Nurses’ Perceived Needs and Barriers Regarding Pediatric Palliative Care: A Mixed-Methods Study / 한국호스피스완화의료학회지

Purpose@#This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). @*Methods@#Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. @*Results@#The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. @*Conclusion@#In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

Delirium-Related Knowledge, Caregiving Performance, Stress Levels, and Mental Health of Family Caregivers of Terminal Cancer Patients with Delirium in a Hospice Care Unit / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. @*Methods@#Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. @*Results@#The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%).The average score for family caregivers’ performance of caregiving for delirium was 2.60 ±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96± 0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. @*Conclusion@#Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

Education, Role, and Prospects of Advanced Practice Nurses in Hospice and Palliative Care in South Korea / 한국호스피스완화의료학회지

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master’s-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

Delirium-Related Knowledge, Caregiving Performance, Stress Levels, and Mental Health of Family Caregivers of Terminal Cancer Patients with Delirium in a Hospice Care Unit / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. @*Methods@#Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. @*Results@#The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%).The average score for family caregivers’ performance of caregiving for delirium was 2.60 ±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96± 0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. @*Conclusion@#Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

Clinical Practice Guideline for Care in the Last Days of Life / 한국호스피스완화의료학회지

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients’ physical and mental symptoms, psychological support, appropriate deci-sion-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

Polyamines and Their Metabolites as Diagnostic Markers of Human Diseases

Polyamines, putrescine, spermidine and spermine, are ubiquitous in living cells and are essential for eukaryotic cell growth. These polycations interact with negatively charged molecules such as DNA, RNA, acidic proteins and phospholipids and modulate various cellular functions including macromolecular synthesis. Dysregulation of the polyamine pathway leads to pathological conditions including cancer, inflammation, stroke, renal failure and diabetes. Increase in polyamines and polyamine synthesis enzymes is often associated with tumor growth, and urinary and plasma contents of polyamines and their metabolites have been investigated as diagnostic markers for cancers. Of these, diacetylated derivatives of spermidine and spermine are elevated in the urine of cancer patients and present potential markers for early detection. Enhanced catabolism of cellular polyamines by polyamine oxidases (PAO), spermine oxidase (SMO) or acetylpolyamine oxidase (AcPAO), increases cellular oxidative stress and generates hydrogen peroxide and a reactive toxic metabolite, acrolein, which covalently incorporates into lysine residues of cellular proteins. Levels of protein-conjuagated acrolein (PC-Acro) and polyamine oxidizing enzymes were increased in the locus of brain infarction and in plasma in a mouse model of stroke and also in the plasma of stroke patients. When the combined measurements of PC-Acro, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated, even silent brain infarction (SBI) was detected with high sensitivity and specificity. Considering that there are no reliable biochemical markers for early stage of stroke, PC-Acro and PAOs present promising markers. Thus the polyamine metabolites in plasma or urine provide useful tools in early diagnosis of cancer and stroke.

Early Prognostic Factors of Patients with Septic Shock

PURPOSE: To identify prognostic factors during the first 6-hour period of therapy associated with the 28-day survival of patients with septic shock. METHODS: We enrolled consecutive patients admitted to the emergency intensive care unit with septic shock. According to the mortality within 28 days, enrolled patients were divided into survivor and non-survivor groups. We compared patients data obtained at 6 hours after therapy between the two groups. Multivariate analysis was performed to find prognostic factors during the first 6 hours of therapy that were associated with the 28-day survival. RESULTS: Among the 138 enrolled patients, 78 survived and 60 died. Amount of fluid which was infused during the first 6 hours of therapy (odds ratio (OR)=1.005; 95% CI, 1.002-1.008; p=0.002) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR=0.859; 95% CI, 0.772-0.955; p=0.005) were independently associated with 28-day survival of patients with septic shock. Area under curve (AUC) of fluid volume for predicting 28-day survival was 0.940 (95% CI, 0.905-0.975) and the optimal cutoff value was 3000 mL. In the survival analysis, patients who received more than 3000 mL of fluid during the first 6 hours of therapy displayed a higher survival rate than patients receiving <3000 mL (p<0.001). CONCLUSION: The amount of fluid infused during the first 6 hours of therapy was independently associated with 28-day survival in patients with septic shock.

Early Prognostic Factors of Patients with Septic Shock

PURPOSE: To identify prognostic factors during the first 6-hour period of therapy associated with the 28-day survival of patients with septic shock. METHODS: We enrolled consecutive patients admitted to the emergency intensive care unit with septic shock. According to the mortality within 28 days, enrolled patients were divided into survivor and non-survivor groups. We compared patients data obtained at 6 hours after therapy between the two groups. Multivariate analysis was performed to find prognostic factors during the first 6 hours of therapy that were associated with the 28-day survival. RESULTS: Among the 138 enrolled patients, 78 survived and 60 died. Amount of fluid which was infused during the first 6 hours of therapy (odds ratio (OR)=1.005; 95% CI, 1.002-1.008; p=0.002) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR=0.859; 95% CI, 0.772-0.955; p=0.005) were independently associated with 28-day survival of patients with septic shock. Area under curve (AUC) of fluid volume for predicting 28-day survival was 0.940 (95% CI, 0.905-0.975) and the optimal cutoff value was 3000 mL. In the survival analysis, patients who received more than 3000 mL of fluid during the first 6 hours of therapy displayed a higher survival rate than patients receiving <3000 mL (p<0.001). CONCLUSION: The amount of fluid infused during the first 6 hours of therapy was independently associated with 28-day survival in patients with septic shock.

Graft-Versus-Host Disease after Liver Transplantation

PURPOSE: Graft-Versus-Host Disease (GVHD) is a rare (0.1~2%) but severe complication after liver transplantation (LT). It is the most lethal complication after LT and there are currently no effective preventive or therapeutic measures available. Approximately 90 such cases have been reported in the literature, but only one case has been reported in Korea. METHODS: We performed a retrospective analysis of 767 patients who underwent LT (living donor:deceased donor=554:213) at Seoul National University Hospital, Korea from 1998 to 2009. Four patients (4/767, 0.52%) with histologically proven GVHD were found. The diagnosis of GVHD was made according to observing macrochimerism in the peripheral blood and the affected tissue biopsy. RESULTS: Four patients underwent LT due to Hepatitis B virus-related liver cirrhosis and two of these patients had coexisting hepatocellular carcinoma. Three patients received livers from deceased donors and one received a liver from a live donor. All their blood matching were identical. The first diagnosed case underwent human leukocyte antigen (HLA) typing only after LT and it showed complete one-way donor-recipient HLA matching. The onset of GVHD occurred between 10 days and 55 days after LT. All the patients developed high-grade fever, skin rash, neutropenia, diarrhea and the main signs and symptoms related to GVHD. All the patients died because of sepsis despite intensive treatment. CONCLUSION: GVHD after LT is an extremely rare and fatal complication and it is difficult to diagnose. Therefore, we should perform pre-transplant HLA matching and try to establish an early diagnosis for patients who are clinical suspicious of having GVHD. Further study in this area is needed and physicians need to be alert to detect this malady.

Effects and Complications of Tracheostomies done by Emergency Physicians

PURPOSE: A tracheostomy is an important, life-saving procedure to maintain a patent airway. Our aim was to evaluate the effects and safety of tracheostomies done by emergency physicians. METHODS: This was a retrospective study conducted in the emergency intensive care unit (ICU) of a regional emergency medical center. We enrolled consecutive patients who had a tracheostomy in the emergency ICU between November 2004 and September 2008. We collected data on demographic characteristics, diagnosis at admission, the indication for a tracheostomy, time from intubation to tracheostomy, weaning success, time from tracheostomy to weaning, hospital stay, survival discharge, and complications. We divided the patients into two groups: the EM group included patients who had a tracheostomy done by an emergency physician; the OL group had it done by an otolaryngologists. We then made between-groups comparisons. RESULTS: One hundred forty six patients were enrolled in this study. Of the 146 patients, 94 were included in the EM group and 52 in the OL group. There was no significant difference in the demographic characteristics except age, diagnosis at admission, indication of tracheostomy, time from intubation to tracheostomy, weaning success, time from tracheostomy to weaning, hospital stay, and survival discharge between the two groups. There was no significant difference in demographic characteristics? or in the incidence of complications between the two groups. CONCLUSION: Tracheostomy done by emergency physicians are as effective and safe as ones done by otolaryngologists.

Effects of a Postpartum Care Program for Postpartum Women on Postpartum Activity and Postpartum Discomfort in Primiparous Women / 여성건강간호학회지

PURPOSE: This study was conducted to develop a postpartum care program and to evaluate the effects of the program on postpartum activity and postpartum discomfort in primiparous women. METHODS: For this control group quasi-experimental study, primiparous women who had a normal delivery at OBGYN clinics in G-city and then went home with assistance from their mothers participated from April 10 to August 2, 2006. The participants were assigned to an intervention group of 25 mothers or a control group of 23 mothers. Data analysis was performed by using SPSS/win10.0 PC+. X(2)-test and t-test, and repeated measure ANOVA. RESULTS: The results showed that the degree of postpartum activity(F=4.66, p=.036) and the degree of postpartum discomfort(F=7.98, p=.007) were supported statistically with significant differences between the two groups. CONCLUSIONS: Therefore, this program needs to be applied as a new nursing intervention because this postpartum care program was proven useful as effective postpartum care.

Pilocarpine Mouth Care for Patients with Terminal Cancer / 기본간호학회지

PURPOSE: This study was done to investigate the effects of pilocarpine mouth care on the condition and discomfort of the oral cavity in patients with terminal cancer. METHOD: A quasi-experimental design with a non-equivalent control group, pre- and post-test was used. The participants were 30 patients admitted to the hospice care unit of C university hospital. Fourteen patients received pilocarpine mouth care for 5 days. The other sixteen received general mouth care. RESULTS: Improvement in the condition of the oral cavity was significantly higher in the experimental group compared to the control group. Decrease in oral discomfort scores was significantly higher in the experimental group compared to the control group. The incidence of oral candidiasis was significantly higher in the control group compared to the experimental group. CONCLUSION: These findings indicate that pilocarpine mouth care could be an effective intervention for relieving oral discomfort, improving the condition of the oral cavity, and decreasing the incidence of oral candidiasis in patients with terminal cancer.

The Socioeconomic Impact of Terminal Cancer on Patients' Families and Its Associated Factors

BACKGROUND: We conducted this study to investigate the financial burden of terminal cancer patient's family and to identify factors influencing their economic burden. METHODS: We approached 187 family members supporting their famly member with terminal cancer who was enrolled in four hospice and palliative care program. We constructed a questionnaire examining the impact of illness on their family. With multiple logistic analysis, we examined the patients' and family members' demographic and the patients' clinical factors associated with the burden caused by terminal cancer. RESULTS: The majority of families reported the loss of savings (54%), the need to make major life changes in order to care for the patient (50%), the loss of incomes (34%), the inability to function normally because of the stress of the illness (27%). Many families had to move to a less expensive home (18%), delay medical care for other family members (12%), or change educational plans for other family members (13%). Families that cared for patients who wanted to be cared for at institution (odds ratio: 2.72, 95% confidential interval: 1.19~6.19), patients with liver cancer (3.61, 1.53~8.57), and families who were poor caregivers (2.97, 1.24~7.10), or primary caregiver was a spouse (3.57, 1.47~8.68) were more likely to lose savings. Families that were in 'new couple' in family life cycle stages (3.91, 1.04~14.63), 'birth of the first child' (8.34, 2.74~25.32), and 'the adolescent family or the launching family' (10.56, 4.07~27.33), were more likely to lose savings than 'the empty family or the aging family'. CONCLUSION: Many families reported severe caregiving and economic burdens. Social and financial support need to be given to families with predictors of high economic burdens.

Comparision of Gene Expression Profiles Between Normal Human Oral Keratinocyte and Skin keratinocyte by cDNA-Microarray

No abstract available.

Deoxyhypusine synthase is phosphorylated by protein kinase C in vivo as well as in vitro

Deoxyhypusine synthase catalyzes the first step in the posttranslational synthesis of an unusual amino acid, hypusine, in the eukaryotic translation initiation factor 5A (eIF-5A) precursor protein. We earlier observed that yeast recombinant deoxyhypusine synthase was phosphorylated by protein kinase C (PKC) in vitro (Kang and Chung, 1999) and the phosphorylation rate was synergistically increased to a 3.5-fold following treatment with phosphatidylserine (P.Ser)/diacylglycerol (DAG)/ Ca2+, suggesting a possible involvement of PKC. We have extended study on the phosphorylation of deoxyhypusine synthase in vivo in different cell lines in order to define its role on the regulation of eIF5A in the cell. Deoxyhypusine synthase was found to be phosphorylated by endogenous kinases in CHO, NIH3T3, and chicken embryonic cells. The highest degree of phosphorylation was found in CHO cells. Moreover, phosphorylation of deoxyhypusine synthase in intact CHO cells was revealed and the expression of phosphorylated deoxyhypusine synthase was significantly diminished by diacyl ethylene glycol (DAEG), a PKC inhibitor, and enhanced by phorbol 12-myristate 13-acetate (PMA) or Ca2+/DAG. Endogenous PKC in CHO cell and cell lysate was able to phosphorylate deoxyhypusine synthase and this modification is enhanced by PMA or Ca2+ plus DAG. Close association of PKC with deoxyhypusine synthase in the CHO cells was evident in the immune coprecipitation and was PMA-, and Ca2+/phospholipiddependent. These results suggest that phosphorylation of deoxyhypusine synthase was PKC-dependent cellular event and open a path for possible regulation in the interaction with eIF5A precursor for hypusine synthesis.

Comparison of Dietary Attitudes and Attitudes to the School Lunch Service of Elementary and Middle School Students Living in the Same Region / 대한지역사회영양학회지

The purpose of this study was to examine dietary attitudes of students and changes in their attitudes toward the school lunch service. The participants of the study were 483 students ranging from third grade elementary school students to middle school sophomores living in the Seoguipo area of Jeju Island. The subjects were asked to complete questionnaires under the supervision of their teachers or dietitians, and data were grouped into elementary school 3rd and 4th grades, elementary school 5th and 6th grades; and middle school 1st and 2nd grades for each gender. There were no significant differences among the groups with respect to their regularity of food intake, dietary considerations, or the frequency of imbalance in their diets. In the case of female participants, their frequency of snacking decreased as their grade level increased. In general, the overall changes in dietary attitudes became more negative as their grade level increased. Male students demanded increased serving sizes of both staple food and side dishes, while female students demanded increased serving sizes dishes, but not staple food as their grade levels increased. there was also an increase in the number of student sin higher grades who discarded or did not eat enough their entire meals. The major reasons for not eating the food were : no taste to the food and not proper saltiness of food. These results may suggest that school dietitians need to pay more attention to increased taste and proper seasoning of meals. Students suggested that the school lunch service should be continued, but that it needs improvement. Students in higher grades were more aware of the importance of the environment in which the meal was provided. Also, an early education in nutrition and healthy diets seemed important in preparing them for following a healthy lifestyle in later life.

Gene Expression Profiling of Human Salivary Gland Carcinogenesis with cDNA Microarray

No abstract available.

The Study on the Quality of Life for the Mothers of Hospitalized Chronic Pediatric Patients / 아동간호학회지

The purpose of this study were to identify the quality of life for the mothers of hospitalized chronic pediatric patients, and to explore the factors affecting the QOL of those mothers. The subjects were 201 mothers whose children had hospitalized at one University hospital with chronic diseases. Data were collected from the December, 1997 to December, 1998. We used a revised QOL instrument consisting of 34 items, 5 point likert scale based on the Noh's QOL instrument. The revised QOL consists of six subscales, those are physical status and function, self esteem, emotional status, economic status, relationship with family members, and relationship with neighborhood. Data were analyzed by t-test, ANOVA, Pearson's correlation using SPSS-PC. The results were as follows: 1. The mean score of quality of life for the mothers of chronic pediatric patients was 100.31, and item mean was 2.95. In subscale analysis, item mean of economic status was the lowest, and that of relationship with family members was the highest. 2.Correlations between characteristics of chronic pediatric patients, their mothers and QOL of mothers were as follows; 1) Total QOL of mothers had a significant positive relationship with progressing time relapse after diagnosing and age of mothers. There was a significant negative relationship between the total QOL of mothers and number of hospitalization of their children. 2) QOL on self esteem and economic status had a significant relationship with age of pediatric patients, the time relapse after diagnosis, and age of mothers. Total number of family members and QOL on economic status showed a significant positive relationship. QOL on emotional status, economic status, and relationship with family members of mothers showed negative correlations with the number of hospitalization of their children. 3. Followings were the result of difference in QOL among different demographic characteristics of the subjects. 1) QOL on economic status of mothers was significantly higher when fathers of pediatric patients had jobs. 2)Total QOL score, QOL on emotional status, and QOL on relationship with neighborhood were significantly higher when mothers of pediatric patients had spouses. 3)QOL on self esteem of mothers was significantly higher when mothers had religion. 4. Followings were the result of difference in QOL among different diagnosis of the children. 1)Total QOL score of mothers whose children had congenital heart disease was higher than that of mothers whose children had leukemia and cancer. 2)QOL on emotional status, economic status, and relationship with family members of mothers whose children had congenital heart disease were higher than those of mothers whose children had leukemia, cancer, and epilepsy.

A Study on Beverage Consumption Pattern Associated with Food and Nutrient Intakes of College Students

This study was conducted to investigate beverage consumptions in relation to food intakes of Korean young people. One hundred thirty five college students(61 males and 74 females) living in Taegu, Kyung-buk and Taejon answered to questionnaires and recorded three day food intakes between May 20 and June 5, 1997. The preferred beverages were fruit juice, carbonated drink, dairy drink, sport beverage for male students, and fruit juice, dairy drink, sport beverage and carbonated drink for female students. Beverage taken most frequently was coffee for both. Frequent consumption of orange juice was associated with consumption of vegetables, meats, and fats and oils used for frying, and light cola seemed to be consumed with greasy dishes. Beverage consumption contributed to intakes of calcium and vitamin B2 more than other nutrients. 4.6% of total energy intake, 15.5% of calcium intake, 11.4% of vitamin B2 provided from beverages in female. Contributions of beverages to nutrient intakes were higher in female than in male students. Calcium intake was the lowest among nutrients for males, and intakes of iron and vitamin A were the lowest for females as compared to the recommended dietary allowances. Therefore it is necessary to guide college students to choose beverages for balanced intakes of necessary nutrients.

Study on the clinical characteristics of systemic sclerosis / 대한내과학회지

BACKGROUND: Systemic sclerosis (scleroderma) is a connective tissue disorder of unknown etiology characterized by fibrosis of the skin and internal organs. It is remarkably heterogeneous in initial presentations and internal organ involvement. Limited and diffuse cutaneous subsets of systemic sclerosis (SSc) are known to be different in clinical and laboratory features. The aim of the present study was to determine the clinical characteristics of systemic sclerosis in Koreans. METHODS: Fifty-six patients with systemic sclerosis at the Rheumatology Clinic of Seoul National University Hospital were studied for age, sex, symptoms, signs, and laboratory results. The differences in clinical and laboratory features between limited and diffuse cutaneous subsets were investigated. RESULTS: The mean age at diagnosis of 56 patients (male:female=1:4.6) was 42.4 years (range 11-72 years). The patients consisted of 30 limited and 26 diffuse cutaneous SSc. Cutaneous involvement was as follows: sclerodactyly (100%), Raynaud's phenomenon (94.6%), digital pitting scar (66.1%), subcutaneous calcinosis (1.8%). In musculoskeletal system, 25 cases (46.3%) developed arthralgia/arthritis, 14 cases (25.9%) myalgia. In gastrointestinal system, esophagus was affected in 11 cases (20.7%). Respiratory involvement consisted of interstitial lung disease (24 cases, 43.7%) and pulmonary hypertension (2 cases, 3.6%). Total skin score and functional vital capacity showed significant negative correlation (p<0.05). Cardiovascular involvement consisted of congestive heart failure (3 cases, 5.5%) and pericardial effusion (1 case, 1.8%). Azotemia was found in one patient (1.8%). Antinuclear antibody was positive in 53 cases (94.6%) and anticentromere antibody 2 cases (3.6%). Anti-Scl 70 antibody was positive in 46.4% of all patients, 40.0% of limited scleroderma and 53.8% of diffuse scleroderma. When comparing clinical features between limited and diffuse cutaneous subsets, musculoskeletal involvement was more common in limited scleroderma. CONCLUSION: Systemic sclerosis in Koreans showed various systemic and organ involvement, musculoskeletal system, lung and esophagus being commonly affected. There was no significant difference between limited and diffuse scleroderma in clinical features except musculoskeletal involvement. Investigation of major internal organs, especially lung and esophagus, is needed, regardless of cutaneous subsets in systemic sclerosis.