Osseointegrated alloplastic ear reconstruction has revolutionized ear prosthetic retention. In this report, we evaluate the results of indirect osseointegration using the Epitec system and discuss the degree of the most serious side effect of this system, the adverse skin reactions close to osseointegrated implant post. During a three year period, Osseointegrated prosthetic ear reconstruction was performed to twenty eight patients with microtia(n = 25) and traumatic ear loss(n = 3), 22 males and 6 females aged from 6 to 43 years(mean 18.2 years). The patients, including 12 children, were treated with 58 titanium implant posts of Epitec system. These were inserted into a 3-dimensional carrier-plate which were fixed to the mastoid process with 7 to 12(mean 9.2) screws. Each patient was operated in a one-stage procedure. Two months of osseointegration of the screws was followed by fabrication of the ear prostheses. All implants were stable after follow-up at 20 to 31 months(mean 24.6 months). Fifty four of the 58 implants showed no sign of skin reactions (93.1 percent: 83.3 percent for children; 100 percent for adult). Hypertrophy of soft tissue surrounding the implants were observed only in children(2 out of 12 treated children) and did not recur after subcutaneous reduction and compressive dressing.In adults, the results of the Epitec system are very satisfactory. Use of the Epitec system in children is also promising because hypertrophy of soft tissue surrounding the implants are successfully managed. In addition, the 3-dimensional carrier-plate is well osseointegrated with bone screws and stability of the carrier-plate is reinforced by osseous covering of the thin bars of the carrier-plate by appositional bone growth of the skull.
Adult ; Bone Development ; Bone Screws ; Child ; Ear* ; Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Male ; Mastoid ; Osseointegration* ; Prostheses and Implants* ; Skin ; Skull ; Titanium

PURPOSE: The purpose of this study was to identify the job of emergency room (ER) nurses working in small and medium sized hospitals and to explore factors affecting their job. METHODS: The survey data were collected between January 2014 and May 2014 and participants were 159 nurses working in Seoul, Kyunggi, Incheon, and Chungnam in hospitals of less than 500 beds. RESULTS: The score for nurses job was 2.12/4.0, and emergency treatment (1.87/4.0) followed basic nursing (3.51/4.0) and counseling (2.32/4.0). The nursing job was significantly different depending on the age, education level, position, resident doctor(emergency medicine specialty or other) and grade of ER (regional ER or local ER). In the multiple regression, education level (beta=.18), position (beta=.24), hospital size (beta=.20), and grade of ER (beta=.21) explained 17.0% of variance in ER nurses' job in small and medium sized hospitals. CONCLUSION: The findings indicate that ER nurses in vulnerable areas do more nursing practice including emergency treatment as well as the usual independent nursing practice. Accordingly, a systematic assignment of nursing professionals is needed to reduce loading of ER nurses in small and medium sized hospitals.
Chungcheongnam-do ; Counseling ; Education ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Gyeonggi-do ; Health Facility Size ; Incheon ; Nursing ; Seoul

PURPOSE: The purpose of this study was to explore the impact of emotional labor on burnout in stroke patients' caregivers. METHODS: Data were collected from 141 paid caregivers working at 3 hospital across Gyeonggi province from January to April 2014. RESULTS: The caregivers' level of emotional labor showed 2.9/5.0 points and burnout, 2.5/5.0. A significant correlation was found among attentiveness to required display rules (p=.007), emotional dissonance (p=.001) and burnout. In a multiple regression, age (beta=.279, p=.001) and emotional dissonance (beta=.193, p=.046) were associated with burnout in caregivers. These factors attributed to 16.9% of variance in the burnout of caregivers. CONCLUSION: These results suggest that burnout in stroke patients' caregivers can be influenced by emotional dissonance as well as physical condition such as age. Accordingly, it is necessary to be develop support program to deal with mental labor to improve their mental health and lighten their workload for caregivers.
Caregivers* ; Gyeonggi-do ; Humans ; Mental Health ; Stroke*

Objectives: ：The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods: ：Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results: ：The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/ Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions ：There was no group difference observed between all three subtypes, which mean the MMPI- 2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

PURPOSE: The purpose of this study was to investigate pediatric nurse parent partnership and factors associated with this partnership. METHODS: A survey was conducted with 158 nurses working in pediatric practice at one of 7 hospitals in Seoul, Incheon, and Chungcheongbuk Province. Data were collected from September to December 2013, and analyzed with SPSS Windows 21.0. RESULTS: In hierarchial multiple regression analysis, self-efficacy (beta=.19, p=.016), clinical decision making (beta=.15, p=.046), and empowerment (beta=.29, p=.001) were associated with pediatric nurse parent partnership, after adjusting for marital status, children, education, position and satisfaction with work unit. These factors accounted for 44.0% of the variance in the pediatric nurse parent relationship. CONCLUSION: These results suggest that pediatric nurse parent partnership could be influenced by the predictors. Ultimately, intervention programs focusing on these factors should be effective in helping pediatric nurses improve partnership with parents.
Child ; Chungcheongbuk-do ; Decision Making ; Education ; Humans ; Incheon ; Marital Status ; Parents* ; Power (Psychology) ; Seoul

PURPOSE: The purpose of this study was to investigate factors affecting childhood asthma and atopic dermatitis. METHODS: For this study, data for 1,170 children (1-11 years) from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-2, 2011) were analyzed. First correlation matrices were computed to test the normality of every data set and then to be in accordance with the real demographic composition, data were added weight before being analyzed. RESULTS: The child with asthma of a three generation family (OR=3.91, 95% CI [1.33, 11.45], p=.013) compared with a two generation family showed higher asthma development, and maternal asthma (OR=9.71, 95% CI [2.66, 35.40], p=.001) showed higher asthma development in child. The only factor affecting atopic dermatitis was parental perceptions of child health: poor (OR=3.40, 95% CI [1.29, 8.98], p=.014). CONCLUSION: These results suggest that childhood asthma and atopic dermatitis are both affected by parental perceptions of child health. Accordingly, management and support programs for children who have asthma and/or atopic dermatitis and their families should be comprehensive and also give attention to any other health problems because health perception represents quality of life.
Asthma* ; Child Health ; Child* ; Cross-Sectional Studies* ; Dataset ; Dermatitis, Atopic* ; Humans ; Nutrition Surveys ; Parents ; Quality of Life

PURPOSE: The purpose of this study was to investigate dysmenorrhea in undergraduate students and its affecting factors. METHOD: The survey was conducted with 453 students at 4 nursing school in Seoul, Incheon, Chungcheongbuk and Jeollabuk Province. Data were collected from September to December 2013, and analyzed with SPSS Windows 21.0. RESULTS: In a final model of hierarchial multiple regression, menarcheal age (beta=-0.13, p=.003), menstrual amount (beta=0.17, p=.001), stress (beta=0.18, p=.010) habit of sitting by crossing one's legs (beta=0.14, p=.003) were associated with dysmenorrhea in undergraduate students. These factors attributed to 12.0% of variance in the dysmenorrhea of undergraduate students. CONCLUSION: These results suggest that dysmenorrhea in undergraduate student could be influenced by habit of sitting by crossing one's legs as well as menstrual history and stress. Ultimately, intervention program including correct of cross-legged sitting postures can be effective for undergraduate students to alleviate dysmenorrhea.
Chungcheongbuk-do ; Dysmenorrhea* ; Female ; Humans ; Incheon ; Leg ; Posture ; Schools, Nursing ; Seoul

PURPOSE: Objectives of this study were to identify factors influencing depression in patients with chronic renal failure according to patient characteristics and to provide basic data to develop nursing interventions for depression in these patients. METHODS: This descriptive correlative study was conducted using structured questionnaires with 114 patients diagnosed with chronic renal failure. Data were analyzed using t-tests, ANOVA, Pearson's correlation and multiple regression analysis with SPSS/WIN 18.0. RESULTS: 1) Level of depression was different according to the history of smoking (p<.001), past health history (p=.001), only drugs as therapy, peritoneal dialysis, hemodialysis (p=.028), and perceived health status (p<.001); 2) Significant correlations were found between depression, stress, value of life and social support; 3) multiple regression analysis showed that stress (beta=.24, t=3.41, p=.001), value of life (beta=-.46, t=-6.37, p<.001) and social support (beta=-.19, t=-2.79, p=.006) in that order contributed to depression and explained 56.4% of variance in depression. CONCLUSION: Findings from this study indicate that health professionals should provide proper management for depression for patients with chronic renal failure, as well as factors influencing depression, including stress, value of life and social support. There is also a need to implement stress management and self-help group programs for these patients.
Depression* ; Health Occupations ; Humans ; Kidney Failure, Chronic* ; Nursing ; Peritoneal Dialysis ; Surveys and Questionnaires ; Renal Dialysis ; Self-Help Groups ; Smoke ; Smoking ; Value of Life

Due to the complex structure and function of the kidneys, the mechanism of kidney disease is unclear. In particular, transcriptomics approaches at the bulk level are unable to differentiate primary autonomous responses, which lead to disease development, from secondary cell non-autonomous responses. Single-cell analysis techniques can overcome the limitations inherent in the measurement of heterogeneous cell populations and clarify the central issues in kidney biology and disease pathogenesis. Single-cell sequencing helps in identifying disease-related biomarkers and pathways, stratifying patients, and deciding on appropriate treatment methods. Here we review a variety of single-cell analysis techniques and single-cell transcriptomics studies performed in the field of nephrology. Moreover, we discuss the future prospects of single-cell analysis-based precision medicine in nephrology.

Leigh syndrome or subacute necrotizing encephalomyelopathy is a rare, rapidly progressive neurodegenerative disorder. In general, symptoms such as shortness of breath and decreased cardiac function usually occur within 1 year of life. It is a serious disease with a mortality rate of 75% in 2–3 years. The cause of Leigh syndrome is DNA mutation. Approximately 75% of patients have nuclear DNA mutations while 25% have mitochondrial DNA mutations. Clinical symptoms vary depending on the affected brain area. Neuroimaging plays an important role in diagnosing patients with Leigh syndrome. Late-onset Leigh syndrome is rarer and progresses more slowly compared to the classic form. Here, we report a case of late-onset Leigh's syndrome mimicking Wernicke's encephalopathy.