No abstract available.
Dermatomyositis*

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: Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. METHODS: From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. RESULTS:Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. CONCLUSION: Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.
Bronchiolitis ; Bronchitis ; Child* ; Communicable Diseases ; Cough ; Epidemiology ; Heart ; Humans ; Incidence ; Infant ; Korea ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Whooping Cough*

Kawasaki disease is an acute vasculitis of unknown causes that occurs predominantly in infants and young children and produces coronary artery aneurysm. We have recently experienced a case of persistent Kawasaki disease in a 24 month-old-girl improved with pulsed doses of methylprednisolone. Even with an administration of intravenous gamma globulin(IVIG), she repeated the course of recovery and aggravation. After four times repeated doses of IVIG, additional intravenous methylprednisolone pulse therapy was tried and resulted in remarkable improvement. We reported the case with a brief review of the related literature.
Aneurysm ; Child ; Coronary Vessels ; Humans ; Immunoglobulins, Intravenous ; Infant ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome* ; Vasculitis

The patterns of the conventional radiation treatment fields and their shielding blocks are analysed to determine the optimal dimension of the MultiLeaf Collimator (MLC) which is considered as an essential tool for conformal therapy. Total 1169 radiation fields from 303 patients (203 from Asan Medical center, 50 from Baek Hosp and 50 from Hanyang Univ. Hosp.) were analysed for this study. Weighted case selection treatment site (from The Korean Society of Therapeutic Radiology 1003). Ninety one percent of total fields have shielding blocks. Y axis is defined as leaf movement direction and it is assumed that MLC is installed on the cranial-caudal direction. The length of X axis were distributed from 4cm to 40cm (less than 21cm for 95% of cases), and Y axis from 5cm to 38cm (less than 22cm for 95% of cases). The shielding blocks extended to less than 6cm from center of the filed for 95% of the cases. Start length for ninety five percent of block is less than 10cm for X axis and 11cm for Y axis. Seventy six percent of shielding blocks could be placed by either X or Y axis direction, 7.9% only by Y axis, 5.1% only by X axis and it is reasonable to install MLC for Y direction. Ninety five percent of patients can be treated with coplanar rotation therapy without changing the collimator angle. Eleven percent of cases of cases were impossible to replace with MLC. Futher study of shielding should be larger than 21cm X 22cm. The MLC should be designed as a pair of 21 leaves with 1cm wide for an acceptable resolution and 17cm long to enable the leaf to overtravel at least 6cm from the treatment field center.
Axis, Cervical Vertebra ; Chungcheongnam-do ; Humans ; Radiation Oncology

From October 1989 to March 1992, ten patients diagnosed as primary central nervous system(CNS) lymphoma were treated with radiation therapy at Asan Medical Center. To obtain pathologic diagnosis, five patients had stereotactic biopsy and the others underwent craniotomy & tumor removal. According to the classification by International Working Formulation, seven of 10 patients showed diffuse large cell types and the remaining 3 had diffuse mixed cell types. Computed tomographic scans of the brain disclosed solitary (6 cases) or multiple (4 cases) intracranial lesions. All patients received 4000cGy/20 fx to the whole brain followed by an additional 2000cGy/10 fx boost to the primary lesion. Six patients with initial cerebrospinal fluid (CSF) involvement were treated with whole brain irradiation and intrathecal Methotrexate(IT-MTX) chemotherapy. One of them received an additional spinal irradiation after 3 cycles of IT-MTX chemotherapy because of MTX induced arachnoiditis. One patient received 3 cycles of systemic chemotherapy prior to rodiation therapy and one received 5 cycles of salvage chemotherapy for recurrence. With a median follow up time of 8 months, all patients were followed from 7 to 26 months. Radiologically seven patients showed complete remission and the remaining three showed partial remission at one month after radiotherapy. The 1 and 2 year survival rate was 86% and 69% respectively. Until now, two patients expired at 7 and 14 months. These patients developed extensive CSF seeding followed by local failure. Considering initial good response to radiation therapy and low incidence of extraneural dissemination in primary CNS lymphoma, we propose to increase total tumor dose to the primary lesion by hyperfractionated radiotherapy or stereotactic radiosurgery. For the patients with CSF involvement at diagnosis, we propose craniospinal irradiation with IT MTX chemotherapy.
Arachnoid ; Arachnoiditis ; Biopsy ; Brain ; Cerebrospinal Fluid ; Chungcheongnam-do ; Classification ; Craniospinal Irradiation ; Craniotomy ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Lymphoma* ; Radiosurgery ; Radiotherapy ; Recurrence ; Survival Rate

No abstract available.
Blood Glucose* ; Glucose*

BACKGROUND: Subjects with normal glucose tolerance (NGT) who have a high 1-hour postload plasma glucose level (> or =155 mg/dL; NGT 1 hour-high) have been shown to be at higher risk for type 2 diabetes than subjects with NGT 1 hour-low postload plasma glucose level (<155 mg/dL). We compared beta-cell function in subjects with NGT 1 hour-high, NGT 1 hour-low, and impaired glucose tolerance (IGT). METHODS: We classified subjects into NGT 1 hour-low (n=149), NGT 1 hour-high (n=43), and IGT (n=52). The beta-cell function was assessed based on insulinogenic index (IGI), oral disposition index (DI), and insulin secretion-sensitivity index-2 (ISSI-2). RESULTS: Insulin sensitivity was comparable between the subjects with NGT 1 hour-high and NGT 1 hour-low. The beta-cell function with/without adjusting insulin sensitivity was significantly different among the three groups. The IGI (pmol/mmol) was 116.8+/-107.3 vs. 64.8+/-47.8 vs. 65.8+/-80.6 (P=0.141), oral DI was 3.5+/-4.2 vs. 1.8+/-1.4 vs. 1.8+/-3.1 (P<0.001), and ISSI-2 was 301.2+/-113.7 vs. 213.2+/-67.3 vs. 172.5+/-87.5 (P<0.001) in NGT 1 hour-low, NGT 1 hour-high, and IGT, respectively. Post hoc analyses revealed that oral DI and ISSI-2 were significantly different between NGT 1 hour-low and NGT 1 hour-high but comparable between NGT 1 hour-high and IGT. CONCLUSION: Among Korean subjects with NGT, those who have a higher 1-hour postload glucose level have a compromised insulin-sensitivity adjusted beta-cell function to a similar degree as IGT subjects.
Blood Glucose* ; Glucose Tolerance Test ; Glucose* ; Insulin ; Insulin Resistance

BACKGROUND: Von Hippel-Lindau (VHL) disease is an autosomal dominantly inherited, multisystemic tumor syndrome caused by mutations in the VHL gene. To date, more than 1,000 germline and somatic mutations of the VHL gene have been reported. We present a novel mutation in the VHL tumor suppressor gene that presented with gestational diabetes mellitus. METHODS: A 30-year-old woman presented with gestational diabetes mellitus. She sequentially showed multiple pancreatic cysts, spinal cord hemangioblastoma, cerebellar hemangioblastoma, and clear cell type renal cell carcinomas. Also, her father and brother had brain hemangioblastomas. Each of the three exons of the VHL gene was individually amplified by polymerase chain reaction and direct sequencing was performed using an ABI 3730 DNA analyzer. RESULTS: DNA sequence analysis to determine the presence of VHL mutation in her family revealed del291C, a novel frameshift mutation. CONCLUSION: We found a novel mutation in the VHL tumor suppressor gene that presented with gestational diabetes mellitus.
Adult ; Brain ; Carcinoma, Renal Cell ; Diabetes, Gestational* ; DNA ; Exons ; Fathers ; Female ; Genes, Tumor Suppressor* ; Hemangioblastoma ; Humans ; Pancreatic Cyst ; Polymerase Chain Reaction ; Pregnancy ; Sequence Analysis, DNA ; Siblings ; Spinal Cord ; von Hippel-Lindau Disease

BACKGROUND: Von Hippel-Lindau (VHL) disease is an autosomal dominantly inherited, multisystemic tumor syndrome caused by mutations in the VHL gene. To date, more than 1,000 germline and somatic mutations of the VHL gene have been reported. We present a novel mutation in the VHL tumor suppressor gene that presented with gestational diabetes mellitus. METHODS: A 30-year-old woman presented with gestational diabetes mellitus. She sequentially showed multiple pancreatic cysts, spinal cord hemangioblastoma, cerebellar hemangioblastoma, and clear cell type renal cell carcinomas. Also, her father and brother had brain hemangioblastomas. Each of the three exons of the VHL gene was individually amplified by polymerase chain reaction and direct sequencing was performed using an ABI 3730 DNA analyzer. RESULTS: DNA sequence analysis to determine the presence of VHL mutation in her family revealed del291C, a novel frameshift mutation. CONCLUSION: We found a novel mutation in the VHL tumor suppressor gene that presented with gestational diabetes mellitus.
Adult ; Brain ; Carcinoma, Renal Cell ; Diabetes, Gestational* ; DNA ; Exons ; Fathers ; Female ; Genes, Tumor Suppressor* ; Hemangioblastoma ; Humans ; Pancreatic Cyst ; Polymerase Chain Reaction ; Pregnancy ; Sequence Analysis, DNA ; Siblings ; Spinal Cord ; von Hippel-Lindau Disease