Drug-induced toxic epidermal necrolysis (TEN) is a bullous erythematous disease that is characterized by the appearance of scaled lesions and large sheets of pilling on the skin. A caseof TEN occured in a 10 month old female patient. The characteristic skin lesions of TEN developed after oral administration of carbamazepine for a partial seizure. Thig case consists of prodrome of malaise, fever, anorexia, and conjunctivity followed by erythema & flaccid bullae formation. Diagnosis was confirmed by histologic findings. This patient was treated with a massive systemic corticosteroid, antibiotics, fluid and electrolytes, and topical measures. Authors experienced an extremely rare case of TEN dur to carbamazepine, So report it with a brief review of literature.
Administration, Oral ; Anorexia ; Anti-Bacterial Agents ; Carbamazepine ; Diagnosis ; Electrolytes ; Erythema ; Female ; Fever ; Humans ; Infant ; Seizures ; Skin ; Stevens-Johnson Syndrome*

Neurofibromatosis type 1(NF1) is one of the most common inherited disorders, clinically characterized by cafe-au-lait spots, Lisch nodules and neurofibromas. In addition, the affected individuals usually develop benign and malignant tumors of the nervous system. One of the most common tumors is the optic nerve glioma. NF1-associated glioma, however, rarely occurs in the cerebellum. Recently, we experienced a NF1-associated cerebellar pilocytic astrocytoma in an 11 years old girl. She has a family history of NF1 and multiple cafe-au-lait spots over her whole body. We report herewith a case of NF1-associated cerebellar pilocytic astrocytoma with a brief review of related literature.
Astrocytoma* ; Cafe-au-Lait Spots ; Cerebellum ; Child ; Female ; Glioma ; Humans ; Nervous System Neoplasms ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Optic Nerve Glioma

Purpose: We evaluated changes in the tear film parameters of the corneal surface, and their correlations with Munk scores,based on corneal topographic scans of patients with nasolacrimal duct obstructions who underwent dacryocystorhinostomy(DCR). We explored whether tear parameters can serve as useful indicators of functional surgical success. Methods: We assessed 72 eyes of 45 patients diagnosed with nasolacrimal duct obstruction who underwent DCR. Tear film parameterswere measured via corneal topography (Keratograph® 5M) once before, and three times after surgery, and includedtear meniscus height (TMH), and the initial and average keratographic tear break-up time (NIKBUT-first and NIKBUT-average,respectively; measured noninvasively). Results: The three postoperative TMH values were 0.31 ± 0.20, 0.30 ± 0.22, and 0.29 ± 0.15 mm, all of which were significantlylower than the preoperative value of 0.48 ± 0.29 mm (all, p < 0.001). Three months after surgery, the NIKBUT-first (6.90 ± 3.39seconds) was significantly shorter than the preoperative value (8.39 ± 5.34 seconds; p = 0.030). The preoperative NIKBUT-averagedid not differ significantly from the values at the three postoperative timepoints (p = 0.756, p = 0.753, and p > 0.999).Changes in the Munk score after surgery correlated significantly with changes in the TMH (r = 0.46, p < 0.001). When functionalsuccess was defined as a Munk score ≤ 1, the area under the curve (AUC) value corresponding to the ability of TMH to definefunctional success of 0.995, was statistically significant (cut-off of 0.31 mm; p < 0.001). Conclusions The TMH DCR correlated significantly with the Munk score, which is a quantitative measure of clinical symptomseverity. The ability of TMH to define functional surgical success was excellent.

Purpose: This study aimed to develop and evaluate the effectiveness of a preceptor educational program in a children’s hospital. The program’s impact was assessed by measuring improvements in clinical competency, communication competency, and leadership competency. Methods: Four day pediatric nurse preceptor education program was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A single-group pretest-posttest design was employed to assess the program’s effects with seventeen participants who were newly trained preceptors. Additionally, participant satisfaction with the program was measured. Results: Following the implementation of the program, significant improvements were observed in clinical competency (Z=-3.62, p<.001), communication competency (Z=-2.77, p=.006), leadership competency (Z=-2.08, p=.038), other competence (Z=-2.64, p=.008), and total competency (Z=-3.52, p<.001) among participants. The overall satisfaction score was 4.41±0.62 on a 5-point scale. Conclusion The pediatric nurse preceptor educational program significantly enhances the overall nursing competencies of preceptor nurses in a children’s hospital. Further research is needed to evaluate the effects of this preceptorship on newly graduated nurses.

Purpose: This study aimed to develop and evaluate the effectiveness of a preceptor educational program in a children’s hospital. The program’s impact was assessed by measuring improvements in clinical competency, communication competency, and leadership competency. Methods: Four day pediatric nurse preceptor education program was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A single-group pretest-posttest design was employed to assess the program’s effects with seventeen participants who were newly trained preceptors. Additionally, participant satisfaction with the program was measured. Results: Following the implementation of the program, significant improvements were observed in clinical competency (Z=-3.62, p<.001), communication competency (Z=-2.77, p=.006), leadership competency (Z=-2.08, p=.038), other competence (Z=-2.64, p=.008), and total competency (Z=-3.52, p<.001) among participants. The overall satisfaction score was 4.41±0.62 on a 5-point scale. Conclusion The pediatric nurse preceptor educational program significantly enhances the overall nursing competencies of preceptor nurses in a children’s hospital. Further research is needed to evaluate the effects of this preceptorship on newly graduated nurses.

Purpose: This study aimed to develop and evaluate the effectiveness of a preceptor educational program in a children’s hospital. The program’s impact was assessed by measuring improvements in clinical competency, communication competency, and leadership competency. Methods: Four day pediatric nurse preceptor education program was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A single-group pretest-posttest design was employed to assess the program’s effects with seventeen participants who were newly trained preceptors. Additionally, participant satisfaction with the program was measured. Results: Following the implementation of the program, significant improvements were observed in clinical competency (Z=-3.62, p<.001), communication competency (Z=-2.77, p=.006), leadership competency (Z=-2.08, p=.038), other competence (Z=-2.64, p=.008), and total competency (Z=-3.52, p<.001) among participants. The overall satisfaction score was 4.41±0.62 on a 5-point scale. Conclusion The pediatric nurse preceptor educational program significantly enhances the overall nursing competencies of preceptor nurses in a children’s hospital. Further research is needed to evaluate the effects of this preceptorship on newly graduated nurses.

Purpose: This study aimed to develop and evaluate the effectiveness of a preceptor educational program in a children’s hospital. The program’s impact was assessed by measuring improvements in clinical competency, communication competency, and leadership competency. Methods: Four day pediatric nurse preceptor education program was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A single-group pretest-posttest design was employed to assess the program’s effects with seventeen participants who were newly trained preceptors. Additionally, participant satisfaction with the program was measured. Results: Following the implementation of the program, significant improvements were observed in clinical competency (Z=-3.62, p<.001), communication competency (Z=-2.77, p=.006), leadership competency (Z=-2.08, p=.038), other competence (Z=-2.64, p=.008), and total competency (Z=-3.52, p<.001) among participants. The overall satisfaction score was 4.41±0.62 on a 5-point scale. Conclusion The pediatric nurse preceptor educational program significantly enhances the overall nursing competencies of preceptor nurses in a children’s hospital. Further research is needed to evaluate the effects of this preceptorship on newly graduated nurses.

A 37-year-old female presented with a conjunctival mass discovered 3 years prior. An excisional biopsy revealed a patternless proliferation of round and spindle-shaped cells with an eosinophilic fibrillary cytoplasm and vesicular nuclei with occasional inclusions. Psammoma bodies were arranged around the dilated irregularly-shaped vessels. Differential diagnoses included conjunctival solitary fibrous tumor (SFT), nevus, glomangioma, ectopic meningioma, and mesectodermal leiomyoma. The tumor cells were immunoreactive for CD34, CD99, bcl-2 and vimentin, and were negative for smooth muscle actin, desmin, glial fibrillary acidic protein, S-100 protein, epithelial membrane antigen, and human melanoma black-45. Ultrastructurally, the tumor cells had rough endoplasmic reticulum, free ribosomes, and scattered mitochondria without basal lamina or cellular junctions, which are features of fibroblasts. A diagnosis of SFT was rendered based on the light microscopic, immunohistochemical, and electron microscopic findings. We report here on the second case of a SFT arising in the conjunctiva, which clinically and histologically mimics conjunctival nevus, glomangioma, ectopic meningioma, and a hybrid neurogenic-myogenic tumor such as mesectodermal leiomyoma.
Actins ; Adult ; Antigens, CD34 ; Basement Membrane ; Biopsy ; Chimera ; Conjunctiva ; Cytoplasm ; Desmin ; Diagnosis, Differential ; Electrons ; Endoplasmic Reticulum, Rough ; Eosinophils ; Female ; Fibroblasts ; Glial Fibrillary Acidic Protein ; Glomus Tumor ; Humans ; Leiomyoma ; Light ; Melanoma ; Meningioma ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Nevus ; Ribosomes ; S100 Proteins ; Solitary Fibrous Tumors ; Vimentin

Objectives: The importance of public healthcare has been further emphasized by the arrival of the era of super-aged societies. This study investigates the landscape among oral health professionals, focusing on the concept development of the public oral health care (POHC) and essential oral health care (EOHC). Methods: A questionnaire survey of oral health professionals was conducted at six associations or societies who have an interest in POHC from December 21 to December 29, 2022. Chi-squared and logistic regression analyses were adopted to identify significant differences between the responses according to general characteristics. Significant differences were considered at a P-value of 0.05. Results: A total of 100 oral health professionals (48 dentists and 52 dental hygienists) participated in this study. The results revealed that there is a need for improvement of the POHC and the establishment of concepts related to the POHC and EOHC. The agreement rate was 90%, 85%, and 86% for the responsible organization, the target object and field, and the concept in the definition of the POHC, respectively. In the case of the construction of the EOHC, the agreement rate was 91% for “Quality of life,” and 85% for “Life and safety.” Among the community oral health programs as the POHC programs, “Oral health education program” showed the highest agreement rate. In healthcare institutions that are capable of providing the POHC services, “Oral health center in the public health center” had the highest agreement rate. Conclusions The POHC would be reasonable to define to ensure universal access to oral healthcare services for all citizens. In the case of EOHC, further research is needed to establish terminology and specific concepts in the future. This study could contribute valuable insights to the field of the POHC in an era of super-aged societies. As further research, more oral health professionals need to participate in the POHC-related policy and health care system.

A 53-year-old woman was presented with several 0.3-0.6 cm-sized nodules within the right lobe of the thyroid. Histologic sections of the thyroid demonstrated multiple papillary microcarcinomas in the background of lymphocytic thyroiditis, with a small focus of Langerhans cell histiocytosis (LCH). Small LCH nodules were also found in the draining cervical lymph nodes. Although the association of LCH with papillary thyroid carcinoma in the thyroid has been reported, their co-existence with LCH in the draining lymph nodes is very rare.
Carcinoma ; Female ; Histiocytosis, Langerhans-Cell ; Humans ; Lymph Nodes ; Middle Aged ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis, Autoimmune