PURPOSE: The purpose of study was to describe and evaluate the educational status regarding clinical practicum for child health nursing to facilitate student's clinical compliance for the bachelor's degree in Korea. Methods: The study was a descriptive study and included data from 40 institutions among the 53 university nursing programs in Korea(75.5% response rate). Data were collected using mailed semi structured questionnaires and content analysis was done. RESULTS: Findings show that most institutions have common learning objectives for the clinical practicum; neonatal care, high risk infant care, hospitalized child care, and advanced nursing practice. The mode for theoretical credits in child health nursing was 5 to 6 and 3 to 4 credits for clinical practice. The practice settings were prepared to provide diverse experiences, including childcare centers, and community centers with various learning activities. Evaluation for learning outcomes included faculty and instructors. It was pointed out that updating evaluation based on student and faculty feedback is important for a comprehensive practicum evaluation. Conclusions: Findings suggest that there is a -need for a generalized curriculum for clinical practicum and for the expanding role of advanced nursing practice-, a need for diverse clinical settings for practice, and effective guidance and learning activities. It is significantly noted that the attitude and teaching methodologies of clinical instructor's are highly important to effective clinical learning outcomes.
Child ; Child Health* ; Child* ; Child, Hospitalized ; Compliance ; Curriculum ; Educational Status ; Humans ; Infant ; Infant Care ; Korea* ; Learning ; Nursing* ; Postal Service ; Surveys and Questionnaires

PURPOSE: An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. METHODS: This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. RESULTS: Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. CONCLUSION: Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.
Antibodies, Antinuclear ; Child ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lupus Erythematosus, Systemic ; Male ; Platelet Count ; Prevalence ; Purpura, Thrombocytopenic, Idiopathic ; Retrospective Studies ; Thrombocytopenia

BACKGROUND: Knowledge of the roles of tacrolimus and minidose methotrexate (MTX) in the prevention of acute graft-versus-host disease (aGVHD) in pediatric allogeneic hematopoietic stem cell transplantation (HSCT) is limited. We retrospectively evaluated the engraftment status, incidence of aGVHD and chronic GVHD (cGVHD), and toxicities of tacrolimus and minidose MTX in aGVHD prophylaxis in children undergoing allogeneic HSCT. METHODS: Seventeen children, who underwent allogeneic HSCT and received tacrolimus and minidose MTX as GVHD prophylaxis from March 2003 to February 2011, were reviewed retrospectively. All the patients received tacrolimus since the day before transplantation at a dose of 0.03 mg/kg/day and MTX at a dose of 5 mg/m2 on days 1, 3, 6, and 11. RESULTS: Of the 17 patients, 9 received human leukocyte antigen (HLA)-matched related donor transplants, and 8 received HLA-matched, or partially mismatched unrelated donor transplants. The median time for follow-up was 55 months. The incidence of aGVHD in the related and unrelated donor groups was 22.2% and 42.9%, respectively. cGVHD was not observed. To maintain therapeutic blood levels of tacrolimus, the younger group (<8 years of age) required an increased mean dose compared to the older group (> or =8 years) (P=0.0075). The adverse events commonly associated with tacrolimus included hypomagnesemia (88%), nephrotoxicity (23%), and hyperglycemia (23%). CONCLUSION: Tacrolimus and minidose MTX were well tolerated and effective in GVHD prophylaxis in pediatric patients undergoing allogeneic HSCT. Children <8 years of age undergoing HSCT required increased doses of tacrolimus to achieve therapeutic levels.
Child ; Follow-Up Studies ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Hyperglycemia ; Incidence ; Korea ; Leukocytes ; Methotrexate ; Retrospective Studies ; Tacrolimus ; Tissue Donors ; Transplants ; Unrelated Donors

To examine the cytotoxic effect of chemotherapy on the ovary, 23 cases undergoing oophorectomy with radical hysterect,orny in premenopausal wemen receiving induction chemotherapy with cisplatin and 5-fluomouracil for carcinoma of the cervix between March, 1989 and December, 1992 were studied by light microscopy. Out of 23 cases, 19 (82.6%) showed vascular congestion and 12(52.1%) revealed hemorrhage around folliele and within corpus luteum. The follicular structure was desLroyed in 16 cnses (69.5%) and oocytes of ovums were lost in 17 cases. The mechanism of injury of the ovarian structures after combination chemotherapy with cisplatin and 5-fluorouracil is considered to be caused by secondary cell damage following circulatory disturbance of direct toxicity on fallicular cells of oocytes.
Cervix Uteri ; Cisplatin ; Corpus Luteum ; Drug Therapy* ; Drug Therapy, Combination ; Estrogens, Conjugated (USP) ; Female ; Fluorouracil ; Hemorrhage ; Humans ; Induction Chemotherapy ; Microscopy ; Oocytes ; Ovariectomy ; Ovary* ; Ovum

PURPOSE: Endothelin-1 is the most potent vasoconstrictor. This study was investigated the correlation of plasma endothelin-1 and pulmonary hypertension associated with congenital heart defect. METHODS: We evaluated the concentration of ET-1 in 24 cases of congenital heart disease diagnosed at the Department of Pediatrics, Pusan National University, from December 1993 to September 1994. The patients were divided into 2 groups according to mean pulmonary arterial pressure: Pulmonary artery hypertension group(Group I) and normal pulmonary artery pressure group(Group II). Between 2 groups, there was no statistical significance in mean age, sex and oxygen saturation. GroupI included 9 patients of VSD and 1 patient of COA. Group II included 9 patients of VSD, 3 patients of TOF and 1 patient of PS, 1 patient of PS with DORV. RESULTS: The results were summarized as follows; 1) The mean pulmonary arterial pressure and pulmonary-to-systemic flow ratio (Qp/Qs), pulmonary vascular resistance in GroupIwere significantly higher than those in Group II. 2) The plasma concentrations of ET-1 in GroupI was significantly higher than those in Group II. 3) But there were no statistical significance between the concentrations of ET-1 and the mean pulmonary artery pressure, Qp/QS, pulmonary vascular resistnace. CONCLUSIONS: Based on these results, plasma ET-1 concentraions were elevated in patients with pulmonary hypertension associated with congenital heart defects.
Arterial Pressure ; Busan ; Endothelin-1* ; Heart Defects, Congenital* ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Oxygen ; Pediatrics ; Plasma* ; Pulmonary Artery ; Vascular Resistance

BACKGROUND: Mutations of p53 gene, rarely found in leukemia, result in accumulation of mutated p53 protein in the nuclei of tumor cells, which can be detected by immunohistochemistry. Lately, anti-p53 antibodies were found in the sera of patients who had solid tumors as a result of immune response to accumulation of mutated p53 protein in tumor cells. METHODS: For investigation of the clinical implication of cellular p53 protein overexpression and serum p53 antibody, immunohistochemical staining for p53 protein of B-5 fixed paraffin embedded bone marrow biopsies and enzyme immunoassay for the presence of anti-p53 antibodies of sera were performed simultanously; in 58 cases of AML, 34 cases of ALL, 11 cases of acute leukemia at relapse, 13 cases of CML in chronic phase and 5 cases of CLL. RESULTS: Overexpression of p53 protein was found in 9.1%(11/121) of all leukemias, with 8.6% of AML with predominance of M6, 5.9% of ALL, 18.2% of acute leukemia at relapse and 40% of CLL, but not found in CML. Serum anti-p53 antibodies were found in 5.8%(7/121) of all leukemias, with 6.9% of AML and 5.9% of ALL, 9.1% of acute leukemia at relapse, but not found in chronic leukemias. In AML and ALL, age, sex, hemoglobin, leukocyte count, platelet count and blast % were not related with p53 protein expression. The AML patients with p53 protein overexpression have more unfavorable karyotypes(complex karyotype, -5, -7 and t(10;11)), with shorter overall survival as compared to those without p53 protein overexpression. The presence of serum anti-p53 antibodies was not related with clinical findings of leukemias. CONCLUSIONS: The indications are that p53 gene alterations will contribute to disease development and progression in some specific patients with leukemia, due to the rare frequency of overexpression of p53 protein and serum anti-p53 antibodies in leukemia. Analysis of the p53 protein and serum p53 antibodies could screen p53 gene mutation and predict prognosis for some leukemias.
Antibodies* ; Biopsy ; Bone Marrow ; Genes, p53 ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; Karyotype ; Leukemia* ; Leukocyte Count ; Paraffin ; Platelet Count ; Prognosis ; Recurrence

Primary biliary cirrhosis(PBC) is a chronic cholestatic liver disease of unknown origin. The small and medium sized intrahepatic bile ducts are destroyed by an inflammatory process, which, it has been suggested, is of the autoimmune type. It is strongly associated with the presence of antimitochondrial antibodies, predominantly IgM and IgG. The liver changes are classified into four stages, of which stage IV represents the development of cirrhosis, which required orthotropic liver transplantation in the longrun. The prevalence rates was reported 128 per millon in Sweden , but the disease is relatively rare in Oriental area. In medical treatment, long-term administration of ursodeoxycholic acid improves both clinical and biochemical signs, slows the progression of the disease and reduces the complication requiring liver transplantation. We report two cases of PBC, one with histologically proven cirrhosis, and the other with bile duct destruction consistent with stage III and hypothyroidism.
Antibodies ; Bile Ducts ; Bile Ducts, Intrahepatic ; Fibrosis ; Hypothyroidism ; Immunoglobulin G ; Immunoglobulin M ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Liver Transplantation ; Prevalence ; Sweden ; Ursodeoxycholic Acid

A ureteral hernia that occurs through the sciatic foramen is very rare. We present a case of a ureteral sciatic hernia with hydronephrosis. Intravenous urography (IVU) showed the presence of a curved, laterally displaced ureter, and computed tomography (CT) clearly depicted the herniated ureter through the sciatic foramen. The patient was treated transiently with a double J catheter.
Catheters ; Hernia ; Humans ; Hydronephrosis ; Tomography, X-Ray Computed ; Ureter ; Urography

Purpose: There has been no nationwide surveillance survey of poisoning cases in Korea. This study examined the clinical characteristics of poisoning admissions in order to obtain preliminary data for future planning. Methods: This study retrospectively reviewed the data on poisoning admissions of 150 hospitals based on the hospital discharge injury surveillance data of Center for Disease Control and Prevention in Korea from January to December in 2004. The demographic data, poisons used, causes of poisoning, reasons for attempted suicide and mortality rate was investigated according to the age group. The factors associated with mortality were also evaluated. Results: A total 836 patients admitted for poisoning were analyzed. Their mean age was 46.5+/-19.5 years (male 415, female 421). The most frequent age group was the 4th and 5th decades. The most common poisons involved were pesticides (45%) and medications (23%). The majority (64%) involved intentional poisoning except for those in the 1st decade. The most common reason for the attempted suicide was family problems. However, individual disease was the most common reason in those over 60 years. The overall mortality rate was 8.7% (73/836). Pesticides and being elderly (over 65 years old) were strongly correlated with fatality. Conclusion: The incidence of intentional poisoning increases from the 2nd decade making it a preventable injury. "Overall, the incidence of intentional poisoning increases from the 2nd decade". Therefore, there is a need to frame a prevention policy corresponding to each factor related to fatality, such as an elderly population and pesticides.
Aged ; Centers for Disease Control and Prevention (U.S.) ; Female ; Humans ; Incidence ; Korea ; Pesticides ; Poisons ; Retrospective Studies ; Suicide, Attempted

It is uncommon that two phenotypically different lymphomas develop in the same person, and especially in the skin. Composite lymphoma is defined as two distinctly demarcated types of non-Hodgkin's lymphoma (NHL) or its association with Hodgkin's lymphoma (HL) within a single organ or tissue. Discordant lymphoma is defined as two types of NHL or the association of HL with NHL at different anatomic sites in the same person. Sequential lymphoma and simultaneous lymphoma are defined as two different types of lymphoma that occur in the same person at different times and at the same times, respectively. We herein report on two cases of sequential composite lymphomas that were limited to the skin. A 57-year-old woman who had had been diagnosed with HL at the face had been treated with chemotherapy for 1.5 years. 6 months later, the patient revisited the dermatologic clinic of our hospital for a one-month history of erythematous nodules on her chest and upper extremities. Punch biopsy was performed and the pathologic diagnosis was mantle cell lymphoma. She refused further treatment. A 68-year old woman, who had been diagnosed as having extranodal marginal zone B cell lymphoma, had been treated with chemotherapy and radiation therapy for one year. After one year, she revisited dermatologic clinic of our hospital for a several-month history of erythematous nodules on her extremities. Punch biopsy from the lesion was performed and the pathologic diagnosis was cutaneous diffuse large B cell lymphoma, the leg type. She was scheduled for chemotherapy (rituximab with cyclophosphamide, adriamycin, vincristine and prednisolone (R-CHOP)). To the best of our knowledge, our cases are the first such cases in the Korean dermatologic literature.
Biopsy ; Composite Lymphoma ; Cyclophosphamide ; Doxorubicin ; Extremities ; Female ; Hodgkin Disease ; Humans ; Leg ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prednisolone ; Skin ; Thorax ; Upper Extremity ; Vincristine