Purpose: The purpose of this study was to identify the factors influencing nurses’ caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

Purpose: The purpose of this study was to identify the factors influencing nurses’ caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

Central core disease is a rare congenital myopathy characterized by the formation of cores that consist of abnormal arrangement of myofibrils inside the myofibers. We report a 5-year-old Korean girl who showed a fairly typical clinical course of non-progressive muscle weakness. Electrodiagnostic studies showed low-amplitude polyphasic electromyograph and normal nerve conduction velocity. Gastrocnemius muscle biopsy showed central cores in over 80% of the fibers on H&E section. Histochemistry revealed deficient or absent mitochondrial enzyme in the cores and type I predominance. Ultrastructurally both structured and non-structured cores were found separately or simultaneously in one fiber. This case is the first report in the Korean literature.
Child, Preschool ; Female ; Humans ; Microscopy, Electron ; Muscles/pathology/ultrastructure ; Muscular Diseases/*congenital/*pathology

The purpose of this study was to implement and evaluate the health education program for elementary school children. The program consisted of nutritional education and physical exercise. The subjects composed of 89 school children, first through sixth grade (n = 100), who had completed ten weeks of health education program from April through July 2010. Pre-post intervention design was used to evaluate the program effectiveness. After completing health education program, the number of overweight subjects decreased (boys 13 to 11 and girls 11 to 9) and the number of obese subjects decreased from 5 to 4 for boys and 4 to 2 for girls The number of sit-ups significantly increased in both 1-2 grade girls and 3-4 grade girls. Backward trunk extension of 1-2 grade girls also significantly increased (p < 0.05). The level of serum total cholesterol decreased from 171.8 mg/dL to 153.5 mg/dL (p < 0.001). Hypercholesterolemia (above 239 mg/dL), hyperLDLcholesterolemia (above 175 mg/dL) and low level hemoglobin subjects changed to normal levels. Total score of nutrition knowledge increased from 5.9 to 6.1 (p < 0.05), percentage of perception answers increased significantly in 5 out of 10 items and percentage of correct answers increased significantly in 6 out of 10 items (p < 0.05). Three food habits improved, including, "having breakfast", "having diverse foods" and "having vegetables per meal" (p < 0.05). Two self-efficacy items improved significantly, including, "having meals slowly", "having exercise instead of watching TV or computer" (p < 0.05). These results suggest that health education program for elementary school children including nutritional education and physical exercise may be effective to improve their anthropometric characteristics, physical fitness, hyperlipidemia, nutrition knowledge, food habits and self-efficacy.
Child ; Cholesterol ; Exercise ; Food Habits ; Health Education ; Hemoglobins ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Meals ; Overweight ; Physical Fitness ; Program Evaluation ; Vegetables

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in children, with a peak incidence at 5-14 years. Extrapulmonary manifestations occur in 20-25% of patients with M. pneumoniae infection. Most auto-antibodies that cause immune hemolytic anemia in humans are cold agglutinins. The formation of cold agglutinins is frequently observed during M. pneumoniae infections, and cold agglutinin disease usually occurs during M. pneumoniae infections. Nevertheless, severe hemolysis is exceptional. If a patient has any underlying disease related to hemolysis, it is possible to accelerate hemolysis. Hereditary spherocytosis is a common cause of hereditary hemolytic anemia resulting from red blood cell membrane defects. Hemolysis of red cells may result from corpuscular abnormalities or extracorpuscular abnormalities, such as immune or non-immune mechanisms. We report a case of hereditary spherocytosis associated with severe hemolytic anemia due to Mycoplasma pneumonia.
Agglutinins ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Anemia, Hemolytic, Congenital ; Child ; Cold Temperature ; Cryoglobulins ; Erythrocytes ; Hemolysis ; Humans ; Incidence ; Membranes ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Spherocytosis, Hereditary

Type 2 fiber predominance or a decrease of the type 1/type 2 ratio was rarely reported as the only abnormal pathologic finding in patients suffering from muscle cramp and myalgia. Here, we describe the clinicopathologic findings of three cases of type 2 fiber predominance, presented with muscle cramp and myalgia in otherwise healthy patients. All of them were young men (18, 19 and 22 years). Light microscopic and neurologic examinations, and laboratory data showed mere nonspecific findings that were not concordant with their subjective symptoms. However, enzyme histochemistry performed on muscle biopsy revealed an increased fraction of type 2 fibers; 73%, 80%, and 75%, in each case. The pathogenesis of this entity remains unclear, but the recognition of this unusual clinicopathologic entity is important for both pathologists and neurologists so they can avoid misdiagnoses or unnecessarily tiresome studies. We emphasize that type 2 fiber predominance should be included in the underlying causes of unexplained muscle cramps and exertional myalgia, especially among young adults, although it remains unclear whether the fiber type predominance is a separate entity or a part of other underlying neurologic or systemic disorders.
Biopsy ; Diagnostic Errors ; Humans ; Male ; Muscle Cramp* ; Myalgia* ; Neurologic Examination ; Young Adult

PURPOSE: Dexmedetomidine, a potent selective alpha2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery. MATERIALS AND METHODS: Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups. The dexmedetomidine group (Group D, n=20) received dexmedetomidine 1 microg/kg, followed by 0.1 microg/kg/h until the end of surgery, whereas the saline group (Group S, n=20) received volume-matched normal saline. Sevoflurane was used for induction and maintenance of anesthesia and caudal block was performed in all children. End-tidal sevoflurane concentration (ET-sevo), the incidence of emergence agitation, pain scores, and sedation scores were recorded. Hemodynamic changes and other adverse effects were assessed in the perioperative period. RESULTS: ET-sevo of Group D was significantly reduced in 23.8-67% compared to Group S during surgery. The incidence of emergence agitation was lower in Group D than in Group S (5% vs. 55%, p=0.001). Postoperative pain was comparable, and discharge time was not different between the groups. Mean arterial pressure and heart rate were significantly lower in Group D during surgery. CONCLUSION: Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery. However, caution should be taken in regard to bradycardia and hypotension.
Adolescent ; Adult ; Ambulatory Surgical Procedures/*methods ; Child ; Dexmedetomidine/*therapeutic use ; Female ; Hemodynamics/drug effects ; Humans ; Male ; Methyl Ethers/*therapeutic use ; Psychomotor Agitation/drug therapy ; Young Adult

PURPOSE: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. METHODS: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. RESULTS: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. CONCLUSION: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.
Adolescent* ; Arrhythmias, Cardiac ; Atrial Flutter ; Chest Pain* ; Child* ; Coronary Aneurysm ; Diagnosis ; Heart Diseases ; Humans ; Mediastinal Emphysema ; Medical Records ; Mucocutaneous Lymph Node Syndrome ; Musculoskeletal Diseases ; Pediatrics ; Pneumothorax ; Referral and Consultation ; Retrospective Studies ; Syncope ; Thorax*

Ring chromosome is a structural abnormality that is thought to be the result of fusion and breakage in the short and long arms of chromosome. Wolf-Hirschhorn syndrome (WHS) is a well-known congenital anomaly in the ring chromosome 4 with a partial deletion of the distal short arm. Here we report a 10-month-old male of mosaic ring chromosome 4 with the chief complaint of severe short stature. He showed the height of -4 standard deviation, subtle hypothyroidism and mild atrial septal defect/ventricular septal defect, and also a mild language developmental delay was suspected. Brain magnetic resonance imaging showed multifocal leukomalacia. Chromosomal analysis of the peripheral blood showed the mosaic karyotype with [46,XY,r(4)(p16q35)[84]/45,XY,-4[9]/91,XXYY, dic r(4;4)(p16q35;p16q35)[5]/46,XY,dic r(4;4)(p16q35;p16q35)[2]]. FISH study showed the deletion of the 4p subtelomeric region with the intact 4q subtelomeric and WHS region. Both paternal and maternal karyotypes were normal. We compared the phenotypic variation with the previously reported cases of ring chromosome 4. The ring chromosome 4 with the subtelomeric deletion of short arm seems to be related with the phenotype of short stature.
*Chromosome Deletion ; *Chromosomes, Human, Pair 4 ; Growth Disorders/*diagnosis/genetics ; Humans ; In Situ Hybridization, Fluorescence ; Infant ; Karyotyping ; Male ; *Ring Chromosomes ; Telomere

A sesquiterpene was purified from Artemisia iwayomogi methanolic extract during the course of searching anti-inflammatory principle from medicinal plants. A sesquiterpene identified as armefolin inhibited the production of nitric oxide (NO) and attenuated inducible nitric oxide synthase (iNOS) protein level in lipopolysaccharide (LPS)-activated RAW 264.7 cells. Armefolin also down-regulated mRNA expressions of iNOS and pro-inflammatory cytokines, interleukin-1β and interleukin-6 in LPS-activated macrophages. Moreover, armefolin suppressed the degradation of inhibitory-κBα (I-κBα) in LPS-activated macrophages. These data suggest that armefolin from A. iwayomogi can suppress the LPS-induced production of NO and the expression of iNOS gene through inhibiting the degradation of I-κBα. Taken together, armefolin from A. iwayomogi might be a candidate as promising anti-inflammatory agent.
Artemisia* ; Cytokines ; Interleukin-6 ; Macrophages ; Methanol ; Nitric Oxide ; Nitric Oxide Synthase Type II* ; Plants, Medicinal ; RAW 264.7 Cells* ; RNA, Messenger