No abstract available.
Factor VIII* ; Prevalence*

PURPOSE: The aim of this study was to identify the roles, duties and tasks of elementary health teachers. Required knowledge, skills, and worker behaviors were also examined. METHODS: Elementary health teachers' jobs were analyzed by DACUM workshop. First, the health teachers' roles and related jobs were described, and then the jobs were divided into duties and subordinate tasks. The identified roles, duties and tasks were reviewed and refined, and then were organized in a DACUM chart. DACUM committee members discussed not only general knowledge, skills and work behaviors but also future trends and concerns. RESULTS: The DACUM chart for elementary health teachers consisted of 8 duties and 52 tasks. Required knowledge, skills and worker behaviors were also listed. CONCLUSION: Elementary health teachers play roles as health manager, health care provider, and teacher in school. Their roles, duties and tasks are being changed. Thus, their jobs need to be redefined legally, politically, and institutionally.
Committee Membership ; Education ; Health Personnel ; Humans ; Job Description ; School Health Services ; Task Performance and Analysis

BACKGROUND: Cellular phone has become a necessary device for communicating in hospitals. Cellular phones contaminated with bacteria may serve as a fomite in the transmission of pathogens by the hands of medical personnel. We investigated the bacterial contamination of cellular phones used by medical personnel in a tertiary hospital. METHODS: Culture swabs were obtained from 101 cellular phones and 99 anterior nasal cavities from medical personnel using cellular phones. The swabs were inoculated on blood agar, MacConkey agar, mannitol salt agar, and enterococcal broths containing 6microgram/mL vancomycin for 48 h at 37degrees C. The bacteria were identified on the basis of colony morphology, gram staining characteristics, catalase test, coagulase test, and DNase test; Microscan (Siemens, USA) was used for the identification of enterococci. RESULTS: Of the 101 cellular phones, 13 were contaminated with Staphylococcus aureus (including 4 methicillin-resistant S. aureus [MRSA]), 61 with coagulase-negative staphylococci (CoNS) (including 38 methicillin-resistant CoNS), 27 with Micrococcus spp., 11 with diphtheroids, 67 with Bacillus spp., and 4 with viridans streptococci. No gram-negative bacilli were isolated. Nasal swabs yielded 36 S. aureus, including 9 MRSA. Only 1 of 9 cellular phones used by the MRSA carriers was contaminated with MRSA. CONCLUSION: Cellular phones used by some medical personnel were contaminated with pathogens such as S. aureus or MRSA. Although, the clinical implications of pathogens isolated from cellular phones have not been fully investigated, pathogens could be transmitted by the hands of medical personnel who are cellular phone users.
Agar ; Bacillus ; Bacteria ; Catalase ; Cellular Phone ; Coagulase ; Deoxyribonucleases ; Disinfection ; Fomites ; Hand ; Hand Hygiene ; Mannitol ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Micrococcus ; Nasal Cavity ; Staphylococcus aureus ; Tertiary Care Centers ; Vancomycin ; Viridans Streptococci

Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.
Delayed Diagnosis ; Hernia ; Hernia, Diaphragmatic ; Humans ; Infant ; Parturition ; Thoracic Cavity ; Thorax ; Vomiting

OBJECTIVE: Among causes of sudden death presumed to be related with use of atypical antipsychotics, all drugs which could induce torsade de pointes had been known to prolong QTc interval. Therefore, to monitor the changes of QTc interval on EKG seemed to be an important marker for the antipsychotic-induced cardiotoxicity, further to prevent sudden death due to fatal ventricular arrythmia. There are several studies and case reports about cardiac toxicity in some patients who were administered newly developed atypical antipsychotics. The aims of this study were to know whether quetiapine causes changes in QTc interval, and to identify affecting factors. METHODS: For the 31 inpatients (21 females, 10 males) with schizophrenia (N=25) or schizoaffective disorder (N=5), schizophreniform disorder (N=1) according to DSM-IV, the EKG monitoring was successively taken on baseline and the 2nd, 4th and 6th weeks after quetiapine administration, and serial changes of every EKG parameters including QTc interval was comparatively analyzed. Furthermore, variables such as cardiovascular risk factors (weight gain, hyperlipidemia, thyroid function, etc.), dose of drugs, drug combination, severity of psychotic symptoms, changes in the activity of autonomic nervous system despite of sex and age were also successively assessed on baseline and the 2, 4, and 6 weeks after quetiapine administration. RESULTS: 1) Every EKG parameters (heart rate, PR interval, QRS and QT) including QTc interval and diastolic blood pressure were not changed significantly on the 2, 4, and 6 weeks after quetiapine administration as compared with baseline. The systolic pressure was significantly declined form the 2 weeks after quetiapine administration as compared with baseline (p<0.05). 2) Among variables affecting the EKG parameters including QTc interval, age, dose of drugs, hyperlipidemia and thyroid function were not correlated with. However, the body weight on the 6 weeks after quetiapine administration had significant negative correlation with QT (gamma=-0.427)and QTc interval (gamma=-0.406), and the drug combination on the 6 weeks after quetiapine treatment had significant positive correlation with QRS (gamma=0.393) and QT (gamma=0.415), while severity of psychotic symptoms on the 4th week had correlation with QT (gamma=0.380) (p<0.05, respectively). Otherwise, the QTc interval on the 6 weeks after was significantly prolonged in female patients (p<0.05). CONCLUSION: Even though the administration of quetiapine did not cause significant changes in the QTc interval in this study, we need to pay attention toward the possibly related factors.
Antipsychotic Agents ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Blood Pressure ; Body Weight ; Death, Sudden ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Female ; Humans ; Hyperlipidemias ; Inpatients ; Psychotic Disorders ; Risk Factors ; Schizophrenia ; Thyroid Gland ; Torsades de Pointes ; Quetiapine Fumarate

OBJECTIVES: The caregiver burden means emotional, social, financial, psychological, physical problems which could be experienced by occupational caregivers or families who cared disable patients. The caregiver burden affected by primary stressors (severity of disability in dementia patients) and secondary stressors (withdrawal from society, conflict between job and caregiving, loss of personal identity) may result in physical ill-health, depression, anxiety for the caregivers. The aims of this study were to assess caregiver burden in dementia, and to identify affecting factors. METHOD: 30 caregivers for dementia patients who had been treated at the "Dementia-Geriatric Mental Health Clinic" in the Kosin University Gospel Hospital and 44 healthy volunteers were selected. Using the Screen for Caregiver Burden (SCB), the degree of caregiver burden was measured. The demographic data was obtained by structured interview. Primary and secondary stressors were also analyzed. The severity of depression and anxiety was assessed by the Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS). The severity of cognitive dysfunction (MMSE, CDR, GDS), behavioral symtoms (Revised Memory and Behavior Problems Checklist, RMBPC), daily functional disability (ADL, IADL) for the dementia patients were evaluated. RESULTS: 1) The SCB scores were significantly (p<0.001) higher in dementia caregivers (8.71+/-4.90) than in controls (0.23+/-0.48). 2) The SCB scores were not correlated with age of caregivers (gamma=0.081), education (gamma=-0.163), duration of caregiving (gamma=0.275). The RMBPC scores had statistically significant positive correlation with SCB scores (gamma=0.545, p<0.01), while age of dementia patients (gamma=-0.234), onset age of dementia (gamma=-0.280), duration of dementia (gamma=0.029), CDR (gamma=0.080), GDS (gamma=-0.125), MMSE (gamma=-0.212), ADL (gamma=-0.315), IADL (gamma=0.155) had not. 3) The SCB scores had statistically significant positive correlation with degree of secondary stress (gamma=0.581, p<0.01) and anxiety (gamma=0.376, p<0.05). The degree of secondary stress had statistically significant positive correlation with degree of emotional stress (gamma=0.757, p<0.01), depression (gamma=0.482, p<0.01), anxiety (gamma=0.376, p<0.01). CONCLUSIONS: The caregiver burden in dementia seemed to be originated from primary stressors related to the behavioral symptoms as well as secondary stressors (degree of emotional stress, depression, anxiety, etc.). Therefore, active intervention by the geriatric specialists might be helpful to reduce their strain.
Activities of Daily Living ; Age of Onset ; Anxiety ; Behavioral Symptoms ; Caregivers* ; Checklist ; Dementia* ; Depression ; Education ; Healthy Volunteers ; Humans ; Memory ; Mental Health ; Specialization ; Stress, Psychological

PURPOSE: To compare the causes and clinical manifestations of pediatric ocular injuries according to grade level. METHODS: We retrospectively reviewed the medical records of 78 children, 15 years and younger, who had been hospitalized for pediatric ocular injuries, classified them into three groups according to grade level, and compared their clinical manifestations. RESULTS: Eighteen (23.1%) were preschoolers, 39 (50.0%) were elementary school students, and 21 (26.9%) were middle and high school students. The most common causes of injury included toys and household goods at home in the preschool group, toys and sporting activity at home and school in the elementary school group, and sporting activity at school in the middle and high school group. The incidence of ocular injury was higher in the 'without supervision group' (57.7%); however, in the preschool group, it was higher (72.2%) even in the 'supervision group' (P<0.05). In the preschool group, the incidence of perforating ocular injury (P<0.05) and the rate of surgical treatment (P<0.05) were higher than those of other groups. CONCLUSIONS: The causes and clinical manifestations of pediatric ocular injury were different according to school degree. The incidence of pediatric ocular injuries can be decreased more efficiently by recognizing these differences.
Child ; Family Characteristics ; Humans ; Incidence ; Medical Records ; Organization and Administration ; Play and Playthings ; Retrospective Studies ; Sports

PURPOSE: Measurement of testicular volume is useful for the evaluation of puberty and testicular development in boys. Four mililiter of testicular volume means Tanner stage 2, the beginning of puberty, and its ethnic differences were reported. However, there is no reference value for Korean children. We tried to establish the standard testicular volume for Korean boys. METHODS: The subjects were selected among the children who visited the out-patient clinic of Kangdong Sacred Heart Hospital and Korea Cancer Center Hospital for the evaluation of growth from 2003 to 2008. Three hundred seventy two healthy Korean boys, 3 to 17 years of age, were included. We excluded the patients who were diagnosed as precocious puberty, delayed puberty, hypopituitarism, adrenal disorder and other endocrinologic disorder. The testicular volume was determined with Prader orchidometer. Clinical data were collected from patient's chart retrospectively. RESULTS: Right and left testicular volumes were 3.65 +/- 1.82 mL and 3.55 +/- 1.80 mL at 10 (10.0 - 10.9) year of age (n = 53), 6.17 +/- 3.60 mL and 6.13 +/- 3.69 mL at 11 (11.0 - 11.9) year of age (n = 52), respectively. There was no significant difference between right and left testicular volumes. CONCLUSION: The time when testicular volume reached 4 mL seemed to be not changed than previous Korean data. However, further study will be required to determine the secular trend of pubertal timing in Korean boys.
Child ; Heart ; Humans ; Hypopituitarism ; Korea ; Outpatients ; Puberty ; Puberty, Delayed ; Puberty, Precocious ; Reference Values ; Retrospective Studies

PURPOSE: Being small for gestational age (SGA) is a risk factor of short stature in children. Genetic background such as mid-parental height (MPH) is known to influence growth of children born SGA. We studied the relationship between growth of children born SGA and MPH and studied the effects of insulin-like growth factor (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) on postnatal growth in children born SGA according to MPH. METHODS: Forty-nine neonates born SGA were included in this study. We defined corrected height standard deviation score (cHtSDS) by modified height SDS (HtSDS) based on their MPH. We categorized subjects into group 1 consisting of children with cHtSDS > or =0 (n=35) and group 2 consisting of children with cHtSDS <0 (n=14), and compared IGF-I and IGFBP-3 between the two groups. RESULTS: The HtSDSs and cHtSDSs in groups 1 and 2 were 0.06+/-1.05 vs. -0.95+/-0.85 (P=0.000) and 0.78+/-0.93 vs. -0.46+/-0.67 (P=0.000), respectively. IGF-I SDS was higher in group 1 than in group 2 (2.82+/-3.69 vs. 0.23+/-2.42, P=0.012). Total cHtSDS (0.42+/-1.03) was significantly higher than HtSDS (-0.22+/-1.10) (P=0.000). CONCLUSION: Our results show that cHtSDS differs significantly from HtSDS. Growth assessment by standardized growth curve does not uniformly show effects of genetic factors. A more accurate assessment of growth uses a personalized corrected growth curve that considers the genetic factor measured by MPH.
Child ; Gestational Age ; Humans ; Infant, Newborn ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Phenazines ; Risk Factors

PURPOSE: Being small for gestational age (SGA) is a risk factor of short stature in children. Genetic background such as mid-parental height (MPH) is known to influence growth of children born SGA. We studied the relationship between growth of children born SGA and MPH and studied the effects of insulin-like growth factor (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) on postnatal growth in children born SGA according to MPH. METHODS: Forty-nine neonates born SGA were included in this study. We defined corrected height standard deviation score (cHtSDS) by modified height SDS (HtSDS) based on their MPH. We categorized subjects into group 1 consisting of children with cHtSDS > or =0 (n=35) and group 2 consisting of children with cHtSDS <0 (n=14), and compared IGF-I and IGFBP-3 between the two groups. RESULTS: The HtSDSs and cHtSDSs in groups 1 and 2 were 0.06+/-1.05 vs. -0.95+/-0.85 (P=0.000) and 0.78+/-0.93 vs. -0.46+/-0.67 (P=0.000), respectively. IGF-I SDS was higher in group 1 than in group 2 (2.82+/-3.69 vs. 0.23+/-2.42, P=0.012). Total cHtSDS (0.42+/-1.03) was significantly higher than HtSDS (-0.22+/-1.10) (P=0.000). CONCLUSION: Our results show that cHtSDS differs significantly from HtSDS. Growth assessment by standardized growth curve does not uniformly show effects of genetic factors. A more accurate assessment of growth uses a personalized corrected growth curve that considers the genetic factor measured by MPH.
Child ; Gestational Age ; Humans ; Infant, Newborn ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Phenazines ; Risk Factors