Case of cytomegalovirus pneumonia presented as pneumothorax in 4-month-old healthy infant

Cytomegalovirus (CMV) is the most common agent of congenital infections and opportunistic infections in an immunocompromised host. CMV in an immunocompetent host has inapparent infections, which are usually asymptomatic or cause mild mononucleosis-like symptoms. However, severe CMV diseases, such as pneumonia, hepatitis, gastrointestinal disease, often occur in a healthy infant. The association of CMV pneumonia with the development of pneumothorax has rarely been reported. We experienced a case of CMV pneumonia presenting as pneumothorax in a 4-month-old healthy infant, who was successfully treated with supportive care. CMV was confirmed by using CMV polymerase chain reaction of tracheal aspirates. This case suggested that CMV should be considered as a cause of viral pneumonia during the infant period.

Comparing adult height gain and menarcheal age between girls with central precocious puberty treated with gonadotropin-releasing hormone agonist alone and those treated with combined growth hormone therapy

PURPOSE: This study aimed to investigate the outcomes of gonadotropin-releasing hormone agonist (GnRHa) therapy with or without growth hormone (GH) therapy for girls with idiopathic central precocious puberty (CPP). METHODS: The medical records of 166 girls diagnosed with CPP from 2002 to 2017 were retrospectively reviewed. All included patients were treated with GnRHa for ≥36 months. Changes in height standard deviation score (SDS) for bone age, chronological age (CA), and predicted adult height (PAH) were assessed for the first three years of treatment. The final height gain SDS was calculated as the difference between the initial PAH SDS and adult height (AH) SDS; these were then compared between the GnRHa group (group A, n=135) and the combined GnRHa/GH group (group B, n=31).

Early diagnostic value of the antimycoplasma antibody (IgM) in Mycoplasma pneumoniae pneumonia: A single-center study in 2015

PURPOSE: Recently, the incidence of refractory Mycoplasma pneumoniae (MP) pneumonia has increased in Korea. Given that its early diagnosis is helpful in selection of the treatment, this study aimed at investigating the value of the antimycoplasma antibody (IgM) for early diagnosis of MP pneumonia. METHODS: A total of 315 children admitted with MP pneumonia from September 2015 to May 2016 were investigated with the IgM and polymerase chain reaction (PCR) for the diagnosis of MP pneumonia. Specifically, patients were grouped into nonrefractory respiratory MP and refractory MP groups according to their response to macrolide therapy. RESULTS: In the 44 PCR-negative seroconversed children, seroconversed IgM was more frequent in the refractory MP group compared with the nonrefractory respiratory MP group with statistical significance (P<0.001). In the 264 IgM-positive children, the time of antibody reaction was more delayed in the refractory MP group compared to the nonrefractory respiratory MP group with statistical significance (P<0.001). CONCLUSION: This study showed that there was a higher incidence of seroconversed IgM and delayed antibody reaction in the refractory MP group. In children with suspect MP pneumonia, follow-up studies of antibody are necessary, even through initial antibody and PCR showed negative findings. In addition, this result may suggest that the diagnosis of refractory MP pneunomia will be helpful in establishing the strategy of the treatment.

Clinical difference between single infection and coinfection with respiratory virus: The 2014 single-center study

PURPOSE: We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections. METHODS: We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups. RESULTS: A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O₂ therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter. CONCLUSION: There were no clinical differences between single infection and coinfection, except sputum and the frequency of high RSV load.

Unmarried Mother's Knowledge and Attitudes toward Emergency Contraceptive Pills

PURPOSE: This study was conducted to identify relationships among knowledge and attitudes of unmarried mothers toward emergency contraceptive pills. METHODS: Data were collected through structured questionnaires from 135 unmarried mothers enrolled in 7 single mothers' facilities nationwide. Data were analyzed using the SPSS/WIN 17.0 program for descriptive statistics, t-test, ANOVA, Scheffe-test, and Pearson correlation coefficients. RESULTS: For knowledge about emergency contraceptive pills, there were significant differences among who live with her before pregnancy, experience of past pregnancies, state of present pregnancy and preparation in using contraceptives. For attitude toward emergency contraceptive pills, there were significant differences according to age, education level and religion. There were significant positive relationships between knowledge and attitudes toward emergency contraceptive pills. CONCLUSION: The results of this study suggest that unmarried women should be better informed about emergency contraceptive pills, and reassured about their safety. Efforts are needed to disseminate up-to-date information to experts in sex education including nurses.

A Study on Parenting Attitude and Stress according to Personality Type in Elementary School Students' Mothers

PURPOSE: This study was performed to examine parenting attitude and stress according to personality type in elementary school students' mothers. METHODS: The subjects consisted of 206 mothers of students. The measurement instrument was the questionnaire consisting of Korean-version MBTI and PSI test. Data was collected from March 15th to April 15th, 2008. RESULTS: Among personality types by function, ST type was most, occupying 60.2%. Among personality types by temperament, SJ type was most, occupying 59.2%. The score of affective attitude was highest among the parenting attitudes. Parenting attitude was significantly different according to age, education, economic status, number of children, planned pregnancy, factor of stress, and family type. Parenting stress was significantly different according to planned pregnancy and factor of stress. In parenting attitudes by personality types, affective attitude was significantly different. Parenting stress was significantly different according to personality type by function. There was a negative correlation between affective and autonomic attitudes and parenting stress. There was a positive correlation between rejective attitude and parenting stress. CONCLUSION: It would be essential to provide dynamic developmental programs for increasing the children's social ability, and nursing intervention, education and counseling programs for decreasing parenting stress through understanding mothers' personality type.

A Survey on Health Management of during Pregnancy, Childbirth, and the Postpartum of Immigrant Women in a Multi-cultural Family / 여성건강간호학회지

PURPOSE: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. METHODS: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. RESULTS: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive antenatal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. CONCLUSION: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.

Effects of Eye Protective Device and Ear Protective Device Application on Sleep Disorder with Coronary Disease Patients in CCU / 간호학회지

PURPOSE: The purpose of this research was to analyze the effects of an eye protective device and ear protective device application on sleep disorder with coronary disease patients in CCU. METHODS: The research design was set up as a nonequivalent control group non-synchronized design. The subjects were coronary disease patients in the CCU of a tertiary hospital. The subjects were composed of 20 in the group with an eye protective device, 18 in the group with an ear protective device, 17 in the group with an eye protective device and ear protective device and 20 in the control group. The data was analyzed by chi-square-test, ANOVA, Repeated measures ANOVA, Sheffe-test, Simple main effect and Time contrast using SPSS Win 12.0. RESULTS: The hypothesis, 'There are significant differences in sleep quantity among the four groups' was supported (F=1,342.71, p=.000). The hypothesis, 'There are significant differences in the subjective evaluation of the general sleep patterns among the four groups' was supported (F=3,638.73, p=.000). In addition the hypothesis, 'There are significant differences in degree of sleep among the four groups' was supported (F=1,616.61, p=.000). CONCLUSION: It is cost effective and a simple eye protective device and ear protective device should be applied to patients according to their preference and characteristics in the clinical setting.

Evaluation of Community Health Center for Vulnerable Population in Urban Areas

PURPOSE: The purpose of this study was to evaluate achievements of a community health center for vulnerable population in urban areas and to find out its strength and weakness. METHOD: This evaluative study employed system theories and analytic techniques. RESULTS: The purpose of improving vulnerable population's health-related self-care abilities adequately met the operation of programs. This center maintained close connection to a nursing college as a information resource. The subjects' satisfaction was high because team members who visited them were faithful and there were face-to-face contact, sufficient time set, closeness and resourcefulness. There were needs for regular meetings to discuss overall matters in organizing the program and to improve management skills. The mean score of health promotion lifestyle was 2.23 on a 4 point scale. This score indicates what in higher than vulnerable people in other communities. CONCLUSIONS: Community-based nursing centers for vulnerable population in urban areas should be developed as support organizations and community network.

Pharmacoeconomic Evaluation of Long-term Treatment with Typical and Atypical Antipsychotics for Patients with Chronic Schizophrenia / 신경정신의학

OBJECTIVES: We aimed to compare clinical outcomes, work status and total costs of care associated with typical and atypical treatment in patients with schizophrenia. METHODS: Cost data for services and prescription use were retrieved retrospectively for 40 and 27 patients with schizophrenia who were initiated on typical or atypical antipsychotics after registration in 1994 and 2000, respectively. Each patient was followed for 3 year after initiation of therapy. Direct and indirect cost were calculated for both groups and analyzed by SAS 8.2. RESULTS: There was not significant difference in clinical outcomes between two groups except the number of admission was higher in typical antipsychotics group (p<0.05). As for direct cost, patients prescribed on atypical antipsychotics have paid almost two-fold more than typical groups. However, the proportion of unemployment was higher in typical group than in atypical group, leading to much loss of productivity. Therefore, considered offset by lower indirect costs, total costs per patients over the study were 19% higher in typical treatment group than in aytpical treatment group. CONCLUSIONS: Atypical antipsychotics were estimated to be of advantage over typical antipsychotics, by offsetting the big difference of medication cost between two classes.

A Three Month Placebo-Controlled Clinical Trial of INM 176 in the Old Aged Subjects with Memory Impairment / 신경정신의학

OBJECTIVES: We examined the effects of INM 176 (K-1107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. METHODS: This was a prospective, 12 week, double-blind, placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities of Daily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. RESULTS: The interaction effect of time (pre- and post- trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes of ADAS-cog, IADL, KGDS scores during the 12 week clinical trail of INM 176 and placebo demonstrated favorable responses in the INM176 administered group. CONCLUSIONS: This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory. Further clinical trial should demonstrate its efficacy.

Development of Korean Gender Role Identity Inventory / 간호학회지

PURPOSE: This study was performed to develope a scale of gender role identity in Korean adults based on the Bem's theory of androgyny. Although there were several tools in Korea, they were revealed having some problems of cultural differences, translation biases, and methodological problems. METHODS: A list of 78 items were developed using the existing tools and descriptions from 5 married couples. The items were the typical personality characteristics which were manifested by gender, male or female. And the list contained several items which were the socially desirable personality characteristics. which would be simply used as contextual items. Validity of the 78 items were screened by 18 expert panels with 4 point Likert scale, and 57 items were judged as highly valid from 70% of the experts, which were selected as preliminary items for the tool. Using the preliminary tool which was developed as a 4 point Likert scale, data were collected from 1,127 subjects for item analysis and factor analysis. 53 items were remained, because 4 items whose item-total correlation were lower than 0.2 were excluded by the result of item analysis. Factor analysis was done with the 53 items, and 49 items whose factor loadings were same and higher than 0.4 were remained. 3 factors were identified with eigen value 2.0, and these factors were named as masculinity, femininity, and social desirability. RESULTS AND CONCLUSION: KGRII(Korean Gender Role Identity Inventory) which contained 45 items was developed, with 15 items for 3 factors. The reliability of the tool was very high. Cronbach alpha of the tool was 0.929, and alpha of the subscales were ranged from 0.841 to 0.922.

Development of a Korean Sexual Satisfaction Scale / 기본간호학회지

PURPOSE: The purpose of this study was to develop an instrument to measure sexual satisfaction in Korean adults. METHOD: Development of items for the instrument was done by a collecting, reorganizing, reducing and selecting process based on the literature. A total of 19 items were selected in this process. For evaluation of the appropriateness of the 19 items, questionnaires were given to an expert group consisting of 18 professionals (7 men and 11 women). Eighteen items having a response of 70% in 'very good' item or 'good' item were included as items for the instrument. With these 18 items, a 5 point Likert scale was developed, and reliability and validity tests of the scale were done. The subjects for the test were 1,127 Korean adults living in 11 areas in Korea. Data were collected from Dec. 1, 2000 to Feb. 28, 2001 and analyzed with SPSS/PC+ 10.0 program. Item analysis and factor analysis were used to assess the reliability and validity of the scale. Chronbach alpha and corrected item-total correlation were obtained to verify internal consistency, and principal component analysis with the varimax rotation was used to identify structure validity of the developed tool. RESULT: Reliability of the scale was .9503 and corrected item-total correlations of the items were distributed from .5208 to .7899. As a result of the factor analysis, the items were categorized into three factors. The cumulative variance of the three factors was 67.1%, and all of the variances of the factors were above 5%. Because factor 1 (8 items) indicated a special feeling of psychological satisfaction with sexual activity, it was named 'psychological factor'. Factor 2 (8 items) indicated a feeling of satisfaction in the interaction with sexual partner through communication and variation, therefore it was named 'interactional factor'. Factor 3 (2 items) was about the frequency and duration of sexual intercourse and indicated physical dimensions of satisfaction, so it was named 'physical factor'. The average score for sexual satisfaction of the 1,127 subjects was 65.32 (+/-12.71), and histogram of the score showed a normal distribution with skewness -.425. CONCLUSION: Finally, a Korean Sexual Satisfaction Scale(KSSS) was accepted as a 5 point Likert scale with 18 items after the statistical test for reliability and validity. In conclusion, KSSS is a useful instrument which is valid and reliable can be used to understand the sexuality of Korean adults.

A Comparison of the Educational Needs of the Mothers' for the Infant Care Between Primipara and Multipara / 아동간호학회지

This study is designed to compare differences of the infant mothers' nursing educational needs between primipara and multipara. And also this study will provide the basic data for the development of Infant care educational programs based on personal characteristics. The subjects of this study were 71 infant-mothers who just experienced delivery. They were selected from a collage hospital and a obstetric hospital in D city, Korea. The tool used in this study was educational need scale developed by Choe, SeonJeong(2000), and modified by researchers. The subjects were requested to check complete the questionnaires by self-report method at the time of hospital discharge. The data were collected from February 7 to April 10, 2001. and were analysed by descriptive statistics, mean, std deviation, t-test, ANOVA with SPSS 10.0. The results of this study were as follows ; 1. The differences of the infant mothers' nursing educational needs were not significantly between primipara and multipara. 2. In the each category of the infant mothers' nursing educational needs, we could see the differences between primipara and multipara as following ; Infant care(t=2.803, p=.007), Attachment between parents and infant (t=2.442, p=.017). 3. In accordance with general characteristics, the infant mothers' nursing educational needs differed significantly according to religion in primipara and according to satisfaction of marriage in multipara. 4. In accordance with obsterical characteristics, the infant mothers' nursing educational needs differed significantly according to places of postpartum care in primipara. In conclusion, this study confirmed that the nursing educational needs of the mothers did not show significant difference between primipara and multipara. However, two subareas' parts of the infant mothers' nursing educational needs, infant care and attachment between parents and infant showed significant difference between primipara and multipara. And the infant mothers' nursing educational needs differed significantly between primipara and multipara according to several personal characteristics. Therefore the results of this study might give some real data for the development of the Infant Care Programs based on personal characteristics.

The Relationship between Job Stress and Nursing Performance of Emergency Room Nurses / 성인간호학회지

The purpose of this study was to assess how job stiess affects the nursing performance of emergerncy room nurses. Data were collected from 210 emergency room nurses at 20 general hospitals, with more than 200 beds, in Pusan, Taegu and Kungbuk province, between October 5 and October 15, 1998. The instruments used for this study were the job stress scale which was developed by Mae Ja, Kim and Mi Ok, Gu(1984), and nursing performance of nurses scale developed by Kwi Ae, Chung(1989). Data Analysis was done using t-test, ANOVA, Tukey test, and Pearson Correlation. The results were as follows : 1. The highest rank of job stress items, emergency room nursing were as follows with lessening order when physicians delegate their clinical responsibilities to nurses(M=3.12+/-0.69). The most stressed factor among the nursing works was reported as night duty(M =2.99+/-0.87). 2. The mean score of nursing performance items, to prevent patient from falling or other injury(M = 3.69+/-0.50). 3. Our study reveals that there was statistically significant negative correlation relationship between stress level and emergency room nursing performance(r= -0.14, p=0.0454), in other words, the more stress the nurses experienced, the weaker their nursing performance became. Two factors, heavy work load(r=0.30, p=0.0001), and poor compensation(r =0.15, p =0.031). were negativly related to nursing performance. 4. The study revealed that the group with monthly income experienced less stress(F=2.71, p= 0.0461). Also, the degree of stress was significantly lower in the group with work experience (F=3.01, p=0.0313). Stress varied according to position superintendent nurse showed a lower level of stress than lay nurses and change nurses (F=2.93, p=0.0349). 5. There was significant difference in the degree of nursing perfnrm~nre according to religion (F= 3.97, p=0.0088). In conclusion, there was statistically significant negative correlations between job stress and nursing performance, so there is need for special consideration in nursing administration in terms of reducing the job stress in emergency nursing. Suggestions based on this study as follows. 1. Further study is necessary to examine variables that influence job stress and nursing performance. 2. The expem~ntaI study is needed for an effectiveness of systerrntic and in-lividual effort in order to reduce or manage nurses'stress in the emergency room.