Purpose: This study was conducted to develop and test the effects of a coronavirus disease 2019 (COVID-19) education program for nursing students. Methods: This study used a non-equivalent control group pretest-posttest design. A total of 71 undergraduate nursing students who had completed a fundamental nursing course and were in their third or fourth year of university participated in this study (experimental group n=38, control group n=33). The COVID-19 education program was developed according to the stages of analysis, design, development, implementation, and evaluation. The program consisted of three weekly sessions that each lasted about two hours. The data were collected from February 26 to March 26, 2022 and were analyzed using the chi-squared, Fisher’s exact, and independent t-tests. Results: Knowledge about COVID-19, knowledge about personal protective equipment and attitudes toward COVID-19 were not significantly different between the experimental and control groups. However, significant differences were found between the experimental and control groups regarding their confidence in COVID-19 patient nursing care (t=3.02, p=.004). Conclusion It was confirmed that the developed program was effective in enhancing the confidence of nursing students in performing nursing for COVID-19. Therefore, it is proposed that the education program developed in this study be used as part of an infection control education program to improve nursing students’ abilities to respond to emerging infectious diseases, including COVID-19.

PURPOSE: Streptococcus pyogenes is an important cause of invasive diseases in children. We aimed to describe the clinical characteristics of invasive infections due to S. pyogenes in children in Korea. METHODS: A retrospective study of children under 18 years of age with invasive infections due to S. pyogenes at Seoul National University Children's Hospital between March 1992 and December 2012, and Seoul National University Bundang Hospital between March 2003 and December 2012 was conducted. Demographic factors, clinical characteristics, laboratory findings, treatment, mortality and morbidity of all patients were reviewed. RESULTS: A total of 30 among 36 cases identified as invasive disease due to S. pyogenes were available for review. There was a predominance for male subjects (male:female=2.75:1). The median age was 50 months (range 12 days to 15 years) and 53.3% were under 5 years of age. Skin and soft tissue infections (9/30, 30.0%), bacteremia without identified focus (4/30, 13.3%) and bone and joint infections (6/30, 20.0%) were the most frequent clinical presentations. Streptococcal toxic shock syndrome (3/30, 10.0%) pulmonary, abdomen and central nervous system infections (2/30, 6.7%) were also seen. There was a peak in number of patients in year 2012 (9/30, 30.0%). There were no cases of mortality. Erythromycin and clindamycin resistance rates were low by 3.8% and 7.5%, respectively. CONCLUSION: We studied the clinical presentations of invasive infections due to S. pyogenes during the past 20 years in Korean children. The findings of this study help us understand the characteristics of the disease, enhancing early recognition and prompting adequate antibiotic therapy which is important in reducing morbidity and mortality.
Abdomen ; Bacteremia ; Bacterial Infections ; Central Nervous System Infections ; Child* ; Clindamycin ; Demography ; Erythromycin ; Humans ; Joints ; Korea ; Male ; Mortality ; Retrospective Studies ; Seoul ; Shock, Septic ; Skin ; Soft Tissue Infections ; Streptococcus pyogenes*

Background: Staphylococcal scalded skin syndrome (SSSS) is a skin disease characterized by blistering and desquamation caused by exfoliative toxins (ETs) of Staphylococcus aureus (S. aureus).Although many countries show predominance of methicillin-susceptible S. aureus (MSSA), cases of methicillin-resistant S. aureus (MRSA) have been reported. Methods: Twenty-six children aged <15 years diagnosed with SSSS from January 2010 to December 2017 from three hospitals were included. S. aureus isolates from cases were analyzed for multilocus sequence types and ETs. Medical records were reviewed for clinical characteristics, treatment, and antimicrobial susceptibility patterns of S. aureus Results: Among the 26 cases, mean age was 2.3 years. According to skin manifestations patients were classified as generalized (n = 10, 38.5%), intermediate (n = 11, 42.3%), and abortive (n = 5, 19.2%). Among all cases, 96.2% (25/26) were due to MRSA and the macrolideresistance rate was 92.3% (24/26). ST89 (n = 21, 80.8%) was the most prevalent clone, followed by single clones of ST1, ST5, ST72, ST121, and ST1507. The eta gene was detected in one (3.8%) isolate which was MSSA. The etb gene was detected in 14 (53.8%) isolates, all of which were ST89. Nafcillin or first-generation cephalosporin was most commonly prescribed (n=20, 76.9%). Vancomycin was administered in four patients (15.4%) and clindamycin in nine patients (34.6%). Among MRSA cases, there was no difference in duration of treatment when comparing the use of antimicrobials to which the causative bacteria were susceptible or non-susceptible (9.75 vs. 8.07 days, P > 0.05). Conclusion S. aureus isolated from children with SSSS in Korea demonstrated a high prevalence of methicillin-resistant ST89 clones that harbored theetb gene. The predominance of MRSA suggests that antibiotics to which MRSA are susceptible may be considered for empirical antibiotic treatment in children with SSSS in Korea. Further studies on the role and effectiveness of systemic antibiotics in SSSS are warranted.

The 7-valent pneumococcal protein conjugate vaccine (PCV7) has been shown to be highly efficacious against invasive pneumococcal diseases and effective against pneumonia and in reducing otitis media. The introduction of PCV7 has resulted in major changes in the epidemiology of pneumococcal diseases. However, pneumococcal vaccines induce serotype-specific immunity, and a relative increase in non-vaccine serotypes has been reported following the widespread use of PCV7, leading to a need for extended serotype coverage for protection. PCV10 and PCV13 have been licensed on the basis of noninferiority of immunogenicity compared to a licensed conjugate vaccine. In this article, we aimed to review important data regarding the efficacy and effectiveness of the extended-coverage PCVs published or reported thus far and to discuss future implications for pneumococcal vaccines in Korea. After the introduction of PCV10 and PCV13, within a short period of time, evidence of protection conferred by these vaccines against invasive and mucosal infections caused by most of the serotypes included in the vaccines is accumulating. The choice of vaccine should be based on the changes in the dynamics of pneumococcal serotype distribution and diseases in the region where the vaccines are to be used. Continuous surveillance is essential for the appropriate use of pneumococcal vaccines and evaluation of the impact of PCVs on pneumococcal diseases.
Epidemiology ; Korea ; Otitis Media ; Pneumococcal Vaccines ; Pneumonia ; Vaccines ; Vaccines, Conjugate*

PURPOSE: This study aimed to investigate the association between respiratory virus infection and pneumococcal colonization in children. METHODS: From May 2009 to June 2010, nasopharyngeal (NP) aspirates were obtained from patients under 18 years old who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses (influenza virus A and B, parainfluenza virus 1, 2 and 3, respiratory syncytial virus A and B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63 and OC43/HKU1) by RT-PCR and pneumococcus by culture. RESULTS: Median age of the patients was 27 months old. A total of 1,367 NP aspirates were tested for respiratory viruses and pneumococcus. Pneumococcus was isolated from 228 (16.7%) of samples and respiratory viruses were detected from 731 (53.5%). Common viruses were rhinovirus (18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influenza virus A (6.8%). Pneumococcal isolation rate was significantly higher in the cases of positive virus detection than negative detection [21.3% (156/731) vs. 11.3% (72/636), P<0.001]. For individual viruses, pneumococcal isolation rate was positively associated with detection of influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhinovirus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]. CONCLUSION: The study revealed that pneumococcal isolation from NP aspirates is related with respiratory virus detection. The result of this study could be used to investigate how respiratory viruses and pneumococcus cause clinical diseases.
Adenoviridae ; Child* ; Colon* ; Coronavirus ; Humans ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Rhinovirus ; Seoul ; Streptococcus pneumoniae

Multiple primary cancer is a state of disease that developed more than two cancers in an individual, independently. Multiple primary malignant cancer is divided to synchronous and metachronous type depending on the interval between their diagnoses. Synchronous multiple cancer is diagnosed within an interval of six months and metachronous multiple cancer more than six months interval. As further advance in diagnostic techniques and treatment method bring about progressive increase in the number of individuals living in the 'cancer age' group. So, the population of patients with subsequent primary cancer will increase and after all the incidence of multiple primary cancer will be increased, gradually. Herein, we experienced a case of a 83-year-old male patient with metachronous triple primary cancer composed of gastric cancer, bladder cancer and lung cancer. We found the adenocarcinoma of stomach, transitional cell cancer of bladder and squamous cell carcinoma of lung. For its great rarity, we report this case with review of literatures about the history, criteria, incidence, site relationship and so on.
Adenocarcinoma ; Aged, 80 and over ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Incidence ; Lung Neoplasms ; Lung* ; Male ; Stomach Neoplasms ; Stomach* ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: The purpose of this study was to investigate the effects of job stress and support from supervisors on depression of care givers in elderly care facilities. METHODS: Subjects were 191 care givers working in elderly care facilities in K-Province in Korea. Data were collected from self-administered questionnaires. Descriptive statistics, chi2 test, t-test, F-test, Pearson's and Spearman's correlation coefficients, and hierarchical multiple logistic regression with dummy variables were used for statistical analysis of data. RESULTS: Job stress measured with Korean Occupational Stress Scale was 56.16+/-5.88. Emotional and instrumental support from supervisors were 37.05+/-7.30 and 32.39+/-7.34, respectively. After controlling for general characteristics, job stress was significantly related to depression (OR: 1.07, 95% CI: 1.01~1.14). However, job stress became non-significant in the model that included instrumental support from supervisors. Not emotional but instrumental support from supervisors was significantly related to depression of care givers (OR: 0.93, 95% CI: 0.88~0.99). CONCLUSION: Results of this study suggest that job stress has negative effects and instrumental support from supervisors has protective effects on depression of care givers in elderly care facilities. Therefore, measures to increase instrumental support by supervisors should be developed to improve psychological health of care givers in elderly care facilities.
Aged* ; Caregivers* ; Depression* ; Humans ; Korea ; Logistic Models

Background: The epidemiology of coronavirus disease 2019 (COVID-19) has changed continuously throughout the pandemic. Methods: We analyzed changes in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to the age group in South Korea from February 2020 to December 2021. Results: Since the COVID-19 pandemic, the incidence among adults aged ≥ 18 years was higher than all the other age groups in 2020; however, a shift toward younger ages occurred in June 2021. In addition, we found significant changes in epidemiology after the introduction of SARS-CoV-2 vaccines in adults aged ≥ 18 and children 12–17 years. Until recently, children were not regarded as the drive for the pandemic; however, children aged 5–11 and 0–4 years had the highest incidence among all the age groups. Conclusion Therefore, policies for clinical support for an increase in COVID-19 cases among young children and age-specific preventive measures are needed.

A five-year-old spayed female Labrador retriever presented with right forelimb lameness one day earlier. Radiographs and computed tomography of the right shoulder joint revealed conspicuous enthesophytes, bone cyst, and bone fragment at the intertubercular groove. Magnetic resonance imaging showed a loss of continuity of the biceps tendon and inhomogeneous hyperintense signal of the surrounding soft tissue and moderate synovial fluid on T2- and proton density-weighted images with contrast enhancement on the postcontrast T1-weighted images. The dog was diagnosed with tenosynovitis and biceps tendon rupture with osteoarthritis based on a comprehensive evaluation of the computed tomography and magnetic resonance imaging features.

A five-year-old spayed female Labrador retriever presented with right forelimb lameness one day earlier. Radiographs and computed tomography of the right shoulder joint revealed conspicuous enthesophytes, bone cyst, and bone fragment at the intertubercular groove. Magnetic resonance imaging showed a loss of continuity of the biceps tendon and inhomogeneous hyperintense signal of the surrounding soft tissue and moderate synovial fluid on T2- and proton density-weighted images with contrast enhancement on the postcontrast T1-weighted images. The dog was diagnosed with tenosynovitis and biceps tendon rupture with osteoarthritis based on a comprehensive evaluation of the computed tomography and magnetic resonance imaging features.