To analyzed the progression of white matter maturation and white matter pathology, MR imaging of the brain was obtained in 38 children with delayed development. Children with developmental delay showed a high incidence of MR abnormalities(34/38, 89.5%). Delayed pattern of myelination and gray-white matter differentiation was seen in 13 patients. Twenty-two patients had white matter patholgy, including 14 with white matter hypoplasia, seven with focal small infarction, five with periventricular leukomalacia, and three with high signal intensities on T2 weighted image. Associated structural abnormalities were also evaluated. The most common lesions in decreasing frequency were cerebral atrophy and dysgenesis of the corpus callosum, pachygyria and/or polymicrogyria, porencephalic cyst and Leigh's disease. Twenty-three of 34 children had multiple abnormalities on MRI. The MRI was useful in depicting the progression of myelination and other white matter lesions, and serial follow-up MR is recommended for patients with delayed or lack of myelination and gray-white matter differentiation.
Abnormalities, Multiple ; Atrophy ; Brain* ; Child* ; Corpus Callosum ; Follow-Up Studies ; Humans ; Incidence ; Infant, Newborn ; Infarction ; Leigh Disease ; Leukomalacia, Periventricular ; Lissencephaly ; Magnetic Resonance Imaging* ; Myelin Sheath ; Pathology ; Polymicrogyria ; White Matter*

PURPOSE: The purpose of this study was to explore the level of professional self-concept, self-efficacy and job satisfaction among nurses who work at hemodialysis units. METHODS: With convenience sampling, 128 nurses working at hemodialysis settings in Chungcheong Province were participated in this study. Data were analyzed using SPSS/WIN 14.0 with descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. RESULTS: The mean scores were 2.68 for professional self-concept, 3.65 for self efficacy and 3.14 for job satisfaction. There were significant differences in professional self-concept according to age, religion, position and clinical experience. There was statistically significant difference in self-efficacy according to age. Also, there was statistically significant difference in job satisfaction according to age, marital status, hospital type, position, clinical experience, and the number of patients per nurse. Job satisfaction was positively correlated with professional self-concept and self-efficacy. CONCLUSION: These findings provided that interventions to enhance professional self-concept as well as the strategies to improve self-efficacy are very important.
Humans ; Job Satisfaction ; Marital Status ; Renal Dialysis ; Self Efficacy

Purpose: The purpose of this study was to understand the effects of infection control fatigue and social support on burnout among nurses during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This study is a descriptive survey study designed to confirm the effects of nurses' infection control fatigue and social support on burnout among nurses during the COVID-19 pandemic. The collected data were analyzed using frequency, percentage, mean, standard devia analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and stepwise multiple regression analysis using SPSS Statistics 26.0. Results: An analysis of the correlations between fatigue from infection control, social support, and burnout showed a positive correlation between burnout and fatigue from infection control (r=.39, p<.001), and a negative correlation between burnout and social support (r=-.29, p<.001). Conflict and lack of support due to uncertain circumstances (β=.51, p<.001), support from supervisor's (β=-.22, p<.001), and experience of infection management education during the previous 1year (β=-.15, p=.007) were identified as the factors that influenced burnout among nurses, and explained 39.0% of the variance in burnout. Conclusion The results of this study demonstrate that fatigue from infection control and social support influence burnout levels among nurses, which suggests the need to establish a new kind of work culture. Additionally, the findings call for the development and implementation of interventional programs that can reduce fatigue from infection control and increase social support for nurses.

No abstract available.
Epidemiologic Studies* ; Mumps*

Congenital diaphragmatic hernia (CDH) associated with pulmonary hypoplasia usually presents in early neonatal life. Despite recent advances in perioperative intensive care and neonatal pharmacology, there is still a 53-62% mortality rate. CDH presenting outside of the neonatal period is called CDH delayed presentation, and it is uncommon and the diagnosis is difficult due to misleading clinical signs and symptoms. The prognosis in delayed presentation is determined by complications as strangulation or incarceration of the herniated bowel or stomach, mediastinal shift. A 3 month-old male infant was visited to pediatric department because of irritability. Breath sound were decreased over the left hemithorax and blood gas examination showed hypoxemia. Plain chest X-rays demonstrated intestinal bowel gas shadow in the left hemithorax and had done revealed CDH. An immediate operation was performed. The post-operative course was uneventful and the postoperative chest X-ray returned to normal. She was discharged on the 8th post-opertive day.
Anoxia ; Diagnosis ; Hernia, Diaphragmatic* ; Humans ; Infant ; Critical Care ; Male ; Mortality ; Pharmacology ; Prognosis ; Stomach ; Thorax

BACKGROUND: Remifentanil is a short-acting drug with a rapid onset that is useful in general anesthesia. Recently, however, it has been suggested that the use of opioids during surgery may cause opioid-induced hyperalgesia (OIH). Researchers have recently reported that esmolol, an ultra-short-acing beta1 receptor antagonist, reduces the postoperative requirement for morphine and provides more effective analgesia than the administration of remifentanil and ketamine. Hence, this study was conducted to determine whether esmolol reduces early postoperative pain in patients who are continuously infused with remifentanil for anesthesia during laparoscopic cholecystectomy. METHODS: Sixty patients scheduled to undergo laparoscopic cholecystectomy were randomly divided into three groups. Anesthesia was maintained with sevoflurane and 4 ng/ml (target-controlled infusion) of remifentanil in all patients. Esmolol (0.5 mg/kg) was injected and followed with a continuous dosage of 10 microg/kg/min in the esmolol group (n = 20). Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 microg/kg/min in the ketamine group (n = 20), while the control group was injected and infused with an equal amount of normal saline. Postoperative pain score (visual analog scale [VAS]) and analgesic requirements were compared for the first 6 hours of the postoperative period. RESULTS: The pain score (VAS) and fentanyl requirement for 15 minutes after surgery were lower in the esmolol and ketamine groups compared with the control group (P < 0.05). There were no differences between the esmolol and ketamine groups. CONCLUSIONS: Intraoperative esmolol infusion during laparoscopic cholecystectomy reduced opioid requirement and pain score (VAS) during the early postoperative period after remifentanil-based anesthesia.
Analgesia ; Analgesics, Opioid ; Anesthesia* ; Anesthesia, General ; Cholecystectomy, Laparoscopic* ; Fentanyl ; Humans ; Hyperalgesia ; Ketamine* ; Morphine ; Pain, Postoperative* ; Postoperative Period

BACKGROUNDS: Rheumatoid factor (RF) is common serological marker for the diagnosis of rheumatoid arthritis (RA), but its sensitivity and specificity are not satisfactory for the diagnosis of RA. Therefore, we investigated the diagnostic performance of a new antifilaggrin antibody test by enzyme linked immunosorbent assay (ELISA) in RA. METHODS: Recombinant human filaggrin was deiminated in vitro by peptidylarginine deiminase and used as the coating antigen for ELISA. We performed the RF and the antifilaggrin antibody for 324 RA patients, 251 non-RA patients (rheumatic diseases other than RA), and 286 normal individuals and evaluated the sensitivities and specificities of RF and antifilaggrin antibody. Optimal cut off values were calculated as mean+2SD in 95% confidence interval except 3SD for 286 normal individuals. Optimal cut off values of antifilaggrin antibody and RF were 9.6 U/ml and 12 U/ml, respectively. RESULTS: The sensitivities and specificities of antifilaggrin antibody were 44.8% and 89.2% at optimal cut off values. The sensitivity and specificity of RF were 75.0% and 83.3%. Combination of "antifilaggrin antibody and RF" showed significantly high specificity of 95.2% and that of "antifilaggrin antibody or RF" showed slightly high sensitivity of 79.3% at optimal cut off values. Antifilaggrin antibody was positive in 17.3% among 81 sero-negative RA patients. CONCLUSION: We considered that antifilaggrin antibody could be used a supplementary test of RF for the diagnosis of RA, because "antifilaggrin antibody and RF" had higher diagnostic specificity than RF alone and antifilaggrin antibody test was easy, convenient ELISA method in performance.
Arthritis, Rheumatoid* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Rheumatoid Factor ; Sensitivity and Specificity

As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.
Compensation and Redress ; Delivery of Health Care ; Job Satisfaction ; Korea ; Phenothiazines ; Public Health ; Surveys and Questionnaires ; Surveys and Questionnaires

BACKGROUND: This study assessed the perceptions of healthcare staff of the health risks of exposure to electromagnetic fields (EMF). METHODS: In total, 328 healthcare workers (e.g., physicians, nurses, medical students, and paramedics) completed a self-administered questionnaire. The questionnaire assessed the following: risk perceptions of 17 environmental factors as potential health threats; EMF sources; information for the potential risks of EMF; and thoughts on how to protect the public from potential EMF-related health risks. RESULTS: Of the included environmental factors, high-tension power lines and mobile phone handsets were ranked as the second and fourth lowest perceived risk, respectively. Approximately 60% of respondents were concerned about the potential health risks of EMF and dissatisfied with the information they received. The main reason for dissatisfaction was insufficient information. The most frequently cited action was that the government should review the available scientific evidence on potential EMF-related health risks. CONCLUSIONS: Having scientific basis through well-designed researches and providing accurate information to the public on the potential health risks of EMF will be important in the future.
Cellular Phone ; Surveys and Questionnaires ; Delivery of Health Care* ; Electromagnetic Fields* ; Humans ; Students, Medical

PURPOSE: The aims of this study are to analyze and to visualize distribution of patients visiting at a dental college hospital, using geographic information system (GIS). The visualized data can be utilized in patient care and treatment planning, ultimately leading to the assessment of risk evaluation and prevention of dental diseases. MATERIALS AND METHODS: Patient information data was obtained from Dankook University Dental Hospital including the unit number, gender, date of birth, and address from 2007 to 2014. Patient distribution was visualized using GIS. Statistical analyses were performed using SAS 9.3 and ArcGIS 10.1. Five factors including proximity, accessibility, age, gender, and socioeconomic status were investigated as the explanatory variables of the patient distribution. RESULTS: The visualized patient data showed a nationwide scale of the patient distribution. There was a little difference in characteristics for each department. As closer at Dankook University Dental Hospital, visitors increased. And it strongly showed that elderly patients in rural areas tend to visit more. CONCLUSION: The distribution of patients has been shown to be significantly affected by the proximity, accessibility, age, gender and socioeconomic status. The underlying reason remains to be further studied.
Aged ; Epidemiology ; Geographic Information Systems* ; Humans ; Parturition ; Patient Care ; Pilot Projects* ; Social Class ; Stomatognathic Diseases