PURPOSE: This study was done to identify the meaning and substantial nature of NICU practice among nursing students by applying a research method based on hermeneutic phenomenology in an attempt to lay a foundation for enhancing theoretical and practical child nursing education. METHODS: The participants were eight nursing student who had experience in clinical practicing in NICU. In-depth interviews were performed from April to December, 2014 until data were fully saturated. Collected data were analyzed using Colaizzi's method. RESULTS: Seven theme clusters were extracted from fourteen themes. The seven theme clusters of the nursing students' clinical practice experience in NICU were: 1) Excitement about the clinical practice setting 2) Afraid of practice environment 3) Babies have priority over clinical practice 4) Comparing with adult nursing clinical practice 5) Feeling pity for babies and their parents 6) New awareness about the role of nurses 7) Demands of enhancing clinical practice. CONCLUSION: The results of the study provide useful information in understanding nursing students' practice experience in NICU and establishing effective strategies to support these nursing students.
Adult ; Child ; Education, Nursing ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Nursing* ; Parents ; Qualitative Research ; Students, Nursing

We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service–National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20–29 and 30–39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

Background: Although cardiovascular outcome trials using sodium-glucose cotransporter-2 inhibitors (SGLT-2i) showed a reduction in risk of 3-point major adverse cardiovascular events (MACE), they did not demonstrate beneficial effects on stroke risk. Additionally, meta-analysis showed SGLT-2i potentially had an adverse effect on stroke risk. Contrarily, pioglitazone, a type of thiazolidinedione (TZD), has been shown to reduce recurrent stroke risk. Thus, we aimed to compare the effect of SGLT-2i and TZD on the risk of stroke in type 2 diabetes mellitus (T2DM) patients. Methods: Using the Korean National Health Insurance Service data, we compared a 1:1 propensity score-matched cohort of patients who used SGLT-2i or TZD from January 2014 to December 2018. The primary outcome was stroke. The secondary outcomes were myocardial infarction (MI), cardiovascular death, 3-point MACE, and heart failure (HF). Results: After propensity-matching, each group included 56,794 patients. Baseline characteristics were well balanced. During the follow-up, 862 patients were newly hospitalized for stroke. The incidence rate of stroke was 4.11 and 4.22 per 1,000 person-years for the TZD and SGLT-2i groups respectively. The hazard ratio (HR) of stroke was 1.054 (95% confidence interval [CI], 0.904 to 1.229) in the SGLT-2i group compared to the TZD group. There was no difference in the risk of MI, cardiovascular death, 3-point MACE between groups. Hospitalization for HF was significantly decreased in SGLT-2i-treated patients (HR, 0.645; 95% CI, 0.466 to 0.893). Results were consistent regardless of prior cardiovascular disease. Conclusion In this real-world data, the risk of stroke was comparable in T2DM patients treated with SGLT-2i or TZD.

Anatomy of the pancreaticobiliary ductal system is so variable that one should think of its normal anatomy as nonexistent. But exact location of the termination of the common bile duct in important to the biliary surgeon when performing transduodenal exploration of the common bile duct, to the physician and radiologist when diagnosing pancreaticobilijary disease by ERCP. We report a case of Lnomalous termination of the common bile duct into thii. duadenal bulb diagnosed by ERCP and operative cholangiogram.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct*

To deterrnine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in ICU, 552 ICU patients who had been admitted from March 1, 1992 to February 28, 1993 were analysed. The mean APACHE II score of nonsurvivors was significantly higher than that of survivors (p<0.01) and there was significant relationship between mortality rate and APACHE II score [Mortality rate(%) =2.994XAPACHE II score-14.987 (r=0.97, p<0.001)). However, the majority of postoperative patients had scores less than 20 points and the postoperative patients were more unevenly distributed. These results suggest that the APACHE II score may be useful for analyses of ICU patients but its application in postoperative patients must take into consideration the patient's clinical condition.
APACHE* ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Survivors

No abstract available.
Lymph Nodes* ; Tuberculosis*

BACKGROUND: The oral ulcer is a common oral disorder, but the precise etiology remains elusive despite of intensive clinical, immunological, hematological and microbiological investigations. OBJECTIVE: The purpose of this study was to examine oral ulcers for the detection of HSV DNA by using PCR and to characterize clinical features of HSV DNA positive cases. METHODS: Specimens collected with cotton swabs and saliva from 48 cases of oral ulcers were examined for HSV DNA by PCR and Southern blot hybridization. RESULTS: 1. HSV DNA was detected in 8 of 48(16.7%) cotton swabbed specimens of oral ulcers and saliva by PCR and Southern blot hybridization. 2. Clinical features of HSV DNA positive oral ulcers were a. predominently located in buccal mucosa. b. mall sized(<3mm), multiple(> or =5) lesions. 3. In Behcet's disease, 2 of 7(28.6%) cases of oral ulcers were positive for HSV DNA CONCLUSION: PCR is an useful and accurate method for the detection of HSV DNA from cotton swabbed specimens of oral ulcers.
Blotting, Southern ; DNA ; Herpes Simplex* ; Mouth Mucosa ; Oral Ulcer* ; Polymerase Chain Reaction* ; Saliva ; Simplexvirus*

We report a case of focal eosinophilic myositis of the frontalis muscle in a 38-year-old man. The skin lesion was a single firm flesh-colored swollen lesion measuring 1×1.5 cm in size on the right forehead. The biopsy revealed inflammatory infiltrates composed of mainly eosinophils and a few lymphocytes in the muscles. The skin lesion subsided with intralesional injections of triamcinolone acetonide, 5 mg/ml.
Adult ; Biopsy ; Eosinophils* ; Forehead ; Humans ; Injections, Intralesional ; Lymphocytes ; Muscles ; Myositis* ; Skin ; Triamcinolone Acetonide

Adult-onset Still's disease (AOSD) is a rare systemic febrile disorder of unknown etiology. AOSD is characterized by spiking fever, arthralgia, sore throat, skin rash, and multi-organ involvement but is difficult to diagnose due to the lack of specific clinical features. AOSD is most frequently observed among young adults. We describe the case of an 18-year-old male patient with multiple cerebral infarction who was diagnosed with AOSD based on the clinical features observed during rehabilitation treatment after the diagnosis of ischemic stroke. Clinical symptoms of the patient was controlled with steroid therapy. If cerebral infarction is accompanied by unusual clinical features as non-infectious fever, rash, and arthralgia, AOSD should be considered in young stroke patient.
Adolescent ; Arthralgia ; Cerebral Infarction* ; Diagnosis ; Exanthema ; Fever ; Fever of Unknown Origin ; Humans ; Male ; Pharyngitis ; Rehabilitation ; Still's Disease, Adult-Onset* ; Stroke ; Young Adult

PURPOSE: To find the risk factors associated with coronory artery lesions, non-responsiveness to intravenous immunoglobulin(IVIG) treatment, and recurrences in Kawasaki disease patients. METHODS: We retrospectively analyzed 1,000 Kawasaki disease patients who were admitted to Yonsei University Medical Center from September 1990 to December 2003. We compared between responder and non-responder groups to IVIG treatment as well as between relapsed and non-relapsed groups, and as to the relapsed group, we also compared variables between patients in their first and second attack states. Finally, factors associated with longer-fever duration from disease onset were evaluated. RESULTS: Longer fever durations before and after IVIG treatment, male sex, lower Hgb and Hct level, higher WBC count and segmented WBC proportion, and higher CRP and Harada's score were related with coronary artery lesions. Non-responsiveness was related to higher WBC count, segmented WBC proportion, CRP, SGPT, Harada's score, and pyuria. Moderate-to-severe coronary artery dilatations and recurrences were more commonly seen among the non-responder group. No significant predictive factors for recurrence were found. In the relapsed group, lower WBC count, CRP, and shorter fever duration from disease onset were observed in their second attack state. Fever duration from disease onset showed positive correlation with WBC count, CRP, and Harada's score and negative correlation with Hgb levels. CONCLUSION: Higher WBC count, CRP, and higher Harada's score were related to both higher incidences of coronary artery lesions and non-responsiveness to IVIG treatment, and these factors were also related with longer fever duration. Non-responders to IVIG treatment showed higher recurrence rate and more moderate-to-severe coronary artery dilatations than responders.
Academic Medical Centers ; Alanine Transaminase ; Arteries ; Coronary Vessels ; Dilatation ; Fever ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Male ; Mucocutaneous Lymph Node Syndrome* ; Pyuria ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Treatment Outcome