Effect of Visiting and a Smartphone Application Based Infection Prevention Education Program for Child Care Teachers: A Non-Randomized Controlled Trial

PURPOSE: This study was performed to develop an infection prevention education program for child care teachers and to verify its effects. METHODS: The study was conducted using a nonequivalent control group with a pretest-posttest design. Four private daycare centers (2 centers per city) that were alike in terms of the number of children by age, number of child care teachers, and child care environment were chosen. Participants were assigned to the experimental group (n=20) or control group (n=20). As a part of the program, visiting education (90 min) was provided in the 1st week, and smartphone application education (10 min) was provided thrice a week, in the 2nd and 3rd weeks. RESULTS: Child care teachers' self-efficacy for infection prevention revealed a significant interaction effect between the group and time of measurement (F=21.62, p < .001). In terms of infection prevention behavior, a significant difference was observed between the experimental and control groups (z=−5.36, p < .001). CONCLUSION: The program implemented in this study was effective in improving the infection prevention self-efficacy and infection prevention behavior of child care teachers. Thus, this program may be effective in enhancing their infection control.

Factors Affecting Job Stress of Pediatric Nurses: Focusing on Self-Efficacy, Emotional Labor, Pediatric Nurse-Parent Partnership

PURPOSE: In this study self-efficacy, emotional labor, pediatric nurse-parent partnership and job stress of pediatric nurses were examined. Factors affecting job stress of pediatric nurses were also investigated. METHODS: The study was done between June and September 2014, with a convenience sample of 145 nurses from 3 advanced general hospitals, 5 general hospitals and 2 children's hospitals. Research data were collected via questionnaires and analysed using SPSS version 18.0. RESULTS: Average levels of self-efficacy, emotional labor and job stress were similar to other general nurses and the average level of pediatric nurse-parent partnership was also similar to other pediatric nurses. Job stress of pediatric nurses showed a positive correlation with emotional labor and negative correlations with self-efficacy and pediatric nurse-parent partnership. The most significant factor affecting job stress in pediatric nurses was emotional labor (beta=0.372, p<.001). The combination of emotional labor, pediatric nurse-parent partnership and self-efficacy accounted for 25.4% of job stress in pediatric nurses. CONCLUSION: These results suggest that nursing management strategies to decrease emotional labor and improve pediatric nurse-parent partnerships and self-efficacy are critical to decrease job stress for pediatric nurses. Continued development of nursing management interventions to decrease job stress in pediatric nurses is suggested.

Nursery Teachers' Knowledge, Attitude and Performance Ability in CardioPulmonary Resuscitation

PURPOSE: This study was done to identify the level of knowledge, attitude and performance ability in CardioPulmonary Resuscitation (CPR) and provided data for the development of an education program to improve CPR performance ability of nursery teachers. METHODS: The participants were 220 nursery teachers working in daycare centers in A city located in G province. Data were collected during July, 2013. RESULTS: The mean scores were 45.88 of 100 for knowledge, 3.69 of 5 for attitude, 2.65 of 5 for performance ability. There were significant differences in knowledge and performance ability according to education experience. There were positive correlations between knowledge and performance ability, and between attitude and performance ability. Factors affecting CPR performance ability were knowledge (beta=.133), attitude (beta=.327), and education in CPR (beta=.343). These factors explained 29.4% of the variance in CPR performance ability. CONCLUSION: Results indicate that nursery teachers' knowledge, attitude and CPR performance ability were not sufficient enough to perform accurate CPR in an emergency. Therefore, to improve performance ability of nursery teachers to carry out CPR in a cardiac arrest emergency of a child, educational strategies that focus on increasing knowledge and attitude need to be developed.

Clinical Efficacy of Human Papillomavirus DNA test after Loop Electrosurgical Excision Procedure in Cervical Intraepithelial Neoplasia / 대한산부인과학회지

OBJECTIVE: The aim of this study was to analyze a relation between the recurrence of cervical intraepithelial neoplasia (CIN) and the detection of high-risk human papillomavirus (HPV) DNA after loop electrosurgical excision procedure (LEEP), and to evaluate the clinical efficacy of HPV DNA test by Hybrid Capture Assay as a predictor of the recurrence of CIN after LEEP. METHODS: From January 2000 through March 2003, the charts of 238 women diagnosed as CIN and treated with LEEP were reviewed retrospectively. HPV DNA test (Hybrid Capture System I) for high-risk HPV was performed in all patients before LEEP. They were followed up with Papanicolaou smears and HPV DNA tests at the interval of 3 months during the first 6 months and then at the interval of 6 months. The Chi-square test was used for the statistical analysis. RESULTS: The rate of detection of high-risk HPV declined chronologically after LEEP. A higher recurrence rate was noted in the HPV DNA positive group after LEEP, comparing with the negative group, at 3 months (54.5% in positive vs. 6.5% in negative; p<0.05), at 6 months (61.1% in positive vs. 5.4% in negative; p<0.05), at 12 months (50.0% in positive vs. 14.0% in negative; p<0.05), and at 18 months (50.0% in positive vs. 15.2% in negative; p<0.05). The negative predictive value was high at 3 months (93.5%), at 6 months (94.6%), at 12 months (86.0%), and at 18 months (84.6%). There were significant associations between the recurrence of CIN and positive resection margin except for glandular involvements. CONCLUSION: The detection of high-risk HPV is a risk factor for the presence of CIN after LEEP. HPV DNA test by Hybrid Capture Assay after LEEP may be useful marker for the negative prediction of recurrence of CIN after LEEP.

A Case of Multiple Juvenile Xanthogranuloma Involving Skin and Systemic Organs / 소아과

Juvenile xanthogranuloma(JXG) is one of the most common non-Langerhans cell histiocytosis, benign histiocytic proliferative disorder. It typically presents as a solitary, benign, rapidly growing cutaneous tumor that may regress spontaneously. Most cutaneous lesions of JXG occur in the head and neck region of infants and young children. This disease is usually present with cutaneous lesion only; visceral involvement including the lung, bone, testis, gastrointestinal tract, kidney, heart, eye and oral cavity is rare, but may affect various organs. Moreover, JXG is associated with neurofibromatosis type I and juvenile chronic myeloid leukemia. In contrast to the cutaneous form, systemic JXG may be associated with significant complications requiring aggressive medical care. The authors report a case of JXG in a 3-month-old male infant which involved systemic organs, with a brief of the literature. The patient presented with cutaneous, pulmonary, pancreatic, testicular and hepatic nodules. The cutaneous nodule biopsy shows the proliferation of histiocytes which have indistinct borders, round vesicular nuclei, foamy cytoplasm and eosinophils. The patient's follow-up was characterized by slow and progressive clinical improvement without specific treatment.

A Case of Numb-Chin Syndrome Assoicated with Hodgkin's Disease

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of the mental nerve (the distal trigeminal nerve). The authors report a patient whose initial symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.

The Relation of Food-Specific IgE to Recurrent Wheezing Attack

PURPOSE: There were some reports that IgE-mediated food hypersensitivity is associated with subsequent development of atopic disease in wheezy infants. So we carried out this study to show whether the food specific IgE antibodies are useful to predict recurrent wheezing attack in wheezy infants. METHODS: A total of 190 children younger than 4-year-old were enrolled in this study. They were divided into 3 groups according to the number of experienced wheezing attacks as 1st, 2nd and more than 3rd attack group. There were 30 age-matched controls who had not wheezing nor family members of allergy. We measured peripheral blood eosinophil count, total serum IgE level, RAST f1(egg white), f2(milk), D1(Dp) and D2(Df) from the all participants. RESULTS: The proportion of patients having more than 250/mm3 cosinophils in each group increased as increasing wheezing attacks(P0.05). There was no significant difference in RAST f1 levels among the four groups. In contrast, the proportion of positive RAST f1 increased significantly as the number of wheezing attacks increased(P0.05). CONCLUSION: Egg white specific IgE antibody appear to be a risk factor for recurrent wheezing in infants and young child.

Two Cases of Marchiafava-Bignami Disease

We described 2 patients with Marchiafava-Bignami disease, a neurological disorder associated with chronic alcohol consumption. Patient 1 expressed general weakness and confusion, while patient 2 expressed dysphagia and seizures. Lesions involving the corpus callosum were identified with T2 weighted MR imaging in which there was a hyperintensity in the splenium of patient 1 and in the entire corpus callosum of patient 2. While the conditions of both patients were improved by with nutritional support, they were left with cognitive impairment.

Thalamic Ataxia in the Elderly

Ataxia is one of the most serious neurological symptoms in elderly The clarification of the related anatomical structures are necessary for the understanding of pathophysiologic mechanisms of ataxia. We have recently experienced a case of thalamic infarct in the territory of thalamogeniculate artery. The localization of lesion was based on CT and MR imaging. At first time, right hemiparesis and ataxia were prominent. Hemiparesis was transient but ataxia had been persistent for several months. It has been suspected that thalamus could be the part of neural circuits in balancing. Our case support this suggestion clinically. Based on clinical observations, a plausible extrapolation can be made to thalamic ataxia. It maybe related with dysfunction of dentatorubrothalamic and corticopontine pathway. Thus our case led us to conclude that thalamus could be engaged in balance control of human body.

The Prevalence of Iron Deficiency in Preschool Children / 대한소아혈액종양학회지

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.

A Case of Infectious Mononucleosis Associated with Pleural Effusion and Ascites

Infectious mononucleosis is an acute infectious disease occurring predominantly in older children and young adults due to primary Epstein-Barr virus infection. The clinical picture is extremely variable in both severity and duration. The disease in children is generally mild. It is characterized clinically by fever, exudative or membranous pharyngitis, generalized lymphadenopathy, and splenomegaly. Rarely, it complicates neurologic involvement such as cranial nerve palsy, meningoencephalitis, and transverse myelitis, hematologic involvement such as hemolytic anemia, immune thrombocytopenic purpura, and aplastic anemia, rupture of spleen, myocarditis, interstitial pneumonia, and orchitis, etc. We experienced a case of infectious mononucleosis with pleural effusion and ascites in a 5-year-old male with the chief complaint of fever, sore throat and vomiting 3 days prior to admission. The diagnosis was made on the clinical findings, immunologic findings and the typical findings of peripheral blood smear. On peripheral blood smear, leukocytosis with atypical lymphocytosis were seen. On immunologic study, anti-VCA IgM and IgG were positive by ELISA method. We reported this case and reviewed related literatures briefly.