PURPOSE: To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. METHODS: Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. RESULTS: For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. CONCLUSION: The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.
Hospitals ; Humans ; Logistic Models ; Nursing Staff, Hospital/economics/*supply & distribution ; Workplace

PURPOSE: This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life. METHODS: Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using χ²-test, t-test, ANOVA and multiple regression analysis. RESULTS: Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity. CONCLUSION: The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.
Adult ; Aged* ; Chronic Disease ; Comorbidity ; Delivery of Health Care ; Drinking ; Education ; Humans ; Insurance, Health ; Korea* ; Motor Activity ; Quality of Life* ; Young Adult*

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

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

Bone marrow metastasis of colon cancer is rare. Here, we report a 56-year-old female patient who presented with pancytopenia. She was diagnosed with colon cancer accompanied by lung and axial skeleton metastasis. The bone marrow study showed metastatic carcinoma. Immunohistochemical (IHC) staining with anti-cytokeratin 7 (CK7) and anti-cytokeratin 20 (CK20) antibodies showed that the bone marrow samples were negative for CK7 and positive for CK20, consistent with metastatic colon cancer. To the best of our knowledge, there has been only one other reported case of bone marrow metastasis of colon cancer as the primary diagnosis in an adult patient in Korea. Bone and bone marrow metastases of colon cancer are regarded as uncommon. However, for proper management, bone marrows should be promptly examined in patients with solid tumors when unexplained cytopenia is noted, even if the origin of the tumor is known to be rarely metastatic to bone marrow. In addition, the use of cytokeratin IHC staining is helpful for determining the origin of metastatic carcinoma.
Adult ; Antibodies ; Bone Marrow ; Colon ; Colonic Neoplasms ; Diagnosis ; Female ; Humans ; Immunohistochemistry ; Keratins ; Korea ; Lung ; Middle Aged ; Neoplasm Metastasis ; Pancytopenia ; Skeleton

Purpose: This study aimed to identify the relationship among musculoskeletal problems, sleep problems, and self-rated mental health of home-care workers. Methods: Data were collected from 447 home-care workers spanning three occupation types: life supporters for the elderly, home-visit caregivers, and life supporters for the disabled. Musculoskeletal problems, sleep problems, and self-rated mental health were assessed using structured questionnaires. Factors affecting self-rated mental health were analyzed using multiple regression.SPSS was used to test the mediating effects of sleep problems on musculoskeletal problems and self-rated mental health. Results: Among the general characteristics, the variables that showed significant differences in musculoskeletal problems were monthly income level, caring-related career duration, weekly working hours, and occupation type; and the variable that showed significant differences in self-rated mental health was occupation type. Among the occupation types, supporters for the disabled had the most musculoskeletal problems and the lowest self-rated mental health. Musculoskeletal problems among home-care workers had a direct negative effect on self-rated mental health and indirect negative effects on sleep problems. Conclusion Measures are needed to reduce the differences in working conditions and health status among the occupation types of home-care workers. Considering the relevance between the health issues of home-care workers, the development of a carefully designed health promotion strategy is required.

Background: Loss of companion animals can result in various psychological reactions, including complicated grief, depression, anxiety, and insomnia. However, research on the prevalence of patients requiring clinical intervention is limited. Moreover, research examining the relationship between childhood trauma and psychological symptoms after pet loss is lacking. Therefore, this study aimed to investigate the rates of clinically significant psychological distress after pet loss and the impact of childhood trauma on adults who have experienced pet loss. Methods: An online survey was conducted with non-clinical adult participants who had experienced the loss of a companion animal. Psychiatric characteristics were evaluated using standardized assessments, including the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI). Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ). Results: In a sample of 137 individuals who had experienced pet loss, the percentages of those who exceeded the cutoff points were 55% for the ICG, 52% for the PHQ-9, 40% for the GAD-7, and 32% for the ISI. The group that reported childhood trauma exhibited significantly higher scores on the ICG (t = 2.16, P = 0.032), PHQ-9 (t = 3.05, P = 0.003), GAD-7 (t = 2.61, P = 0.010), and ISI (t = 2.11, P = 0.037) than in the group without childhood trauma.For participants who experienced pet loss for less than one year, there was no significant difference in the ICG between the trauma and non-trauma groups, as both had extremely high scores. However, the trauma group had a significantly higher PHQ-9 (t = 2.58,P = 0.012) than the non-trauma group. In contrast, for participants who experienced pet loss for more than one year, the trauma group had a significantly higher ICG (t = 2.22, P = 0.03) than the non-trauma group, while there was no significant difference in the PHQ-9. Additionally, the emotional abuse scores on the CTQ were most significantly correlated with the ICG scores even after controlling for depressive symptoms. Conclusion People who experienced pet loss had significant psychological symptoms, ranging from 32% to 55%. Childhood trauma experiences affect complicated grief, depressive symptoms, anxiety symptoms, insomnia and prolonged grief disorder after pet loss. After pet loss, people with childhood trauma may require more psychological help than those without trauma.

Background: Aquaporin (AQP) expression has been investigated in various malignant neoplasms, and the overexpression of AQP is related to poor prognosis in some malignancies. However, the expression of AQP protein in clear cell renal cell carcinoma (ccRCC) has not been extensively investigated by immunohistochemistry with large sample size. Methods: We evaluated the AQP expression in 827 ccRCC with immunohistochemical staining in tissue microarray blocks and classified the cases into two categories, high and low expression. Results: High expression of aquaporin-1 (AQP1) was found in 320 cases (38.7%), but aquaporin-3 was not expressed in ccRCC. High AQP1 expression was significantly related to younger age, low TNM stage, low World Health Organization/International Society of Urologic Pathology nuclear grade, and absence of distant metastasis. Furthermore, high AQP1 expression was also significantly associated with longer overall survival (OS; p<.001) and progression-specific survival (PFS; p<.001) and was an independent predictor of OS and PFS in ccRCC. Conclusions Our study revealed the prognostic significance of AQP1 protein expression in ccRCC. These findings could be applied to predict the prognosis of ccRCC.

OBJECTIVE: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. MATERIALS AND METHODS: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. RESULTS: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. CONCLUSION: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.
Adult ; Aged ; Comparative Study ; *Endosonography/methods ; Female ; Human ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Hemorrhage/etiology/*ultrasonography

PURPOSE: The purpose of this study was to evaluate the reliability and validity of the Korean version of Diabetes Empowerment Measurement Scale Short Form (DES-SF) for use with diabetic patients in Korea. METHODS: A cross-sectional descriptive study was used with 107 participants. Bilingual nursing professionals performed translation and reverse translation. Reliability and validity such as face validity, construct validity, and concurrent validity were conducted. To assess the concurrent validity, the correlation coefficients between the Korean version of the DES-SF and a concurrent scale (Diabetes Self-Efficacy Scale, DSES) were calculated. RESULTS: In the explanatory factor analysis, a uni-dimension was proposed, the one factor accounted for 49.4% of total variances. The Korean version of the DES-SF correlated with a concurrent variable such DSES for reliability of the Korean version of the DES-SF, Cronbach's α=.85. CONCLUSION: The findings show that the Korean version of the DES-SF is reliable and valid for evaluating empowerment in patients with diabetes in Korea.
Humans ; Korea ; Nursing ; Power (Psychology)* ; Reproducibility of Results*