PURPOSE: We evaluated plasma coagulation parameters sequentially and the influence of antithrombin III adjuvant treatment in children with acute lymphoblastic leukemia. METHODS: Twenty-nine cases with acute lymhoblastic leukemia who had been treated with L-asparaginase at Pusan National University Hospital were enrolled in this study. The coagulation parameters were checked before and on every week of L-asparaginase administration. The patients whose level of antithrombin III was below normal range were given antithrombin III done adjuvant treatment. RESULTS: In the twenty-nine cycles of chemotherapies, nine cycles were treated with antithrombin III adjuvant therapy and others were not treated with the therapy. The PT and aPTT levels showed no changes during L-asparaginase treatment. After one week of L-asparaginase treatment, the fibrinogen and antithrombin III levels were decreased markedly. Antithrombin III level in patients under antithrombin III adjuvant treatment had increased significantly. On the other hand, antithrombin III level in patients not on antithrombin III adjuvant treatment showed low levels until finishing L-asparaginase. We observed only one case of sudden cerebral thrombosis in the non-antithrombin III adjuvant treatment. CONCLUSION: Antithrombin III adjuvant treatment can correct hemostatic parameters partially and may prevent thromboembolic events in patients with L-asparaginase.
Antithrombin III* ; Busan ; Child* ; Drug Therapy ; Fibrinogen ; Hand ; Humans ; Intracranial Thrombosis ; Leukemia ; Plasma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Reference Values

PURPOSE: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. METHOD: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. RESULT: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. CONCLUSION: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost?effectiveness, and the patients' and staffs' satisfaction.
Critical Pathways* ; Diagnosis ; Diet ; Humans ; Length of Stay ; Medical Records ; Specialization ; Uterine Artery Embolization* ; Uterine Artery*

No abstract available.
Pigmentation*

No abstract available.
Pigmentation*

Purpose: This study aimed to examine the effects of the nursing work environment and self-efficacy on medical safety competence of nurses in general hospital. Methods: Participants included 183 nurses who were recruited through convenience sampling in a general hospital in South Korea. Questionnaires were collected from August 25 to September 22, 2023. The nursing work environment, self-efficacy and medical safety competence scales were used to assess the study variables. The t-test, one-way ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression tests were performed using IBM SPSS ver. 26.0. Results: Statistically significant correlations were found between nurses’ medical safety competence and nursing work environment (r=.34, p<.001), and self-efficacy (r=.48, p<.001). Self-efficacy (β=.38, p<.001), nursing work environment (β=.25, p<.001), and clinical experience (β=.14, p=.043) had the greatest effect on nurses’ medical safety competence (F=21.21, p<.001), with an explanatory power of 30.0%. Conclusion This study confirmed that the nursing work environment and nurses' self-efficacy have a significant impact on nurses' medical safety competence. In order to implement patient safety in hospitals, it is necessary to develop and apply strategies to improve the nursing work environment and increase nurses’ self-efficacy to enhance their medical safety capabilities.

Purpose: This study aimed to examine the effects of the nursing work environment and self-efficacy on medical safety competence of nurses in general hospital. Methods: Participants included 183 nurses who were recruited through convenience sampling in a general hospital in South Korea. Questionnaires were collected from August 25 to September 22, 2023. The nursing work environment, self-efficacy and medical safety competence scales were used to assess the study variables. The t-test, one-way ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression tests were performed using IBM SPSS ver. 26.0. Results: Statistically significant correlations were found between nurses’ medical safety competence and nursing work environment (r=.34, p<.001), and self-efficacy (r=.48, p<.001). Self-efficacy (β=.38, p<.001), nursing work environment (β=.25, p<.001), and clinical experience (β=.14, p=.043) had the greatest effect on nurses’ medical safety competence (F=21.21, p<.001), with an explanatory power of 30.0%. Conclusion This study confirmed that the nursing work environment and nurses' self-efficacy have a significant impact on nurses' medical safety competence. In order to implement patient safety in hospitals, it is necessary to develop and apply strategies to improve the nursing work environment and increase nurses’ self-efficacy to enhance their medical safety capabilities.

Purpose: This study aimed to examine the effects of the nursing work environment and self-efficacy on medical safety competence of nurses in general hospital. Methods: Participants included 183 nurses who were recruited through convenience sampling in a general hospital in South Korea. Questionnaires were collected from August 25 to September 22, 2023. The nursing work environment, self-efficacy and medical safety competence scales were used to assess the study variables. The t-test, one-way ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression tests were performed using IBM SPSS ver. 26.0. Results: Statistically significant correlations were found between nurses’ medical safety competence and nursing work environment (r=.34, p<.001), and self-efficacy (r=.48, p<.001). Self-efficacy (β=.38, p<.001), nursing work environment (β=.25, p<.001), and clinical experience (β=.14, p=.043) had the greatest effect on nurses’ medical safety competence (F=21.21, p<.001), with an explanatory power of 30.0%. Conclusion This study confirmed that the nursing work environment and nurses' self-efficacy have a significant impact on nurses' medical safety competence. In order to implement patient safety in hospitals, it is necessary to develop and apply strategies to improve the nursing work environment and increase nurses’ self-efficacy to enhance their medical safety capabilities.

Purpose: This study aimed to examine the effects of the nursing work environment and self-efficacy on medical safety competence of nurses in general hospital. Methods: Participants included 183 nurses who were recruited through convenience sampling in a general hospital in South Korea. Questionnaires were collected from August 25 to September 22, 2023. The nursing work environment, self-efficacy and medical safety competence scales were used to assess the study variables. The t-test, one-way ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression tests were performed using IBM SPSS ver. 26.0. Results: Statistically significant correlations were found between nurses’ medical safety competence and nursing work environment (r=.34, p<.001), and self-efficacy (r=.48, p<.001). Self-efficacy (β=.38, p<.001), nursing work environment (β=.25, p<.001), and clinical experience (β=.14, p=.043) had the greatest effect on nurses’ medical safety competence (F=21.21, p<.001), with an explanatory power of 30.0%. Conclusion This study confirmed that the nursing work environment and nurses' self-efficacy have a significant impact on nurses' medical safety competence. In order to implement patient safety in hospitals, it is necessary to develop and apply strategies to improve the nursing work environment and increase nurses’ self-efficacy to enhance their medical safety capabilities.

Although some cases of benign positional vertigo are associated with a chronic ipsilateral sensorineural hearing loss, an association with simultaneous ipsilateral sudden deafness is rare. We report a 53-year old woman with sudden deaf-ness with simultaneous positional vertigo in the same ear characterized by benign paroxysmal positional vertigo of pos-terior semicircular canal type. After a modified Epley particle-repositioning maneuver, the patient's vertigo was resolved. Clinical and neuro-otologic evaluations suggested that the lesion responsible for this patient was probably located within inner ear rather than within the vestibulocochlear nerve. (J Korean Neurol Assoc 19(4):410~412, 2001)
Ear ; Ear, Inner ; Female ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Middle Aged ; Semicircular Canals ; Vertigo* ; Vestibulocochlear Nerve

PURPOSE: Langerhans cell histiocytosis (LCH) has a wide spectrum of clinical features. Especially, disseminated disease has been associated with a chronic course, high rate of morbidity and possible mortality. The purpose of our study was to investigate the clinical features, subsequent disease course, survival and late sequelae in multisystem LCH (ms-LCH). METHODS: Fourteen cases diagnosed to histologically proven ms-LCH at Pusan National University Hospital between January 1991 and December 1997 were enrolled in this study. All patients received combination chemotherpy. The medical records were retrospectively reviewed for organ involvement at diagosis, disease course, and late sequelae. RESULTS: 1) The peak incidence was between 6 months and 2 years and sex distribution revealed female predominance with the ratio of 1.8:1. 2) Mean number of involved organs was 4.4 and the most frequently involved organ was liver (85.7%) followed by bone, middle ear, skin and spleen. 3) The mean duration of follow up was 41.6 27.5 months. And the overall estimated survival rate at 5 years was 75.9%, with an estimated disease free survival rate of only 40.8% at 5 years. 4) Three patients died and the causes of death were respiratory failure due to pneumonia, gastrointestinal bleeding due to hepatic failure and septicemia. 5) Late sequelae were seen in 42.8% among 14 patients. The most common sequelae were skeletal defects in 21.4% and diabetes insipidus in 21.4%. 6) Among the late sequelae, 3 patients had vertebra plana. Conservative treatment was done and long term follow up of 28.7 7.0 months demonstrated partial healing of the vertebra plana in two cases and no improvement in one. 7) The diabetes insipidus developed in 3 cases, at diagnosis, at 14 months and 20 months after diagnosis respectively. None of the cases received radiation therapy. All of them responded to anti-diuretic CONCLUSION: These data show that, despite the favorable survival, about half of ms-LCH patients had further dissemination of disease or late sequelae. Further treatment needs to be designed to prevent disease progression and late sequelae. hormone replacement therapy.
Busan ; Cause of Death ; Diabetes Insipidus ; Diagnosis ; Disease Progression ; Disease-Free Survival ; Ear, Middle ; Female ; Follow-Up Studies ; Hemorrhage ; Histiocytosis, Langerhans-Cell* ; Hormone Replacement Therapy ; Humans ; Incidence ; Liver ; Liver Failure ; Medical Records ; Mortality ; Pneumonia ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Sex Distribution ; Skin ; Spine ; Spleen ; Survival Rate