Purpose: The purpose of this study was to understand the experiences of mothers of infants who received sustained nurse home visiting services. The program of sustained home visit by nurses (Seoul Maternal Early Childhood Sustained Home-Visiting Program) is an intervention program. Its effectiveness has been verified in Australia, where services are provided to families in a vulnerable families during the period from prenatal period until the newborn is 2 years old. Methods: The study protocol used qualitative approaches. Eleven mothers of infants who received nursing services in December 2015 were invited for an in-depth interview. The data collected were subjected to directed content analysis. Results: The following 4 themes were identified from the analysis: (1) reduction in suspicion and increased feeling of benefit from the visiting service, (2) emotional support to the parents and use of community resources, (3) reliance on friendly nurses, and (4) gaining confidence about parenting and motherhood. Conclusion Sustained nursing home visiting services can be applied effectively in South Korea. The concrete narrations and descriptions of the experiences of mothers in this study can be used as a base for education, practice, and research.

This study analyzed Kimchi eating culture in 178 households with female middle school children located in Incheon and Seosan areas, investigated the Kimchi eating patterns of female middle school students, and also analyzed the differences in value recognition for Kimchi between mothers and their female middle school students. Results showed that 23.0% of subject households answered eat Kimchi at every meal and the main reason for eating Kimchi in most households was good for taste. Most households made their own Kimchi, and only 12.3% of households bought Kimchi. Subject households preferred hot and spicy taste (34.8%) and pleasing taste (20.2%), and 44.4% of middle school children answered as eating Kimchi at every meal, and the source for information on Kimchi was home in 51.6% and mass media in 33.7%, suggesting the lack of school education. Both mothers and their female middle school students placed high value on Kimchi for its nutritional aspect and on Kimchi from the market for its convenience. Mothers showed significantly higher value (p<0.05) on the storage aspect of Kimchi compared to their middle school students, and female middle school students showed significantly higher value (p<0.05) on the value recognition for Kimchi as an international food compared to their mothers. Also, the value for hot pepper powder was high among other additional ingredients, and both mothers and middle school students had high values for Kimchi stew among other food dishes using Kimchi, and middle school students showed higher values (p<0.001) on foreign dishes using Kimchi such as Kimchi pizza and Kimchi spaghetti compared to the mothers group. Therefore, based on these results, the development of educational programs on Kimchi is needed not only at home but also at schools, by re-emphasizing the importance of value recognition for KImchi in our food culture.
Child ; Chungcheongnam-do ; Eating* ; Education ; Family Characteristics ; Female* ; Humans ; Incheon ; Mass Media ; Meals ; Mothers*

PURPOSE: To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. METHODS: Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. RESULTS: The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. CONCLUSION: Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.
Censuses ; Hospitals, General ; Humans ; Inpatients ; Long-Term Care ; Nurses ; Nursing

PURPOSE: We encountered 7 cases (7.1%) of infection (5 deep and 2 superficial) in 98 cases of anterior cruciate ligament (ACL) reconstruction using hamstring autografts in a 17-month period. The aim of this study was to analyze the causes of infection and to introduce our treatment strategy. MATERIALS AND METHODS: We investigated the shelf-life of the fixation implants, the order of surgery, previous knee surgery, infectious pathogen, treatment of infection, and results of treatment. RESULTS: There was no problem with the expiration date of the fixation implants. The order of surgery was either the last or second to the last of all those performed on the same day. One patient had undergone knee surgery 8 months previously. The treatment after infection included aggressive debridement in all cases. Revision ACL reconstruction with graft removal was performed in 1 case of persistent infection with methicillin-resistant Staphylococcus aureus. All cases had satisfactory clinical results without recurrence during a mean 24.9 months of follow-up. CONCLUSIONS: We could not verify the exact cause of the high incidence of infection during the 17-month period. However, preventive measures are important to decrease the incidence of infection after ACL reconstruction.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Debridement ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Methicillin-Resistant Staphylococcus aureus ; Recurrence ; Transplants

Influenza vaccination is recommended for all people over 65 years, for those with chronic respiratory disease and chronic renal failure. Severe side effects of influenza vaccination are rare. We report a case of leukocytoclastic vasculitis in a 68-year-old woman which developed 2 days after influenza vaccination. Disseminated palpable purpura were located on both her lower extremities. A skin biopsy showed characteristic features of leukocytoclastic vasculitis. Purpura were reduced after prednisolone and dapsone medication.
Aged ; Biopsy ; Dapsone ; Female ; Humans ; Influenza, Human* ; Kidney Failure, Chronic ; Lower Extremity ; Prednisolone ; Purpura ; Skin ; Vaccination* ; Vasculitis*

PURPOSE: Competency is a key foundation of the nursing education curriculum and a baseline element of nursing practice. The purpose of this study was to explore the competencies of community health nurses in a maternal early childhood sustained home-visiting program based on nurses' field experiences. METHODS: The participants were 21 nurses who had more than 1 year of experience in this program. Reflective interviews were performed; lasting 1 hour per nurse, on August 18, 2016, and the collected data were analyzed using qualitative directed content analysis. RESULTS: Twenty-four themes were extracted for 9 competencies. The major themes included implementing a long-term relationship-based approach, providing client-led service rather than expert-led service, helping mothers with psychosocial difficulties, and applying skills in a practical manner in the home environment. CONCLUSION: In order to develop a home-visiting program as part of maternal-early childhood nursing practice, nurses should develop competencies that help them make significant and positive interventions. Results indicate that the curriculum for community health nurses should be changed to improve competencies in building relationships with clients and to focus on the application of skills in specific cases and in clinical practice.
Competency-Based Education ; Curriculum ; Education, Nursing ; Humans ; Mothers ; Nurses, Community Health ; Nursing ; Qualitative Research

Sphingosylphosphorylcholine (SPC) is one of the bioactive phospholipids that has many cellular functions such as cell migration, adhesion, proliferation, angiogenesis, and Ca²⁺ signaling. Recent studies have reported that SPC induces invasion of breast cancer cells via matrix metalloproteinase-3 (MMP-3) secretion leading to WNT activation. Thrombospondin-1 (TSP-1) is a matricellular and calcium-binding protein that binds to a wide variety of integrin and non-integrin cell surface receptors. It regulates cell proliferation, migration, and apoptosis in inflammation, angiogenesis and neoplasia. TSP-1 promotes aggressive phenotype via epithelial mesenchymal transition (EMT). The relationship between SPC and TSP-1 is unclear. We found SPC induced EMT leading to mesenchymal morphology, decrease of E-cadherin expression and increases of N-cadherin and vimentin. SPC induced secretion of thrombospondin-1 (TSP-1) during SPC-induced EMT of various breast cancer cells. Gene silencing of TSP-1 suppressed SPC-induced EMT as well as migration and invasion of MCF10A cells. An extracellular signal-regulated kinase inhibitor, PD98059, significantly suppressed the secretion of TSP-1, expressions of N-cadherin and vimentin, and decrease of E-cadherin in MCF10A cells. ERK2 siRNA suppressed TSP-1 secretion and EMT. From online PROGgene V2, relapse free survival is low in patients having high TSP-1 expressed breast cancer. Taken together, we found that SPC induced EMT and TSP-1 secretion via ERK2 signaling pathway. These results suggests that SPC-induced TSP-1 might be a new target for suppression of metastasis of breast cancer cells.
Apoptosis ; Breast Neoplasms ; Cadherins ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Gene Silencing ; Humans ; Inflammation ; Neoplasm Metastasis ; Phenotype ; Phospholipids ; Phosphotransferases ; Receptors, Cell Surface ; Recurrence ; RNA, Small Interfering ; Thrombospondin 1 ; Vimentin

Sphingosylphosphorylcholine (SPC) is one of the bioactive phospholipids that has many cellular functions such as cell migration, adhesion, proliferation, angiogenesis, and Ca²⁺ signaling. Recent studies have reported that SPC induces invasion of breast cancer cells via matrix metalloproteinase-3 (MMP-3) secretion leading to WNT activation. Thrombospondin-1 (TSP-1) is a matricellular and calcium-binding protein that binds to a wide variety of integrin and non-integrin cell surface receptors. It regulates cell proliferation, migration, and apoptosis in inflammation, angiogenesis and neoplasia. TSP-1 promotes aggressive phenotype via epithelial mesenchymal transition (EMT). The relationship between SPC and TSP-1 is unclear. We found SPC induced EMT leading to mesenchymal morphology, decrease of E-cadherin expression and increases of N-cadherin and vimentin. SPC induced secretion of thrombospondin-1 (TSP-1) during SPC-induced EMT of various breast cancer cells. Gene silencing of TSP-1 suppressed SPC-induced EMT as well as migration and invasion of MCF10A cells. An extracellular signal-regulated kinase inhibitor, PD98059, significantly suppressed the secretion of TSP-1, expressions of N-cadherin and vimentin, and decrease of E-cadherin in MCF10A cells. ERK2 siRNA suppressed TSP-1 secretion and EMT. From online PROGgene V2, relapse free survival is low in patients having high TSP-1 expressed breast cancer. Taken together, we found that SPC induced EMT and TSP-1 secretion via ERK2 signaling pathway. These results suggests that SPC-induced TSP-1 might be a new target for suppression of metastasis of breast cancer cells.
Apoptosis ; Breast Neoplasms ; Cadherins ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Gene Silencing ; Humans ; Inflammation ; Neoplasm Metastasis ; Phenotype ; Phospholipids ; Phosphotransferases ; Receptors, Cell Surface ; Recurrence ; RNA, Small Interfering ; Thrombospondin 1 ; Vimentin

Cutaneous protothecosis is a rare skin infection, caused by the genus prototheca, especially Prototheca wickerhamii. A 73-year-old woman had a painful, ulcerative patch and oozing plaque on left wrist and dorsum of hand for 2 months. Biopsy specimen revealed thick walled morula-like sporangia in the dermis. P. wickerhamii was isolated in the culture. Oral itraconazole therapy for 8 weeks is not satisfactory. New skin lesion is formed. After oral fluconazole therapy, patient's skin lesion is improved.
Aged ; Biopsy ; Dermis ; Female ; Fluconazole ; Hand ; Humans ; Itraconazole ; Prototheca ; Skin ; Sporangia ; Ulcer ; Wrist

Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are decribed. Case 1 was a 28-year -old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multisepatation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 reveated moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus, Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms, Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells, All two cases revealed neither nuclear atypism nor increased abnormal mitoses in both giant and stromal cells, suggesting no evidence of malignancy. Therafter the lesions were treated with excision and curettage and histologically confirmed as giant cell tumors of the bone.
Biopsy, Fine-Needle* ; Chromatin ; Curettage ; Cytoplasm ; Epiphyses ; Female ; Femur ; Forearm ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Male ; Mitosis ; Osteoclasts ; Radius ; Stromal Cells ; Thigh ; Young Adult