OBJECTIVES: Outbreaks of pneumonia caused by Mycoplasma pneumoniae (MP) occur every 3-4 years in Korea, most recently in 2011. The aim of our study was to determine the optimal time to perform indirect particle agglutination antibody assays to improve early diagnosis of MP pneumonia in children. METHODS: A database of 206 pediatric patients treated for pneumonia at the Hanyang University Hospital from June to October 2011 was analyzed retrospectively for demographic characteristics and laboratory test results. RESULTS: Among the 206 patients treated for pneumonia during the study period, there were 160 children (mean age, 5.44 years) diagnosed with MP pneumonia, who were studied further. The mean age of these MP pneumonia patients was 5.44 years. Antibody titers increased with increasing time between symptom onset and the collection of serum collection: MP titers were <1:640 for sera collected after 5.44 days and titers > or =1:640 for those collected after 8.58 days; P<0.001). Antibody titers were considered positive when they reached > or =1:640. In 42 MP pneumonia patients in whom there was a four-fold or greater increase in titer between successive serum samples, the optimal cut-off time-point for distinguishing between the initial and second titer groups was 7.5 days after the onset of symptoms (sensitivity, 90.5%; specificity, 92.9%). CONCLUSIONS: Negative MP antibody titers earlier than 8 days after the onset of symptoms in children with pneumonia may require repeating to confirm the diagnosis. This finding could optimize diagnosis and result in better therapeutic outcomes of MP pneumonia in children.
Agglutination ; Child ; Disease Outbreaks ; Early Diagnosis ; Humans ; Korea ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The purpose of this study was to investigate the relationship among nursing work environment, job embeddedness, and turnover intention in order to provide basic data for efficient management of human resources in nursing organizations. METHODS: A cross-sectional, descriptive study design was conducted with 177 nurses who had worked for more than 6 months in five general hospitals on Jeju Island. A self-report questionnaire was used for data collection. RESULTS: About 88% of the participants reported that they were considering a turnover plan because of overload in their jobs and poor salaries. Nursing work environment was significantly related to job embeddedness and turnover intention. Job embeddedness was significantly related to turnover intention. Hierarchical multiple regression analysis showed that factors affecting turnover intention were the organizational embeddedness factors of organization fit and organization sacrifice. CONCLUSION: The results indicate that nurses' turnover intention is associated with nursing work environment and job embeddedness. To reduce nurses' turnover intention and improve nurses' retention, nurse managers should improve the nursing work environment and consider job embeddedness, particularly in relation to the organization fit and sacrifice.
Data Collection ; Hospitals, General ; Humans ; Intention* ; Nurse Administrators ; Nursing* ; Salaries and Fringe Benefits

No abstract available.
Aged* ; Humans

To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person

Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.
Child ; Male ; Female ; Humans

PURPOSE: To determine the preferred method of drinking water before spiral CT scanning of a gastric lesion. MATERIALS AND METHODS: Spiral CT scans of 92 patients with gastric lesion were obtained and evaluated. Patients drank tap water as oral contrast material and were scanned in the prone position; they were divided into two groups according to the method by which water was ingested. Group 1 patients drank 500ml 60 minutes before scanning; 500mL, 30 minutes before scanning; and 500mL just before scanning, while those in group 2 drank 800-1000mL just before scanning. In all cases, precontrast images were obtained, and an additional 300mL of water was given if the stomach was not adequately distended. Postcontrast images were obtained at 35 seconds, 80 seconds and 3 minutes after the start of infusion of contrast material. For 35- and 80-second scans, spiral CT was performed with 5-mm collimation, 7mm/sec table feed, and 5-mm reconstruction interval; for precontrast and 3-minute scans, 10-mm collimation, 10mm/sec table feed, and 10-mm reconstruction interval were used. There were 40 patients in group 1, and 52 in group 2. The images of the two groups were evaluated according to three criteria: gastric distension, mucosal enhancement, and tumor distinction. For each criterion, the images were evaluated by grading; an 'excellent' image scored 3, 'good' 2, 'ordinary' 1, and 'poor' 0. The differences in imaging quality between the two groups were statistically evaluated. Images obtained at 35 and 80 seconds, and at 3 minutes after the start of infusion of contrast material were compared, and the detectability of 18 confirmed cases of early gastric cancer was evaluated. RESULTS: For gastric distension, the mean score was 1.65 in group 1, and 1.81 in group 2 (P=0.33); the corresponding figures for mucosal enhancement were 1.45 and 1.65 (P=0.11), and for tumor distinction, 1.30 and 1.52 (P=0.09). Between the two groups, there was therefore no statistical difference in image quality. With regard to postcontrast images, those obtained after a delay of 35 seconds were best; those obtained at 80 seconds were better than those obtained at 3 minutes. Fifteen of 18 case of early gastric cancer were detected on spiral CT, and the detection rate was 83.8%. CONCLUSION: No statistically significant difference was seen between the two groups, and a single drink of water-just before scanning- is thus preferable to several drinks. Two scans, with images delayed for 35 and 80 seconds after contrast enhancement, are adequate. The use of these methods may improve the image quality of gastric lesions and the detection rate of early gastric cancer.
Drinking Water ; Eating* ; Humans ; Prone Position ; Stomach ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Water*

No abstract available.
Diabetes Mellitus, Type 1* ; Echocardiography*

PURPOSE: Forward pulmonary blood flow may be absent in some neonates with Ebstein's anomaly by anatomical or functional pulmonary atresia in association with the elevated pulmonary vascular resistance, patent ductus arteriosus and tricuspid regurgitation. We reviewed the presentation and outcomes of symptomatic neonates with Ebstein's anomaly focusing on the pulmonary atresia. METHODS: Clinical presentation and outcome of 15 symptomatic neonates with Ebstein's anomaly seen at Asan medical center from 1998 to 2004 were reviewed. RESULTS: Ten (67%) of 15 patients showed no forward pulmonary blood flow and 6 of them had functional pulmonary atresia. O2 saturation and pH were lower and cardiothoracic (CT) ratio in chest radiography was more increased in the patients with pulmonary atresia than in the patients without pulmonary atresia (P< 0.05). pH and CT ratio were not different between the anatomical and functional pulmonary atresia group, but O2 saturation was lower in functional atresia group (P< 0.05). 13 patients (87%) were managed with PGE1. 4 of 6 patients with functional pulmonary atresia were treated with inhaled nitric oxide. Surgery was performed in 1 of 5 patients without pulmonary atresia and in 8 of 10 patients with pulmonary atresia during follow-up period (mean 37 months). 3 patients (20%) died and none of patients without pulmonary atresia died. CONCLUSION: We found that most symptomatic neonates with Ebstein's anomaly had functional or anatomical pulmonary atresia. The neonates with Ebstein's anomaly who had no forward pulmonary blood flow were more symptomatic and needed surgery earlier. Further studies will be needed to distinguish effectively functional and anatomical pulmonary atresia and to manage appropriately neonates with functional atresia.
Infant, Newborn ; Humans

Clear cell chondrosarcoma, first described by Unni in 1976, is distinguished from classical chondrosarcoma by a typical histological picture, mostly an epiphyseal site of origin, and relatively a benign clinical course. We present a case of clear cell chondrosarcoma arising from hyoid bone in a 70-year-old male. Histologically, large areas of closely packed cells with characteristic clear cytoplasm were seen in addition to the usual elements of a conventional chondrosarcoma. Our search and review of the literature did not reveal any reported case of clear cell chondrosarcoma arising from hyoid bone.
Aged ; Chondrosarcoma* ; Cytoplasm ; Humans ; Hyoid Bone* ; Male

The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing factors explained 17.1 and 8.9% correspondingly.
Causality ; Chronic Disease ; Family Characteristics ; Humans ; Jeollanam-do ; Poverty Areas ; Prevalence