BACKGROUND: With the increase of interest in health promotion, doctor's role in health promotion has been progressively emphasized. Although there were many findings which showed that interventions by doctors can result in important changes in the health behaviors of patients, little was known about patients perception of doctor's intervention. Therefore, we attempted to find out about the factors related to patients interests in health behaviors (smoking, alcohol drinking, body weight, and exercise) and patient's perception of the need for doctor's intervention in changing these health behaviors. METHODS: The study subjects were patients who visited either two private clinics (265 patients) or the department of family medicine in a tertiary hospital(410 patients) located in Seoul. Questionnaires concerning demographic characteristics, patients interests, health behaviors, and their perception of the need for doctors intervention in changing health behaviors were administered to the study subjects between March 1997 and June 1997. We examined the factors which had significant relatianship with patient's interest and the perceptions of the need for doctor's intervention in health behaviors with multiple linear logistic regression analysis. The relationship between patients interests in health behavior and the perception of the need for doctor's intervention was evaluated with Spearman's correlation coefficients. RESULTS: Patient's interest and the perception of the need for doctors intervention in smoking was significantly higher in males, smokers, and private clinic patients. Patients interest in alcohol drinking was significantly higher in males, exsmokers, and drinkers. Patient's perception of the need for doctor's intervention in drinking was significantly higher in males, smokers, drinker's, and those who had chronic disease. Patient's interest in body weight control was significantly higher in females, exsmokers, tertiary hospital patients, and those who viewed themselves as obese. Patients perception of the need for doctor's intervention in body weight control was significantly higher in private clinic patients and those who viewed themselves as obese, and was significantly lower in those who recognized their body frame as normal. Patients interest in exercise was significantly higher in those who were older and who was exercising more than once a week. Patient's perception of the need for doctor's intervention in exercise was significantly higher among tertiary hospital patients. Significant relationship between patient's interest and the perception of the need for doctor's intervention in health behaviors, especially in smoking and drinking habit, was observed in private clinic patients as well as those in tertiary hospital. CONCLUSIONS: The degree of patients interest in health behaviors and their perception of the need for doctor's intervention in health promotion was significantly different according to the type of health behavior, the individual health habits, the demographic characteristics, and the type of medical center used by the patient. Therefore, doctors should pay more attention to providing interventions that affect the health behaviors of patients in consideration of these factors.
Alcohol Drinking ; Body Weight ; Chronic Disease ; Drinking ; Female ; Health Behavior ; Health Promotion ; Humans ; Logistic Models ; Male ; Seoul ; Smoke ; Smoking ; Tertiary Care Centers ; Surveys and Questionnaires

PURPOSE: The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice. METHODS: Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program. RESULTS: Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance. CONCLUSION: According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.
Conflict of Interest ; Humans ; Nursing ; Resilience, Psychological ; Students, Nursing

PURPOSE: Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. METHODS: We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. RESULTS: Final height SDS was -0.11+/-1.15 (-0.26+/-1.33 in females, 0.04+/-0.91 in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average HbA1C. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average HbA1C than patients without complications. Patients whose microalbuminuria regressed had lower levels of average HbA1C, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. CONCLUSION: The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.
Adolescent ; Diabetes Mellitus, Type 1* ; Diagnosis ; Female ; Humans ; Puberty ; Retrospective Studies

PURPOSE:Worldwide incidence of type 2 diabetes mellitus in youth is increased for last 3 decades. We reviewed the clinical characteristics of the patients and their long term complications. METHODS:We reviewed the medical data of 69 patients who were diagnosed type 2 diabetes mellitus at Seoul National University Children's Hospital before the age of 18 years between January 1991 and December 2007. RESULTS:Forty seven patients (68.1%) developed after 2000. The mean age of onset was 13.1+/-2.0 years. Forty seven (69.1%) patients had family history of diabetes mellitus and forty six (66.6%) patients had overweight or obesity. Thirteen (22.4%) patients were small for gestational age but their body mass index wasn't increased compared to that of appropriate for gestational age at the onset of disease. There were 7 patients who had microvascular complication and the mean disease duration was 9.1+/-3.3 years. Hemoglobin A1c was not increased in the complication group compared to the complication-free group. CONCLUSION:The number of childhood and adolescence onset type 2 diabetes mellitus was increased. The proportion of small for gestation age was high and the long term complication developed in adolescence or early adult life. Early intervention of the risk factors and regular evaluation of the complications are needed and systematized follow-up of small for gestational age is also necessary.
Adolescent ; Adult ; Age of Onset ; Body Mass Index ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Early Intervention (Education) ; Follow-Up Studies ; Gestational Age ; Hemoglobins ; Humans ; Incidence ; Infant ; Obesity ; Overweight ; Pregnancy ; Risk Factors

BACKGROUND: It has been estimated that 1 unit per 493,000 blood donations could transmit HIV by infected persons in seroconversion window in America. The 4th generation enzyme immunoassay (EIA) kits which are designed to detect HIV antigen and antibody simultaneously, could reduce the period of seroconversion window and thereby increase the safety of donated bloods without additional expenses. METHODS: Sensitivity and specificity of Vironostika HIV Uni-Form II Ag/Ab (Organon Technika, Boxtel, Netherlands) were evaluated using 53 samples (11 western blot positive samples and 42 sera from BBI panel) and 391 samples (282 healthy donors, 20 anti-HCV positive sera and 89 FANA positive sera), respectively. Seroconversion window was compared with that of COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS (Roche Diagnostics, Basel, Switzerland) using 6 kinds of BBI seroconversion panel. RESLUTS: Sensitivity was 100% (53/53). Aggregated specificity was 99.5% (389/391), while all the samples from the healthy donors showed negative (282/282). COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS also showed 100% sensitivity (53/53) and 100% specificity (391/391). Vironostika HIV kit detected HIV-1 infection earlier about 9.8 days than COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS. CONCLUSION: Sensitivity and specificity of Vironostika HIV kit were as good as those of COBAS CORE kit. Vironostika HIV kit, however, could get more safety of donated bloods than the 3rd generation EIA such as COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS, in that it can reduce seroconversion window of HIV infection.
Americas ; Blood Donors ; Blotting, Western ; HIV Infections ; HIV* ; HIV-1 ; Humans ; Immunoenzyme Techniques* ; Sensitivity and Specificity ; Tissue Donors

Yersinia pseudotuberculosis is a relatively infrequent cause of human infections, mostly as intestinal yersinosis. A septicemic form of Y. pseudotuberculosis infection has been reported only rarely. It is usually seen in patients with underlying disorders such as diabetes, hepatic cirrhosis or iron overload. A 63-year-old man with diabetes mellitus and liver fibrosis was admitted to Asan Medical Center via emergency department because of epigastric pain, fever and watery diarrhea; he was septic. The stool culture did not grow Salmonella, Shigella, or Yersinia. But, in the blood culture Y. pseudotuberculosis grew from one anaerobic vial among two sets of aerobic and anaerobic blood cultures. Serotype of Y. pseudotuberculosis strain was could not be determined because it was a rough type. The isolate was positive in the autoagglutination test and polymerase chain reaction for the virF gene. The serum levels of iron, TIBC and ferritin were within normal range. The patient received ceftriaxone therapy for 3 days and was discharged with a clinical improvement.
Ceftriaxone ; Chungcheongnam-do ; Diabetes Mellitus ; Diarrhea ; Emergency Service, Hospital ; Ferritins ; Fever ; Humans ; Iron ; Iron Overload ; Liver Cirrhosis ; Middle Aged ; Polymerase Chain Reaction ; Reference Values ; Salmonella ; Sepsis* ; Shigella ; Yersinia pseudotuberculosis* ; Yersinia*

Enterococcus gallinarum carrying both vanA and vanC1 genes were detected from a surveillance culture from a patient staying at the surgical intensive care unit for a few years. E. gallinarum, SI04, was highly resistant to vancomycin (MIC of >or=256ng/mL) and teicoplanin (MIC of >or=256ng/mL). Multiplex PCR for vanA, vanB, vanC1 and vanC2/3 genes revealed SI04 to be positive for both vanA and vanC1 genes. This finding supports the fact that genotyping is needed to classify vancomycin-resistant enterococci (VRE). This is the first report on VanC VRE accompanying vanA gene in Korea.
Enterococcus* ; Humans ; Critical Care ; Korea ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Vancomycin

BACKGROUND: The previous performance tests of URiSCAN GEN 10SGL dipstick reagent strip (Yeongdong pharmaceutical Co., Seoul, Korea) were mainly done by comparison with the approved urine strips. However, adequate comparison was inavailable because the grading systems were different among the manufacturers. We evaluated the correlation of new generation URiSCAN GEN 10SGL urine strip with known quantitative, microscopic, and culture methods. METHODS: We used urine specimens which were collected for the urinalysis and culture from November 2000 to Mars 2001. We evaluated the correlation between the results of URiSCAN GEN 10SGL and the quantitative methods by comparing the mean of change of reflectance rate (change %R) with the result of the corresponding quantitative method for protein, glucose, bilirubin, urobilinogen, pH, and specific gravity. To calculate the sensitivity and specificity, we used microscopic examination for leukocytes and erythrocytes, and used urine culture for nitrite test. RESULTS: The correlation coefficients between the change %R of URiSCAN GEN 10SGL and the corresponding quantitative method exceeded 0.81, except bilirubin and specific gravity (P<0.01; respectively). The agreements of identical or neighboring concentration block were more than 90%, except urobilinogen and specific gravy. The sensitivity and specificity of URiSCAN GEN 10SGL were 63.6% and 94.2% for leukocytes; 92.8% and 74.1% for erythrocytes; 74.4% and 85.0% for nitrite producing organisms. CONCLUSTIONS: URiSCAN GEN 10SGL had acceptable accuracy and agreement compared with the corresponding quantitative methods and culture result. Also, it had improved sensitivity and specificity of leukocytes and erythrocytes detection compared with previous URiSCAN urine dipstick strip.
Bilirubin ; Erythrocytes ; Glucose ; Hydrogen-Ion Concentration ; Leukocytes ; Mars ; Reagent Strips ; Sensitivity and Specificity ; Seoul ; Specific Gravity ; Urinalysis ; Urobilinogen

A 17-year-old girl with 12-year history of systemic lupus erythematosus (SLE) was presented with one month history of diplopia and headache. She had experienced acute cerebral infarction due to multiple cerebral arterial stenosis one year before, and fully recovered except right-side central facial nerve palsy. When she visited pediatric emergency room, ophthalmologic examination showed ophthalmoplegia of the left eye ball; limitation of medial gaze, supra-adduction and infra-adduction. Neurologic examination didn't show any newly developed neurologic defect. There was no newly developed intra-cranial lesion on the brain MRI. But, the brain MRI revealed irregularly enhanced thickened left medial rectus muscle, and that was compatible with orbital myositis. There was no definite evidence of infection or other autoimmune disease. Her condition responded to high dose intravenous methylprednisone therapy (1 g/day for 3 days) and continued oral prednisolone.
Adolescent ; Autoimmune Diseases ; Brain ; Cerebral Infarction ; Constriction, Pathologic ; Diplopia ; Emergency Service, Hospital ; Facial Nerve ; Female ; Headache ; Humans ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Neurologic Examination ; Ophthalmoplegia ; Orbit* ; Orbital Myositis* ; Paralysis ; Prednisolone

Testicular adrenal rest tumors are a well-known complication in male patients with congenital adrenal hyperplasia. Corticosteroid suppressive therapy usually results in the regression of these tumors. We describe a patient with 21-hydroxylase deficiency who developed bilateral testicular masses. Despite steroid suppressive therapy, the tumors did not regress and hormonal control was poor. Consequently, bilateral partial orchiectomies were performed.
Adrenal Hyperplasia, Congenital ; Adrenal Rest Tumor ; Child ; Humans ; Male ; Orchiectomy ; Steroid 21-Hydroxylase ; Testicular Neoplasms