PURPOSE: The purpose of this study was to evaluate the CT findings of acute pyelonephritis (APN) in children and to assess the correlation between these findings, clinical parameters and renal scar development, as seen on follow-up CT scans. MATERIALS AND METHODS: Contrast-enhanced CT scans of thirty children in whom APN had been diagnosed were assigned to one of three groups according to whether an abscess had formed, and then to subgroups on the basis of the number of lesions in the renal parenchyme. Initial CT findings were retrospectively correlated with five clinical parameters (maximal body temperature, fever duration, leukocytosis, pyuria and admission period) and renal scar development, as seen on follow-up CT (n=12). RESULTS: CT scans demonstrated linear, wedge-shaped, low-density renal parenchymal lesions in 35 kidneys of 25 patients and abscesses in seven kidneys of seven patients, but no abnormal lesions in five patients. In the three groups there was correlation between these findings and some clinical parameters (maximal body temperature, fever duration and admission period), but no subgroup showed significant correlation with any clini-cal parameter. Renal cortical scars detected by follow-up CT were more prevalent in patients in whom initial CT demonstrated the presence of an abscess. CONCLUSION: Clinical parameters correlated with the presence of renal parenchymal hypoenhancing lesions and abscess formation, as seen on CT scans, rather than the number of renal parenchymal lesions. Renal cortical scars were more prevalent in patients in whom initial CT revealed the presence of an abscess. Enhanced CT is thought to be useful both for diagnosing APN and for predicting its clinical course in children.
Abscess ; Body Temperature ; Child ; Cicatrix ; Fever ; Follow-Up Studies ; Humans ; Kidney ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: This study aimed to describe the cultural competence among community health practitioners (CHPs). METHODS: A cross-sectional descriptive study design was used with a convenience sample of 257 CHPs. Data collection was conducted with a structured questionnaire, including Cultural Competence Assessment. Data were analyzed by t-test and ANOVA with the SPSS/WIN 17.0 program. RESULTS: Most participants reported a moderate level of cultural competence (M=3.0, SD=0.41). Scores for culturally competent behaviors were high (M=3.4, SD=0.48) and cultural knowledge scores were low (M=2.6, SD=0.54). Those CHPs who were living with their family, were working in rural area, and had more opportunities to contact with multicultural patients and experience abroad showed significantly higher cultural competence. CONCLUSION: The findings support the need for future education and training to enhance CHPs' cultural competence.
Community Health Nursing ; Cultural Competency ; Data Collection ; Humans ; Surveys and Questionnaires

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

Cytologic features of inflammatory pseudotumor of the lung have not been described frequently. We report fine needle aspiration cytologic(FNAC) finding of a case of inflammatory pseudotumor misdiagnosed as adenocarcinoma in a 63-year- old man. The FNAC displayed a mixture of histiocytes, myofibroblasts, pneumocytes, and plasma cells. Some histiocytes and myofibroblasts had large nuclei with irregular nuclear membrane and prominent nucleoli, which mislead the diagnosis of adeno- carcinoma on FNAC. The heterogeneous cell population is the unique cytologic features of inflammatory pseudotumor, which are helpful to distinguish it from other circumscribed benign and malignant lesions. Familiarity with these features is essential to avoid misdiagnosis and possible overtreatment.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

PURPOSE: The purpose of this study was to verify the relationship among depression, school adjustment, parent-child bonding, parental control and smartphone addiction, and to identify factors which influence smartphone addiction in adolescents. METHODS: A cross-sectional design was used, with a convenience sample of 183 middle school students from 3 middle schools. Data collection was conducted through self-report questionnaires from April to May, 2017. Data were analyzed using χ² test, Fisher's exact test, t-test, one-way ANOVA, correlation coefficient analysis, and binary logistic regression with SPSS Ver. 21.0. RESULTS: The mean score for smartphone addiction was 29.40. Of the adolescents, 21.3% were in the smartphone addiction risk group. Logistic regression analysis showed that gender (OR=7.09, 95% Cl: 2.57~19.52), school life (OR=0.86, 95% Cl: 0.79~0.93), smartphone usage time (OR=1.32, 95% Cl: 1.04~1.66), and parental control (OR=4.70, 95% Cl: 1.04~21.29) were effect factors for the smartphone addiction risk group. CONCLUSION: Findings indicate that school satisfaction was an important factor in adolescents' smartphone addiction. Control oriented parent management of adolescents' smartphone use did not reduce the risk of smartphone addiction and may have worsen the addiction. Future research is needed to improve understanding of how teachers and parents will manage their adolescents' use of smartphones.
Adolescent* ; Behavior, Addictive ; Data Collection ; Depression ; Humans ; Logistic Models ; Parents ; Smartphone*

PURPOSE: Many studies from the past have indicated that women tend to have lower self- esteem than men. This cross-sectional study looks for this tendency in a medical school in Korea, where men are still thought to comprise much of a dominating force despite the current growth in number of female students in student body. Along with the cross-examination of possible gender difference in self-esteem, the significant and relevant factors will also be sought and discussed. METHODS: Questionnaires were obtained from 202 junior and senior students (125 male and 77 female students) in a medical school in Korea. Self-esteem was determined using the Rosenberg self-esteem scale (reliability = 86% in our study). Multiple regression analysis was used to determine gender difference in self-esteem and statistical relevance in each covariate. RESULTS: There was no statistically significant difference in self-esteem between male and female medical students. Significant factors related to self-esteem include school rank, physical attractiveness, and depression, among which of them, depression was the strongest. CONCLUSION: Innate limitation of cross-sectional studies and evaluation of selected junior and senior students of a single medical school could possibly explain for the absence of gender difference in self-esteem in this study. Academic achievement and physical attractiveness are shown to be positive factors for self-esteem, while depression puts negative force in one's self-esteem.
Cross-Sectional Studies ; Depression ; Female ; Humans ; Korea ; Male ; Schools, Medical ; Students, Medical* ; Surveys and Questionnaires

OBJECTIVES: The aim of this study was to assess the change in oral health-related quality of life among patients with head & neck cancer who received radiotherapy. METHODS: A total of 40 patients who were diagnosed as having head and neck cancer and scheduled to have radiotherapy were enrolled in this study; however, only 25 patients were included in the final analysis. Prior to radiotherapy, a dentist performed an oral examination to check for the presence of decayed and missing teeth, plaque, and determine the gingival index. Oral health-related quality of life was assessed using the OHIP-14 questionnaire. Eight weeks after starting radiotherapy, oral health-related quality of life was re-evaluated using the same questionnaire. RESULTS: The mean age of the participants was 60.20 (±7.29) years, and 22 (88.8%) of them were men. The majority of the participants were diagnosed as having squamous cell carcinoma (68.0%). The total OHIP-14 score was significantly decreased from 56.20 (±13.50) at baseline to 45.72 (±10.98) eight weeks after radiotherapy. In addition, according to subjective oral health at baseline, the observed change in the OHIP-14 score was significantly different. CONCLUSIONS: Oral health-related quality of life was significantly lowered after radiotherapy in patients with head and neck cancer.
Carcinoma, Squamous Cell ; Dentists ; Diagnosis, Oral ; Head and Neck Neoplasms* ; Head* ; Humans ; Male ; Oral Health ; Periodontal Index ; Quality of Life* ; Radiotherapy* ; Tooth

OBJECTIVES: This study evaluated the relationship between oral hygiene and health status and radiationinduced mucositis among patients with head and neck cancer over an 8-week period. METHODS: We recruited 40 patients with head and neck cancer scheduled to receive radiation therapy (RT), and 25 patients were included in the study. Before commencing RT, a dentist examined the patients for plaque, and determined the gingival index and pocket depth. A dental hygienist assessed the patients for radiation-induced mucositis once weekly, for 8 weeks, during RT. RESULTS: The mean patient age was 60.96 (±8.47) years, and 21 (87.5%) patients were male. Twenty patients (83.3%) had been diagnosed with squamous cell carcinoma. Patients with cancer located in the head region had more severe mucositis than those with cancer in the neck region, but this was not significant statistically (P=0.053). However, toothbrushing frequency, plaque, gingival index, and pocket depth were not related to radiation-induced mucositis. During RT, the severity of mucositis significantly worsened compared to that at baseline. CONCLUSIONS: Mucositis severity worsened during RT, but this was not related to oral hygiene and health status among patients with head and neck cancer.
Carcinoma, Squamous Cell ; Dental Hygienists ; Dentists ; Head and Neck Neoplasms ; Head ; Humans ; Male ; Mucositis ; Neck ; Oral Health ; Oral Hygiene ; Periodontal Index ; Radiotherapy ; Toothbrushing

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five(54.35%) were detected by mammogram alone, six(13.04%) by clinical breast examination(CBE) alone, and the remaining 15(32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18(72%) belonged to DCIS or stage|. In contrast, four(66.7%) of six cancers detected by CBE alone and nine(60%) of 15 cancers by both CBE and mammography were included in stage II a or II b. However, the total incidence of early cancers(stage 0 and I) was significantly higher in the screening group than in the symptomatic group(P<0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.
Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Incidence ; Mammography ; Mass Screening

This study was understand in order to examine the effect of hardness on stress-causing factors, defined in this study as burnout in nursing. The subjects were 248 nurses working in three general hospitals in Taejon. The instruments used for this study were a survey of general characteristics, modified Health-Related Hardiness Scale(HRHS) (25 items), job stress scale (63 items), and burnout scale(20 items). Analysis of data was done through the mean, percentage, Person correlation coefficient, and stepwise multiple regression done with a SAS program. The results of this study are as follows. 1) The average item score for the job stress was high at 4.44. In the subcategories, the highest degree of stress was night duty(5.11), and work overload(4.70), responsibility for extra affairs(4.70), conflict in nurse-doctor relationships(4.69), and low reward (4.63) in that order. 2) In the stepwise multiple regression analysis, hardiness(11.55%) was a significant determinant of burnout along with job stress(17.24%) and job duration(12.94%). The results of this study show that hardiness has an effect on psychological distress caused by stress.
Daejeon ; Hardness ; Hospitals, General ; Humans ; Nursing ; Reward