OBJECTIVES: The purpose of this investigation was to determine whether women with unexplained elevations of maternal serum human chorionic gonadotropin(hCG) at 14-20weeks gestation are at incresed risk for poor pregnancy outcomes. METHODS: 661 pregnant women undergoing second trimester triple marker screening test for Down syndrome and neural tube defect and delivered at our hospital were reviewed. Of 656 pregnancies that did not have maternal serum alpha feto-protein> or =2.5 multiples of the median(MoM), risk for poor pregnancy outcomes include to preeclampsia, preterm delivery, preterm rupture of membrane(PROM), small for gestational age(SGA) and fetal distress was evaluated in women with elevated hCG(> or =2.0 MoM) compared with women without elevated hCG(<2.0 MoM). RESULTS: Pregnancies with elevated hCG levels were at increased risk for preeclampsia (risk ratio 3.4, 95% confidence interval 1.5-7.6) but elevated hCG levels were not significantly associated with preterm delivery, PROM, and SGA and fetal ditress independent with preeclampsia. CONCLUSION: Pregnancies with elevated second-trimester hCG appear to be at higher risk of subsequent preeclampsia and this finding supports the theory that placental vascular changes that ultimately lead to preeclampsia begin at least by the second trimester. But further studies must be to determine how such information can be used to improve pregnany outcome.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Fetal Distress ; Humans* ; Mass Screening ; Neural Tube Defects ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Rupture

PURPOSE: To investigate the degree and sources of stress which fathers of infants in NICU experience. METHOD: Eighty-five fathers of NICU infants at 5 university hospitals in Seoul volunteered to complete the Parental Stressor Scale for NICU (PSS: NICU) from September 1, to October 15, 2002. RESULTS: Total perceived stress was 3.50+/-0.76. The highest score were in Parental Role Alteration (3.76+/-0.83) and Appearance and Behavior (3.65+/-1.04). The total perceived stress score (PSS), correlated significantly with method (t=3.50, p=.01), and route (F=5.30, p=.00) of feeding. Light & Sound correlated significantly with birth weight (F=3.39, p=.02), medical diagnosis(F=2.30, p=.03), plan of operation(t=2.50, p=.01), operation (t=3.80, p=.02), method (F=4.90, p=.003), and route (F=4.70, p=.00) of feeding. Infant Appearance and Behavior correlated significantly with birth weight (F=5.12, p=.01), plan of operation (t=2.50, p=.01), method (F=3.50, p=.01), and route (F=7.80, p=.00) of feeding. Parental Role Alteration correlated significantly with care of incubator (t=-.68, p=.03), method of feeding (F=2.80, p=.04) and education level of father (F=3.00, p=.05). CONCLUSION: Father with NICU infants were concerned mostly with parental role alteration and infant appearance. Nursing intervention should include fathers of NICU infants.
Birth Weight ; Education ; Fathers* ; Hospitals, University ; Humans ; Incubators ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal* ; Nursing ; Parents ; Seoul ; Child Health

PURPOSE: The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice. METHODS: Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program. RESULTS: Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance. CONCLUSION: According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.
Conflict of Interest ; Humans ; Nursing ; Resilience, Psychological ; Students, Nursing

PURPOSE: Kawasaki disease (KD) is the main cause of acquired heart disease in children. In addition to cardiovascular involvement, many complications have been recognized in KD. However, respiratory complications have been rarely reported. We investigated the differences in clinical characteristics, laboratory findings, radiography findings, and echocardiography findings of Mycoplasma pneumoniae infection and other types of pneumonia in KD patients. METHODS: Among 358 patients with KD, 54 developed concurrent pneumonia. Among the 54 patients, 12 (22.2%) with high titers of anti-M. pneumoniae antibody (AMA) (>1:640) were grouped in the M. pneumoniae group and 42 were included in the control group. Serum AMA was measured in each patient. Clinical laboratory findings and total duration of fever were analyzed. RESULTS: The duration of fever, serum hemoglobin, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, albumin level, and the incidence of coronary arterial lesions showed no statistical difference in the 2 groups. Neutrophil count was significantly higher in the M. pneumoniae group than in the control group. Among various radiography findings observed in pneumonia, consolidation and pleural effusion were more frequent in the M. pneumoniae group than in the control group. On the other hand, parahilar peribronchial opacification, diffuse interstitial lesion, and normal findings prevailed in the control group. CONCLUSION: KD patients can have concurrent infections, especially pulmonary symptoms. The cause of KD is likely to be associated with M. pneumoniae infection. Thus, immediate treatment of M. pneumoniae infection in KD patients is very important.
Blood Sedimentation ; C-Reactive Protein ; Child ; Echocardiography ; Fever ; Hand ; Heart Diseases ; Hemoglobins ; Humans ; Incidence ; Leukocyte Count ; Mucocutaneous Lymph Node Syndrome ; Mycoplasma ; Mycoplasma pneumoniae ; Neutrophils ; Platelet Count ; Pleural Effusion ; Pneumonia ; Pneumonia, Mycoplasma

We have studied thirty two cases of inappropriately treatable and intractable epileptics to various anti-convulsants. Zonisamide had a definite anti-epileptic activity in eleven subjects(52.4%) of intractble epilepsy. Five patients(45.5%), who were previously inappropriately treatable epileptic patients became seizure free on zonisamide. Two subjects were withdrawn from study because of side effect and two subjects were also withdrawn because of uncontrolled seizure. Zonisamide is not only effective in intractable epileptic patients but also in first trial for untreated epileptic patients.
Epilepsy ; Humans ; Seizures

BACKGROUND: The purpose of this study was to examine site-specific bone strength changes induced by hindlimb unloading in mature adult male rats. METHODS: Eight month old (390-410 g) 26 male Sprague-Dawley rats were weight-mated assigned to either a Ground control (CON) or a Hindlimb Unloading (HU) for 24 days. Daily body weight was watched for status of animal. Weight, BMD, strength, geometry of femur, tibia and humerus were examined in both groups. RESULTS: The 24-day hindlimb unloading of HU showed no significant change of body weight, total bone mineral, and bone geometry compared to CON. HU showed that the upper limb had maintained total bone mineral, bone geometry, and bone mechanical strength compared to CON. The hindlimb of HU had significantly decreased bone strength and ultimate stress (F/B) compared to CON. DEXA analysis of BMD and BMC in HU showed inconsistent changes at femur and tibia, although a relatively constant increase was shown in humerus. In HU rats, mechanical stress testing of compulsive fracture showed that more significant decreases in UL (ultimate load) and ultimate stress (F/B) was seen in femur than in tibia. CONCLUSION: These results support the theory that hindlimb unloading contribute to deleterious effects in femur rather than in tibia. It induced higher loss of mechanical bone strength in femur. In testing for BMD, pQCT, 2D, or 3D is recommended. DEXA is not recommended because it has inconsistent results and limitation with respect to the characteristics of area BMD (g/cm2) as a surrogate of volume BMD (g/cm3).
Adult* ; Animals ; Body Weight ; Femur ; Hindlimb Suspension* ; Hindlimb* ; Humans ; Humerus ; Male* ; Rats* ; Rats, Sprague-Dawley ; Stress, Mechanical ; Tibia ; Upper Extremity ; Weightlessness

PURPOSE: A mucocele of the appendix is an infrequent entity of appendiceal pathology. A preoperative diagnosis is important to determine for appropriate treatment and to avoid unintended rupture of the mucocele during surgery. The purpose of our study was to identify the clinical features of an appendiceal mucocele (AM) and to describe the experience of the use of the laparoscopic approach for an AM. METHODS: Between July 1998 and July 2008, 32 cases of AM were diagnosed. We reviewed the clinicopathological characteristics and surgical experience for an AM. RESULTS: The incidence of an AM was 0.66% for 4825 performed appendectomies. Most cases manifested with symptoms of abdominal pain (84.4%), but two cases were determined based on CT incidental findings. A preoperative diagnosis of a mucocele was determined for 34.4% of the cases. The use of ultrasonography, CT and colonoscopy helped to achieve a correct diagnosis. Open surgery was performed in 15 cases and laparoscopic surgery was performed in 17 cases. For patients that underwent an appendectomy, the mean operation time and diet-start date were significantly shorter for patients that underwent laparoscopic surgery as compared to patients that underwent open surgery (p=0.030, p=0.007, respectively). Pathology identified mucosal hyperplasia (25%), mucinous cystadenoma (59.4%) and a simple mucocele (15.6%). The mean duration of follow-up was 46 months. Recurrence or development of pseudomyxoma peritonei and complications after laparoscopic surgery were not seen. CONCLUSION: Laparoscopic resection of an AM was feasible when there was no mucinous spillage. Close follow-up is recommended in all patients due to the risk of recurrence in the form of pseudomyxoma peritonei or a gastrointestinal neoplasm.
Abdominal Pain ; Appendectomy ; Appendix ; Colonoscopy ; Cystadenoma, Mucinous ; Follow-Up Studies ; Gastrointestinal Neoplasms ; Humans ; Hyperplasia ; Incidence ; Incidental Findings ; Laparoscopy ; Mucins ; Mucocele ; Pseudomyxoma Peritonei ; Recurrence ; Rupture

OBJECTIVES: A Pregnancy becomes a developmental challenge and a life-turning point for both the woman herself and her family. The purpose of this study was to identify the correlation amomg the family support, intention of pregnancy and the antenatal self-care of pregnant women. METHOD: The data were collected from 129 pregnant women by a questionnaire. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, using the SPSS program. RESULT: The findings of the study are as fellows : Statistically significant variables related to family support were age, religion, educational level, occupation, relationship with husband, relationship with mother. Statistically significant variables related to intention of pregnancy were religion, abortion history. Statistically significant variables related to antenatal self-care were age, religion, occupation, abortion history, relationship with mother, the term of marriage. There was a significant correlation between family support and intention of pregnancy, family support and antenatal self-care, intention of pregnancy and antenatal self-care. CONCLUSION: Therefore, it is proposed that family support is an appropriate nursing intervention to improve the antenatal self-care and intention of pregnancy in pregnant women.
Abortion, Induced ; Female ; Humans ; Intention* ; Marriage ; Mothers ; Nursing ; Occupations ; Pregnancy* ; Pregnant Women* ; Surveys and Questionnaires ; Self Care* ; Spouses

OBJECTIVES: According to preceding studies, many people with mental disability have unbalanced dietary habits or excessive intake of calories. Most of them are overweight or obese due to lack of self-control for food consumption, swallowing with inadequate chewing and physical inactivity. Therefore, this study aimed to assess the nutritional intake, including carotenoid, in mentally disabled people and find out a possible solution for nutritional improvement. METHODS: People with intellectual disability (N=28), emotional disability (N=44) participated in this study. The disorder grades were from I to III and ages were between 20 and 65 years. Assessments included anthropometry, daily intake of nutrients, including carotenoid, ROMA III questionnaire for assessing bowel movement. RESULTS: The average BMI of intellectually disabled people and emotionally disabled people was in the range of overweight and obesity respectively (23.7 +/- 6.3 kg/m2, 25.8 +/- 4.1 kg/m2). Overall, the frequencies of vegetable and dairy product intakes were lower in this population. When compared with Recommended Nutrient Intake (RNI) from Dietary Reference Intakes for Koreans 2010, the intakes of vitamin B1, vitamin B2 and calcium were insufficient in both groups. Also, lycopene intakes of carotenoid were low, compared with traditional Korean diet of the non-disabled people from the second year 2008 of the 4th National Health and Nutrition Survey. In addition, emotionally disabled people also had lower intake of cryptoxanthin. CONCLUSIONS: The mentally disabled people in this study showed lower intakes of vitamin B1, vitamin B2, calcium and carotenoids. Based on these findings, we recommend that it is important to encourage mentally disabled people to consume sufficient amounts of such nutrients in order to promote nutritional status.
Adult* ; Anthropometry ; Calcium ; Carotenoids ; Dairy Products ; Deglutition ; Diet ; Food Habits* ; Humans ; Intellectual Disability ; Mastication ; Mentally Disabled Persons* ; Nutrition Surveys ; Nutritional Status ; Obesity ; Overweight ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Riboflavin ; Thiamine ; Vegetables

Poland syndrome is characterized by unilateral absence or hypoplasia of the pectoralis muscle and variable degree of ipsilateral hand anomalies. Mobius syndrome is a congenital neurological disorder characterized by complete or partial facial paralysis. Although the pathogeneses of these diseases are not well-characterized, diminished blood flow to the affected side is thought to play a role. A male infant weighing 2.670 g was born at 38+3 weeks of gestation with left facial paralysis, left chest wall defect with dextrocardia, and symbrachydactyly between the second and third fingers. The combination of Poland-Mobius syndrome is rare, and only 2 cases associated with dextrocardia have been reported worldwide. Here, we report the first case of Poland-Mobius syndrome associated with dextrocardia in Korea.
Dextrocardia ; Facial Paralysis ; Fingers ; Hand ; Humans ; Infant ; Korea ; Male ; Mobius Syndrome ; Nervous System Diseases ; Pectoralis Muscles ; Poland Syndrome ; Pregnancy ; Thoracic Wall