BACKGROUND: To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital. METHODS: We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL. RESULTS: Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups. CONCLUSIONS: Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.
APACHE ; Body Mass Index ; Calcitriol ; Chronic Disease ; Critical Care ; Critical Illness* ; Humans ; Intensive Care Units ; Mortality ; Prevalence* ; Respiration, Artificial ; Retrospective Studies ; Tertiary Healthcare ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

Empathy is an essential factor for establishing therapeutic relationship. Especially for pediatric nursing, the nurses need to know how to perceive children's feeling and thought and to express her understanding about them affectively. So, empathy is considered as an important concept in pediatric nursing. This study was attempted to measure the empathic ability of pediatric nurses by pediatric nurse and mothers of hospitalized children. The subject of this study consisted of 83 pediatric nurses and 106 mothers of hospitalized children in 4 hospitals in Seoul and 1 hospital in Kyung-Gi. Data were collected from Jan. 14 to Feb. 6, 1997, by the questionnaire method. The instrument for this study was the Empathic Construct Rating Scale : ECRS(60-item, 5 point scale). Data Were analyzed by descriptive statistics, t-test and ANOVA. Result of this study are summarized as follows : 1. Pediatric nurses perceived their empathic ability to be moderately high(Mn=3.71) The level of perceived empathic ability of the pediatric nurses showed no significance by general characteristics. 2. The mothers of hospitalized children perceived nurses' empathic ability to be moderate(Mn=3.27). The level of perceived nurses' empathic ability of the mothers of hospitalized children showed significant differences by the experience of hospitalization of the children and the age of the mothers. 3. The perceived nurses' empathic ability of the mothers was significantly low than of the pediatric nurses(t=6.50, P<.001). From the above results, it can be concluded. that the empathic ability of the pediatric nurses is not sufficient for caring children and mothers efficiently. So, the pediatric nurses' empathic ability is needed to improve through facilitative relationship training as refreshment in-service education program.
Child ; Child, Hospitalized ; Education ; Empathy* ; Gyeonggi-do ; Hospitalization ; Humans ; Mothers ; Pediatric Nursing ; Seoul ; Child Health ; Surveys and Questionnaires

Leri-Weill syndrome or Leri-Weill dyschondrosteosis represents a short stature syndrome that is characterized by symmetric shortening of the forearms and lower legs and a bilateral shortening and bowing of the radius with a dorsal subluxation of the distal ulna(Madelung deformity). Recent genetic analyses demonstrated that functional haploinsufficiency of SHOX(short stature homeobox-containing gene) accounts for Leri-Weill syndrome. Further studies are needed to explain phenotypic heterogeneity of SHOX defect. We experienced a case of Leri-Weill syndrome in a 11-year-old girl with short stature, who revealed typical Madelung deformity, mesomelic(middle segment) dysplasia, and a karyotype of 46,XX. In cases with dyschondrosteosis or Turner-characteristic dysmorphic skeletal features, detection of SHOX mutation is recommended.
Child ; Congenital Abnormalities ; Female ; Forearm ; Haploinsufficiency ; Humans ; Karyotype ; Leg ; Population Characteristics ; Radius

BACKGROUND: Osteoporosis is the most common metabolic bone disorder. Osteoporosis has emerged as a leading public health problem with elderly persons and its detection is important for prevention and treatment of fracture. this population-based study was conducted to evaluate the prevalence and risk factors of osteoporosis in the elderly women. METHODS: One hundred thirty eight women aged 60 years or older in rural area were investigated with questionnaires and measurements of height, weight. Bone mineral density(BMD) measurements of lumbar spine and femoral neck were made with dual energy X-ray absorptiometry(DEXA). The World Health Organization criteria for diagnosis of osteoporosis using the manufacturer's young adult population mean and our study young population mean have been applied. Our study's young adult population mean was derived using normal premenopausal 37 women aged 30~45 years. RESULTS: The prevalence of osteoporosis was 45.7% for lumbar spine, 13.0% for femoral neck by the manufacture's young adult mean and 63.0% and 34.8% by our study young adult population mean, respectively. Weight and smoking were associated with lumbar spine BMD. Age was associated with femoral neck BMD. CONCLUSION: Our data suggest that the prevalence of osteoporosis is dependant on reference population mean and measurement site.
Aged* ; Diagnosis ; Female ; Femur Neck ; Humans ; Osteoporosis* ; Prevalence* ; Public Health ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Spine ; World Health Organization ; Young Adult

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Oral stereognosis is a function recognizing the characteristics, such as the size and shape, of objects in the mouth by integrating the senses with movement. As a child grows up, this function develops gradually but is reduced by aging and neurological damage, such as a stroke. In addition, it may affect the swallowing function in the oral phase of stroke patients with dysphagia. The shape and size of an intraoral bolus provide sensory information that is important for swallowing. Therefore, oral stereognosis is important for safety during eating and drinking. Oral stereognosis is designed for evaluation using two-dimensional or three-dimensional shapes of various sizes, and the accuracy or response rate is scored. On the other hand, there is no method of standardized examination. Accordingly, it is necessary to develop a new training method for promoting the recovery of the oral sensory function. The method should also aim to recover the oral stereognostic ability through a larger number of subjects and diseases in the future.

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p < 0.05). The risk of stroke was 2.17 times (95% confidence interval, 1.43~3.28) higher in the group with less than 19 remaining teeth, but it was not statistically significant as a result of adjusting for age and sex, income level, education level, drinking and smoking (p>0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.
Adult ; Cause of Death ; Drinking ; Education ; Humans ; Inflammation ; Korea ; Logistic Models ; Mouth ; Nutrition Surveys ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Social Class ; Stroke ; Tooth ; Tooth Loss

Crossed renal ectopia is a congenital malformation in which both kidneys lie on the same side of the spine, usually side by side longitudinally. More often on the right side. Fusion of the two renal units is eight times more common than nonfusion. Although crossed renal ectopia is uncommon, this unusual entity must be considered in an infant when cystic mass in the abdomen or pelvis paticularly if no kidney can be found on the opposite side. In many cases of crossed fused ectopia with multicystic dysplastic kidney(MCDK), the diagnosis can be strongly suspected from the sonogram, and no other studies may be necessary. However, both intravenous urography and isotope renography is useful to assess the function of the crossed kidney. Crossed renal ectopia and MCDKs are associated with a greater incidence of ureteropelvic junction obstruction and reflux. So, screening voiding cystourethrography should be performed. Very few studies of MCDK in the setting of crossed fused ectopia have been reported. We have experienced a 3-year-old boy with crossed fused renal ectopia with multicystic dysplasia.
Abdomen ; Humans ; Incidence ; Infant ; Kidney ; Mass Screening ; Multicystic Dysplastic Kidney ; Pelvis ; Preschool Child ; Radioisotope Renography ; Spine ; Urography

OBJECTIVES: The dysfunctional neural networks underlying self-evaluation in schizophrenia are overlapped with the neural structures involved in emotion regulation. The purpose of this study was to investigate the influence of anhedonia on the self-evaluation attitude of patients with schizophrenia. METHODS: Twenty healthy controls and twenty patients with schizophrenia performed a self-evaluation task, presenting a pair of the face (self, familiar other, and unfamiliar other) and word (negative, neutral, and positive noun) at the same time. Participants were asked to evaluate relevance between the pairs by pressing a corresponding button. Relevance rating scores were compared between the groups and were correlated with the severity of physical and social anhedonia. RESULTS: Patients evaluated the condition of a self face with a negative word and a familiar face with a negative word to be more relevant than healthy controls. In the patient group, the scores of relevance rating in the condition of an unfamiliar other face with a negative word were positively correlated with the anhedonia scale scores (physical : r=0.486, p=0.030 ; social : r=0.499, p=0.025). There was no correlation between the self-evaluation attitude and the severity of anhedonia. CONCLUSION: Patients with schizophrenia evaluate themselves badly in only negative circumstances, and anhedonia is not related to self-evaluation, but rather other-evaluation.
Anhedonia* ; Diagnostic Self Evaluation ; Humans ; Schizophrenia*

This study was designed to explore the effectiveness of education to improve self-care of stroke patients with three types of character health locus of control and constitution. A total of 56 patients were selected by convenience sampling at one oriental hospital. The teaching of self-care was conducted by the researcher. The self-care performance was measured for 10 days. The data were analyzed using t-test, ANOVA and Scheffe method as post hoc test. The result of this study are as follows : 1. The self-care performance by patients characteristics : Age and education had impact on the self-care performance. The level of self-care performance of young and high educated patients was high, gender, religion, occupation, monthly income, and the paralyzed side, however, didn't have influence on the self-care performance. 2.. The self-care performance of patients with three types of constitution : There was no statistical significance on the self-care performance of patients group by constitution, However, average score of self-care performance of patients with So-Um was high. 3. The self-care performance of patients with three types of health locus of control : There was no statistical significance on self-care performance of patient group by health locus of control. 4. The correlation between the constitution and the health locus of control : There was no statistical significance on the introverted and chance health locus of control of patients with three types of constitution. However, there was a statistically significant relationship between the powerful others health locus of control and So-Yang. Even though there was no statistically significant self-care performance of patients with So-Um, there was a clinical significance on the high score of self-care performance of patients with So-Um as compared with the self-care performance of the patients. The health locus of control didn't have influence on the self-care performance of patients. There was a statistically significant relationship between the powerful others health locus of control and So-Yang. Therefore, this study suggest the need to develop the nursing intervention to improve the self-care of stroke patients with the powerful others health locus of control and So-Yang, Furthermore, the longitudinal research is needed to determine the effectiveness of training to imp.
Constitution and Bylaws* ; Education* ; Humans ; Internal-External Control ; Nursing ; Occupations ; Self Care ; Stroke*