The Association between 10-Year Atherosclerotic Cardiovascular Diseases Risk Score Calculated Using 2013 American College of Cardiology/American Heart Association Guidelines and Serum 25-Hydroxyvitamin D Level among Aged 40–79 Years in Korea: The Sixth / 가정의학회지

BACKGROUND: We examined the relationship between 10-year predicted atherosclerosis cardiovascular disease (ASCVD) risk score and 25-hydroxyvitamin D in Koreans aged 40–79 years. METHODS: A population-based, cross-sectional design was used from data based on the Korea National Health and Nutrition Examination Survey 2014. RESULTS: A total of 1,134 healthy Koreans aged 40–79 years were included. A positive relationship between serum 25-hydroxyvitamin D level and ASCVD score was shown in women (β=0.015) after adjusting for central obesity, physical activity, and supplement intake. The chances of being in the moderate to high risk (risk group, ASCVD score ≥5%) with vitamin D sufficiency (serum 25-hydroxyvitamin D ≥20 ng/mL) was 1.267-fold (95% confidence interval, 1.039–1.595) greater than the chance of being included in the group with vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/mL) after adjustments in women. CONCLUSION: Our research indicated a significantly positive association between 25-hydroxyvitamin D and ASCVD score. Further detailed studies to evaluate this correlation are needed.

Multidimensional Factors Influencing Burnout in Intensive Care Unit Nurses / 임상간호연구

PURPOSE: This study aimed to identify multidimensional factors influencing burnout in intensive care unit(ICU) nurses. METHODS: A descriptive cross-sectional design was used. Data were collected during February 2016 from a convenience sample of 222 tertiary hospital ICU nurses and analyzed using t-test, ANOVA, correlation analysis, and multiple regression analysis. RESULTS: Burnout correlated positively with compassion fatigue (CF)(r=.37, p < .001), and negatively with compassion satisfaction (CS)(r=-.66, p < .001). The regression model explained 57% of the variance in burnout. For individual characteristics in the model, perceived health status (β=-.27, p < .001) and gender (β=.14, p=.028) were the most influential factors for ICU nurses' burnout. In the model with added work-related characteristics, nursing environment (β=-.22, p=.001), perceived health status (β=-.20, p=.001), and satisfaction with department (β=-.19, p=.007) were the most influential factors. Finally, for the model with psychological characteristics added, CS (β=-.56, p < .001) and CF (β=.35, p < .001) were the most influential factors. CONCLUSION: Results reveal that most ICU nurses have a moderate level of CF and a moderate to high level of CS and burnout, and that individual, work-related and psychological factors are relevant in ICU nurses' burnout. Programs or interventions to reduce burnout should be developed taking into account these multidimensional factors.

Defective Erythropoiesis in Bone Marrow is a Mechanism of Anemia in Children with Cancer

Evaluation of the mechanism of anemia in cancer patients might help to select patients for the more efficient use of erythropoietin (EPO, a growth factor for erythroid precursor cells). For this, we investigated whether the production of EPO responds to anemia and the bone marrow responds to EPO appropriately, and whether chronic inflammation is inhibitory to erythropoiesis in anemic cancer children. Serum levels of EPO, soluble transferrin receptor (sTfR), tumor necrosis factor (TNF)-alpha, and erythrocyte sedimentation rate (ESR) in anemic cancer children were measured by enzyme-linked immunosorbent assay and then the correlation coefficients between those parameters and hemoglobin (Hb) were determined. Both in leukemia and in solid tumor patients, there were significant inverse correlations between Hb and EPO (leukemia: tau=-0.547, p<0.0001; solid tumor: tau=-0.591, p<0.0001), and between sTfR and EPO (leukemia: tau=-0.223, p<0.05; solid tumor: tau=-0.401, p<0.05). In contrast, sTfR showed a correlation with Hb in leukemia (tau=0.216, p<0.05) but not in solid tumor patients. sTfR was suppressed in 53% of anemic episodes of leukemia and 78% of those of solid tumor patients. Our results suggest that in cancer children, the EPO production is not defective and chronic inflammation is not inhibitory to erythropoiesis. Rather, the defective erythropoiesis itself is thought to be responsible for the anemia.

A Case of Bilateral Tubo-Ovarian Abscesses in a One-and-Half Year-Old Girl

Tubo-ovarian abscess is an end-stage disease of acute pelvic inflammatory disease (PID). Since most cases of PID are caused by sexually transmitted microorganisms, this is very rare in children. Here, we report an 1 1/2-year-old girl with bilateral tubo-ovarian abscesses. She was admitted to our Department with chief complaints of fever, vomiting and diarrhea. Abdominal ultrasonography and CT scanning of the patient showed solid and cystic masses in pelvic cavity. It was very difficult to differentiate the lesions from abscess and tumor. In addition, intravenous pyelography (IVP) and abdominal CT scanning of the patient showed both hydronephrosis and ureteral dilatation. Because of severe visceral adhesions, we could not perform laparoscopic examination of the pelvic masses. By exploratory operation and frozen biopsy, the masses were confirmed as tubo-ovarian abscesses and they were drained. In the bacterial culture, K. pneumoniae and E. coli were grown. The patient was treated with sensitive antibiotics and recovered from her disease. After 4 weeks of operation, IVP showed no abnormal findings and voiding cystourethrography (VCUG) showed grade I vesicoureteral reflux of the left side. It was suggested the hydronephroses were developed by the ureteral obstruction of tubo-ovarian abscesses.

A Case of Bilateral Tubo-Ovarian Abscesses in a One-and-Half Year-Old Girl

Tubo-ovarian abscess is an end-stage disease of acute pelvic inflammatory disease (PID). Since most cases of PID are caused by sexually transmitted microorganisms, this is very rare in children. Here, we report an 1 1/2-year-old girl with bilateral tubo-ovarian abscesses. She was admitted to our Department with chief complaints of fever, vomiting and diarrhea. Abdominal ultrasonography and CT scanning of the patient showed solid and cystic masses in pelvic cavity. It was very difficult to differentiate the lesions from abscess and tumor. In addition, intravenous pyelography (IVP) and abdominal CT scanning of the patient showed both hydronephrosis and ureteral dilatation. Because of severe visceral adhesions, we could not perform laparoscopic examination of the pelvic masses. By exploratory operation and frozen biopsy, the masses were confirmed as tubo-ovarian abscesses and they were drained. In the bacterial culture, K. pneumoniae and E. coli were grown. The patient was treated with sensitive antibiotics and recovered from her disease. After 4 weeks of operation, IVP showed no abnormal findings and voiding cystourethrography (VCUG) showed grade I vesicoureteral reflux of the left side. It was suggested the hydronephroses were developed by the ureteral obstruction of tubo-ovarian abscesses.

Plasma Atrial Natriuretic Peptide Concentration after Birth in Low Birth Weight Neonates

PURPOSE: Atrial natriuretic peptide(ANP) is a hormone with diuretic and natriuretic properties that is released by the atrial stretch and plays an important role in sodium and volume homeostasis. We studied plasma ANP concentration and the influence of ANP on sodium balance after birth in low birth weight neonates on the basis of 34 wks gestational age when the nephrogenesis was completed. METHODS: Twenty low birth weight neonates without congenital heart disease, respiratory insufficiency, renal disease or sepsis born between June 1997 and December 1997 at Korea University Guro Hospital were enrolled in this study. Blood sampling for ANP was done at 6 hr, 12 hr, 24 hr, 3 days, 4 days and 10 days after birth. FENa was calculated by blood and urine electrolyte and creatinine. We analyzed the correlation of plasma ANP concentration and fractional Na excretion rate(FENa). RESULTS: Plasma ANP concentration of low birth weight neonates less than 34 wks was 63.67+/-12.94pg/ml at 6 hr after birth and peaked at 24 hr(110.67+/-6.34pg/ml). Thereafter, it gradually decreased and reached 42.43+/-21.89pg/ml at 10 days(P<0.05). Plasma ANP concentration of low birth weight neonates more than 34 wks was 25.50+/-8.22pg/ml at 6 hr after birth and peaked at 12hours(152.67+/-39.93pg/ml). Thereafter, it gradually decreased and reached 42.78+/-17.67pg/ml at 10 days(P<0.001). And plasma ANP concentration did not correlate significantly with FENa in low birth weight neonates less than 34 wks(r=0.02, P=0.09), but there was good correlation between plasma ANP and FENa in low birth weight neonates more than 34 wks(r=0.6, P<0.001). CONCLUSION: From the above results, it is concluded that ANP influences renal Na excretion after 34-week gestational age when the development of distal tubule, containing ANP receptors, is rapid and contributes to body fluid and Na homeostasis.

A Case of 18q-Deletion Syndrome with Hydronephrosis and Anhydrosis

The 18q-syndrome is a deletion disorder that occurs in humans. Clinical symptoms are mental retardation, craniofacial anomalies, skeletal deformity, seizure, and hearing loss. 18q- deletion occurs over a broad region, spanning the interval from 18q22.2 to 18qter rather than a single critical region containing 18q. We experienced a case of 18q-syndrome in a male child. It was diagnosed by clinical and chromosomal study. He was a 15month-old infant who was admitted because of prolonged fever and vomiting. And he manifested a depressed midface, esotropia, anhydrosis, and developmental delay. Peripheral blood chromosome studies showed deleted chromosomal material at the distal part of the long arm of chromosome 18. He showed right hydronephroureterosis on IVP. So, he was diagnosed as 18q-syndrome with right hydronephroureterosis and anhydrosis. We report this syndrome with a review and related literature.

Clinical Symptoms and Response to the Management of Chronic Idiopathic Thrombocytopenic Purpura in Childhood / 대한소아혈액종양학회지

BACKGROUND: Idiopathic thromboycytopenic purpura(ITP) is one of the most common acquired bleeding disorders in childhood. The entity of chronic ITP is defined as the persistence of thrombocytopenia for more than 6 months from initial presentation. There are the controversies regarding the diagnosis and management of this disease. The aim of this study is to compare the responses to managements and clinical symptoms of children with chronic ITP. METHODS: We retrospectively analyzed patients with chronic ITP diagnosed and managed between Jan., 1992 and June, 1997. Data from 33 cases were collected. The length of follow-up ranged from 6 months to 5 years. Statistical analysis was done using Jandel Sigmastat software(version 2.0). RESULTS: 1) Mean age is 5.4+/-4.3 years. The ratio of female to male is 0.65. 2) Most common clinical symptoms at presentation were petechiae(81.8%) and mucosal bleeding(42.4%). The patients who presented only petechiae and purpurae were 18 cases(54.5%), both petechiae and mucosal bleeding were 9 cases(27.3%). 3) The platelet count was 43,015+/-39,912/mm3. Bone marrow examinations showed normal or increased megakaryocyte, no abnormal cells and normal cellularity. 4) The prolonged complete response lasting more than 6 months without maintenance therapy was attained in 15.2% of the patients. A continuous complete response was observed in 6.1% to prednisone and IV-gamma-globulin. A prolonged complete response to dexamethasone was in 23.8% and continuous complete response was in 14.3%. The splenectomy was underwent in 3 patients. All of them had a prolonged complete response. One of six patients who were treated with combination chemotherapy had a prolonged complete response. CONCLUSION: This analysis of chronic ITP patients suggests that splenectomy remains the most effective treatment and the next one is high dose dexamethasone therapy. But the number of patients was not enough, more attention should be given to the management of chronic idiopathic thrombocytopenic pupura(ITP).

Restriction Endonuclease Analysis of Plasmids and Antimicrobial Resistance Pattern of Staphylococcus Aureus and S. Epidermidis Isolated from Clinical Specimens / 대한임상병리학회지

BACKGROUND: Methicillin-resistant Staphylococcus aureus is a major etiologic agent of hospital acquired infection. Coagulase negative staphylococci (CNS) species are previously regarded as contaminants. However nowadays CNS were regarded as an important cause of bacteremia. So in this study we wanted to analyze the patterns of plasmids and antimicrobial susceptibility test of Staphylococcus species isolated from clinical specimens. METHOD: Plasmid DNA was extracted and then processed through restriction enzyme digestion for plasmid analysis of S. aureus and antimicrobial susceptibility, which was done by agar dilution method. For S. epidermidis plasmid analysis was done without enzyme digestion. RESULTS: All of MRSA have 1 to 5 plasmids. There exists 6 patterns of S. aureus plasmid without enzyme digestion. With EcoRI and HindIII digestion pattern were more distinct and clear. For S. epidermidis enzyme digestion is not needed. Antimicrobial susceptibility patterns of S. aureus are simple whereas S. epidermidis showed variable patterns. CONCLUSIONS: For the plasmid analysis of S. aureus restriction enzyme digestion is required and for the S. epidermidis, the pattern of plasmids are variable so without restriction enzyme analysis we can obtain several patterns. Plasmid analysis will be used as a good epidemilogical tool for Staphylococcus.

A study on coulter STKS differential counts / 대한혈액학회지

No abstract available.