Purpose: The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. Methods: Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression. Results: It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. Conclusion The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology and incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.
Empty Sella Syndrome ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Incidence ; Magnetic Resonance Imaging ; Multiple Endocrine Neoplasia ; Pancreatitis ; Parathyroid Neoplasms ; Pituitary Gland ; Sella Turcica

Philadelphia chromosome-positive acute myeloid leukemia (Ph+AML) is a rare disease characterized by a poor prognosis with resistance to standard chemotherapy. We report a patient with Ph+AML with a minor BCR-ABL-positive mRNA transcript who achieved a hematologic, cytogenetic, and major molecular complete response after cytarabine-based chemotherapy followed by imatinib. After more than 6 months of continuous imatinib therapy, the patient is in continuous complete remission. Our results show that imatinib mesylate is effective in treating Ph+AML.
Benzamides ; Cytogenetics ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Mesylates ; Philadelphia ; Philadelphia Chromosome ; Piperazines ; Prognosis ; Pyrimidines ; Rare Diseases ; RNA, Messenger ; Imatinib Mesylate

Abnormal thyroid function is associated with impaired glucose homeostasis. This study aimed to determine whether free thyroxine (FT4) influences the prevalence of prediabetes in euthyroid subjects using a cross-sectional survey derived from the Korea National Health and Nutrition Examination Survey, conducted between 2013 and 2015. We studied 2,399 male participants of >20 years of age who were euthyroid and non-diabetic. Prediabetic participants had lower FT4 concentrations than those without prediabetes, but their thyrotropin concentrations were similar. We stratified the population into tertiles according to FT4 concentration. After adjusting for multiple confounding factors, glycosylated hemoglobin (HbA1c) levels significantly decreased with increasing FT4 tertile, whereas fasting plasma glucose (FPG) levels were not associated with FT4 tertiles (HbA1c, P<0.01 in T3 vs. T1; FPG, P=0.489 in T3 vs. T1). The prevalence of prediabetes was significantly higher in T1 (odds ratio, 1.426; 95% confidence interval, 1.126 to 1.806; P<0.01) than in T3. In conclusion, subjects with low-normal serum FT4 had high HbA1c and were more likely to have prediabetes. These results suggest that low FT4 concentration is a risk factor for prediabetes in male, even when thyroid function is within the normal range.
Blood Glucose ; Cross-Sectional Studies ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Homeostasis ; Humans ; Korea ; Male ; Nutrition Surveys ; Prediabetic State ; Prevalence ; Reference Values ; Risk Factors ; Thyroid Gland ; Thyrotropin ; Thyroxine

BACKGROUND: Hypoglycemia is an important complication in the treatment of patients with diabetes. We surveyed the insight by patients with diabetes into hypoglycemia, their hypoglycemia avoidance behavior, and their level of worry regarding hypoglycemia. METHODS: A survey of patients with diabetes, who had visited seven tertiary referral centers in Daegu or Gyeongsangbuk-do, Korea, between June 2014 and June 2015, was conducted. The survey contained questions about personal history, symptoms, educational experience, self-management, and attitudes about hypoglycemia. RESULTS: Of 758 participants, 471 (62.1%) had experienced hypoglycemia, and 250 (32.9%) had experienced hypoglycemia at least once in the month immediately preceding the study. Two hundred and forty-two (31.8%) of the participants had received hypoglycemia education at least once, but only 148 (19.4%) knew the exact definition of hypoglycemia. Hypoglycemic symptoms identified by the participants were dizziness (55.0%), sweating (53.8%), and tremor (40.8%). They mostly chose candy (62.1%), chocolate (37.7%), or juice (36.8%) as food for recovering hypoglycemia. Participants who had experienced hypoglycemia had longer duration of diabetes and a higher proportion of insulin usage. The mean scores for hypoglycemia avoidance behavior and worry about hypoglycemia were 21.2±10.71 and 23.38±13.19, respectively. These scores tended to be higher for participants with higher than 8% of glycosylated hemoglobin, insulin use, and experience of emergency room visits. CONCLUSION: Many patients had experienced hypoglycemia and worried about it. We recommend identifying patients that are anxious about hypoglycemia and educating them about what to do when they develop hypoglycemic symptoms, especially those who have a high risk of hypoglycemia.
Avoidance Learning ; Cacao ; Candy ; Daegu ; Dizziness ; Education ; Emergency Service, Hospital ; Gyeongsangbuk-do ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Korea ; Self Care ; Sweat ; Sweating ; Tertiary Care Centers ; Tremor

Altered expression of neurotrophic factors as well as neuroinflammation is commonly associated with Major depressive disorder (MDD) and Alzheimer's disease (AD). To investigate whether or not reserpine-induced MDD affects the expression of AD-related proteins, the expression of gamma-secretase components and substrate were measured in brains of ICR mice following reserpine treatment for 15 days. In active avoidance test, total response time and peak slightly increased in the 2 mg/kg reserpine (RSP2)-treated group compared to vehicle-treated group (P<0.05). Expression and phosphorylation of MKP-1, which is a key factor in MDD pathology, were both higher in the RSP2-treated group than the vehicle- and 1 mg/kg reserpine (RSP1)-treated groups (P<0.02). Furthermore, full-length expression of amyloid precursor protein (APP) was enhanced in the RSP1 and RSP2-treated groups compared to the vehicle-treated group, whereas expression of gamma-secretase components decreased (P<0.03). Among the three components of the gamma-secretase complex, nicastrin protein underwent the largest decrease in expression, as detected by Western blotting (P<0.03). Therefore, the data presented here provide additional evidence about the pathological correlation between MDD and AD.
Alzheimer Disease ; Amyloid ; Amyloid Precursor Protein Secretases ; Animals ; Blotting, Western ; Brain ; Depressive Disorder, Major ; Membrane Glycoproteins ; Mice ; Mice, Inbred ICR ; Models, Animal ; Nerve Growth Factors ; Phosphorylation ; Proteins ; Reaction Time ; Reserpine

Peroxiredoxin I (Prx I) is a member of the peroxiredoxins (Prxs) family, which are antioxidant enzymes that regulate various cellular process via intracellular oxidative signal pathways. In order to investigate the correlation between Prx I and the gamma-secretase complex, which causes Alzheimer's disease (AD), the expression level of Prx I was firstly evaluated in an animal model for AD. NSE/hPen-2 transgenic (Tg) mice, which were used as animal model in this study, showed a high level of Pen-2 expression and accumulation of Abeta-42 peptides in the hippocampus of brain. The expression level of Prx I was significantly higher on the mRNA and protein level in the brain of this model, while not change in Prx VI expression was observed. Furthermore, to verify the effect of Prx I on the gamma-secretase components in vitro, the expression level of these components was analyzed in the Prx I transfectants. Of the components of the gamma-secretase complex, the expression of PS-2 and Pen-2 was lower in the transfectants overexpressing Prx I compared to the vector transfectants. However, the expression of APP, NCT and APH-1 did not change in Prx I transfectants. Therefore, these results suggested that the expression of Prx I may be induced by the accumulation of Abeta-42 peptides and the overexpression of Prx I in neuroblastoma cells may regulate the expression of gamma-secretase components.
Alzheimer Disease ; Amyloid Precursor Protein Secretases ; Animals ; Brain ; Hippocampus ; Humans ; Mice ; Models, Animal ; Neuroblastoma ; Peptides ; Peroxiredoxins ; RNA, Messenger ; Signal Transduction

Purpose: Surgical margin status is a surrogate marker for residual tumors after breastconserving surgery (BCS). A comparison of ipsilateral breast tumor recurrence (IBTR) rates between re-excision combined with radiotherapy (excision with RTx) and RTx alone, following the confirmation of ductal carcinoma in situ (DCIS) in the resection margin after BCS, has not been reported previously. Therefore, in the present study, the clinical characteristics of DCIS involvement in the surgical resection margin between excision with RTx and RTx alone were investigated, and the IBTR rate was compared. Methods: We analyzed 8,473 patients treated with BCS followed by RTx between January 2013 and December 2019. Patients were divided into 2 groups based on surgical resection margin status in permanent pathology, and superficial and deep margins were excluded. Patients who underwent re-excision with DCIS confirmed in the resection margin were identified and the IBTR rate was examined. Results: Among 8,473 patients treated with BCS, 494 (5.8%) had positive surgical resection margins. The median follow-up period was 47 months. Among the 494 patients with a positive resection margin, 368 (74.5%) had residual DCIS at the surgical resection margin in the final pathology. Among those with confirmed DCIS at the resection margin, 24 patients (6.5%) were re-excised, and 344 patients (93.5%) underwent RTx after observation. The IBTR rates were 4.2% and 1.2% in the re-excision and observation groups, respectively. IBTR-free survival analysis revealed no significant difference between the excision with RTx and RTxonly groups (p = 0.262). Conclusion The IBTR rate did not differ between the excision with RTx and RTx-only groups when DCIS was confirmed at the resection margins. This suggests that RTx and close observation without re-excision could be an option, even in cases where minimal involvement of DCIS is confirmed on surgical resection.

The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS based on systematic reviews. All key questions targeted randomized controlled trials (RCTs) exclusively. If fewer than two RCTs were available, studies using propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.

The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS based on systematic reviews. All key questions targeted randomized controlled trials (RCTs) exclusively. If fewer than two RCTs were available, studies using propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.