To elucidate the clinical characteristics of childhood onset systemic lupus erythematosus (SLE), we carried out a retrospective reivew on medical records of fourteen patients who were diagnosed as SLE on the base of "the 1982 revised criteria for the SLE"(by american Rheumatism Association) at the Department of pediatrics, Hanyang University Hospital from January 1980 through August 1992. The results were summerized as follows: 1) Eleven girls and three boys were recruited in our study, The eight of them were early teens at the time of SLE diagnosis. 2) The frequencies of their clinical manifestations on admission were persistent facial rashes, edema, hepatosplenomegaly, renal abnormalities were proteinuria and hematuria. 3) Immunologic abnormalities were noted as follows: Positive ANA 100%. positive LE cell 64%, elevated anti DS-DNA antibody 64%, and decreased only C3 level 28%, decreased both C3 & C4 64% of the patients. 4) Serum anti-DS DNA(>10units) titer was increased in clinical exacerbated three patients and decreased in four resolved. 5) The high ANA titers( >1;80)obtained in eleven and/or homogenous pattern shown in seven strongly suggested SLE. 6) Renal biopsies of the four patients revealed lupus nephritis and three of the four patients had lupus band in their biopsied skin. 7) Three of 14 patients were recoverd spontaneously with supportive care. Other 11 patients were treated: 7 with prednisolone only, 4 combined prednisolone and other agents. After treatment five were clinically improved. But 4 patients were frequently exacerbated over 2 years, and 2 patients were died of their complications. In conclusion, serum anti-DS DNA level and ANA may be useful for the screening of SLE and for predicting clinical course and prognosis of SLE.
Adolescent ; Biopsy ; Child* ; Diagnosis ; DNA ; Edema ; Exanthema ; Female ; Hematuria ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Mass Screening ; Medical Records ; Neutrophils ; Pediatrics ; Prednisolone ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Diseases ; Skin

PURPOSE: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. METHODS: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. RESULTS: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. CONCLUSION: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.
Cross-Sectional Studies ; Korea ; Public Health*

BACKGROUND: Allergic diseases are characterized by immediate - and late - phase reactions to various allergens by the selective activation of a subset of CD4 + T cells. In response to allergen, T cells isolated from atopic donors are biased to low levels of IFN - y and high levels of IL - 4, and vice versa by T cells from non - atopic donor. Objective : The aim of this study was to evaluate the patterns of IL - 4 and IFN - y production after Der p I stimulation and the effect on the cytokine production from T cells by budesonide, disodium cromoglycate and cyclosporin A in atopic and non - atopic individuals. MATERIAL AND METHOD: Seven Der p I specific atopic and 7 non - atopic individuals were selected. We decided the 50% inhibiting concentration of each immunomodulator by lymphocyte proliferation assay, and measured their effects on the cytokine production in vitro by intracellular IL - 4, IFN - y staining and flow cytometry. Results and CONCLUSION: There was significant difference on stimulation index ( SI ) of production of IFN - y as well as IL-4 after Der p I stimulation between atopic and non-atopic individuals ( IL - 4 ; 1.57 +/- 0.7 : 0.98 +/- 0.2, p = 0.026, IFN - r : 1.45 +/- 0.5 : 0.95 +/- 0.2, p = 0.048 ). The synthesis of IL - 4, and IFN - r were significantly inhibited after the stimulation of every immunomodulators in atopic individuals, DSCG couldnt inhibit IL - 4 and IFN - r in nonatopic individuals. There was no significant difference in the inhibiting effect of these immunomodulators in both of them.
Allergens ; Bias (Epidemiology) ; Budesonide ; Cromolyn Sodium ; Cyclosporine ; Dust* ; Flow Cytometry ; Humans ; Immunologic Factors ; Interferons* ; Interleukin-4 ; Lymphocytes ; Pyroglyphidae* ; T-Lymphocytes* ; Tissue Donors

PURPOSE: The purpose of this study was to analyze factors affecting burnout among clinical nurses according to Positive Psychological Capital. METHODS: The study design was a descriptive survey and questionnaires were collected from 412 clinical nurses who worked in a general hospital in "J" city. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffe test, Pearson Correlation, and hierarchical multiple regression. RESULTS: In Model individual characteristics accounted for 27.8% of the influence on burnout. In model II with the addition of the 4 factors; Self-efficacy, Hope, Resilience, Optimism, individual characteristics accounted for 48.5% of the influence on burnout. Optimism and Resilience of the Positive Psychological Capital sub-variables were statistically useful as factors influencing burnout. CONCLUSION: The results indicate that it is necessary to develop active human resource management and educational programs to decrease burnout and strengthen the Positive Psychological Capital of the nurses.
Hospitals, General ; Humans ; Surveys and Questionnaires

We have evaluated the clinical results following the 46 cases of free vascularized osteocutaneous fibular flap transfer to the tibial defect combined with soft tissue defect, which were performed from May 1982 to January 1997. In the 46 consecutive procedures of free vascularized osteocutaneous fibular flap transfer, initial bony union were obtained in the 43 grafted fibulars at average 3.75 months after operation. There were 2 cases in delayed unions and 1 in nonunion. 44 cutaneous flaps among the 46 cases were survived but 2 cases were necrotized due to deep infection and venous insufficiency. One necrotized flap was treated with latissimus dorsi free flap transfer and the other was treated with soleus muscle rotational flap. Grafted fibulas have been hypertrophied during the follow-up periods. The fracture of grafted fibula (15 cases) was the most common complication and occurred at average 9,7 months after the operation. The fractured fibulas were treated with the cast immobilization or internal fixation with conventional cancellous bone graft. In the cases of tibia and fibula fracture at recipient site, the initial rigid fixation for the fibula fracture at recipient site could prevent the fracture of grafted fibula to the tibia.
Fibula ; Follow-Up Studies ; Free Tissue Flaps ; Immobilization ; Muscle, Skeletal ; Superficial Back Muscles ; Tibia* ; Transplants* ; Venous Insufficiency

OBJECTIVES: Amid the spread of coronavirus disease 2019 (COVID-19), with its high infectivity, we have relied on mathematical models to predict the temporal evolution of the disease. This paper aims to show that, due to active behavioral changes of individuals and the inherent nature of infectious diseases, it is complicated and challenging to predict the temporal evolution of epidemics. METHODS: A modified susceptible-exposed-infectious-hospitalized-removed (SEIHR) compartment model with a discrete feedback-controlled transmission rate was proposed to incorporate individuals’ behavioral changes into the model. To figure out relative uncertainties in the infection peak time and the fraction of the infected population at the peak, a deterministic method and 2 stochastic methods were applied. RESULTS: A relatively small behavioral change of individuals with a feedback constant of 0.02 in the modified SEIHR model resulted in a peak time delay of up to 50% using the deterministic method. Incorporating stochastic methods into the modified model with a feedback constant of 0.04 suggested that the relative random uncertainty of the maximum fraction of infections and that of the peak time for a population of 1 million reached 29% and 9%, respectively. Even without feedback, the relative uncertainty of the peak time increased by up to 20% for a population of 100,000. CONCLUSIONS It is shown that uncertainty originates from stochastic properties of infections. Without a proper selection of the evolution scenario, active behavioral changes of individuals could serve as an additional source of uncertainty.

OBJECTIVES: Amid the spread of coronavirus disease 2019 (COVID-19), with its high infectivity, we have relied on mathematical models to predict the temporal evolution of the disease. This paper aims to show that, due to active behavioral changes of individuals and the inherent nature of infectious diseases, it is complicated and challenging to predict the temporal evolution of epidemics. METHODS: A modified susceptible-exposed-infectious-hospitalized-removed (SEIHR) compartment model with a discrete feedback-controlled transmission rate was proposed to incorporate individuals’ behavioral changes into the model. To figure out relative uncertainties in the infection peak time and the fraction of the infected population at the peak, a deterministic method and 2 stochastic methods were applied. RESULTS: A relatively small behavioral change of individuals with a feedback constant of 0.02 in the modified SEIHR model resulted in a peak time delay of up to 50% using the deterministic method. Incorporating stochastic methods into the modified model with a feedback constant of 0.04 suggested that the relative random uncertainty of the maximum fraction of infections and that of the peak time for a population of 1 million reached 29% and 9%, respectively. Even without feedback, the relative uncertainty of the peak time increased by up to 20% for a population of 100,000. CONCLUSIONS It is shown that uncertainty originates from stochastic properties of infections. Without a proper selection of the evolution scenario, active behavioral changes of individuals could serve as an additional source of uncertainty.

PURPOSE: The purpose of this study was to test the mediating effect of job embeddedness in the relationship between nursing practice environment on nursing job performance and organizational commitment. METHODS: For this study a descriptive design with survey method was utilized. Participants were 192 clinical nurses recruited from 2 hospitals in A, B city and J province in Korea. From June, 6 to 24, 2018, a questionnaire scale was used to collect the data. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and liner regression analysis. RESULTS: There were significant positive relationships for nursing job performance and organizational commitment with nursing practice environment. In addition, job embeddedness had a full mediating role in the relationship between nursing practice environment and nursing job performance, and a partial mediation effect in nursing practice environment and organizational commitment. CONCLUSION: The purpose of this study was to identify the mediating effects of job embeddedness and to find ways to improve organizational commitment, which is a useful variable to predict performance outcomes, nurse job performance and job behavior of organizational members. Also, the study results can be used as basic data for nursing manpower management strategies.
Korea ; Negotiating ; Nursing ; Surveys and Questionnaires ; Work Performance

No abstract available.
Korea*

Currently, 10% of cancer chemotherapy is provided to patients by oral formulation; however, by 2013 this percentage is predicted to increase to 25%. Chemotherapy is traditionally given by injection. Oral chemotherapy has been developed as a more convenient method for treating patients. Oral chemotherapy offers many advantages including the elimination of pain often caused by injections, the lack of fees for administering intravenous drugs, more time at home for patients, and a patient's increased sense of autonomy. The role of oral chemotherapy has been expanding because of the potential advantages in convenience and better quality of life for patients, and in the cost-effectiveness of treatment as compared to intravenous chemotherapy. A number of novel oral targeted and cytotoxic chemotherapeutic agents are entering the market or are in development. Many of the agents display significant clinical activity against various cancers. The growing availability of effective oral chemotherapy treatments, especially the new class of 'targeted biologic therapies', is one of the wonderful recent advances in cancer care. This manuscript describes the progress of clinical development and efficacy of these newly developed chemotherapeutic agents.
Administration, Oral ; Fees and Charges ; Humans ; Quality of Life