PURPOSE: This descriptive study was done to identify factors that influence stress related to clinical practice for nursing students. METHODS: Structured questionnaires were used to collect data from 278 students from two nursing colleges located in G metropolitan city and one nursing college in C region. RESULTS: The factors that most influenced stress for the nursing students during their clinical practice were critical thinking disposition, clinical competence, year, and gender. Especially, the result showed that higher critical thinking disposition and clinical competence correlated with lower stress in clinical practice. CONCLUSION: The results indicate that improving nursing students' critical thinking ability and clinical competence would help to relieve stress during clinical practice and increase the ability to cope with stress efficiently. The development of a variety of teaching and learning strategies and education in both theoretical and clinical practice education would be necessary to achieve this goal.
Clinical Competence ; Education ; Humans ; Learning ; Nursing ; Surveys and Questionnaires ; Students, Nursing* ; Thinking

PURPOSE: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. METHODS: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. RESULTS: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. CONCLUSION: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.
Ambulatory Care Facilities ; Child ; Eating ; Feeding Behavior ; Feeding Methods ; Humans ; Meals ; Parents ; Surveys and Questionnaires

Peritoneal melanosis is an extremely rare condition characterized by diffuse pigmentation in the peritoneum. Only 7 cases have been reported in the literature, 4 cases in associated ovarian teratoma, 1 case in peritoneal cyst, 1 case in ovarian teratoma and mucinous adenoma, and 1 case in enteric duplication cyst. All occurred in young females and the source of the pigmentation was inconclusive. The authors have experienced one case of primary peritoneal melanosis with mucinous cystadenoma and report our case with a brief review of literature.
Adenoma ; Cystadenoma, Mucinous* ; Female ; Humans ; Melanosis* ; Mucins* ; Peritoneum ; Pigmentation ; Teratoma

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five (54.35%) were detected by mammogram alone, six (13.04%) by clinical breast examination (CBE) alone, and the remaining 15 (32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18 (72%) belonged to DCIS or stage I. In contrast, four (66.7%) of six cancers detected by CBE alone and nine (60%) of 15 cancers by both CBE and mammography were included in stage IIa or IIb. However, the total incidence of early cancers (stages 0 and I) was significantly higher in the screening group than in the symptomatic group (p < 0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.
Adult ; Breast* ; Breast Neoplasms/diagnosis* ; Clinical Protocols ; Female ; Human ; Mammography ; Middle Age ; Palpation*

The left aortic arch with an aberrant right subclavian artery, or arteria lusoria, is the most common aortic arch anomaly, occurring in 0.5-2.5% of individuals. In such cases, the angular course of the arteria lusoria to the ascending aorta imposes difficulty in passing a guide wire to the ascending aorta during right transradial catheterization. Here, the case of a 53-year-old woman with intermittent chest tightness and coughing is reported. Aberrant right subclavian artery (arteria lusoria) was diagnosed via aortogram during right transradial coronary angiography. Compression of the esophagus and trachea by the aberrant right subclavian artery was demonstrated by chest computed tomography (CT).
Aneurysm ; Aorta ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Catheterization ; Catheters ; Coronary Angiography ; Cough ; Deglutition Disorders ; Esophagus ; Female ; Humans ; Middle Aged ; Subclavian Artery ; Thorax ; Trachea

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*

Although early natural menopause has been postulated to increase stroke risk, studies have not produced convincing results. We examined the associations between stroke risks and age at natural menopause or time since natural menopause. 5,731 naturally postmenopausal women more than 65 yr of age were followed from 1993 to 1998. Information on age at menopause and risk factors were obtained using mailed questionnaires. 186 cases of stroke occurred over a total 27,936 person years. After adjusting for age, hypertension, and physical activity, age at menopause was not found to be significantly associated with stroke or cerebral infarction. However, adjusted relative risks (aRRs) showed a significant increasing tendency of hemorrhagic stroke versus age at menopause (aRRs, 0.66, 0.48, 1.00 and 2.33 for the following age groups at menopause; 40-44, 45-49, 50-54 [reference group], and > or =55 yr). Time since menopause (11-20, 21-30, and > or =31 yr) was not found to be significantly associated with cerebral infarction, or hemorrhagic stroke. Late menopause (menopause age > or =55 yr) showed a tendency of a lower risk of cerebral infarction (aRR, 0.79) and a higher risk of hemorrhagic stroke (aRR, 2.33). Further study is warranted to determine stroke risk in women during the decade following menopause.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage/etiology ; Cerebral Infarction/etiology ; Cerebrovascular Accident/*etiology ; Cohort Studies ; Female ; Humans ; Korea ; *Menopause ; Middle Aged ; Prospective Studies ; Questionnaires ; Research Support, Non-U.S. Gov't ; Time Factors

OBJECTIVES: This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.
Adolescent ; Adult ; Child ; Female ; *Handwashing ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; Toilet Facilities

PURPOSE: MMPs are involved in the degradation of the extracellular matrix, which is an important step in tumor invasion and metastasis. Among the MMPs, a positive correlation between the expressions of MMP-2 and MMP-9, and the aggressive behavior of breast carcinomas has been reported, but the role of the MMP-2 and MMP-9 expressions in DCIS is still not known. Angiogenesis has a crucial role in tumor growth and metastasis. The aim of this study was to investigate the relationships between the expressions of the MMPs, the angiogenic factor (VEGF) and the microvessel density (MVD) in a ductal carcinoma in situ (DCIS) of the breast. METHODS: 42 cases of DCIS, diagnosed at the Busan Paik Hospital, between 1992 and 2002, were the subjects of this study. The rates of MMP-2 and 9 expressions and VEGF were evaluated using immunohistochemistry, and the MVD was measured by CD 34 immunohistochemical staining. The statistical analyses between the expressions of MMP-2, MMP-9 and VEGF and the MVD, patient's age (more than 50 years old, less than 50 years old), histological subtype (comedo or non-comedo) and nuclear grade (I, II, III), and their correlation were exained. RESULTS: The expressions of MMP-2 and MMP-9 were noted in 20 (47.6%) and 22 (52.4%) of the 42 cases, respectively. There were no significant relationships between the expressions of MMP-2 and MMP-9 and the patient's age and histological subtype, but the expression rate of MMP-9 showed an increased tendency in cases with nuclear grades II and III compared with the cases with nuclear grade I (P=0.0863), but no significant difference between the MMP-2 expression and the nuclear grades was noted. The VEGF was expressed in 47.6% of the cases, and the mean MVD was 21 per x200 field, with 13 (30.9%) of the 42 cases showing increased MVD. The VEGF expression rate showed an increasing tendency in the cases younger than 50 years old (P= 0.1011), but no significant differences according to the histological subtype and nuclear grades were seen. There were no relationships between the MVD and the clinico-pathological factors. The MVD showed an increasing tendency in cases with a non-comedo histological type compared to the comedo type (P=0.0536). No positive correlation between the expression of VEGF and MVD was noted. No significant relationship between expressions of MMP-2 and VEGF and the MVD were seen, but the rate of MMP-9 expression was significantly higher in the VEGFpositive cases (P=0.0293), however, no relationship between MMP9 expression and MVD was found. CONCLUSION: The expressions of MMP-2 and MMP-9 in DCIS are suggestive of their involvement in the development of breast cancers. However, with non-invasive lesions, and the positive correlation between the MMP-9 and VEGF expressions and the nuclear grades, means that the expression of MMP-9 may represent the biological behavior of DCIS, but the role of MMP-2 expression is still uncertain in the development of breast carcinomas.
Angiogenesis Inducing Agents ; Breast Neoplasms ; Breast* ; Busan ; Carcinoma, Intraductal, Noninfiltrating* ; Extracellular Matrix ; Immunohistochemistry ; Matrix Metalloproteinases ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

BACKGROUND: Even though several oral anti-diabetic drugs (OAD) with various modes of action are replacing sulfonylurea (SU), some patients seem to be dependent on SU for adequate glycemic control. Therefore, we evaluated the clinical characteristics of such patients. METHODS: We selected the patients with type 2 diabetes who met following criteria from 2009 to 2014 at Seoul National University Hospital: glycated hemoglobin (HbA1c) was maintained below 7.5% for at least 6 months under small dose of SU (glimepiride < or =2 mg/day or equivalent dose); after discontinuation of SU, HbA1c increased > or =1.2% within 3 months or > or =1.5% within 6 months; and after resuming SU, HbA1c reduction was > or =0.8% or reduction of fasting plasma glucose was > or =40 mg/dL within 3 months. Patients with impaired hepatic or renal function, and steroid users were excluded. RESULTS: Nineteen subjects were enrolled: after averaged 4.8+/-1.5 months of SU-free period, HbA1c increased from 6.7%+/-0.4% to 8.8%+/-0.8% even though adding other OAD such as gliptins. However, HbA1c decreased to 7.4%+/-0.7% after resuming SU within 2.4+/-0.8 months. There was no sexual predominance. Despite their old age (67+/-11 years) and long duration of diabetes (18+/-10 years), fasting C-peptide was relatively well-reserved (3.9+/-2.6 ng/mL), and nephropathy was not observed (albumin-creatinine ratio 21.2+/-16.6 mg/g and estimated glomerular filtration rate 75.8+/-18.0 mL/min/1.73 m2). Strong family history was also noted (73.7%). CONCLUSION: Despite hypoglycemia risk of SU, it seemed indispensable for a subset of patients with regard to insulin secretion. Genetic influences would be evaluated.
Blood Glucose ; C-Peptide ; Diabetes Mellitus ; Dipeptidyl-Peptidase IV Inhibitors ; Fasting ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Seoul