BACKGROUND: Core hypothermia after induction of anesthesia results from an core-to-peripheral redistribution of body heat and a loss of body heat to environment. The purpose of this study is finding body temperatures during operation by either general of epidural anesthesia and evaluates content of total body heat. METHODS: We measured tympanic membrane temperature, 4 point skin temperature (mid calf, mid thigh, upper extremity, nipple). And we calculate mean skin temperature, mean body temperature, total body heat content changes based on tympanic membrane temperature and 4 point skin temperature. RESULTS: Tympanic membrane temperature of the first group decreased significantly after 10 minutes of induction (p<0.005), the second group decreased after 45 minutes of induction. Although upper extremity temperature has continuously increased as time passed, there was no significant difference in both group. Lower extremity temperature has significantly increased after 30 minutes of induction in the first group, and the second group has significantly increased after 10 minutes of induction (p<0.05). Mean skin temperature hasdecreasd temperaturily in both group after 10 minutes of induction and increased as time passed. Mean body temperature of the first group has significantly decreased after 10 minutes of induction (p<0.05) and second group has no significant changes. Total body heat content has continuously decreased after induction with no significance. CONCLUSIONS: General anesthesia reveals more significant decrease than epidural anesthesia. Both groups show significant decrease of body temperature after induction. We think that we need to close attention to temperature changes after induction for preventing possible side effects due to core hypothermia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General* ; Body Temperature Changes* ; Body Temperature* ; Hot Temperature ; Hypothermia ; Lower Extremity ; Skin Temperature ; Thigh ; Tympanic Membrane ; Upper Extremity

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

OBJECTIVE: The aim of this study was to develop a decision support system that helps school nurses manage health problems they encounter while caring for the elementary and secondary school students, and evaluate usability of it. METHODS: Knowledge was aquired by literatures review and interviews with senior school nurses and was validated by another group of school nurses. The Omaha System was used as a standardized nursing terminology to describe nursing diagnoses and interventions. The system was developed under the Windows environment. C++ was used as a program language and MS Structured Query Language as a database. To investigate usability of the system, 30 school nurses in elementary and secondary schools were recruited and asked to apply it to nursing problems they encountered in actual students care setting. RESULTS: The decision support system with seven major signs and symptoms was developed. It automatically makes a nursing diagnosis based on the input data, and also provides nursing interventions with evidence. It was proven that the system was very useful for school nurses to manage students` health problems. CONCLUSION: The system will contribute to development of expert knowledge concerning student's health problems and improve the quality of school nursing and professionalism.
Expert Systems ; Humans ; Nursing ; Nursing Care* ; Nursing Diagnosis ; Nursing Process ; School Nursing

PURPOSE: The purpose of this study was to survey the current status of mental health education and need for mental health education enhancing protective factors in the elementary schools. METHODS: We surveyed 10 school health teachers and 328 fifth- and sixth-grade students using 19- and 20-item questionnaires, respectively. RESULTS: All of the teachers and 65.2% of the students replied that they were either teaching or being taught mental health in school. Topics covered suicide, depression, school violence, and Internet addiction. All of the teachers and 84.1% of the students expressed the need for mental health education enhancing protective factors in school. Both groups replied that two sessions are enough. The teachers preferred role play and discussion as teaching methods, and audiovisual materials and computer as instructional media. The students preferred lecture and role play as teaching methods, and audiovisual materials and smartphone as instructional media. Both groups ranked self-esteem, parent-child relationship, peer relationship, and emotional regulation as the most important topics to be covered in the education. CONCLUSION: There is a high demand for mental health education enhancing protective factors. Therefore, it is recommended to develop educational programs enhancing protective factors by enabling formal and informal learning using smartphone.
Depression ; Education* ; Health Education ; Humans ; Internet ; Learning ; Mental Health* ; Needs Assessment ; Parent-Child Relations ; School Health Services ; School Nursing ; Suicide ; Teaching ; Violence ; Smartphone

PURPOSE: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. METHODS: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. RESULTS: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). CONCLUSION: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.
Alanine ; Bilirubin ; Busan ; Cholestasis ; Cytomegalovirus ; Fibrosis ; Hepatitis* ; Hepatomegaly ; Humans ; Immunoglobulin M ; Jaundice ; Liver ; Liver Diseases ; Male ; Necrosis ; Pediatrics ; Polymerase Chain Reaction

OBJECTIVE: To understand the clinical manifestations and disease course of adult onset Still' s disease (AOSD). METHODS: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. RESULTS: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia' Hgb <10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root joint arthritis and polyarthritis were factors associated with chronicity. CONCLUSION: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.
Adult* ; Arthritis ; Chronic Disease ; Exanthema ; Female ; Ferritins ; Fever ; Hepatomegaly ; Humans ; Joints ; Leukocytosis ; Liver ; Lymphatic Diseases ; Male ; Pharyngitis ; Prevalence ; Retrospective Studies ; Serositis ; Splenomegaly ; Still's Disease, Adult-Onset*

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy*

Partial hydatidiform mole and coexisting fetus is a rare entity with antecedent high risk of maternal and fetal complications, and risk of persistent trophoblastic disease in later life. Here, we report a case of twin pregnancy with live fetus identified as 45,X and normal placenta and another partial mole. Ultrasound scan at 10 weeks showed a hydrops fetus with a focal area of multicystic placenta. The patient underwent chorionic villus sampling and amniocentesis for chromosomal analysis, and the result was 45,X. Based on these finding, the patient then underwent induced abortion. Pathological examination (immunohistochemical staining) of the placenta confirmed the partial mole. This report suggests that careful prenatal ultrasonography and appropriate karyotyping in a molar pregnancy and coexisting fetus enable early diagnosis and may be beneficial for prognosis.
Abortion, Induced ; Amniocentesis ; Chorionic Villi Sampling ; Early Diagnosis ; Edema ; Female ; Fetus* ; Humans ; Hydatidiform Mole* ; Karyotyping ; Molar* ; Placenta ; Pregnancy ; Pregnancy, Twin ; Prognosis ; Trophoblasts ; Turner Syndrome* ; Twins ; Ultrasonography ; Ultrasonography, Prenatal

PURPOSE: We analyzed the risk factors affecting readmission of children with pneumonia. METHODS: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. RESULTS: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. CONCLUSIONS: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.
Child* ; Follow-Up Studies ; Humans ; Jeollabuk-do ; Lung ; Lymphocytes ; Medical Records ; Neutrophils ; Patient Readmission ; Pediatrics ; Pneumonia* ; Protestantism ; Retrospective Studies ; Risk Factors*

PURPOSE: We analyzed the risk factors affecting readmission of children with pneumonia. METHODS: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. RESULTS: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. CONCLUSIONS: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.
Child* ; Follow-Up Studies ; Humans ; Jeollabuk-do ; Lung ; Lymphocytes ; Medical Records ; Neutrophils ; Patient Readmission ; Pediatrics ; Pneumonia* ; Protestantism ; Retrospective Studies ; Risk Factors*