PURPOSE: The 2000-2001 measles epidemic resulted in more than 50,000 cases with the highest attack rate occuring in infants less than one year of age, indicating the necessity of measles immunization before 12 months of age when a measles outbreak occurs again. The study was conducted to measure maternal measles antibody in infants by plaque reduction neutralization test(PRN), for the first time in Korea, to assess the optimal age for measles vaccination before the first birthday, when necessary. METHODS: Sera were obtained from 95 infants younger than 12 months of age who were healthy or recovered from mild llnesses, and had not had measles vaccination, measles infection, or blood transfusion. Measles antibodies were measured by PRN. RESULTS: Geometric mean titers and seropositive rates of measles antibody measured by PRN were 879.7 mIU/mL(100.0%), 690.0 mIU/mL(83.3%), 182.7 mIU/mL(50.0%), 91.3 mIU/mL(50.0%), 32.2 mIU/ mL(0.0)%, 25.1 mIU/mL(0.0%), 18.1 mIU/mL(0.0%), 38.4 mIU/mL(25.0%), 27.1 mIU/mL(0.0%), 31.2 mIU/mL(0.0%), 54.3 mIU/mL(0.0%), and 27.1 mIU/mL(0.0%) from 0 to 11 months respectively. CONCLUSION: By PRN, which was used for the first time to measure the measles antibody in Korea, placentally transferred measles antibody was detected in all newborns tested and decreased reciprocally to the age of infants, leaving almost all infants older than four months seronegative. These results indicate that measles vaccination at six months of age or older, which is the current recommendation during the period of epidemic issued by the Korean Society of Pediatrics, should not cause the primary vaccine failure. It seems advisable to utilize PRN further in order to find the optimal schedule for measles vaccination to infants born to women who were vaccinated.
Antibodies* ; Appointments and Schedules ; Blood Transfusion ; Female ; Humans ; Immunization ; Infant* ; Infant, Newborn ; Korea ; Measles* ; Neutralization Tests* ; Pediatrics ; Vaccination

PURPOSE: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. METHOD: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). RESULTS: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. CONCLUSION: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.
Costs and Cost Analysis ; *Fee Schedules ; Humans ; Inpatients/*classification ; Intensive Care Units/*economics ; Nursing Service, Hospital/*economics ; Prospective Payment System ; Time Factors

Epidermal cysts are common benign subcutaneous lesions that occur in or on the skin. It is not very difficult to diagnose subcutaneous epidermal cysts using ultrasound imaging because they exhibit typical sonographic features. However, the differential diagnosis can be confused when epidermal cysts are found in unusual sites. The authors report a case involving a 4-year-old girl who presented with an intramuscular epidermal cyst in the gluteus maximus muscle. Magnetic resonance imaging revealed characteristic internal features of the epidermal cyst, despite being in an uncommon site, and was very useful in the preoperative diagnosis.

PURPOSE: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. METHOD: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characte-ristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. RESULTS: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was 36.76 55.7 hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. CONCLUSION: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.
Child ; Ethics ; Humans ; Intensive Care Units ; Nursing ; Nursing Care ; Patient Rights ; Restraint, Physical* ; Surveys and Questionnaires

Endoscopic treatment for obesity, especially intragastric balloon insertion, is on the rise in Korea. From 2016 to 2019, we performed intragastric balloon placement for the treatment of obesity in 12 patients at a single tertiary center. One balloon was removed on the next day due to nausea and severe abdominal pain, and the remaining 11 patients were followed up for 6 months. Body weight reduction of 8.9±5.4 kg was achieved, and the body mass index was reduced by 3.3±2.0 kg/m2. Significant effects regarding total body weight loss and excess weight loss were noted. The effect of weight reduction was greatest within 1 month after the procedure. Low density lipoprotein cholesterol significantly decreased by 18.0±18.2 mg/dL, but there were no significant changes in blood pressure, fasting blood glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol. Common adverse events were nausea and epigastric pain, but no serious adverse events occurred. Further studies regarding the long-term effects of endoscopic treatment for obesity and the improvement of metabolic syndrome are needed.

Endoscopic treatment for obesity, especially intragastric balloon insertion, is on the rise in Korea. From 2016 to 2019, we performed intragastric balloon placement for the treatment of obesity in 12 patients at a single tertiary center. One balloon was removed on the next day due to nausea and severe abdominal pain, and the remaining 11 patients were followed up for 6 months. Body weight reduction of 8.9±5.4 kg was achieved, and the body mass index was reduced by 3.3±2.0 kg/m2. Significant effects regarding total body weight loss and excess weight loss were noted. The effect of weight reduction was greatest within 1 month after the procedure. Low density lipoprotein cholesterol significantly decreased by 18.0±18.2 mg/dL, but there were no significant changes in blood pressure, fasting blood glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol. Common adverse events were nausea and epigastric pain, but no serious adverse events occurred. Further studies regarding the long-term effects of endoscopic treatment for obesity and the improvement of metabolic syndrome are needed.

PURPOSE: Histone deacetylase 6 (HDAC6) is an enzyme that deacetylates heat-shock protein 90 (HSP90). Many studies have investigated the role of HDAC6 and HSP90 in tumorigenesis and in the prognosis of cancer patients. This study aimed to evaluate the prognostic value of HDAC6 and acetylated HSP90 (acetyl-HSP90) in a cohort of breast cancer patients. METHODS: Immunohistochemical analysis of 314 surgical specimens obtained from patients with invasive breast cancer was carried out to assess standard pathologic factors and the expression of HDAC6 and acetyl-HSP90. Statistical analyses were performed to determine the association between HDAC6, acetyl-HSP90, and conventional clinicopathological factors, and the prognostic values of these factors were evaluated. RESULTS: HDAC6 expression did not show any correlation with other clinicopathological factors, but acetyl-HSP90 was significantly correlated with histologic grade (p=0.001) and the Ki-67 index (p=0.015). HDAC6 and acetyl-HSP90 expression were significantly associated with each other (p=0.047). Although HDAC6 was not prognostic for disease-free survival (DFS), some patients with high expression of HDAC6 experienced recurrence 5 years after diagnosis, while there was no recurrent disease after 5 years in those with low expression. Acetyl-HSP90 was significantly associated with the DFS of all patients (p=0.016) and with high HDAC6 expression (p=0.017), but not with low expression. CONCLUSION: Expression of HDAC6 and acetyl-HSP90 are correlated. HDAC6 is proposed to be a possible predictive marker of late recurrence, and acetyl-HSP90 has prognostic value in predicting the DFS of breast cancer patients.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Heat-Shock Proteins* ; Histone Deacetylases* ; Histones* ; Humans ; Prognosis ; Recurrence

PURPOSE: Prader-Willi syndrome (PWS) is a well-known genetic disorder, and microdeletion on chromosome 15 is the most common causal mechanism. Several previous studies have suggested that various environmental factors might be related to the pathogenesis of microdeletion in PWS. In this study, we investigated birth seasonality in Korean PWS. METHODS: A total of 211 PWS patients born from 1980 to 2014 were diagnosed by methylation polymerase chain reaction at Samsung Medical Center. Of the 211 patients, 138 were born from 2000-2013. Among them, the 74 patients of a deletion group and the 22 patients of a maternal uniparental disomy (UPD) group were compared with general populations born from 2000 using the Walter and Elwood method and cosinor analysis. RESULTS: There was no statistical significance in seasonal variation in births of the total 211 patients with PWS (chi2=7.2522, P=0.2982). However, a significant difference was found in the monthly variation between PWS with the deletion group and the at-risk general population (P<0.05). In the cosinor model, the peak month of birth for PWS patients in the deletion group was January, while the nadir occurred in July, with statistical significance (amplitude=0.23, phase=1.2, low point=7.2). The UPD group showed the peak birth month in spring; however, this result was not statistically significant (chi2=3.39, P=0.1836). CONCLUSION: Correlation with birth seasonality was identified in a deletion group of Korean PWS patients. Further studies are required to identify the mechanism related to seasonal effects of environmental factors on microdeletion on chromosome 15.
Chromosomes, Human, Pair 15* ; Humans ; Methylation ; Parturition* ; Polymerase Chain Reaction ; Prader-Willi Syndrome* ; Seasons* ; Uniparental Disomy

OBJECTIVE: To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion. MATERIALS AND METHODS: This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance. RESULTS: Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively). CONCLUSION: Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.
Acute Pain/diagnosis/radiography ; Adnexa Uteri/pathology/*radiography ; Adnexal Diseases/*radiography ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Child ; Female ; Humans ; Middle Aged ; Pelvis/radiography ; ROC Curve ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Torsion Abnormality/*diagnosis/*radiography ; Young Adult

Biopsy ; Classification ; Dataset ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography