Purpose: To present the case of a patient with localized orbital granulomatosis with polyangiitis (GPA) characterized by a significant ocular motility disorder, increased eosinophilia, and hyper-immunoglobulin E (hyper-IgE).Case Summary: A 61-year-old male, with no previous history of allergy, atopy, asthma, sinonasal disease, respiratory disease, or renal disease, came to our hospital due to a 2-day history of binocular diplopia. His left eye exhibited inward and upward deviation, along with gaze limitation. His vision was 20/20 in both eyes, and the pupillary light reflex and color test were normal. He had severe eyelid swelling and conjunctival injection without tenderness in his left eye, and retinal vessel congestion around the optic nerve, without proptosis. Laboratory tests revealed a positive cytoplasmic antineutrophil cytoplasmic antibody (cANCA), a normal WBC count, elevated eosinophils at 28.3% (2,462/mm3), and high serum levels of IgE (400 KU/L). Magnetic resonance imaging showed an inferolateral orbital mass with an enlarged lacrimal gland and myositis of the extraocular muscles. A biopsy of the lacrimal gland revealed nonspecific chronic inflammation with an eosinophilic infiltrate. The presence of cANCA, in combination with clinical and pathological findings, led to the diagnosis of an eosinophilic variant of localized orbital GPA. This variant was primarily confined to the orbital tissue, marked by elevated eosinophil and IgE levels, and was treated with oral steroids without requiring surgery for the ocular motility disorder. Conclusions GPA may present as acute strabismus with orbital inflammation, even in the absence of systemic signs. Therefore, it should be considered in the differential diagnosis of unexplained acute orbital syndromes.

BACKGROUND: This study was performed to evaluate the results of intervention activities on the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories. METHODS: A checklist was developed and used to monitor and evaluate the adequacy of sterilizers and sterilized items at out-patient clinics and clinical laboratories in a tertiary-care hospital. The checklist consisted of 7 items: condition of the material used for packaging sterile items, maintenance of shelf-life records, sterilizer cleanliness, maintenance of expiry date details of sterilized items, sterilization conditions, use of chemical indicators, and the results of biological indicators. Monitoring and additional intervention activities were carried out once every week for 53 weeks from August 2007 to July 2008. The study period was divided into 2 terms, early and late intervention; the duration of each term was 6 months, and we compared the ratio of adequacy of management of sterilizer and sterilized items between the 2 terms. RESULTS: There were a total of 795 observations from 15 departments in 1 year. Sterility of the materials used for packaging increased from 87.4% in the first 6-month term to 97.9% in the second 6-month term. Records for shelf-life increased from 89.6% to 98.5% in the same period, while the figures for maintaining expiry date details of sterilized items and for steam sterilizer cleanliness increased from 92.6% to 99.2%, and from 91.9% to 98.5 (P<0.05), respectively. CONCLUSION: Our intensive checklist-based intervention was effective in improving the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories.
Ambulatory Care Facilities ; Checklist ; Humans ; Infertility ; Organothiophosphorus Compounds ; Outpatients ; Product Packaging ; Steam ; Sterilization

PURPOSE: To determine the effects of hand massage on nausea and vomiting, and anxiety in children with lymphocytic leukemia receiving high dose chemotherapy. METHOD: The children were assigned to an experimental group(15) or a control group(15). All of the children were diagnosed with acute lymphocytic leukemia and admitted for high dose chemotherapy at C University Medical Center in Seoul. The hand massage was performed for 10 minutes twice a day over three days. To measure the effects of hand massage, the Index of Nausea and Vomiting by Rhodes et al. and the State-Trait Anxiety Inventory for children by Spielberger were used. The level of anxiety was measured by systolic blood pressure, diastolic blood pressure, and pulse rate. RESULTS: The score for nausea and vomiting decreased in the experimental group. State anxiety for the experimental group was significantly more positive than for the control group at the 2nd measurement. There was a significant difference in systolic blood pressure between the two groups. The level of diastolic blood pressure in the two groups decreased significantly over time. CONCLUSION: Hand massage could be effective in decreasing nausea and vomiting, state anxiety, pulse rate and blood pressure in children with acute leukemia receiving high dose chemotherapy.
Academic Medical Centers ; Anxiety* ; Blood Pressure ; Child ; Drug Therapy* ; Hand* ; Heart Rate ; Humans ; Leukemia* ; Leukemia, Lymphoid ; Massage* ; Nausea* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Seoul ; Vomiting* ; Child Health

PURPOSE: This study was conducted to identify current health care management and barriers in health care management according to ecological systems, and to develop an ecological model for enhancing health care in child care centers. METHODS: Focus group interviews were conducted with directors and teachers of child care centers, and with parents of children enrolled in child care. Data were analyzed by the latent content analysis method. RESULTS: Twelve categories of health care management were identified. Barriers to child health care included knowledge deficit and lack of competence in health care by teachers, lack of useful health care manuals, non-existence of professional child health care personnel in child care centers, lack of mutual information sharing and disagreement on child health conditions between child care personnel and parents, lack of specific health related child care inspection criteria and time flexible child care centers with a lack of policy on collaboration with health care facilities. The ecological model developed included specific strategies to improve health care management in child care. CONCLUSION: The proposed ecological model to improve child health care management should be useful to plan future health care program considering both the immediate and indirect social environment surrounding children in child care.
Child ; Child Care ; Child Health ; Child, Preschool ; Cooperative Behavior ; Delivery of Health Care ; Ecology ; Ecosystem ; Focus Groups ; Humans ; Information Dissemination ; Mental Competency ; Parents ; Social Environment

PURPOSE: A large number of studies have demonstrated that bronchiolitis by RSV can develop into recurrent wheezing or asthma in infancy. The severity on first attack, atopic finding and evironmental factors can be a risk factors for this recurrent wheezing but not yet defined clearly. We studied to know the risk factors to cause recurrent wheezing after bronchiolitis by RSV. METHODS: Sixty three children who were hospitalized for bronchiolitis by RSV from June 1996 through May 1997 were followed-up. They were classified into recurrent group with wheezing of more than 3 times and no-recurrent group and compared. RESULTS: 1) The recurrent group was 46%(29 of 63 cases) and was higher in both male and whom first wheezing occured in less than 6 months of age. 2) On the first admission, the degree of respiratory distress was more severe in recurrent group. 3) On the first admission, serum ECP was more higher in the recurrent group. And during follow-up, frequency of increased serum IgE and positive skin test to D.p, D.f was higher in the recurrent group. 4) The household environment, personal history of patients and familial history of atopy did not affect on recurrence of wheezing. CONCLUSION: This study demonstrated that younger age of lesser than 6 month of age and severity of respiratory distress on the first admission and positive skin test to D.p, D.f and higher serum IgE during follow-up had significant association with recurrent wheezing.
Asthma ; Bronchiolitis* ; Child ; Family Characteristics ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Male ; Recurrence ; Respiratory Sounds ; Risk Factors ; Skin Tests

PURPOSE: The purpose of this study was to identify the relationship between self-esteem and sexual attitude in healthcare college students, and also to provide a basis for sexual health education programs to help establish healthy sexual attitudes. METHODS: A survey was conducted with 218 unmarried students attending the healthcare colleges in B and U cities. Data were collected from October 15 to November 10, 2015 and analyzed using Stepwise multiple regression with SPSS PASW 18.0. RESULTS: Mean score for self-esteem was 3.23±0.46 out of 5 and sexual attitude 2.64±0.54 out of 5. Self-esteem and sexual attitude had a negative correlation (r=-.169, p=.012). Among sub-variables of sexual attitude, negative correlations were found between self-esteem and premarital chastity (r=-.207, p=.002), and between self-esteem and homosexual attitudes (r=-.167, p=.013). There were statistically significant differences in sexual attitude according to perceived intimacy with mother (β=-.228, p<.001), year in college (β=.135, p=.047), major (β=.148, p=.023), religion (β=-2.429, p=.016), and homosexual tendencies (β=.139, p=.037). These factors explained 14.6% of the variance in sexual attitude. CONCLUSION: Findings demonstrate the importance of self-esteem for sexual attitudes. This finding should be used in the development of healthcare college students, promotion programs to enhance healthy sexual attitudes.
Delivery of Health Care* ; Education ; Homosexuality ; Humans ; Mothers ; Reproductive Health ; Sexual Behavior ; Single Person

PURPOSE: Epidemiologic studies have demonstrated that rhinitis and asthma commonly coexist in the same patients and that a temporary relationship exists between the onset of rhinitis and asthma, with rhinitis frequently preceeding the development of asthma. Despite the compelling evidence that rhinitis has a remarkable impact on asthma, it has been controversial how the presence of rhinitis causes asthma to be worsen. We studied to know the effect of coexistence of allergic rhinitis on lower airway eosinophilic inflammation in mild persistent bronchial asthma. METHODS: A total of 129 mild persistent asthmatics were enrolled and divided into three different groups as follows: 37 cases with asthma only; 40 cases with mild allergic rhinitis; and 52 cases with moderate to severe allergic rhinitis. Methacholine challage test and sputum induction were performed and sputum ECP, sputum eosinophils and bronchial hyperresponsiveness (BHR) were compared in each group. RESULTS: In mild asthmatics with moderate to severe allergic rhinitis, the BHR to methacholine increased compared to those with mild or no allergic rhinitis. Eosinophils and ECP in induced sputum were significantly higher in more severe allergic rhinitis groups. We also found a significant correlation between BR index and sputum eosinophils. (gamma=0.578, P< 0.05) CONCLUSION: Our results demonstrated that the severity of allergic rhinitis was related to lower airway eosinophilic inflammation and bronchial hyperresponsiveness in mild persistent asthmatics with allergic rhinitis.
Asthma* ; Child ; Eosinophils* ; Epidemiologic Studies ; Humans ; Inflammation* ; Methacholine Chloride ; Respiratory System ; Rhinitis* ; Sputum

Bortezomib (Velcade(R)) is proteasome inhibitor that is used as a first-line therapy for multiple myeloma. It can cause gastrointestinal, hematologic, and neuromuscular side effects, and a cutaneous reaction is one of its common adverse reactions. To date, several bortezomib-induced cutaneous adverse reactions have been reported, including folliculitis-like rash, pruriginous rash, purpuric rash, mouth swelling, stomatitis-mucositis, edema in the lower limbs, telogen effluvium, and vasculitis. In the Korean literature, only one case of vasculitis has been reported earlier. Two patients have presented with multiple plaques on the trunk at our clinic. The lesions developed several days after bortezomib chemotherapy, and disappeared spontaneously in about 1 week. Herein, we report bortezomib-induced drug eruption presenting as multiple plaques on the trunk with a review of the relevant literature.
Drug Eruptions* ; Drug Therapy ; Edema ; Exanthema ; Humans ; Lower Extremity ; Mouth ; Multiple Myeloma ; Proteasome Inhibitors ; Vasculitis ; Bortezomib

PURPOSE: The purpose of this study was to figure out emotional labor, healthy lifestyle, needs for health services of flight attendants and the relationships among needs for health services according to various characteristics of flight attendants. METHODS: The participants of this study were 140 flight attendants who work on major and low cost airlines. Data were collected through a questionnaire from 2017 .Jan.~2017. Feb. Data were subsequently analyzed using the SPSS 21 Program. RESULTS: The score of emotional labor was 3.76 surface acting was 3.75 and deep acting was 3.77. The average of healthy lifestyle was 2.41, and the highest was 3.13 of personal relationship and the lowest was 1.91 of eating habits. There is a positive correlation between emotional labor-deep acting and healthy lifestyle. Flight attendants demand health services for physical exercise, stress and emotional labor management, healthy eating habits, emergency treatment, prevention of fatigue, cancer screening, sexual harassment prevention, sex education and etc. CONCLUSION These results show that flight attendants need to various interventions for improving healthy lifestyle and reducing emotional labor. It is necessary to develop customized health promotion program suited to their job and general characteristics.

PURPOSE: This descriptive study aimed to explore the effects of bullying, health promotion lifestyles, and physical symptoms on the occupational stress of new nurses in general hospitals. METHODS: The participants of this study were 157 new nurses in fivegeneral hospitals with 100 to 399 beds in Gyeonggi-do. Data were collected from January to February, 2018, using a structured questionnaire and analyzed using the SPSS software version 20. RESULTS: A total of 60.5% of the participants experienced bullying, and 38.2% experienced bullying more than 10 times a month. The perceived severity of bullying was severe (32.4%) and the nurses'first bullying experience began within the first six months (47.7%). Their occupational stress was scored 3.1. The regression model for occupational stressors was significant (F=23.86, p < .001), and the total explanatory power was 46.8%. The variables affecting occupational stress were bullying awareness (β=−.30, p < .001), preceptor satisfaction (β=−.30, p < .001), and health promotion lifestyles (β=−.26, p=.001). CONCLUSION It is important to reduce the incidence of bullying in order to help new nurses with high occupational stress. Stress management programs are needed to improve relationships between new nurses and preceptors and to encourage their health promotion lifestyles.