Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

PURPOSE: The purpose of this study was to analyze how a nursing student recognizes PBL with simulation education and its relationship to academic achievement. METHODS: The study objects were the students in C college who learn through PBL using simulator for 15 weeks(September 2007 to December 2007). Learning element recognition was developed by Cho(2002) and three key evaluations(performance, self-evaluation, and colleague evaluation) were designed by professors. RESULTS: Learning element recognition ranged from 2.37 to 4.83 with the average at 3.94. For Learning element recognition, students who preferred discussion score 4.15. This was statistically more significant than those who do not. Students who preferred presentations show significantly higher score in colleague evaluation. For Learning element recognition and academic achievement, self-evaluation and colleague evaluation showed relationship to PBL learning element. CONCLUSION: There was definitely a relationship with PBL learning element and academic achievement after learning the PBL with simulation education.
Achievement ; Diagnostic Self Evaluation ; Humans ; Learning ; Problem-Based Learning ; Students, Nursing

PURPOSE: The purpose of this study was to analyze nursing students' learning styles and relationship of learning style to participation and academic achievement. METHOD: The study participants were nursing students in C college learning through problem based learning (PBL). Data were collected using a questionnaire which included Kolb's learning styles. Performance evaluation and paper examination were used to evaluate academic achievement. RESULTS: Most of the students had converger type learning style. Student with a tendency to abstract conceptualization, such as converger type and assimilator type, preferred discussion and presentation. The students with converger type learning style participated and achieved better than students with diverger style. CONCLUSION: The results indicate that learning style was related to participation and academic achievement. Therefore in order to use PBL effectively, facilitators should consider students' learning styles.
Achievement ; Humans ; Learning ; Problem-Based Learning ; Surveys and Questionnaires ; Students, Nursing

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

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PURPOSE: The purpose of this study was to investigate factors affecting job embeddedness of nurses in trauma centers. METHODS: This study was a cross-sectional study using structured questionnaires completed by 140 nurses in three regional trauma centers in Korea. Data were collected from July 15 to September 10, 2017, and analyzed using SPSS/WIN 23.0 program. RESULTS: The mean score of organizational commitment was 3.65±0.75, positive psychological capital was 3.00±0.45, and job embeddedness was 3.00±0.45. The organizational commitment showed a significant positive correlation with positive psychological capital (r=.36, p<.001) and job embeddedness (r=.60, p<.001), and positive psychological capital also showed a significant positive correlation with job embeddedness (r=.74, p<.001). The factors affecting job embeddedness of nurses in trauma centers were positive psychological capital (β=.61, p<.001), organizational commitment (β=.38, p<.001), and marital status (β=-.14, p=.017). CONCLUSION: The results of this study suggest that to enhance job embeddedness, it is necessary to develop education and programs to strengthen organizational commitment and positive psychological capital of nurses in trauma centers. In addition, for unmarried nurses, interest and consideration are needed to enhance job embeddedness and to reduce turnover.
Cross-Sectional Studies ; Education ; Humans ; Korea ; Marital Status ; Single Person ; Trauma Centers

BACKGROUND/OBJECTIVES: Although a lot of effort has been put into increasing fruit and vegetable intakes in preschool children, vegetable intake in this group is still low. This study investigated whether nutrition education focusing on fruit and vegetable intakes can affect preschoolers' fruit and vegetable intakes as well as their behavioral outcomes. SUBJECTS/METHODS: Thirty-five preschoolers (54.3% boys, n = 19) aged 4–6 years residing in Seoul underwent weekly nutrition education intervention (8 sessions) between May and July 2016. Intakes of fruits and vegetables were measured during pre and post-intervention. At snack time, fresh fruit (150 g) and vegetable (120 g) snacks were distributed to each child by teachers. The remaining portions of the snacks were weighed and recorded for each child. Behavioral outcomes were measured by applying Child behavior checklist 1.5–5 and the Diagnostic and statistical manual of mental disorders. RESULTS: During post intervention, vegetable intake increased from 36.15 ± 30.64 g to 48.01 ± 31.23 g (P = 0.010). Among the emotional and behavioral problems measured by parents, levels of total problems (P = 0.001), internalizing (P = 0.004), externalizing (P = 0.003), anxiety and depression (P = 0.001), and aggressive behavior (P = 0.005) decreased. Anxiety (P = 0.026) score, as measured by teachers, also decreased. CONCLUSIONS: Nutrition education of preschoolers regarding the intakes of fruits and vegetables had a positive effect on preschoolers' vegetable intake as well as on their emotional and behavioral outcomes. A long-term, large-scale study with a broader study design is warranted to further investigate the role of fruit and vegetable intake in cognitive development and behavior of preschoolers.
Anxiety ; Checklist ; Child ; Child Behavior ; Child, Preschool ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Education* ; Fruit* ; Humans ; Parents ; Problem Behavior ; Seoul ; Snacks ; Vegetables*

BACKGROUND: The clinical and electroencephalographic differentiation of the mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) may have a practical value. Until now, a few comparative studies reported some relatively minor differences between the two groups. We investigated the clinical history, interictal and ictal electroencephalographic (EEG) patterns to differentiate NTLE from MTLE. METHODS: Twenty two patients with medically refractory MTLE and fourteen patients with isolated neocortical lesions were recruited. The interictal and ictal scalp EEG patterns were compared in terms of the interictal EEG distribution patterns of epileptiform discharges, focal slow waves (ipsilateral/contralateral refers to side of pathology), and the frequencies of ictal discharges on EEG at seizure onset. RESULTS: Interictal EEG patterns of epileptiform discharges and focal slow waves were recorded most often at the ipsilateral or bilateral sphenoidal electrodes in both groups without significant differences. Ictal EEG onset with rhythmic theta waves was significantly more frequent in MTLE (72.3%) than in NTLE (36.7%), but ictal EEG onset with rhythmic alpha waves and those with rhythmic beta waves were significantly more frequent in NTLE (33.3%, 20.0%, respectively) than in MTLE (10.8%, 1.2%, respectively). Initial ictal EEG patterns appeared more frequently at the sphenoidal electrodes in both groups (MTLE:73.5%, NTLE:60.0%). Initial ictal EEG patterns of the bilateral hemisphere, ipsilateral hemisphere or ipsilateral diffuse temporal area were seen only in NTLE (16.7%, 3.3%, 10% respectively), but not in MTLE. CONCLUSIONS: This study showed that the initial ictal patterns and the frequency of ictal onset were significantly different in MTLE and NTLE. These differences could give a practical help in diagnosing MTLE and NTLE.
Electrodes ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Scalp* ; Seizures ; Temporal Lobe*

It is well known that inflammation has a important role in the pathogenesis of diverse neurodegenerative disorders. There are also growing numbers of evidences that inflammation is involved in the pathogenesis of epilepsy. For many decades, implication of brain inflammation to epilepsy has been suggested by the effectiveness of anti-inflammatory medications in treating intractable pediatric epilepsies, increased incidence of spontaneous epilepsy in autoimmune disorders, and increased level of proinflammatory cytokines in the blood of patients who experienced recent seizures. Recently, activation of microglia and astrocytes and production of proinflammatory cytokines and related molecules have been reported in surgically resected brain tissue from epilepsy patients as well as from experimental animals of epilepsy models. These evidences suggest that inflammatory process may contribute to epileptogenesis and to neuronal injury after seizures. Thus we provide a review of current understandings about implication of brain inflammation to diverse neurological disorders associated with epilepsy.
Animals ; Astrocytes ; Brain ; Cytokines ; Encephalitis ; Epilepsy ; Humans ; Incidence ; Inflammation ; Microglia ; Nervous System Diseases ; Neurodegenerative Diseases ; Neurons ; Seizures