Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

A male baby with intrauterine growth retardation had a short neck, small hands and feet, hypospadia, both grade I hydronephrosis, type II atrial septal defect, and moderate valvular pulmonary stenosis. The routine chromosome and banding analyses revealed a 46,XY,rec(8)del(8)(p21)dup(8) (q24.1)inv(8)(p21q24.1)pat chromosome constitution. His mother has normal chromosomes, but the father had 46,XY,inv(8)(p21q24.1). Also his uncle had an inv(8) chromosome constitution. We used lymphocytes and examined 40 mitotic cells. All mitotic cells showed deletion of 8p21-->pter and duplication of 8q24.1-->qter. Because 8p21 involves secretion of macrophage and lymphocyte against cancer cells, long-term follow-up for cancer will be needed.
Chromosome Deletion ; Chromosomes, Human, Pair 8 ; Constitution and Bylaws ; Fathers ; Female ; Fetal Growth Retardation ; Foot ; Hand ; Heart Septal Defects, Atrial ; Humans ; Hydronephrosis ; Hypospadias ; Lymphocytes ; Macrophages ; Male ; Mothers ; Neck ; Pulmonary Valve Stenosis ; Trisomy

PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents ; Asthma ; Bronchitis, Chronic ; Bronchodilator Agents ; Child ; Cough* ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Interview, Psychological ; Male

Grand multifetal pregnancies (4 or more), usually caused by ovulation induction agents and assisted reproductive technologies, challenge all members of a perinatal team and put mothers and infants increased risk. Important anesthetic considerations include greater incidence of complications that in the singleton pregnancy, risks related to the large pregnant uterus, impaired uterine contraction prior to delivery secondary to fetal oxygenation, and preparation of sufficient man-power and instruments. The importance of neonatal resuscitation cannot be overemphasized. We report a successful general anesthetic management for an emergent quadruplet cesarean section at 31 weeks 5 days weeks gestational age.
Anesthesia, General ; Cesarean Section ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Mothers ; Ovulation Induction ; Oxygen ; Pregnancy ; Quadruplets* ; Reproductive Techniques, Assisted ; Resuscitation ; Uterine Contraction ; Uterus

BACKGROUND: Rescently, the immunotherapy against infectious disease and cancer is being actively studied, and high yield of pure CD14+ monocytes is a key of concern. In this study, we optimized the percoll gradient method to increase the purity and yield of monocytes from peripheral mononuclear cells. METHODS: We separated mononuclear cells (MNC) from healthy donors, and monocytes from MNC were separated with the various density of percoll gradient. After centrifugation, we determined the most efficient density of the percoll gradient to get the highest yield and purity of monocytes. We also obtained monocytes by the plastic absorption method. Monocytes were differentiated into dendritic cells (DC) and the efficacy of differentiation to DC is confirmed and compared by morphological characteristics and using a flowcytometer. RESULTS: The purity of monocytes was 51.3+/-8.3% by the 35% percoll gradient method and the purity was improved to 82.9+/-4.2% with 100% of yield by repeating the same method. Therefore, the yield of mature dendritic cells was 3.6+/-0.9% of the total input MNC by the 35% percoll repetition method, which was 1.7 times higher than the plastic adherent method (2.1+/-0.5%). CONCLUSION: This study shows a cost-effective method to isolate CD14+ monocytes and these cells demonstrate high differentiation rate to DC. This process will be valuable for obtaining a sufficient number of DC.
Absorption ; Centrifugation ; Communicable Diseases ; Dendritic Cells ; Humans ; Immunotherapy ; Monocytes ; Plastics ; Povidone ; Silicon Dioxide ; Tissue Donors

PURPOSE: Although asthma is generally understood as a disease of the the small airways, FEF25-75%, an index representing peripheral small airways, is a appropriately used in the diagnosis of asthma. The objectives of this study are to assess the usefulness of FEF25-75% in children with asthma for clinical application. METHODS: Five hundred sixty two 5- to 15-year-old children with symptoms suggestive of asthma were enrolled. Methacholine bronchial provocation tests were performed and the children were divided into two groups according to their test results. RESULTS: Forced expiratory flow between 25-75 percent of vital capacity (FEF25-75%) was significantly lower in asthma group (P< 0.001). A 25 percent fall of FEF25-75% of percentage predicted value was correlated with PC20FEV1 (provacation concentration of methacholine required to reduce FEV1 by 20 percent) (r=0.601, P< 0.001). The sensitivity of PC25FEF25-75% (provocation concentration of methacholine required to reduce FEF25-75% by 25 percent) was 94.11 percent when PC20FEV1 was a point of reference. Youden's index was 0.64. CONCLUSION: FEF25-75% is an useful and sensitive index that predicts the presence or absence and the degree of bronchial hyperresponsiveness and PC25FEF25-75% should be brought into clinical application in asthmatic children.
Adolescent ; Asthma* ; Bronchial Provocation Tests* ; Child* ; Diagnosis ; Humans ; Methacholine Chloride* ; Vital Capacity

OBJECTIVES: This study was conducted to examine blood pressure and other characteristics of a high sodium intake group assessed with 24-hr urine analysis and the dietary factors related to the risk of high sodium intake among Korean adults. METHODS: A cross-sectional study was conducted with adults aged 20-59 years. Subjects who completed 24-hr urine collection (N = 205) were divided into 3 groups (tertile) according to the sodium intake estimated with 24-hour urine analysis. We compared the blood pressure, BMI and dietary related factors of the 3 groups (low, medium, high sodium intake group) with General Linear Model (GLM) and Duncan's multiple range test (p < 0.05). The risk factors related to high sodium intake were assessed with odds ratio (p < 0.05). RESULTS: The sodium intake (mg/day) of the 3 groups were 3359.8 +/- 627.9, 4900.3 +/- 395.1 and 6770.6 +/- 873.9, respectively, corresponding to daily salt intake (g/day) 8.5, 12.4 and 17.2, respectively. High sodium group showed significantly elevated age, BMI and systolic/diastolic blood pressure. Being male gender was associated with significantly increased risk of sodium intake (OR = 1.972; 95%CI: 1.083-3.593). The other factors related to high sodium intake were higher BMI (> or = 25) (OR = 2.619; 95% CI: 1.368-5.015), current alcohol consumption (OR = 1.943; 95%CI: 1.060-3.564), and having salty soybean paste with salt percentage > 14% (OR = 3.99; 95% CI: 1.404-6.841). The dietary attitude related to increased risk of high sodium intake included 'enjoy dried fish and salted mackerel' (p < 0.001) and 'eat all broth of soup, stew or noodle' (p < 0.001). CONCLUSIONS: Because high sodium intake was associated with higher blood pressure, nutrition education should focus on alcohol consumption, emphasis on related dietary factors such as using low salt soybean paste, improvements in the habit of eating dried fish and salted mackerel or eating all broth of soup, stew or noodle.
Adult* ; Alcohol Drinking ; Blood Pressure* ; Cross-Sectional Studies ; Eating ; Education ; Humans ; Linear Models ; Male ; Odds Ratio ; Perciformes ; Risk Factors* ; Sodium* ; Soybeans ; Urine Specimen Collection

An 8-year-old male was admitted because of dysphagia and substernal pain suffered while eating followed by postprandial vomiting for 2 years. He was always hungry due to postprandial vomiting and willing to eat again just after vomiting. After this meals, he used to jump up and down to shake off the substernal discomfort. A narrowing of the gastroesophageal junction was noted by esophagogram. Manometry revealed high Lower esophageal sphincter (LES) pressure (51.6mmHg), incomplete LES relaxation during swallowing, loss of esophageal peristalsis and a positive pressure of the esophageal body compared to intragastric pressure. After the 1st balloon dilatation, symptoms were much improved even though LES pressure still remained high (37.2mmHg). About 2 months after the 1st balloon dilatation, symptoms relapsed and we managed him with a 2nd balloon dilatation. Symptoms were more improved than after the 1st dilatation and LES pressure normalized as well. Since the 2nd dilatation, symptoms have not recurred for 3 years. We present an 8-year-old boy with achalasia successfully managed by the use balloon dilatation.
Child ; Deglutition ; Deglutition Disorders ; Dilatation* ; Eating ; Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Esophagogastric Junction ; Humans ; Male ; Manometry ; Meals ; Peristalsis ; Relaxation ; Vomiting