No abstract available.

PURPOSE: To reilluminate academic fundamentals and missions of child health nursing (CHN). METHODS: Critical review of literature. RESULTS & CONCLUSION: The academic fundamentals of CHN were analyzed for three different basis; philosophical, theoretical, and legal & ethical basis. The philosophical basis of CHN was summarized as six beliefs; A child is an important human resource and a valuable asset for future society; A child should be respected as a unique and dignified human being; A child has his/her own unique developmental needs; A child is a vulnerable client and should be advocated for; Atraumatic care should be provided to each child; Child health care should be family-centered. The essence of the theoretical basis were reilluminated into caring theory and client advocacy theory. The legal basis of CHN was stated as pertaining to the various child-related laws and international conventions, such as UN Convention on the Rights of the Child. The ethical basis were stated as 4 principles of biomedical ethics and The UNESCO Universal Declaration on Bioethics and Human Rights. The mission of the CHN was stated and the role of CHN was described as one who is a child rights advocator, professional caring service provider, policy maker, health educator, researcher.
Administrative Personnel ; Bioethics ; Child ; Child Welfare* ; Child* ; Health Educators ; Human Rights ; Humans ; Jurisprudence ; Missions and Missionaries* ; Nursing* ; United Nations

Since 1990, descriptive studies about the concept of client advocacy have been published in the health journals. However, empirical studies of the concept are still lacking. There are not enough bases to apply the concept of client advocacy in nursing practice. The purpose of this paper is to encourage empirical research about client advocacy by clarification of the concept and to discusses application of the theory in child healthcare. The literature was reviewed that empirical studies on client advocacy conducted after the year 2000. The changing trends in the client advocacy concept was examined; it was changed from the philosophical concept to nursing action and changed from individual advocacy to collective advocacy, with the rise of the self advocacy concept. The research trends on client advocacy evolves from descriptive study to quasi-experimental study and instrument development study, with diversification and expansion of research methods, advocates, clients and settings. The advocacy role of the nurse in child healthcare is significant due to the child's lack of self determination ability. In ill child care, the application of individual advocacy is potent, while in healthy child care, collective advocacy, policy advocacy, and social advocacy is effective.
Child ; Child Care ; Delivery of Health Care ; Empirical Research ; Humans ; Patient Advocacy ; Personal Autonomy

PURPOSE: Smoking during pregnancy contributes to the risk of negative health outcomes in mothers and babies. The purposes of this study were to review the harmful effects of maternal smoking during pregnancy on fetal and child development, to discuss if maternal smoking should be criminalized as a form of child abuse, and to explore advocating for fetal rights. METHODS: A variety of published literature and legal documents including the Korean constitution, criminal laws, and children's welfare laws were reviewed and critically analyzed. RESULTS: Women who smoke during pregnancy are more likely to experience abortion related to placental dysfunction. Their unborn risk premature birth, fetal growth restriction, low birth weight, neurobehavioral disturbances, and/or other complications and newborn babies are also at risk for complications. The advocates for fetal rights can assert that maternal smoking should be regarded as a crime. CONCLUSION: Findings show that maternal smoking during pregnancy is a major risk factor for many adverse pregnancy outcomes. Effective strategies and health policies for smoking cessation during pregnancy are required to protect pregnant women and their babies.
Child ; Child Abuse ; Child Development ; Constitution and Bylaws ; Crime ; Criminal Law ; Female ; Fetal Development ; Health Policy ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Jurisprudence ; Mothers ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Premature Birth ; Risk Factors ; Smoke* ; Smoking Cessation ; Smoking* ; Value of Life*

No abstract available.
C-Peptide* ; Child* ; Diabetes Mellitus* ; Histocompatibility Testing* ; Humans ; Insulin* ; Islets of Langerhans*

PURPOSE: The study was undertaken to see whether the culturally sensitive education for perinatal care using a face to face approach improves understanding of spouse's culture, knowledge of pregnancy and parenting skills, and self-efficacy among Korean husbands and Vietnamese wives. METHODS: This study has a pre- and post-test study design conducted in a total of 13 couples who live in Seoul and agreed to participate. The education program consisted of lecture and hands on practice. The self-administered questionnaires and the checklist developed based on the educational purpose were used to assess the education effects. RESULTS: The knowledge scores on Korean/Vietnamese culture, pregnancy and parenting skills as well as the performance scores on hand washing, pelvic strengthening, feedings and newborn bathing techniques were significantly improved in both husbands and wives after education, but pelvic floor exercises were improved only in wives. CONCLUSION: Overall, the individual education for culturally sensitive perinatal care was effective in our study participants.
Asian Continental Ancestry Group* ; Baths ; Checklist ; Education* ; Exercise ; Family Characteristics ; Hand ; Hand Disinfection ; Humans ; Infant, Newborn ; Parenting ; Parents ; Pelvic Floor ; Perinatal Care* ; Pregnancy ; Seoul ; Spouses*

The ureteral fistula is the most common urologic complication and it usually occurs within the first 3 weeks after renal transplantation. The dominant cause is damage to the arterial supply of the transplanted ureter by close dissection at time of donor nephrectomy. The signs and symptoms of ureteral fistula can mimmic acute rejection, which is oliguria, anuria, fever, wound tenderness, swelling and decreased renal function. It was well established that open intervention was standardized for such problem. Recently nonoperative percutaneous approaches to the placement of stents and tubes are used. Herein we report a case of ureteral fistula, misdiagnosed as acute rejection after renal transplantation, which was healed with Silastic drain insertion in a 22-year-old male recipient.
Anuria ; Fever ; Fistula* ; Humans ; Kidney Transplantation* ; Male ; Nephrectomy ; Oliguria ; Stents ; Tissue Donors ; Ureter* ; Wounds and Injuries ; Young Adult

Failure in the formation of a hymeneal orifice is a rare congenital malformation. There are many cases of imperforated hymen with hematocolpos in literature. However this condition associated with obstructive uropathy such as acute urinary retention is rare. We experienced a case of imperforated hymen with hematocolpos which caused acute urinary retention in a 16-year-old girl. Herein we report this case with brief review of literature.
Adolescent ; Female ; Hematocolpos ; Humans ; Hymen* ; Urinary Retention*

PURPOSE: The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose R ate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The PURPOSE of this report is to evaluate the effects of the High dose rate (HL)R) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. MATERIALS AND METHODS: From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 7 1 patients w -re treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in st;ge III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40-46 Gy (median 43 Gy), And LDR Radium intracavitary irradiation was performed with Henschke applicator, 22-59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage I, 38 in stag <, II and 17 in stage III. The total dose of external radiation was 40-61 Gy(median 45 Gy), daily 1.8-2.0 3y. HDR Co-60 intracavitary irradiation was performed with RALS (Remote Afterloading System), 30-57 Gy (median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. RESULTS: The 5-year overall survival rate in LDR Group was 72.9%, 6 1.9%, 45.0% in stage I, II, III, respectively and corresponding figures for HDR were 87.1%, 58.3%, 41.2%, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in a denocarcinoma of the uterine cervix. There was 1 1% of late complication rates in LDR Group and 27% in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group ( 16.7% vs. 31.6% in stage II, 11. 1% vs. 35.3% in stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. CONCLUSION: There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group it was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.
Adenocarcinoma* ; Brachytherapy ; Cervix Uteri* ; Female ; Humans ; Incidence ; Radiation Oncology ; Radium ; Retrospective Studies ; Survival Rate

BACKGROUND: The insulin resistance is reported as the independent risk factor of the DM and the ischemic heart disease. The association between the insulin resistance and the essential hypertension was reported at the various countries and races. We performed this study to know if the hypertensive patients show the increased insulin resistance than that of the normotensive persons and factors that influence the insulin resistance and the blood pressure. METHODS: The serum lipid profiles, OGTT, body habitus measurement and abdominal CT at umbilical level were performed in 24 hypertensive patients(male : 10, female : 14) and 45 normotensive persons(male : 19, female : 26) who showed the same distributions of age, sex, weight and body mass index(BMI). RESULTS: The average age of the hypertensive group was 49.1+/-7.9 years, and that of the normotensive group was 46.1+/-7.6 years(p>0.05). The average blood pressure of the hypertensive group was 152.2+/-14.2/98.4+/-6.4mmHg and that of the normotensive group was 116.8+/-9.4/78.2+/-49.mmHg(p<0.001). The hypertensive group had significantly higher area under curve(AUC) of glucose(246.8+/-30.4 Vs 219.2+/-32.2mg/dL.hr) and AUC of insulin(88.9+/-38.2 Vs 69.6+/-34.2microU/mL.hr) than the normotensive group(p<0.05), while there were no differences in the age, sex, weight, body mass index(BMI) and waist to hip ratio(WHR) between two groups. They had nodifferences in lipid profile and plasma renin activity. In CT assessment, the hypertensive group had significantly higher visceral fat to thigh muscle area ratio(VSFTM ratio)(0.61+/-0.29 Vs 0.47+/-0.20) and visceral fat to thigh muscle and fat area ratio(VSFTMF ratio)(0.27+/-0.10 Vs 0.22+/-0.13)(p<0.05), while they had same degree of visceral fat to subcutaneous fat area(VS) ratio and visceral fat area. The visceral fat area, VSFTM ratio, VS ratio, visceral fat area to thigh fat area ratio(VSFTF ratio) were positively correlated with AUC of insulin and AUC of glucose ordinary(p<0.05). After adjustment for plasma insulin, AUC of insulin, VS ratio, VSFTM ratio, age and BMI, the AUC of glucose was positively correlated with the diastolic blood pressure(R square=0.19, p <0.05) and the AUC of glucose and WTR were positively correlated with the systolic blood pressure(R square=0.26, p<0.05). THe subgroup over the 75 percentile of AUC of glucose, AUC of insulin and VSFTM ratio in study population had significantly higher odds ratio of the hypertension(OR of AUC of glusose : 5.8, OR of AUC of insulin : 3.2, OR of VSFTM ratio : 4.5, p<0.05). CONCLUSION: These results suggest that the insulin resistance is more prevalent in the hypertensive patients and associated with the hypertension.
Area Under Curve ; Blood Pressure ; Body Weight ; Continental Population Groups ; Female ; Glucose ; Glucose Tolerance Test ; Hip ; Humans ; Hypertension* ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Myocardial Ischemia ; Odds Ratio ; Plasma ; Renin ; Risk Factors ; Subcutaneous Fat ; Thigh ; Tomography, X-Ray Computed