An analysis of the educational needs priorities for clinical nurse educators: Utilizing the Borich needs assessment and the locus for focus model / 한국간호교육학회지

Purpose@#This study used a descriptive investigative design to compare the educational needs and priorities of education-dedicated nurses and preceptors regarding clinical nurse educator competency. @*Methods@#A survey was conducted from March to April 2023 with 308 participants, including 140 education-dedicated nurses and 168 preceptors. The collected data were analyzed using descriptive statistics and a paired t-test with the IBM SPSS 26.0 program. For the purpose of analyzing educational needs, we further analyzed data through the Borich needs assessment and the locus for focus model. @*Results@#Among the clinical nurse educator competency, both education-dedicated nurses and preceptors identified “new theory and practice” as the highest priority educational need. Additionally, education-dedicated nurses prioritized “teaching design ability,” “teaching evaluation ability,” and “evidence-based nursing/practice and research,” while preceptors prioritized “clinical nursing knowledge” and “professional development ability” as their educational needs. @*Conclusion@#While both education-dedicated nurses and preceptors responded that education is necessary for all the competency areas required of clinical nurse educators, variations were observed in their reported educational needs and priorities. Thus, it is imperative to develop and implement a differentiated education program for enhancing the competency of clinical nurse educators that considers the distinct requirements of education-dedicated nurses and preceptors.

The Association Between Alcohol Use and Suicidal Ideation Among Employees

Objective@#The risk of suicide is assessed by identifying the relationship between alcohol-use patterns and suicidal ideation in Korean employees. @*Methods@#The study involved 13,858 employees who underwent workplace mental health screening at the Workplace Mental Health Institute of Kangbuk Samsung Hospital over a 6-year period between 2014 and 2019. Analysis was performed separately for Alcohol Use Disorders Identification Test-Korea (AUDIT-K) items related to the frequency/volume of alcohol consumption (items 1 to 3, AUDIT-C) and those regarding alcohol dependence/related problems (items 4 to 10, AUDIT-D/P). Subjects were then classified into three groups on the basis of the presence or absence of clinical depression and suicidal ideation. The groups’ sociodemographic factors and clinical features of depression, anxiety, and alcohol-use patterns were analyzed with a chi-square test as well as one-way analysis of variance, followed by a post hoc test using the Bonferroni correction. @*Results@#AUDIT-K and AUDIT-D/P scores were significantly associated with the presence or absence of clinical depression as well as the presence or absence of suicidal ideation (p<0.05). However, no significant differences were found among the three groups with regard to the AUDIT-C score (p=0.054). @*Conclusion@#Identifying or treating alcohol dependence/related problems can help lower the occurrence of mental health problems, and suicidal ideation in particular, in employees and reduce social costs.

Effects of low-level laser therapy and adipose-derived stem cells on the viability of autologous fat grafts: a preliminary study

Background@#Autologous fat grafts are commonly used in cosmetic and reconstructive surgery, and various methods are used to improve their viability. Low-level laser therapy (LLLT) can enhance the proliferation, growth, and differentiation of various cell lines, including stem cells. Our study investigated and compared the effects of LLLT and the addition of adipose-derived stem cells (ADSCs) on the viability of fat grafts. @*Methods@#Twenty nude mice were divided into four groups: control (group 1), LLLT irradiation (group 2), ADSC addition (group 3), and LLLT irradiation+ADSC addition (group 4). ADSCs were combined with the fat tissue. LLLT irradiation was performed once daily for 1 week from the day of grafting. After 8 weeks, the weight, volume, histology, and Western blot findings of the grafted fat tissues were evaluated. @*Results@#The retention rate and volume of the fat tissue in groups 2, 3, and 4 were higher than that of group 1, but the difference was not statistically significant. The number of capillaries, histological parameters, and immunofluorescence staining analyses for CD68, CD31, fibroblast growth factor, and vascular endothelial growth factor (VEGF) showed no significant differences among the four groups. The expression level of VEGF was higher in group 2 than in the other groups, but not to a statistically significant level. @*Conclusions@#LLLT and ADSCs did not significantly improve the viability of autologous fat grafts. Therefore, further study is necessary to develop safe and effective methods to improve the viability of these grafts for clinical application.

Effects of low-level laser therapy and adipose-derived stem cells on the viability of autologous fat grafts: a preliminary study

Background@#Autologous fat grafts are commonly used in cosmetic and reconstructive surgery, and various methods are used to improve their viability. Low-level laser therapy (LLLT) can enhance the proliferation, growth, and differentiation of various cell lines, including stem cells. Our study investigated and compared the effects of LLLT and the addition of adipose-derived stem cells (ADSCs) on the viability of fat grafts. @*Methods@#Twenty nude mice were divided into four groups: control (group 1), LLLT irradiation (group 2), ADSC addition (group 3), and LLLT irradiation+ADSC addition (group 4). ADSCs were combined with the fat tissue. LLLT irradiation was performed once daily for 1 week from the day of grafting. After 8 weeks, the weight, volume, histology, and Western blot findings of the grafted fat tissues were evaluated. @*Results@#The retention rate and volume of the fat tissue in groups 2, 3, and 4 were higher than that of group 1, but the difference was not statistically significant. The number of capillaries, histological parameters, and immunofluorescence staining analyses for CD68, CD31, fibroblast growth factor, and vascular endothelial growth factor (VEGF) showed no significant differences among the four groups. The expression level of VEGF was higher in group 2 than in the other groups, but not to a statistically significant level. @*Conclusions@#LLLT and ADSCs did not significantly improve the viability of autologous fat grafts. Therefore, further study is necessary to develop safe and effective methods to improve the viability of these grafts for clinical application.

Associations of Physical Activity and Sitting Time with Serum Vitamin D Status in Korean Adults: Results from the 2014 Korea National Health and Nutrition Examination Survey

Background@#Recent evidence has reported the relationships between 25-hydroxyvitamin D (25[OH]D) insufficiency and chronic diseases. This study examined the association of physical activity and sitting time with vitamin D status. @*Methods@#This study analyzed the data of 1,598 adults aged ≥19 who participated in the 2014 Korea National Health and Nutrition Examination Survey. Vitamin D insufficiency was defined as a serum 25(OH)D level of ≤20 ng/mL. The odds ratios and 95% confidence intervals of vitamin D insufficiency according to physical activity and sitting time were calculated using a multivariable logistic regression analysis. @*Results@#The mean levels of serum 25(OH)D were 16.5 ng/mL in males and 15.2 ng/mL in females, respectively and was significantly higher in the participants with sitting times of <5 hours/day than those with sitting times of ≥5 hours/day. After adjusting for confounding variables, sitting time of <5 hours/day was associated with decreased odds of vitamin D insufficiency as compared with sitting time of ≥5 hours/day in the total participants and females. In addition, the odds ratio for vitamin D insufficiency was significantly lower in the group with sitting times of <5 hours/ day than in the group with sitting times of ≥5 hours/day even among people with low physical activity in the total participants and females. @*Conclusion@#Serum 25(OH)D level was insufficient in the Korean adults and shorter sitting time was related to lower odds ratio of vitamin D insufficiency. Our findings suggest that sitting time is an independent factor of serum vitamin D status.

Successful Treatment of Acquired Perforating Dermatosis in a Peritoneal Dialysis Patient Using Oral Isotretinoin / 대한내과학회지

Acquired perforating dermatosis (APD) triggers severe itching, and is observed most often in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Various treatments, such as topical steroids, topical and oral retinoids, allopurinol, and ultraviolet B (UVB) phototherapy, have been used. However, as the precise etiology is unknown, there are a lack of well-established treatment guidelines. We report a peritoneal dialysis patient with a diagnosis of APD who was resistant to topical steroids, phototherapy, allopurinol, and topical retinoids. Severe pruritus persisted, which compromised his ability to lead a normal life. As a final treatment option, we used oral isotretinoin and the patient experienced a dramatic improvement.

Outcome Differences by Delirium Motor Subtype in Patients with Ischemic Stroke

OBJECTIVE: This study evaluated the outcomes of ischemic stroke patients according to delirium motor subtype.METHODS: This study included patients who were admitted to the stroke unit between August 2017 and March 2019 and met the DSM-5 diagnostic criteria for delirium. Patients were assessed twice weekly throughout their delirium episodes using the Korean version of the Delirium Motor Subtype Scale (K-DMSS) and the Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-98). The clinical characteristics and short-term outcomes of the patients were also assessed.RESULTS: A total of 943 stroke patients were included; the rate of incident delirium was 10.18%. Of the 95 delirium patients, 34 were classified as the hyperactive subtype, 30 as the mixed subtype, 25 as the hypoactive and six as no subtype. Among the subtype groups, the hypoactive subtype had the highest initial scores on the National Institutes of Health Stroke Scale (NIHSS; 6.72±4.75, p=0.02) and the modified Rankin Scale (mRS; 3.96±1.24, p<0.01). Additionally, the mixed and hypoactive subtypes had longer durations (p<0.01) and more severe symptoms of delirium (p=0.03) than the other motor subtypes, and the hypoactive subtype group had a significantly longer hospital stay (36.88±27.71 days, p<0.01) than the other subtype groups. After adjusting for baseline covariates in a multiple linear regression analysis, these differences remained significant.CONCLUSION: The present results suggest that the motor subtype of delirium is associated with different characteristics and outcomes in ischemic stroke patients.

Non-Enhancing Primary Central Nervous System Lymphoma

No abstract available.

Factor Analysis of Delirium in Elderly, Using the Korean Version of Delirium Rating Scale-Revised-98

OBJECTIVE: This study aimed to identify the core symptoms of delirium, particularly in elderly people associated with major risk factors, using the Korean version of the Delirium Rating Scale-Revised-98. METHODS: The study sample consisted of 200 patients (mean age: 72.7±3.9 years, male: 68.5%) who had been diagnosed with delirium. Exploratory factor analysis was used to investigate the factor structure, and confirmatory factor analysis was used to evaluate the goodness of fit of the results. RESULTS: The results demonstrated three core domains of delirium in the elderly patients: 1) the cognitive domain (e.g., language, thought process, orientation, attention, long-term memory, and visuospatial ability); 2) the circadian domain (e.g., sleep-wake cycle and motor behavior); and 3) the short-term memory domain (short-term memory). These results were confirmed by confirmatory factor analysis. CONCLUSION: The findings of this study suggest a theoretical domain structure for delirium in elderly patients.

Validation of the Korean Version of the Delirium Motor Subtype Scale

OBJECTIVE: The Delirium Motor Subtype Scale (DMSS) is a validated and reliable instrument developed from various methods previously used to assess delirium motor subtypes. It focuses on pure motor disturbances with a relative specificity for delirium. The aim of this study was to investigate the validity and reliability of a Korean version of the DMSS (K-DMSS). METHODS: We recruited 145 patients who were older than 60 years and had been referred for psychiatric consultation for delirium. These patients were evaluated using the K-DMSS, Liptzin & Levkoff criteria, and the Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-R98) to compare delirium motor subtypes. RESULTS: The internal consistency of the K-DMSS in assessing delirium motor subtypes was acceptable (Cronbach's alpha=0.79). Delirium motor subtypes identified with the K-DMSS and K-DRS-R98 showed almost perfect agreement (Cohen's Kappa=0.81), while those identified with the K-DMSS and Liptzin & Levkoff criteria showed substantial agreement (Cohen's Kappa=0.78). CONCLUSION: Our results suggest that the K-DMSS is a valid and reliable tool for identifying delirium subtypes.

Dural Metastases from Prostate Cancer

No abstract available.

Prevalence of Suicidal Ideation and Associated Factors among Community-Dwelling Korean Elderly

OBJECTIVE: This study aimed to evaluate the relationship between suicidal ideation and its associated clinical factors among community-dwelling elderly in Korea. METHODS: A cross-sectional survey was conducted using the data obtained from the face to face interviews of 1,500 (mean age : 74.41±6.44, male : 41.0%) elderly people aged 65 or above living in the community. The questionnaire used in this study was composed of detailed questions about the clinical characteristics including sociodemographic, life style, physical status, and psychiatric factors. In order to assess the suicidal ideation, the subjects were asked questions about the suicidal idea in the past year. RESULTS: A total of 156 (10.4%) elderly reported the suicidal ideation over the last year. Multiple logistic regression analysis revealed significant correlation with dissatisfaction with life [odds ratio (OR) 4.41, 95% confidence interval (CI) 1.55-12.60], depression (OR 2.87, 95% CI 1.62-5.07), cognitive decline (OR 2.38, 95% CI 1.38-4.10), poor perception of health (OR 2.34, 95% CI 1.04-5.24), and insomnia (OR 2.24, 95% CI 1.31-3.84). CONCLUSION: These results showed the several clinical factors associated with suicidal ideation among community-dwelling elderly living in Korea. The present study suggested the necessity for the various aspects of approach.

Comparative Analysis of Emotional Symptoms in Elderly Koreans with Hwa-Byung and Depression

OBJECTIVE: This study compared the symptomatic emotional traits of elderly South Korean patients with hwa-byung and those with depression. METHODS: We enrolled 58 patients with hwa-byung, 180 patients with depression, and 181 healthy control subjects. All participants completed the Hwa-byung Scale, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Geriatric Depression Scale (GDS), State Trait Anger Expression Inventory (STAXI), Reaction Inventory (RI), and Aggression Questionnaire (AQ). Chi-square tests and a one-way analysis of variance with Games-Howell post-hoc tests were used to compare demographic variables and scores. RESULTS: A binary logistic regression analysis was used to examine risk factors for hwa-byung. Scores in the hwa-byung group were higher than those in the depression group for the HDRS; BDI; GDS; trait anger STAXI subscale (trait anger temperament and trait anger reaction); state anger and anger expression STAXI subscales (anger-in, anger-out, and anger control); physical and verbal aggression as well as anger and hostility AQ subscales; and disturbance, embarrassing circumstances, personal disrespect, and unpleasant encounters RI subscales. A binary logistic regression analysis demonstrated that the state anger STAXI subscale, verbal aggression and anger AQ subscales, and unpleasant encounters RI subscale were significantly associated with hwa-byung. CONCLUSION: Elderly patients with hwa-byung had more severe anger traits and states as well as higher depression severity compared to those diagnosed with clinical depression. Excessive anger and anger reactivity to unpleasant factors may be risk factors for hwa-byung, whereas the appropriate expression (rather than suppression) of anger may decrease the risk of hwa-byung.

Epicardial Cyst Originating from Right Ventricle

Pericardial cysts are reported by some authors, but epicardial cysts are extremely rare. We report one case of epicardial cyst that was detected incidentally and was removed successfully. Furthermore, unusually, pathological examinations confirmed that the cyst wall was looked like a vessel wall.

Human Papillomavirus Prevalence and Cell Cycle Related Protein Expression in Tonsillar Squamous Cell Carcinomas of Korean Patients with Clinicopathologic Analysis

BACKGROUND: Human papillomavirus (HPV)-related tonsillar squamous cell carcinoma (TSCC) has recently been characterized as a distinct subset with a favorable prognosis. The prevalence and clinicopathologic significance of HPV-related TSCC in Koreans are not well known. METHODS: HPV in situ hybridization (ISH) accompanied by p53, p16, pRb, and cyclin D1 immunohistochemical staining were performed on 89 resection cases of TSCC from 2000 through 2010. RESULTS: HPV was detected by ISH in 59 of 89 cases (66.3%). HPV-positive TSCCs were more common in younger ages (p=0.005), and tumor sizes were smaller in the HPV-positive compared to the HPV-negative group (p=0.040). Positive HPV staining was significantly correlated with p16 expression (p<0.001), pRb inactivation (p=0.003), and cyclin D1 down-regulation (p<0.001) but not with p53 expression (p=0.334). Seventeen cases that showed p16-immunopositivity with HPV-negativity by ISH were retested by HPV typing; HPV DNA was not detected in all cases. There was no significant difference between HPV-positive and HPV-negative patients either in the disease-specific survival (DSS, p=0.857) or overall survival (p=0.910). Furthermore, pRb-inactivated cases showed better DSS (p=0.023), and p53-positive cases showed worse DSS (p=0.001). CONCLUSIONS: Although high HPV prevalence was noted, it was not correlated with histopathologic findings or survival benefit. In addition to p53 expression, pRb inactivation along with p16 overexpression and down-regulation of cyclin D1 are thought to be important pathogenetic steps for developing TSCCs.

EBV-positive diffuse large B-cell lymphoma of the elderly with aberrant expression of CD3 and TIA-1

No abstract available.

Clinicopathologic Features of Q Fever Patients with Acute Hepatitis

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.

Clinicopathologic Features of Q Fever Patients with Acute Hepatitis

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.