PURPOSE: The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0. RESULTS: Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment. CONCLUSION: Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.
Adult ; Female ; Hospitals, General ; Humans ; Intention ; Nursing Staff, Hospital/economics/*psychology ; *Organizational Culture ; *Personnel Turnover ; Questionnaires

The most common manifestation of multiple endocrine neoplasia type 1 (MEN1) is hyperparathyroidism. Treatment of hyperparathyroidism in MEN patients is surgical removal of the parathyroid glands, however ectopic parathyroid gland is challenging for treatment. A 51-year-old female, the eldest of 3 MEN1 sisters, had hyperparathyroidism with ectopic parathyroid adenoma in the mediastinal para-aortic region, which was detected by technetium-99m (Tc-99m) sestamibi scintigraphy and single-photon emission computed tomography/computed tomography (SPECT/CT). She underwent total parathyroidectomy with video-assisted thoracoscopic surgery on an anterior mediastinal mass. Anterior mediastinal parathyroid adenoma in MEN1 patients is rare. Precise localization of an ectopic parathyroid gland with Tc-99m sestamibi SPECT/CT can lead to successful treatment of hyperparathyroidism. This is the first reported case in the literature of mediastinal parathyroid adenoma in MEN1 patient visualized by Tc-99m sestamibi SPECT/CT.
Female ; Humans ; Hyperparathyroidism ; Male ; Middle Aged ; Multiple Endocrine Neoplasia Type 1* ; Multiple Endocrine Neoplasia* ; Parathyroid Glands ; Parathyroid Neoplasms* ; Parathyroidectomy ; Radionuclide Imaging ; Siblings ; Thoracic Surgery, Video-Assisted ; Tomography, Emission-Computed, Single-Photon

Objective: Gender incongruence (GI) is a condition in which an individual’s gender identity, role, and expression differ from their assigned sex. This study aimed to evaluate when GI first arises in transgender and non-binary individuals seeking hormone therapy and their years living untreated in South Korea. Methods: This retrospective study analyzed GI patients seeking gender-affirming hormone therapy (GAHT) or surgery between 2015 and 2021. The recorded data included gender identity, legal transition status, age of onset of GI, age at the initiation of therapy, and total therapy duration. Results: In total, 337 patients were enrolled, including 149 (44.2%) transgender men, 153 (45.4%) transgender women, and 35 (10.4%) non-binary individuals. The mean age of onset of GI was 10.6 years (standard deviation, 5.1). Of the total patients, 29% had an onset of GI before age 6 years (preschool), 61% before age 12 (elementary-school), and 87% before age 15 (middle-school). Patients lived with GI for almost 14 years before GAHT initiation at a median age of 23.0 years. 90% of transgender men, 82.3% of transgender women, and 85% of non-binary patients disclosed their gender identities to their families. Regarding social transition, 31.5% of transgender men, 16.3% of transgender women, and none of the non-binary patients (P<0.005) changed their legal gender markers. Conclusion Many transgender and non-binary individuals experience GI early in life. These findings emphasized the need for early evaluation, timely gender-affirming care, and more accessible legal processes for gender marker changes in South Korea, aiming to enhance the safety and well-being of these individuals.

The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and beta-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including beta-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.
Adrenal Cortex Hormones ; Adult ; Antithyroid Agents ; Cholestyramine Resin* ; Drug Resistance ; Female ; Glycogen Storage Disease Type VI ; Graves Disease* ; Humans ; Hypersensitivity ; Iodine ; Thyroid Function Tests ; Thyroid Gland ; Thyroidectomy* ; Thyrotoxicosis

PURPOSE: To analyze the effect of allogeneic blood transfusion on clinical outcome in 119 patients with stage IIB cervical cancer who were treated with radiotherapy +/- chemotherapy. PATIENTS AND METHODS: Medical records were examined for hemoglobin levels before and during radiotherapy, history of allogeneic blood transfusions and the time point when transfusions were given. These factors were retrospectively analyzed along with other clinical risk factors for influences on the patients' clinical outcomes. RESULTS: Thirty-two patients (26.9%) received packed red blood cell transfusion (mean, 3.4 units; range, 1-12 units) before or during radiotherapy. Median follow-up period was 39.3 months (range, 7.6-58.4 months). Patients with history of transfusion showed poorer metastasis-free survival and a trend toward poorer overall survival than non-transfused patients. When patients who received transfusions were sub-divided by the time of transfusion, those who received transfusions before radiotherapy had significantly poorer clinical outcome than those who received transfusions during radiotherapy. In a multivariable analysis, patients with pretreatment transfusion showed a higher risk of distant metastasis (HR = 3.75, 95% CI: 1.28-12.15, p = 0.017) and decreased overall survival rates (HR = 4.62, 95% CI: 1.15-18.54, p = 0.031) compared with those of other patients. CONCLUSION: Our results suggest that allogeneic blood transfusions given before radiotherapy may be associated with higher incidence of distant metastases and decreased survival in patients with stage IIB cervical cancer.
Adult ; Aged ; Aged, 80 and over ; Anemia/etiology/therapy ; Blood Transfusion/*adverse effects ; Carcinoma, Squamous Cell/complications/radiotherapy/secondary/therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Treatment Outcome ; Uterine Cervical Neoplasms/complications/*radiotherapy/*therapy ; Young Adult

In 2009, infection with the liver fluke Clonorchis sinensis (C. sinensis) was classified as "carcinogenic to humans" (Group 1) based on its involvement in the etiology of cholangiocarcinoma by the International Agency for Research on Cancer. However, little is known about the descriptive epidemiology of cholangiocarcinoma in Korea. We examined incidence trends of intrahepatic and extrahepatic cholangiocarcinomas, using data from the Korea National Cancer Incidence database for 1999-2005. The prevalence of C. sinensis infection was estimated from a recent population-based survey in rural endemic areas. Cholangiocarcinoma incidence rates are currently rising, even while primary liver cancer incidence rates are decreasing. Annual percent changes in cholangiocarcinoma incidence rates were 8% for males and 11% in females. Known areas of C. sinensis endemicity showed high incidence rates of cholangiocarcinoma. The positivity of C. sinensis eggs in stool samples from endemic areas was more than 25% of adults tested during 2005-2008. From a meta-analysis, the summary odds ratio for cholangiocarcinoma due to C. sinensis infection was 4.7 (95% confidence interval: 2.2-9.8). Approximately 10% of cholangiocarcinomas in Korea were caused by chronic C. sinensis infections. More specific policies, including health education and an extensive effort for early detection in endemic areas, are needed.
Adult ; Aged ; Aged, 80 and over ; Animals ; Bile Duct Neoplasms/*epidemiology/parasitology ; Bile Ducts, Intrahepatic/parasitology/*pathology ; Cholangiocarcinoma/*epidemiology/parasitology ; Clonorchiasis/*epidemiology ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged

BACKGROUND: The tall cell variant of papillary thyroid carcinoma (TCVPTC) is more aggressive than classic papillary thyroid carcinoma (PTC), but the percentage of tall cells needed to diagnose TCVPTC remains controversial. In addition, little is known about the clinicopathologic features of classic PTC with tall cell features (TCF). METHODS: We retrospectively selected and reviewed the clinicopathologic features and presence of the BRAF mutation in 203 cases of classic PTC, 149 cases of classic PTC with TCF, and 95 cases of TCVPTCs, which were defined as PTCs having <10%, 10-50%, and > or =50% tall cells, respectively. RESULTS: TCVPTCs and classic PTCs with TCF did not vary significantly in clinicopathologic characteristics such as pathologic (p) T stage, extrathyroidal extension, pN stage, lateral lymph node metastasis, or BRAF mutations; however, these features differed significantly in TCVPTCs and classic PTCs with TCF in comparison to classic PTCs. Similar results were obtained in a subanalysis of patients with microcarcinomas (< or =1.0 cm in size). CONCLUSIONS: Classic PTCs with TCF showed a similar BRAF mutation rate and clinicopathologic features to TCVPTCs, but more aggressive characteristics than classic PTCs.
Classification ; Humans ; Lymph Nodes ; Mutation Rate ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Neoplasms*

Objective: We evaluated the incidence of newly diagnosed gestational diabetes mellitus (GDM) during the 3rd trimester in women with suspected large for gestational age (LGA) fetuses on ultrasound and assessed their perinatal outcomes. Methods: A retrospective cohort study was performed. Singleton pregnant women with suspected LGA on the 3rd trimester ultrasound and whose results of GDM screening at midpregnancy had been normal were enrolled. All participants were retested with 100-g oral glucose tolerance test (OGTT) within 2 days after diagnosis of LGA. We compared perinatal outcomes between the newly diagnosed with GDM group and the non-GDM group. Results: Among 169 pregnant women, 13% (23/169) were newly diagnosed with GDM. The women in the GDM group had a higher HbA1c level at diagnosis (5.8 vs. 5.3, P<0.01) and earlier gestational age at delivery (38.0 vs 38.9 weeks of gestation, P=0.003) than those in the non-GDM group. The rate of cesarean delivery (CD) was significantly higher in the GDM group than that in the non-GDM group (73.9%, vs. 49.3%, P=0.028) with similar proportions for the indications of CD except CD on maternal request (CDMR). The CDMR rate was higher in the GDM group than nonGDM group (41.2% vs. 23.6%) but it did not reach statistical significance. There were no significant differences in the obstetrical and neonatal complications between the two groups. Conclusion Among pregnant women with suspected LGA, 13% were newly diagnosed with GDM in late pregnancy. Nonetheless, there were no differences in the perinatal outcomes between women with newly diagnosed GDM and those without GDM. However, concerns over shoulder dystocia appear to increase CD rates in the GDM group.

Objective: We evaluated the incidence of newly diagnosed gestational diabetes mellitus (GDM) during the 3rd trimester in women with suspected large for gestational age (LGA) fetuses on ultrasound and assessed their perinatal outcomes. Methods: A retrospective cohort study was performed. Singleton pregnant women with suspected LGA on the 3rd trimester ultrasound and whose results of GDM screening at midpregnancy had been normal were enrolled. All participants were retested with 100-g oral glucose tolerance test (OGTT) within 2 days after diagnosis of LGA. We compared perinatal outcomes between the newly diagnosed with GDM group and the non-GDM group. Results: Among 169 pregnant women, 13% (23/169) were newly diagnosed with GDM. The women in the GDM group had a higher HbA1c level at diagnosis (5.8 vs. 5.3, P<0.01) and earlier gestational age at delivery (38.0 vs 38.9 weeks of gestation, P=0.003) than those in the non-GDM group. The rate of cesarean delivery (CD) was significantly higher in the GDM group than that in the non-GDM group (73.9%, vs. 49.3%, P=0.028) with similar proportions for the indications of CD except CD on maternal request (CDMR). The CDMR rate was higher in the GDM group than nonGDM group (41.2% vs. 23.6%) but it did not reach statistical significance. There were no significant differences in the obstetrical and neonatal complications between the two groups. Conclusion Among pregnant women with suspected LGA, 13% were newly diagnosed with GDM in late pregnancy. Nonetheless, there were no differences in the perinatal outcomes between women with newly diagnosed GDM and those without GDM. However, concerns over shoulder dystocia appear to increase CD rates in the GDM group.

Objective: With the recent development of various MRI-conditional cardiac implantable electronic devices (CIEDs), the accurate identification and characterization of CIEDs have become critical when performing MRI in patients with CIEDs. We aimed to develop and evaluate a deep learning-based algorithm (DLA) that performs the detection and characterization of parameters, including MRI safety, of CIEDs on chest radiograph (CR) in a single step and compare its performance with other related algorithms that were recently developed. Materials and Methods: We developed a DLA (X-ray CIED identification [XCID]) using 9912 CRs of 958 patients with 968 CIEDs comprising 26 model groups from 4 manufacturers obtained between 2014 and 2019 from one hospital. The performance of XCID was tested with an external dataset consisting of 2122 CRs obtained from a different hospital and compared with the performance of two other related algorithms recently reported, including PacemakerID (PID) and Pacemaker identification with neural networks (PPMnn). Results: The overall accuracies of XCID for the manufacturer classification, model group identification, and MRI safety characterization using the internal test dataset were 99.7% (992/995), 97.2% (967/995), and 98.9% (984/995), respectively. These were 95.8% (2033/2122), 85.4% (1813/2122), and 92.2% (1956/2122), respectively, with the external test dataset. In the comparative study, the accuracy for the manufacturer classification was 95.0% (152/160) for XCID and 91.3% for PPMnn (146/160), which was significantly higher than that for PID (80.0%,128/160; p < 0.001 for both). XCID demonstrated a higher accuracy (88.1%; 141/160) than PPMnn (80.0%; 128/160) in identifying model groups (p < 0.001). Conclusion The remarkable and consistent performance of XCID suggests its applicability for detection, manufacturer and model identification, as well as MRI safety characterization of CIED on CRs. Further studies are warranted to guarantee the safe use of XCID in clinical practice.