BACKGROUND: Epidermolysis bullosa is a group of inherited disorcier characterized by blistering of the skin as a result of minor trauma. OBJECTIVE: There exist very little epidemiologic data for most of the major and minor subsets of inherited epidermolysis bullosa in Korea. We look forward to obtaining basic data for the pathogenesis and treatment of epidermolysis bullosa. METHOD: We performed 1st and 2nd trial of survey with the help of 28 dermatologic Departments snd 28 pediatric departments of medical colleges and 14 dermatologic dipartments of general hospitals. RESULTS: 68 cases were collected and classified by disease type, sex distribution, age distribution, and regional distribution. In disease type, 42 cases of EB simplex(62%), 8 cases of junctional type(12%), 10 cases of dominant dystrophic type(15%), 8 cases of recessive dytrcphic type(12%) were reported. In most cases males predominnted, but in dominant dystrophic type both sexes were equivalent. EB simplex, junctional type, RDEB were mostly developed in the 1st decade of life, dominant dystrophic type in the 2nd decade of life. In regional distribution, the number of pi tients was outstanding in large cities such as Seoul, Pusan, Taegu, Kwanju. CONCLUSION: Due to many limitations and shortage of techniques, this epidemiologic study may be notgood enough for the total estimated number of epidermolysis bullos. patients, prevalence rate, and therapeutic modalities. Furthe evaluation should be necessary next time.
Age Distribution ; Blister ; Busan ; Daegu ; Epidemiologic Studies* ; Epidermolysis Bullosa* ; Gwangju ; Hospitals, General ; Humans ; Korea* ; Male ; Prevalence ; Seoul ; Sex Distribution ; Skin

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

The purpose of nursing education is to prepare the professional practitioner as nurse who will be interested in the health and the related aspects of community and will assume responsibility for contributing toward the improvement of the health for the all. This means that nursing education must provide opportunities for the development of knowledge, skills, and attitudes which make this possible. Consequently, this approach has relevance for nursing education. Faculty engaged in endless debates about what is to be included, and to what death, and what will be given short shrift as a result. Thus, it can be seen why there is so much confusion and lack of agreement between the emphasis and objectives in nursing. This study attempted to review and identify the curriculum content of child nursing in Korea to build and develop the standard curriculum contents for national board examination for nurses and child's health needs for the coming 21st century. The questionnaire was consisted of items for selection and organization of the knowledge components and type of unit with weigh to be attained in child nursing. Response of 34% of nursing program in university and junior college. Content analysis was done by using consensual validation of essential knowledge for curriculum content to identify what is obvious or trivial. This study pointed out that it is not yet apparent that demographic fact has greatly influenced child nursing curriculum content. In a similar vein the majority of content of child nursing devote little time and weigh to social and epidemically significant to child health. It seems to be needed that the content of child nursing may push the paradigm shift in nursing education such as health promotion and prevention for postretinal roles of child and family. In conclusion, it is time to convoke and content and standardization on job analysis for national board exam for nurses in Korea.
Child* ; Curriculum* ; Education, Nursing ; Health Promotion ; Humans ; Korea* ; Nursing* ; Veins ; Child Health ; Surveys and Questionnaires

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*

BACKGROUND: Demand for emergency medical information is high according to the health information use, utilization and demand survey for on the Internet. In spite of high demand for emergency information service, emergency information service on-line and off-line are very limited. Therefore, it is necessary to develop a website providing emergency medical information and emergency medical resources information by linking emergency medicine where timely information is required with the Internet technology for health promotion of the public. OBJECTIVE: This study is conducted to develop and evaluate a Web site to provide information on emergency medicine and resources for health promotion. METHODS: To identify and specify users' requirements for the emergency medicine related information, online survey was performed for 209 Internet users who visited the Healthguide. Based on this survey results, we developed content for emergency medical information service: cause, risk factors, prevention, treatment, facilities, laws and rules, policy and statistics of emergency medicine. To evaluate the web site developed in this study, twenty health and nursing informatics experts were recruited and asked to rate using an evaluation tool. RESULTS: This content was integrated into the healthy life (http://healthguide.kihasa.re.kr/health_life/emergency/pages/index.html), which is a service component of the Healthguide. This approach was expected to increase accessibility and usability of implemented services. The rating score of the website was fairly high with mean 3.9(SD 0.6) out of 5.0. According to each evaluation criteria, purpose of the site, easiness of use, relevancy, and reliability were scored 4.1-4.2 and authority and accuracy 3.8-3.9 and currency 3.5-3.7. This evaluation results will be fed back to the Healthguide for operation, maintenance, and upgrade in the future.
Emergencies* ; Emergency Medicine ; Health Promotion* ; Information Services* ; Internet ; Jurisprudence ; Nursing Informatics ; Risk Factors

BACKGROUND: Vitiligo is a relatively common acquired depigmentating disorder that affects at least 1 % of the population. The mode of transmission has not been clearly,stablished, but either polygenic or autosomal dominant with incomplete penetrance and variable expresion has been proposed. OBJECTIVE: Our purpose was to evaluate the causative factor, variable clinical features and current teratment of generalized vitiligo patients. METHOD: This clinical in vestigation was made with 225 outpatiens of generalized type vitiligo who had visited the Department of Dermatology, Keirnyung Universitv Hospital from January 1987 till December 1991. Results & CONCLUSION: 1. There were 125 female, (55.5%) and 100 males(44.4%). 2. The mean age of onset was 21.4 years(male . 24.3, female: 19.1). 3. The mean age at the first visit was 27.5 years (male : 28.8, female : 26.5). 4. The mean duration of the disease was 10.7 years(male : 9.9, female : 10.9). 5. The mean interval between onset and visiting was 6.1 years (male : 4.5, female : 7.4). 6. The most common sites of involvernent at the first visit was tie face 11.7% (male : 11.4%, female : 11.8%). 7. The most common precipitating factor was trauma(8.8%). 8. The most common previous treatment was sunlight irradiaion after application of topical oxoralene(33.2%). 9. The most common degree of depigmented lesion was 5-10%(64.4%). 10. The most common occupations of the patients were students mals, and housewife females.
Age of Onset ; Dermatology ; Female ; Humans ; Occupations ; Penetrance ; Precipitating Factors ; Sunlight ; Vitiligo*

Objective: It is essential to measure the effect of burnout on doctors because burnout can affect doctors’ mental health as well as the functioning of medical practice. This study aims to validate a Korean version of the single-item burnout measure (SIBM), which was developed to quickly measure the level of burnout among doctors. Methods: Through an online survey, a self-report questionnaire was administered to 324 public health doctors in Korea. The Korean version of the SIBM was validated against the Maslach Burnout Inventory-General Survey (MBI-GS), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) screening tool, the Perceived Stress Scale (PSS), and the Vaccination Attitudes Examination (VAX) scale. Pearson correlation coefficients and analysis of variance (ANOVA) were used to determine the association between the SIBM and other scales. ANOVA was additionally used to determine the associations between the subscales of the MBI-GS and those of the SIBM. Results: The correlation coefficient between the SIBM and the MBI-GS, PHQ-9, GAD-7, and PSS was positive (p<0.01), and the correlation coefficient between the SIBM and the VAX scale was not significant. Therefore, convergent and discriminant validity was verified. Exhaustion and cynicism, which were correlated with the SIBM, with r2=0.43 (p<0.01) and 0.48 (p<0.01), yielded R2 scores of 0.27 (p<0.01) and 0.20 (p<0.01) in ANOVA. Conclusion The Korean version of the SIBM is an appropriate screening tool for burnout. It can be evaluated in a short time, thereby enhancing continuous follow-up observations and response rates to burnout.

Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) has been disseminating nationwide due to clonal spread and is taking a serious action at the national level in Korea. The mobilized colistin resistance (MCR1) gene confers plasmid-mediated resistance to colistin and is known to be capable of horizontal transfer between different strains of a bacterial species. We have experienced a fatal case of the patient who developed MCR1-possessing, ST307/Tn4401a[blaKPC2] K. pneumonia bacteremia in the community of non-capital region after being diagnosed as pancreatic cancer with multiple liver metastases and treated in the capital region. The ST307/Tn4401a[blaKPC2] K. pneumonia was the most commonly disseminated clone in Korea. Our strain is the first MCR1 and KPC2 co-producing K. pneumonia in Korea and our case is the critical example that the multi-drug resistant clone can cause inter-regional spread and the community-onset fatal infections. Fortunately, our patient was admitted to the intensive care unit on the day of visit, and the contact precaution was well maintained throughout and KPC-KP was not spread to other patients. The high risk patients for KPC-KP need to be screened actively, detected rapidly and preemptively isolated to prevent outbreak of KPC-KP. Inter-facility communications are essential and the nationwide epidemiologic data of KPC-KP should be analyzed and reported regularly to prevent spread of KPC-KP. The prompt identification of species and antimicrobial susceptibilities for successful treatment against KPC-KP should be emphasized as well.

PURPOSE: We wished to compare CT colonography with conventional colonoscopy for the detection of colorectal polypoid lesions, and we wanted to evaluate the role of IV contrast-enhanced CT colonography for the differentiation between benign polypoid lesions and malignant polypoid lesions. MATERIALS AND METHODS: Thirty-four consecutive patients underwent CT colonography prior to conventional colonoscopy. Precontrast prone-position CT images and postcontrast supine position CT images were obtained and the virtual colonoscopic images were reconstructed. Axial, sagittal and coronal images with virtual colonoscopic images were prospectively interpreted for the presence, size and morphologic features of colorectal polypoid lesions, and then these findings were compared with the colonoscopic findings. The degree of enhancement of colorectal polypoid lesions was measured by subtracting the attenuation values obtained with precontrast and postcontrast CT images for the differentiation of benignity and malignancy of the colorectal polypoid lesions. RESULTS: Among 75 colorectal polypoid lesions identified on conventional colonoscopy, 49 neoplasms were found on CT colonography, and the overall detection rate was 65.3%. Detection rate of lesions smaller than 10 mm was 52.1% (24/46), and the detection rate for lesions equal to or larger than 10 mm was 86.2% (25/29). Morphologic features of the sessile type lesions on CT colonography were well correlated with those noted on colonoscopy, but the stalks were not identified in 6 of 13 polyps on CT colonography. There was no statistical correlation between benignity and malignancy and the degree of contrast enhancement on CT colonography. CONCLUSION: CT colonography is a useful modality for the detection of colorectal polypoid lesions equal to or larger than 10mm, and it well demonstrates the morphologic features, except for the stalk of pedunculated polyps. However, CT colonography cannot differentiate benignity from malignancy.
Colonography, Computed Tomographic* ; Colonoscopy ; Humans ; Polyps ; Prospective Studies ; Supine Position ; Tomography, X-Ray Computed