PURPOSE: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM©) for Korean nursing students. METHODS: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. RESULTS: The Korean version of the NASC-CDM© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety. CONCLUSION: The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM© version.
Anxiety ; Clinical Decision-Making ; Cross-Sectional Studies ; Humans ; Korea ; Nursing ; Reproducibility of Results ; Students, Nursing

PURPOSE: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM©) for Korean nursing students. METHODS: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. RESULTS: The Korean version of the NASC-CDM© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety. CONCLUSION The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM© version.

Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

PURPOSE: The purpose of this study was to know the changes and types of diabetes mellitus (DM) in children who lived in Jeollabuk-do for last 26 years. METHODS: We subdivided 26 years (January 1981-December 2006) as group 1 (January 1981-December 1993) and group 2 (January 1994-December 2006). Patients under 15 years old who had been newly diagnosed with DM in these periods in general hospitals situated in Jeollabuk-do were reviewed retrospectively about clinical conditions at the onset. RESULTS: 141 patients were enrolled; group 1 was 43 (30.5%) and group 2, 98 (69.5%). Patients number in same period increased over twice. For types of diabetes, group 1 was all type 1 diabetes and group 2 was 75.5% in type 1 diabetes, 21.4% type 2 diabetes and 3.1% clinically suspected maturity onset diabetes of the youth (cMODY). The incidence of diabetes was 0.12 patients per 100,000 under 15 years old in 1980 and increased upto 4.73 ones in 2005. The diagnosed mean age increased from 8.9 years (group 1) to 10.3 years (group 2), but type 1 diabetes had no significant difference. Diabetes occurred in girls more than boys. Two-thirds of all patients were diagnosed in the winter (December-February) and the spring (March-May). CONCLUSION: The incidence of childhood diabetes in Jeollabuk-do increased rapidly and type 2 diabetes was remarkable. We think these aspect would be not only the problem in this province but also the national one. So, we suggest that the practicing of the dynamic survey nationwide is important for the treatment and the management of childhood diabetes.
Adolescent ; Child ; Diabetes Mellitus ; Hospitals, General ; Humans ; Incidence ; Retrospective Studies

Background: Although an ambulatory surgical practice continues to increase, there is a few data exist about patient discharge criteria. This study was undertaken to evaluate the usefulness and safety of Aldrete PAR (postanesthetic recovery) score and modified PADSS (modified postaneathesia discharge scoring system) on ambulatory surgery patients for recovery in Korea. Methods: Demographic, anesthetic data, Aldrete PAR score and modified PADSS on 279 patients were recorded. The time to dicharge, from recovery room and postoperative complications were evaluated, also. Results: PAR score and modified PADSS are correlated to length of stay in ambulatory surgery center. 24hr after discharge, 16% patients complained postoperative complications. Pain was most frequent postoperative complication. The PAR score was correlated with the occurrence of the complication. Conclusion: PAR score and modified PADSS are useful scoring systems to evaluate patients and make a decision to discharge the patients from ambulatory surgery center in safe.
Ambulatory Surgical Procedures* ; Humans ; Korea ; Length of Stay ; Patient Discharge* ; Postoperative Complications ; Recovery Room

PURPOSE: We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis. METHODS: Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded. RESULTS: We assessed a total of 72 patients. There were 68 stool culture-positive cases, 7 blood culture-positive cases, and 3 both stool culture- and blood culture-positive cases. Salmonella group D was the most frequent pathogen in stool (63.9%) and blood (71.4%) cultures. Salmonella typhi was isolated in 1 case. Of the 72 patients, 45 (62.5%) were male children, of which 29 (40.3%) were aged <3 years. The patients most commonly presented with diarrhea (90.2%) and fever (83.3%). Leukocytosis (leukocyte count, >15,000/microliter) and leukopenia (leukocyte count, <4,000/microliter) were detected in 8.3% and 5.6% of the patients, respectively. Elevated serum C-reactive protein concentration (>5 mg/dL) and erythrocyte sedimentation rate (>20 mm/h) were observed in 88.9% and 58.3% of the patients, respectively. Fifty-two (85.2%) of 61 patients who had undergone antibiotic treatment received a third-generation cephalosporin as definitive antibiotic therapy. Multidrug resistance rate was 40.0% in the first 5 years of the study and 71.4% in the last 5 years. No fatalities occurred in this series. CONCLUSION: Children with culture-proven salmonellosis showed relatively benign clinical outcomes. Appropriate antibiotic treatment of <2 weeks is probably adequate for those without a suppurative focus of infection. The incidence of antibiotic resistant isolates was recently seen to increase.
Aged ; Blood Sedimentation ; C-Reactive Protein ; Child ; Diarrhea ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Fever ; Humans ; Incidence ; Leukocytosis ; Leukopenia ; Male ; Retrospective Studies ; Salmonella ; Salmonella Infections ; Salmonella typhi

Glycogen storage disease(GSD) type Ia is an autosomal recessive disease, caused by the absence or deficiency of glucose-6-phosphatase activity in the liver, kidney, and intestinal mucosa. Glucose-6-phosphatase is an essential enzyme necessary for gluconeogenesis and glycogenolysis. GSD type Ia is characterized by hypoglycemia, lactic acidosis, hepatomegaly, seizures, doll-like faces with fat cheeks, thin extremities, short stature, protuberant abdomen, easy bruising and epistaxis, delayed puberty, early gout, pancreatitis, kidney stone, and other metabolic derangements such as hyperlipidemia. The most important complications of GSD-Ia are focal segmental glomerulosclerosis and hepatic adenomas. Various mutations have been reported. The most common mutation sites are g727t, G122D, and T255I and also P178A and Y128X muations have been reported. We experienced a female patient showing typical clinical characteristics, laboratory findings such as hypoglycemia, hyperuricemia, and hyperlipidemia, and g727t mutation confirmed by DNA analysis. We present this case with a brief review of related articles
Abdomen ; Acidosis, Lactic ; Adenoma ; Cheek ; DNA ; Epistaxis ; Extremities ; Female ; Glomerulosclerosis, Focal Segmental ; Gluconeogenesis ; Glucose-6-Phosphatase ; Glycogen ; Glycogen Storage Disease ; Glycogen Storage Disease Type I ; Glycogenolysis ; Gout ; Hepatomegaly ; Humans ; Hyperlipidemias ; Hyperuricemia ; Hypoglycemia ; Intestinal Mucosa ; Kidney ; Kidney Calculi ; Liver ; Pancreatitis ; Puberty, Delayed ; Seizures

Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis associated with a high mortality rate. Bacterial peritonitis (BP), a complication of EPS treatment, is uncommon, and treatments for BP are not well known. We report two patients who had undergone steroid treatment who developed BP after hemodialysis transfer. In the first case, we treated the BP with antibiotics and performed several surgical drainage procedures; however, the fluid became too thick to drain. This patient died of malnutrition and sepsis. In the second case, antibiotics and surgical enterolysis with peritonectomy were used to treat the BP. Solid food was accepted on day 7 postoperatively, and the patient was stable after 20 months. Thus, surgical enterolysis with peritonectomy may be a good treatment modality for patients with EPS and BP.
Anti-Bacterial Agents ; Drainage ; Humans ; Malnutrition ; Mortality ; Peritoneal Dialysis ; Peritoneal Fibrosis* ; Peritonitis* ; Renal Dialysis ; Sepsis

Type 1 diabetes is an insulin-deficient status due to severe destruction of pancreatic beta cells, and is classified into two subtypes, type 1A and type 1B. Type 1A diabetes is autoimmune and type 1B is idiopathic diabetes. Recently fulminant type 1 diabetes has been identified as a new subtype of idiopathic diabetes. It develops rapidly without any evidence of autoimmunity. This subtype of type 1 diabetes was firstly introduced by Imagawa et al. in 2000, and exclusively reported in Japan. Nonetheless, there has been no case reported in Korea till now. Here, we report a case of fulminant type 1 diabetes in 14-year-old girl. She had acute symptoms for short duration, negative islet-related autoantibodies, elevated serum levels of pancreatic exocrine enzymes (amylase, lipase), high blood glucose level and peripheral neuropathy. But HbA1c level was in normal range. Treatment with insulin was successful, acute symptoms were improved and abnormal laboratory data normalized. Her recent HbA1c level showed only a mild elevation.
Adolescent ; Autoantibodies ; Autoimmunity ; Blood Glucose ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Neuropathies ; Humans ; Insulin ; Insulin-Secreting Cells ; Japan ; Korea ; Peripheral Nervous System Diseases ; Reference Values