To elucidate the clinical characteristics of childhood onset systemic lupus erythematosus (SLE), we carried out a retrospective reivew on medical records of fourteen patients who were diagnosed as SLE on the base of "the 1982 revised criteria for the SLE"(by american Rheumatism Association) at the Department of pediatrics, Hanyang University Hospital from January 1980 through August 1992. The results were summerized as follows: 1) Eleven girls and three boys were recruited in our study, The eight of them were early teens at the time of SLE diagnosis. 2) The frequencies of their clinical manifestations on admission were persistent facial rashes, edema, hepatosplenomegaly, renal abnormalities were proteinuria and hematuria. 3) Immunologic abnormalities were noted as follows: Positive ANA 100%. positive LE cell 64%, elevated anti DS-DNA antibody 64%, and decreased only C3 level 28%, decreased both C3 & C4 64% of the patients. 4) Serum anti-DS DNA(>10units) titer was increased in clinical exacerbated three patients and decreased in four resolved. 5) The high ANA titers( >1;80)obtained in eleven and/or homogenous pattern shown in seven strongly suggested SLE. 6) Renal biopsies of the four patients revealed lupus nephritis and three of the four patients had lupus band in their biopsied skin. 7) Three of 14 patients were recoverd spontaneously with supportive care. Other 11 patients were treated: 7 with prednisolone only, 4 combined prednisolone and other agents. After treatment five were clinically improved. But 4 patients were frequently exacerbated over 2 years, and 2 patients were died of their complications. In conclusion, serum anti-DS DNA level and ANA may be useful for the screening of SLE and for predicting clinical course and prognosis of SLE.
Adolescent ; Biopsy ; Child* ; Diagnosis ; DNA ; Edema ; Exanthema ; Female ; Hematuria ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Mass Screening ; Medical Records ; Neutrophils ; Pediatrics ; Prednisolone ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Diseases ; Skin

PURPOSE: The purpose of this study was to analyze factors affecting burnout among clinical nurses according to Positive Psychological Capital. METHODS: The study design was a descriptive survey and questionnaires were collected from 412 clinical nurses who worked in a general hospital in "J" city. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffe test, Pearson Correlation, and hierarchical multiple regression. RESULTS: In Model individual characteristics accounted for 27.8% of the influence on burnout. In model II with the addition of the 4 factors; Self-efficacy, Hope, Resilience, Optimism, individual characteristics accounted for 48.5% of the influence on burnout. Optimism and Resilience of the Positive Psychological Capital sub-variables were statistically useful as factors influencing burnout. CONCLUSION: The results indicate that it is necessary to develop active human resource management and educational programs to decrease burnout and strengthen the Positive Psychological Capital of the nurses.
Hospitals, General ; Humans ; Surveys and Questionnaires

Clear cell chondrosarcoma, first described by Unni in 1976, is distinguished from classical chondrosarcoma by a typical histological picture, mostly an epiphyseal site of origin, and relatively a benign clinical course. We present a case of clear cell chondrosarcoma arising from hyoid bone in a 70-year-old male. Histologically, large areas of closely packed cells with characteristic clear cytoplasm were seen in addition to the usual elements of a conventional chondrosarcoma. Our search and review of the literature did not reveal any reported case of clear cell chondrosarcoma arising from hyoid bone.
Aged ; Chondrosarcoma* ; Cytoplasm ; Humans ; Hyoid Bone* ; Male

We have evaluated the clinical results following the 46 cases of free vascularized osteocutaneous fibular flap transfer to the tibial defect combined with soft tissue defect, which were performed from May 1982 to January 1997. In the 46 consecutive procedures of free vascularized osteocutaneous fibular flap transfer, initial bony union were obtained in the 43 grafted fibulars at average 3.75 months after operation. There were 2 cases in delayed unions and 1 in nonunion. 44 cutaneous flaps among the 46 cases were survived but 2 cases were necrotized due to deep infection and venous insufficiency. One necrotized flap was treated with latissimus dorsi free flap transfer and the other was treated with soleus muscle rotational flap. Grafted fibulas have been hypertrophied during the follow-up periods. The fracture of grafted fibula (15 cases) was the most common complication and occurred at average 9,7 months after the operation. The fractured fibulas were treated with the cast immobilization or internal fixation with conventional cancellous bone graft. In the cases of tibia and fibula fracture at recipient site, the initial rigid fixation for the fibula fracture at recipient site could prevent the fracture of grafted fibula to the tibia.
Fibula ; Follow-Up Studies ; Free Tissue Flaps ; Immobilization ; Muscle, Skeletal ; Superficial Back Muscles ; Tibia* ; Transplants* ; Venous Insufficiency

OBJECTIVES: Amid the spread of coronavirus disease 2019 (COVID-19), with its high infectivity, we have relied on mathematical models to predict the temporal evolution of the disease. This paper aims to show that, due to active behavioral changes of individuals and the inherent nature of infectious diseases, it is complicated and challenging to predict the temporal evolution of epidemics. METHODS: A modified susceptible-exposed-infectious-hospitalized-removed (SEIHR) compartment model with a discrete feedback-controlled transmission rate was proposed to incorporate individuals’ behavioral changes into the model. To figure out relative uncertainties in the infection peak time and the fraction of the infected population at the peak, a deterministic method and 2 stochastic methods were applied. RESULTS: A relatively small behavioral change of individuals with a feedback constant of 0.02 in the modified SEIHR model resulted in a peak time delay of up to 50% using the deterministic method. Incorporating stochastic methods into the modified model with a feedback constant of 0.04 suggested that the relative random uncertainty of the maximum fraction of infections and that of the peak time for a population of 1 million reached 29% and 9%, respectively. Even without feedback, the relative uncertainty of the peak time increased by up to 20% for a population of 100,000. CONCLUSIONS It is shown that uncertainty originates from stochastic properties of infections. Without a proper selection of the evolution scenario, active behavioral changes of individuals could serve as an additional source of uncertainty.

OBJECTIVES: Amid the spread of coronavirus disease 2019 (COVID-19), with its high infectivity, we have relied on mathematical models to predict the temporal evolution of the disease. This paper aims to show that, due to active behavioral changes of individuals and the inherent nature of infectious diseases, it is complicated and challenging to predict the temporal evolution of epidemics. METHODS: A modified susceptible-exposed-infectious-hospitalized-removed (SEIHR) compartment model with a discrete feedback-controlled transmission rate was proposed to incorporate individuals’ behavioral changes into the model. To figure out relative uncertainties in the infection peak time and the fraction of the infected population at the peak, a deterministic method and 2 stochastic methods were applied. RESULTS: A relatively small behavioral change of individuals with a feedback constant of 0.02 in the modified SEIHR model resulted in a peak time delay of up to 50% using the deterministic method. Incorporating stochastic methods into the modified model with a feedback constant of 0.04 suggested that the relative random uncertainty of the maximum fraction of infections and that of the peak time for a population of 1 million reached 29% and 9%, respectively. Even without feedback, the relative uncertainty of the peak time increased by up to 20% for a population of 100,000. CONCLUSIONS It is shown that uncertainty originates from stochastic properties of infections. Without a proper selection of the evolution scenario, active behavioral changes of individuals could serve as an additional source of uncertainty.

PURPOSE: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. METHODS: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. RESULTS: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. CONCLUSION: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.
Cross-Sectional Studies ; Korea ; Public Health*

A death due to angle grinder injuries is reported. An angle grinder is a widely used electronic device at a working place or at home. A deceased old man and an angle grinder without a protective guard were found at the living room in his house where he had been renovating. The wound of the victim's head showed an oblique laceration, skull fractures and tearing on the brain, embedded with grinder disk fragments. A small intraparenchymal hematoma was in the midbrain, which could be the cause of the fall leading to the accident. Disreard of the cause of the accident, the absence of a protective guard and removal of one hilt might have contribute to the death of the victim.
Brain ; Electronics ; Electrons ; Head ; Hematoma ; Hypogonadism ; Lacerations ; Mesencephalon ; Mitochondrial Diseases ; Ophthalmoplegia ; Skull Fractures

PURPOSE: The purpose of this study was to test the mediating effect of job embeddedness in the relationship between nursing practice environment on nursing job performance and organizational commitment. METHODS: For this study a descriptive design with survey method was utilized. Participants were 192 clinical nurses recruited from 2 hospitals in A, B city and J province in Korea. From June, 6 to 24, 2018, a questionnaire scale was used to collect the data. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and liner regression analysis. RESULTS: There were significant positive relationships for nursing job performance and organizational commitment with nursing practice environment. In addition, job embeddedness had a full mediating role in the relationship between nursing practice environment and nursing job performance, and a partial mediation effect in nursing practice environment and organizational commitment. CONCLUSION: The purpose of this study was to identify the mediating effects of job embeddedness and to find ways to improve organizational commitment, which is a useful variable to predict performance outcomes, nurse job performance and job behavior of organizational members. Also, the study results can be used as basic data for nursing manpower management strategies.
Korea ; Negotiating ; Nursing ; Surveys and Questionnaires ; Work Performance

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services