Inflammatory linear verrueous epidermal nevus (ILVEN) first mentioned by Unna in 1896 is a rare variant of epidermal nevus characterized clinically by early onset in childhood, moderate to marked pruritus and persistent clinical course and histopathologically by predominant features of a chronic dermatitis or psoriasis. We present tbe first recorded case of a typical ILVEN developed in a 20-year-old Korean male, who has had an intensely pruritic linear verrucous patch, involving the entire length of the posterior aspeet of right upper extremity, volar aspect of right thumb and nails of ind.ex and ring finger since 5 years. Microscopic examination of the skin, biopsy specimens from the lesion on the right elbow joint area and the palm showed hyperkeratosis witb focal parakeratosis, moderate to marked acanthosis and elongation of rete ridges and papilla with mild exocytosis and moderate perivascular lymphocytic infiltration. Literature were reviewed.
Biopsy ; Dermatitis ; Elbow Joint ; Exocytosis ; Fingers ; Humans ; Male ; Nevus ; Parakeratosis ; Pruritus ; Psoriasis ; Skin ; Thumb ; Upper Extremity ; Young Adult

No abstract available.
Humans ; Nitroblue Tetrazolium* ; Skin* ; Tuberculosis, Cutaneous*

Several investigators have attempted to clarify th well-known phenomenon of anergy in lepromatous leprosy during past two decades, utilizing various methods of immunologic assessrvent, including response to skin test antigens, active skin sensitization with strong allergens, skin homograft survival rate, imrnunopathology of lymphnodes, in vitro blastogenic response by antigens or mitogens of lymphocytes, lymphokine production in vitro and measurement of peripheral T and B cell ratio. Howcver, there is no general agreement as to the cellular irnmunologic status of leprosy patients b tween various investigators. The present study was undertaken to evaluate the ability to mount cutaneous hypersensitivity reactions to various skin test antigens and to investigate active sensitization with DViCB in patients with leprosy. Ten polar lepromatous (LL) and 12 polar tuberculoid (TT) p-tients who have been treated at Department of Dermatology, National Iviedical Center and Seoul Nationa,l University Hospital were the subjects. The subjects have rcceived regular antileprosy chemotherapy with DDS and the average duration of treatment in LL and TT groups was 6. 2 and 4. 7 years, respectively. The control group included 10 healthy physicians and nurs-s. Skin test antigens includ=d lepromin (1 x10' bacilli,ml'), PPD (Parke-Davis 5ppJ/0.1ml), SK-SD (Lederle, 40 u SK and 10 u SD/0.1 ml), Candidin (Hollister stier Lab 1: 1000 dilution) and DNCB aceton solution in the concentrations of 1000ug,/0.1ml for sensitization and 100ug/0.1ml for challenge, respcctively. Skin reactions were read 48 hours after intraderrnal injection of 0.1 rnl of each antigen anci th.' metho4 of DNCB sensitization was same as described elsewhere. The result showed that in polar lepromatous leprosy patients, the skin reactivity to various antigens were generally decroased, as cornpared to both th healthy control group and polar tuberculoicl patients, especially to lepromin, PPD and I')NCB sensitization (p<0.05, respectively). We concluded thxt lepromatous leprosy patients were especially unresponsive to mycobacterial antigcns(lepromin and PPD) and to newly administered antigen (DNCB) and tbe possible mechanism was discussed.
Allergens ; Allografts ; Antigens ; Dermatology ; Dinitrochlorobenzene ; Drug Therapy ; Humans ; Hypersensitivity* ; Lepromin ; Leprosy* ; Leprosy, Lepromatous ; Lymphocytes ; Mitogens ; Research Personnel ; Seoul ; Skin Tests* ; Skin* ; Survival Rate

PURPOSE: To provide basic data to improve the practice environment of pediatric nurses by identifying their recognition of nursing professionalism and self-efficacy, and to examine the pediatric nurse parent partnership. METHODS: Participants in the study were 165 nurses with 6 months of work experience in a university children's hospital in Seoul. Data were collected using a self-report questionnaire. Research tools measuring nursing professionalism, self-efficacy, and pediatric nurse parent partnership were used. The collected data were analyzed using SPSS PASW statistics 19.0. RESULTS: There were statistically significant positive correlations for nursing professionalism and self-efficacy (r=.359, p<.001), nursing professionalism and the pediatric nurse parent partnership (r=.487, p<.001), and self-efficacy and the pediatric nurse parent partnership (r=.442, p<.001).According to the general characteristics of the participants, nurses who were married, practiced religion and had children tended to have higher nursing professionalism. Higher self-efficacy was exhibited by nurses who were older, married and raising children and the pediatric nurse parent partnership tended to have higher scores for nurses who practiced religion and worked in a general ward. CONCLUSION: The findings indicate that higher nursing professionalism and self-efficacy result in a better pediatric nurse parent partnership which should improve the practice environment of pediatric patients.
Child ; Humans ; Parents ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate working mothers' satisfaction with non-maternal infant care, social support, and the relationships thereof with variables including parenting efficacy. METHODS: A total of 116 working mothers who had experiences of infant non-maternal care were recruited from online communities of working mothers, and 93 participants were ultimately included in this study. Data were collected using self-report questionnaires in March 2018. Descriptive statistics, ANOVA and Pearson correlation coefficients were used for analysis. RESULTS: Satisfaction with non-maternal care showed positive correlations with social support from others (r=0.52, p < 0.001), and parenting efficacy (r=0.39, p < 0.001). There was a significant positive correlation between social support from others and parenting efficacy (r=0.32, p=0.002). Satisfaction with non-maternal care was relatively high (86.27%), and it was highest when non-maternal care was provided by the maternal grandparents. The mean score for social support from others was 36.49±8.86. CONCLUSION: To increase satisfaction with non-maternal care, education for non-maternal caregivers and social support programs for working mothers are required.
Caregivers ; Education ; Grandparents ; Humans ; Infant ; Infant Care ; Infant ; Mothers ; Parenting ; Parents

Purpose: This study examined the effects of an educational program for fathers on improving father-infant interactions, child-rearing knowledge, and attachment. Methods: In this quasi-experimental study, the participants were recruited by convenience sampling among fathers with infants (2-6 months of age) residing in three districts of Seoul. Fifteen participants in the experimental group and 17 participants in the control group completed the follow-up investigation. A 5-week online and offline intervention program with five sessions was provided to the experimental group. The data were analyzed using generalized estimating equations (GEEs). Results: There was a significant difference in the change in father-infant interaction scores of the experimental group, especially in the caregiver aspect with a significance level of .100 in time and group-to-group interactions (B=6.46, p=.051, 95% confidence interval [CI]=-0.02-12.94). The changes between the groups and times were not statistically significant when it came to infant development knowledge and father-infant attachment. Conclusion We conclude that hybrid online and offline education should be implemented as an effective method to improve fathers’ interactions with their children based on accurate knowledge about infant development.

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. THE SPECIFIC OBJECTIVES WERE: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i) FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the medically supervised deliveries, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. STUDY DESIGN: The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum "package" program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and "before and after" surveys were conducted to measure the change. SERVICE INPUT: This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. METHOD OF EVALUATION: a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed. b. Neverthless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the "intergration process" itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltructure, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable. Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. SUMMARY OF FINDINGS: A) PROGRAM EFFECTS AND IMPACT. 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 78% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller. 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) & delivery care (45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregnancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) EFFECTS ON INTERACTIVE LINKAGE. 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in carrying for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, 85-90% of the services provided by the health workers were other than FP/MCH, mainly for immunization such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs. 31%) and for more combined care (45% vs. 23%). C) ORGANIZATION FACTORS (ADMINISTRATIVE INTEGRATIVE ISSUES). 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub-center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwives's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea). 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through planning practice. 2) Goal consensus in FP/MCH should be made among the health workers & administrators, especially to emphasize the need of care of "wanted" child. But there is a long way to go to realize the "real" integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (ii) there should be a health sub-center director who can provide leadership training for managing the integrated program. There is a need for "organizational support", if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the management of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Workers, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.
Abortion, Induced ; Administrative Personnel ; Child ; Child Health ; Chungcheongnam-do ; Cohort Studies ; Community Health Workers ; Consensus ; Contraception ; Cooperative Behavior ; Delivery of Health Care ; Encephalitis ; Family Characteristics ; Family Health ; Family Planning Services* ; Female ; Hand ; Health Personnel ; Health Services ; House Calls ; Humans ; Immunization ; Infant ; Infant Mortality ; Insurance Benefits ; Clinical Trial* ; Jurisprudence ; Korea* ; Leadership ; Live Birth ; Local Government ; Midwifery ; Organization and Administration ; Parturition ; Population Growth ; Postnatal Care ; Pregnancy ; Prenatal Care ; Primary Health Care ; Referral and Consultation ; Social Control, Formal ; Specialization

No abstract available.
Anesthesia, Epidural*

No abstract available.
Carcinoma, Hepatocellular* ; Spleen*

OBJECTIVE: To investigate the effect of epilepsy and neonatal seizure on development in children with cerebral palsy (CP) or delayed development (DD). METHOD: The subjects were 135 patients with CP or DD. Development was evaluated by Bayley Scale of Infant Development II (BSID II). Epilepsy was diagnosed on the base of clinical features, past history and electroencephalography. RESULTS: The incidence of epilepsy was 18.4% in CP, and 37.8% in DD. Spastic quadriplegia of CP has the highest incidence of epilepsy (38.4%). First seizure attack was occurred before 6 months old of age in 66.7% of CP with epilepsy and in 64.3% of DD with epilepsy. The prevailing type of epilepsy was generalized seizure in DD (57.1%), partial seizure in CP (50.0%). The group with epilepsy had lower psychomotor and mental development quotient on BSID II than the group without epilesy (p<0.05). Polytherapy was more used to control epilepsy than monotherapy. Valproate (50.0%), phenobarbital (37.5%), carbamazepine (31.3%) were commonly used drugs for controlling epilepsy. CONCLUSION: The epilpesy has a negative effect on psychomotor and mental development in the children with CP or DD.
Carbamazepine ; Cerebral Palsy* ; Child ; Child Development ; Developmental Disabilities* ; Electroencephalography ; Epilepsy* ; Humans ; Incidence ; Infant ; Phenobarbital ; Quadriplegia ; Seizures* ; Valproic Acid