Background: Living-donor liver transplantation (LDLT) is a viable alternative to deceased-donor liver transplantation. Enhanced recovery after surgery protocols that include early extubation offer short-term benefits; however, the effect of immediate extubation in the operating room (OR) on long-term outcomes in patients undergoing LDLT remains unknown. We hypothesized that immediate OR extubation is associated with improved long-term outcomes in patients undergoing LDLT. Methods: This retrospective cohort study included 205 patients who underwent LDLT. The patients were classified based on the extubation location as OREX (those extubated in the OR) or NOREX (those extubated in the intensive care unit [ICU]). The primary outcome was overall survival (OS), while secondary outcomes included ICU stay, hospital stay duration, and various postoperative outcomes. Results: Among the 205 patients, 98 (47.8%) underwent extubation in the OR after LDLT. Univariate analysis revealed that OR extubation did not significantly affect OS (hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.24–1.05; P = 0.066). Furthermore, multivariate analysis revealed no statistically significant association between OR extubation and OS (HR: 0.79, 95% CI: 0.35–1.80; P = 0.580). However, OR extubation was significantly associated with a lower incidence of 30-day composite complications and shorter ICU and hospital stays. Multivariate analysis indicated that higher preoperative platelet counts, increased serum creatinine levels, and a longer surgery duration were associated with poorer OS. Conclusions Immediate OR extubation following LDLT surgery was associated with fewer 30-day composite complications and shorter ICU and hospital stays; however, it did not significantly improve OS compared with ICU extubation.

Objectives: The study aim was to analyze smoking knowledge and smoking cessation intentions according to the stage of change in smoking cessation behavior among smokers in their 20s. This program was implemented to prepare smoking cessation educational content in order to increase the success rate of smoking cessation. Methods: The analysis included 99 smokers in their 20s who lived in Seoul and Gyeonggi; the study period was February 14-16, 2024. After explaining the study purpose and obtaining consent for participation in the study, an online Google Forms survey was conducted. Results: Smoking cessation intention and smoking knowledge according to the smoking cessa-tion behavior change stage were significantly different depending on the presence of smokers and whether they attempted smoking cessation in the pre-contemplation period (P<0.05). In addition, the intention to quit smoking significantly increased in the pre-contemplation, contemplation, and preparation periods in the smoking cessation behavior change stage (P<0.001). Conclusions By operating a smoking cessation intervention program for smokers in their 20s, pro-viding correct smoking knowledge and finding ways to increase smoking cessation intention, smok-ers’ behavior can change and they can form a quitting habit. Therefore, we can expect that even middle-aged or older people can quit smoking.

Background: Although the consumption of vitamin beverages has increased because of the recent interest in health and beauty, guidelines addressing appropriate consumption habits are lacking. Thus, the aim of this study was to investigate the erosive potential of several vitamin beverages and to propose guidelines for the appropriate intake of these drinks. Methods: Five vitamin beverages were selected after a pre-investigation of the current beverage market. Coca-Cola and mineral water were selected as the control beverages. The pH of the beverages was measured with a calibrated pH meter, and the titratable acidity (TA) was determined by using 1 M sodium hydroxide to reach pH 5.5 (TA5.5) and 7.0 (TA7.0). The screening method suggested by the International Organization for Standardization was used to measure pH variation (pH) by using an under-saturated hydroxyapatite solution to determine the difference between the initial and final pH of the screening solution. All measurements were performed in triplicate. Results: All vitamin beverages tested in this study exhibited a low pH (2.53∼2.99), similar to Coca-Cola, which is known to be a highly acidic beverage. The highest TA5.5 and TA7.0 values of the vitamin beverages were 7.03 ml and 8.81 ml, respectively. The largest change in pH determined by using the screening solution was found in Bacchus D (pH 1.44±0.05). The mean pH of the vitamin beverages was 1.12±0.29, which was higher than that of Coca-Cola (positive control, pH 0.58±0.05). Conclusion Vitamin beverages exhibited an erosive potential capable of damaging enamel surfaces. Therefore, the frequency of vitamin beverage intake should be limited, and individuals consuming these drinks should try to restore normal oral pH as quickly as possible.

PURPOSE: This study aimed to confirm the mediating effect of job involvement in the relationship between grit and turnover intention among nurses working at university hospitals. METHODS: Participants included 437 nurses from university hospitals located in C city, Gyeongnam. Data were collected from January 8 to 19, 2018, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient, and multiple regression, with the SPSS/22.0 program. A mediation analysis was performed according to the Baron and Kenny, and bootstrapping methods. RESULTS: There were significant relationships between grit and job involvement (r=.40, p<.001), grit and turnover intention (r=−.29, p<.001), and turnover intention and job involvement (r=−.52, p<.001). Job involvement showed partial mediating effects in the relationship between grit and turnover intention. CONCLUSION Grit increased job involvement and lowered turnover intention. Therefore, to reduce nurses' turnover intention, it is necessary to develop a program and strategies to increase their grit.

PURPOSE: This study aimed to confirm the mediating effect of job involvement in the relationship between grit and turnover intention among nurses working at university hospitals. METHODS: Participants included 437 nurses from university hospitals located in C city, Gyeongnam. Data were collected from January 8 to 19, 2018, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient, and multiple regression, with the SPSS/22.0 program. A mediation analysis was performed according to the Baron and Kenny, and bootstrapping methods. RESULTS: There were significant relationships between grit and job involvement (r=.40, p<.001), grit and turnover intention (r=−.29, p<.001), and turnover intention and job involvement (r=−.52, p<.001). Job involvement showed partial mediating effects in the relationship between grit and turnover intention. CONCLUSION: Grit increased job involvement and lowered turnover intention. Therefore, to reduce nurses' turnover intention, it is necessary to develop a program and strategies to increase their grit.
Hospitals, University ; Intention ; Job Syndrome ; Negotiating ; Personnel Turnover

PURPOSE: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). METHODS: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and χ2-test. RESULTS: Although there was no significant difference in 75g OGTT (χ2=.11, p=.748) or self-management (t=−1.28, p=.206), there was a statistically significant increase in self-efficacy (t=−2.02, p=.048) in the experimental group compared to that in the control group. CONCLUSION: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.
Blood Glucose ; Counseling ; Diabetes, Gestational* ; Education ; Female ; Glucose Tolerance Test ; Humans ; Postnatal Care* ; Postpartum Period ; Pregnancy ; Self Care* ; Telephone

The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.
Cross-Sectional Studies ; Data Collection ; Dental Hygienists ; Discrimination (Psychology) ; Education ; Expert Testimony ; Humans ; Hygiene ; Learning* ; Medical Assistance ; Oral Health* ; Oral Hygiene* ; Social Security

BACKGROUND: Immunoglobulin E (IgE) has traditionally been associated with anaphylaxis and atopic disease. Previous studies reported that serum IgE levels are elevated in nephrotic syndrome and suggested IgE levels as a prognostic indicator in glomerular diseases. The aim of this study was to explore the association between serum IgE levels and renal outcome in patients with immunoglobulin A nephropathy (IgAN). METHODS: We included 117 patients with biopsy-proven IgAN. Renal progression was defined if a patient meets one of these criteria: (1) a negative value of delta estimated glomerular filtration rate (mL/min/1.73 m²/mo) or (2) a rise in serum creatinine to an absolute level of ≥ 1.3 mg/dL (male) or 1.2 mg/dL (female). We defined delta changes in serum creatinine, estimated glomerular filtration rate, and proteinuria as a difference of values during the follow-up period. RESULTS: A total of 117 patients with IgAN were included. The serum IgE level was significantly high in the renal progressive group compared with the nonprogressive group. Sex and history of gross hematuria were significantly different between the high-IgE group and the low-IgE group. Regression analysis showed that a male sex, initial proteinuria, and change of proteinuria were significantly associated with serum IgE levels. CONCLUSION: The serum IgE level is potentially associated with disease progression and pathogenesis of IgAN.
Anaphylaxis ; Creatinine ; Disease Progression ; Follow-Up Studies ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulin E* ; Immunoglobulins* ; Male ; Nephrotic Syndrome ; Proteinuria

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Mucormycosis of the gastrointestinal tract manifests with features similar to ischemic colitis. A 48-year-old man with end-stage renal disease due to diabetic nephropathy underwent deceased donor kidney transplantation. He complained of abdominal pain and distension on postoperative day 17. A computed tomography (CT) scan revealed symmetrical wall thickening of the ascending colon, which was consistent with ischemic colitis. However, a follow-up CT scan showed a localized wall-off colon perforation in the hepatic flexure and segmental mural gas in the ascending colon. Microscopic examination obtained from a surgical specimen demonstrated numerous fungal hyphae and spores in the mucosa and submucosa. A total colectomy was performed, but the patient died 36 days later due to multiple organ failure, despite antifungal agents. Clinicians should be informed about fungal infection, such as colonic mucormycosis mimicking ischemic colitis, in kidney transplant patients with diabetes mellitus, and treatment should be initiated at the earliest.
Abdominal Pain ; Antifungal Agents ; Colectomy ; Colitis, Ischemic* ; Colon* ; Colon, Ascending ; Diabetes Mellitus ; Diabetic Nephropathies ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Hyphae ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Middle Aged ; Mucormycosis* ; Mucous Membrane ; Multiple Organ Failure ; Spores ; Tissue Donors ; Tomography, X-Ray Computed ; Transplant Recipients*

BACKGROUND: The objective of the current study was to determine whether there was an association between urinary albumin excretion and cardiovascular disease (CVD) risk by estimating the Framingham Risk Score (FRS) in postmenopausal women without diabetes. METHODS: This study was based on data from the Korea National Health and Nutrition Examination Survey, which was conducted by the Korean Ministry of Health and Welfare in 2011 to 2013. Data on 2,316 postmenopausal women from a total of 24,594 participants was included in the analysis. RESULTS: The mean FRS was significantly different in each of the urinary albumin to creatinine ratio (UACR) subgroups, and it increased with UACR. The FRS was 12.69±0.12 in the optimal group, 14.30±0.19 in the intermediate normal group, 14.62±0.26 in the high normal group, and 15.86±0.36 in the microalbuminuria group. After fully adjusting for potential confounding factors, high normal levels and microalbuminuria were significantly associated with the highest tertile of FRS ([odds ratio (OR), 1.642; 95% confidence interval (CI), 1.124 to 2.400] and [OR, 3.385; 95% CI, 2.088 to 5.488], respectively) compared with the optimal subgroup. High normal levels and microalbuminuria were also significantly associated with a ≥10% 10-year risk of CVD ([OR, 1.853; 95% CI, 1.122 to 3.060] and [OR, 2.831; 95% CI, 1.327 to 6.037], respectively) after adjusting for potential confounding covariates. CONCLUSION: Urinary albumin excretion reflects CVD risk in postmenopausal women without diabetes, and high normal levels and microalbuminuria were independently associated with a higher risk of CVD.
Cardiovascular Diseases ; Creatinine ; Female ; Humans ; Korea ; Nutrition Surveys* ; Postmenopause