Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby’s four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.

Saethre-Chotzen syndrome is an autosomal dominant craniosynostosis syndrome, usually involving unior bilateral coronal synostosis and mild limb deformities, and is induced by loss-of-function mutations of the TWIST1 gene. Other clinical features of this syndrome include ptosis, low-set ears, hearing loss, hypertelorism, broad great toes, clinodactyly, and syndactyly. The authors of the present study report 2 children with clinical features of Saethre-Chotzen syndrome who showed mutations in the TWIST1 gene, and is the first molecular genetic confirmation of Saethre-Chotzen syndrome in Korea. The molecular genetic testing of the TWIST1 gene for patients with coronal synostoses is important to confirm the diagnosis and to provide adequate genetic counseling.
Acrocephalosyndactylia ; Child ; Congenital Abnormalities ; Craniosynostoses ; Ear ; Extremities ; Genetic Counseling ; Hearing Loss ; Humans ; Hypertelorism ; Korea ; Molecular Biology ; Syndactyly ; Synostosis ; Toes

Leaf spot on lemon balm is frequently observed in Korea, causing considerable damage to crops. In 2014 and 2015, the occurrence of leaf spot was observed in several production greenhouses at Suwon, Gongju, and Namwon in Korea. Symptoms on lower leaves initially developed as small, distinct, discolored lesions, which enlarged progressively turning into dark brown, angular spots surrounded by purplish-brown margins. Based on the morphological characteristics and sequence analysis of actin (ACT), translation elongation factor 1-alpha (EF-1α), internal transcribed spacer (ITS), 28S nrDNA (LSU), and RNA polymerase II second largest subunit (RPB2), the fungus associated with the lemon balm leaf spot was determined as Septoria melissae. To the best of our knowledge, this is the first report of lemon balm leaf spot caused by S. melissae in Asia as well as in Korea.

Leaf spot on lemon balm is frequently observed in Korea, causing considerable damage to crops. In 2014 and 2015, the occurrence of leaf spot was observed in several production greenhouses at Suwon, Gongju, and Namwon in Korea. Symptoms on lower leaves initially developed as small, distinct, discolored lesions, which enlarged progressively turning into dark brown, angular spots surrounded by purplish-brown margins. Based on the morphological characteristics and sequence analysis of actin (ACT), translation elongation factor 1-alpha (EF-1α), internal transcribed spacer (ITS), 28S nrDNA (LSU), and RNA polymerase II second largest subunit (RPB2), the fungus associated with the lemon balm leaf spot was determined as Septoria melissae. To the best of our knowledge, this is the first report of lemon balm leaf spot caused by S. melissae in Asia as well as in Korea.

Primary systemic amyloidosis is a progressive disease that is frequently fatal. Nephrotic syndrome is present in almost one-third, congestive heart failure in one-quarter, and peripheral neuropathy in one-sixth of patients at the time of diagnosis. If heart or renal failure are presented, survival rate is poor. We experienced a case of a 66 year-old female patient who had complained lower leg edema and paresthesia of extremities for about 5 months. The laboratory findings were consistent with nephrotic syndrome, but the lower leg edema was non-pitting and the cause of paresthesia was unknown. We performed kidney and nerve biopsy and confirmed a case of primary systemic amyloidosis. In this case, presence of postural hypotension, probable cardiac involvement and relatively long spikes along the outside of the glomerular capillary loops on methenamine silver stain is suggestive of poor prognosis. We can predict chronic renal failure and congestive heart failure in the course of this case. We report a case of primary systemic amyloidosis predominantly presenting nephrotic syndrome and peripheral neuropathy with review of related literatures.
Aged ; Amyloidosis* ; Biopsy ; Capillaries ; Diagnosis ; Edema ; Extremities ; Female ; Heart ; Heart Failure ; Humans ; Hypotension, Orthostatic ; Kidney ; Kidney Failure, Chronic ; Leg ; Methenamine ; Nephrotic Syndrome* ; Paresthesia ; Peripheral Nervous System Diseases* ; Prognosis ; Renal Insufficiency ; Survival Rate

BACKGROUND: Serotonin type 3 receptors are abundant in the dorsal horn of the spinal cord and in the spinal tract of the trigeminal nerve in the medulla. Moreover, the intrathecal (IT) or epidural administration of ondansetron, a selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, might prevent postoperative nausea, vomiting and intrathecal opioid-induced pruritus more effectively than the drug administered systemically. Before new drugs for spinal administration are accepted for clinical practice, experimental neurotoxicity studies must be undertaken. This study was performed in rats in order to reveal the behavioral and morphological signs of spinal cord damage after chronic IT ondansetron administration. METHODS: Rats were anesthetized using enflurane in oxygen and an 8 cm polyethylene catheter was advanced caudally through the atlanto-occipital membrane under aseptic surgical conditions. Twelve rats were randomly divided into two groups, an ondansetron (O) group (n = 6) and a normal saline (N) group (n = 6). After postoperative 7 days, we started the IT injection of ondansetron 40microgram (20microliter) or normal saline 20microliter once a day over two weeks. Potential changes of spinal cords were evaluated morphologically by light microscopy (LM) and electron microscopy (EM) in addition to behavioral changes. RESULTS: No rat in either groups showed any motor or behavioral changes during the administration of ondansetron. By LM and EM, all six rats in the O group showed massive neovascularization over the white and gray matters of spinal cords. CONCLUSIONS: The results suggest that chronic IT administration of ondansetron causes pathologic changes in the rat spinal cord.
Animals ; Catheters ; Enflurane ; Horns ; Membranes ; Microscopy ; Microscopy, Electron ; Ondansetron* ; Oxygen ; Polyethylene ; Postoperative Nausea and Vomiting ; Pruritus ; Rats* ; Serotonin ; Spinal Cord* ; Trigeminal Nerve ; Vomiting

PURPOSE: Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. METHODS: Seventy-two patients (23.9+/-2.4 years) with T1 DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. RESULTS: Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects (0.43+/-0.06 mm vs 0.39+/-0.06 mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). CONCLUSION: Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.
Adolescent ; Atherosclerosis ; Body Mass Index ; Diabetes Mellitus, Type 1 ; Dyslipidemias ; Humans ; Hypertension ; Incidence ; Insulin ; Male ; Mass Screening ; Risk Factors ; Vasodilation ; Young Adult

OBJECTIVES: Bedding in childcare centers (CCCs) can hold house dust mite (HDM) allergens. This study examined whether HDM allergen levels can be reduced through the distribution of an educational newsletter on bedding control to parents of CCC children in Korea. METHODS: All 38 CCCs were measured for Der 1 (sum of Der f 1 and Der p 1) concentrations on classroom floors and bedding before the intervention. Educational newsletters on children’s bedding control were sent to 21 CCCs by mail, and teachers were asked to distribute the newsletters to the parents of the children (intervention group). The remaining 17 CCCs were not sent newsletters (control group). The measurement of Der 1 concentrations in 38 CCCs was repeated after the intervention. Dust samples were collected with a vacuum cleaner and analyzed using enzyme-linked immunosorbent assay methods. RESULTS: The Der 1 concentrations on the bedding were significantly higher than those on the floors in 38 CCCs at baseline (p<0.05). Although changes of the Der 1 concentrations for the control group (n=17) were not significant, Der 1 concentrations for the intervention group (n=21) decreased significantly from 2077.9 ng/g dust to 963.5 ng/g dust on the floors and from 3683.9 ng/g dust to 610.4 ng/g dust on bedding (p<0.05). CONCLUSIONS: The distribution of educational newsletters on bedding control to parents may be an effective means of controlling HDMs in CCCs.
Allergens ; Child ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea* ; Parents ; Periodicals as Topic* ; Postal Service ; Pyroglyphidae* ; Vacuum

OBJECTIVES: Bedding in childcare centers (CCCs) can hold house dust mite (HDM) allergens. This study examined whether HDM allergen levels can be reduced through the distribution of an educational newsletter on bedding control to parents of CCC children in Korea. METHODS: All 38 CCCs were measured for Der 1 (sum of Der f 1 and Der p 1) concentrations on classroom floors and bedding before the intervention. Educational newsletters on children’s bedding control were sent to 21 CCCs by mail, and teachers were asked to distribute the newsletters to the parents of the children (intervention group). The remaining 17 CCCs were not sent newsletters (control group). The measurement of Der 1 concentrations in 38 CCCs was repeated after the intervention. Dust samples were collected with a vacuum cleaner and analyzed using enzyme-linked immunosorbent assay methods. RESULTS: The Der 1 concentrations on the bedding were significantly higher than those on the floors in 38 CCCs at baseline (p<0.05). Although changes of the Der 1 concentrations for the control group (n=17) were not significant, Der 1 concentrations for the intervention group (n=21) decreased significantly from 2077.9 ng/g dust to 963.5 ng/g dust on the floors and from 3683.9 ng/g dust to 610.4 ng/g dust on bedding (p<0.05). CONCLUSIONS: The distribution of educational newsletters on bedding control to parents may be an effective means of controlling HDMs in CCCs.
Allergens ; Child ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea* ; Parents ; Periodicals as Topic* ; Postal Service ; Pyroglyphidae* ; Vacuum

No abstract available.
Consolidation Chemotherapy* ; Induction Chemotherapy* ; Leukemia, Promyelocytic, Acute*