendocrine tumors in the stomach is very rare, but should be considered in patients diagnosed with MEN 1 who present with a new tumor in the stomach.
Aged ; Duodenum ; Female ; Gastrectomy ; Humans ; Male ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia ; Neuroendocrine Tumors ; Pancreatectomy ; Parathyroidectomy ; Splenectomy ; Stomach Neoplasms ; Stomach

BACKGROUND: Clear cell renal cell carcinoma (CCRCC) is presumed to be associated with adipogenic differentiation. Histone modification is known to be important for adipogenesis, and the function of histone demethylase plant homeodomain finger 2 (PHF2) has been noted. In addition, PHF2 may act as a tumor suppressor via epigenetic regulation of p53 and is reported to be reduced in colon cancer and stomach cancer tissues. In this study, we examined PHF2 expression in CCRCC specimens by immunohistochemistry. METHODS: We studied 254 CCRCCs and 56 non-neoplastic renal tissues from patients who underwent radical or partial nephrectomy between 2000 and 2003 at the Seoul National University Hospital. Tissue microarray blocks were prepared, and immunohistochemical staining for PHF2 was performed. RESULTS: Among 254 CCRCC cases, 150 cases (59.1%) showed high expression and 104 cases (40.1%) showed low expression. High expression of PHF2 was significantly correlated with a low Fuhrman nuclear grade (p < .001), smaller tumor size (p < .001), low overall stage (p = .003), longer cancer-specific survival (p = .002), and progression-free survival (p < .001) of the patients. However, it was not an independent prognostic factor in multivariate analysis adjusted for Fuhrman nuclear grade and overall stage. CONCLUSIONS: Our study showed that low expression of PHF2 is associated with aggressiveness and poor prognosis of CCRCC.
Adipogenesis ; Carcinoma, Renal Cell* ; Colonic Neoplasms ; Disease-Free Survival ; Epigenomics ; Fingers ; Histones ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Nephrectomy ; Plants ; Prognosis ; Seoul ; Stomach Neoplasms

PURPOSE: This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea. METHODS: Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency. RESULTS: For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability. CONCLUSION: The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.
Cross-Sectional Studies ; Diabetes Mellitus ; Humans ; Insulin Resistance* ; Insulin* ; Korea ; Psychology

Anti-K alloantibody is a type of red blood cell (RBC) antibody which is generated through immunization. It is well noted that the anti-K antibody causes hemolytic transfusion reactions. Although Koreans generally do not have the K antigen on RBCs, we report a rare case of transfusion-related anti-K antibody in Korean patient. Just twelve pints of packed RBCs had been transfused to the patient before the anti-K was identified for the first time, but the donor information about Kell phenotype (K or k) was not available. The anti-K had been continuously detected, and the patient neither received immunoglobulins nor experienced bacterial infections which could generate anti-K antibody. Therefore we believe that her anti-K is the truly positive, previously transfused packed RBCs-related alloantibody. The packed RBCs transfused to our patient were likely to be donated from other races. The pre-transfusion irregular antibody detection test should be performed carefully to detect very rare RBC alloantibodies.
Bacterial Infections ; Continental Population Groups ; Erythrocytes ; Humans ; Immunization ; Immunoglobulins ; Isoantibodies ; Kell Blood-Group System ; Phenotype ; Tissue Donors ; Transfusion Reaction