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Background Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. Methods Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. Results The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. Conclusion Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.

This study was a preliminary study that assessed the acceptability of a communication-based advance care planning (ACP) intervention for older adults to improve decision making for treatment at the end of life. Twenty dyads were recruited, including patients who were older than 65 years and registered in a home health care center of a teaching hospital in South Korea and their surrogates. The intervention is a patient-centered ACP program with surrogates and a structured and guided discussion by home health care nurses as the trained interventionists. The acceptability of the intervention was assessed by a mixed method including a survey and a structured interview with participants. Findings in this study indicate that recruiting older adults with chronic diseases and their surrogates in a home health care center and conducting the intervention by home health care nurses is feasible. In addition, the outcomes of this study suggest that the intervention may have a potential impact on end-of-life care decision making for older adults in South Korea. A larger-scale trial is required to determine the effects of the ACP program when implemented with various groups. This study suggests that older adults need an ACP program as part of routine care.

Background: Tuberculosis (TB) causes undernutrition, and it has a long recovery time after treatment. It is accompanied by adverse health outcomes, such as sarcopenia. Objective: We aimed to evaluate the prevalence of sarcopenia and its association with protein and total energy intakes among Korean TB survivors. Methods: Data of the population-based Korea National Health and Nutrition Examination Survey (2008–2011) were analyzed, including 9,203 participants aged ⩾ 40 years. We used three definitions for sarcopenia-appendicular skeletal muscle mass (ASM, kg) divided by body mass index (BMI, kg/m2), weight (kg), or height squared (m2). Daily protein and total energy intakes were estimated with a 24-h recall method. Multiple logistic regression was used to evaluate the association between dietary protein/total energy intake and sarcopenia among TB survivors. Results: The prevalence of sarcopenia was 11.2%, 10.7%, and 24.3% among TB survivors with sarcopenia defined by ASM divided by BMI, weight, and height squared, respectively. The prevalence of sarcopenia among TB survivors was higher than among those without TB. After adjusting for age, weight, sex, education level, employment status, smoking status, and drinking status, sufficient protein and total energy intakes were associated with a lower risk of sarcopenia in TB survivors. Conclusion: The prevalence of sarcopenia was higher in TB survivors than in those without TB. We suggest consuming sufficient protein intake along with increasing total energy intake in TB survivors.

Objective This study was performed to evaluate the significance of positive resection margins (RMs) with the loop electrosurgical excision procedure combined with cold coagulation (LEEP with CC) as a definitive treatment for patients with cervical intraepithelial neoplasia (CIN) and adenocarcinoma in-situ. Methods We retrospectively reviewed 467 patients who underwent LEEP with CC. A right-angled triangular loop in a single pass followed by a CC (120 °C) to the cone bed for 10 to 20 s was used. Pathology reports and clinical data were obtained and evaluated. Results Histopathology evaluation of LEEP tissue samples revealed the presence of CIN 1 in 69, CIN 2/3 in 366, AIS in 5 and invasive carcinoma in 16 (microinvasive squamous cell carcinoma (SCC) and invasive SCC, 13 and 3) patients. Margins were positive in 66 (14.5%) cases: 0 in CIN 1, 54 in CIN 2/3 (12.4%), 1 in AIS (20.0%) and 11 in microinvasive/invasive SCC (68.8%). Although 54 CIN2/3 patients with positive RMs did not undergo additional treatment, 1 of these (1.9%) was confirmed to have residual CIN3 at the first follow-up. Two of 8 (25.0%) microinvasive SCC patients with positive RMs were confirmed to have residual diseases (1 microinvasive SCC and 1 invasive SCC) after hysterectomy. Four out of 360 (1 positive RM, 3 negative RM) CIN cases recurred during the study period. Conclusions These results suggest that CIN patients with positive RMs after LEEP with CC may be followed up without additional treatment.

Endurance exercise training (ET) can improve outcomes for patients with heart failure (HF). We investigated the preventive effects of ET on serum biomarkers for HF in mice treated with doxorubicin (DOX).A cohort of male wild-type mice were randomly assigned to 3 groups: sedentary control (CON), DOX-treated sedentary (DOX), and DOX-treated endurance ET (ET-DOX) groups. ET groups performed moderate intensity endurance ET on a motor treadmill for 8 weeks. After 8 weeks, the DOX and ET-DOX groups were treated with DOX via weekly intraperitoneal injections of 8 mg/kg for a total of 4 weeks. We compared M-mode echocardiography, histology, and biomarkers for HF between groups.A total of 30 mice survived during the study period and were analyzed: CON (n=9), DOX (n=9) and ET-DOX (n=12). There was no significant difference in left ventricular ejection fraction (LVEF) or fractional shortening (FS) between DOX and ET-DOX groups. The ET-DOX group had a significantly lower soluble ST2 level (176.6±44.1 vs. 225.4±60.5 pg/mL, p=0.021) compared to the DOX group. Also similar between the ET-DOX and the DOX groups were the serum N-terminal prohormone of brain natriuretic peptide (30.3±12.5 vs. 34.0±21.7 pg/mL, p=0.849), troponin I (685.7±99.2 vs. 722.5±126.7 pg/mL, p=0.766), and neutrophil gelatinase-associated lipocalin (324.3±82.4 vs. 312.7±68.2 pg/mL, p=0.922) levels. Histologically, there was no significant difference in degree of perivascular fibrosis between DOX and ET-DOX groups.Endurance ET is effective for preventing increases in serum soluble ST2 in mice treated with DOX.

Quarantine often provokes negative psychological consequences. Thus, we aimed to identify the psychological and behavioral responses and stressors of caregivers quarantined with young patients after a close contact to a coronavirus disease 2019 case at a children's hospital. More than 90% of the caregivers reported feelings of worry and nervousness, while some of them reported suicidal ideations (4.2%), and/or homicidal ideations (1.4%). Fear of infection of the patient (91.7%) and/or oneself (86.1%) were most frequently reported stressors. A multidisciplinary team including infection control team, pediatrician, psychiatrist, nursing staff and legal department provided supplies and services to reduce caregiver's psychological distress. Psychotropic medication was needed in five (6.9%), one of whom was admitted to the psychiatry department due to suicidality. Quarantine at a children's hospital makes notable psychological impacts on the caregivers and a multidisciplinary approach is required.

Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) might be considered a bridge therapy in patients who are expected to have short waiting times for heart transplantation. We investigated the clinical outcomes of patients who underwent VA-ECMO as a bridge to heart transplantation and whether the deployment of an early extubation ECMO strategy is beneficial. Methods Between November 2006 and December 2018, we studied 102 patients who received VA-ECMO as a bridge to heart transplantation. We classified these patients into an early extubation ECMO group (n = 24) and a deferred extubation ECMO group (n = 78) based on the length of the intubated period on VA-ECMO (≤ 48 hours or > 48 hours). The primary outcome was in-hospital mortality. Results The median duration of early extubation VA-ECMO was 10.0 (4.3–17.3) days. The most common cause for patients to be put on ECMO was dilated cardiomyopathy (65.7%) followed by ischemic cardiomyopathy (11.8%). In-hospital mortality rates for the deferred extubation and early extubation groups, respectively, were 24.4% and 8.3% (P = 0.147). During the study period, in the deferred extubation group, 60 (76.9%) underwent transplantation, while 22 (91.7%) underwent transplantation in the early extubation group. Delirium occurred in 83.3% and 33.3% of patients from the deferred extubation and early extubation groups (P < 0.001) and microbiologically confirmed infection was identified in 64.1% and 41.7% of patients from the two groups (P = 0.051), respectively. Conclusion VA-ECMO as a bridge therapy seems to be feasible for deployment in patients with a short waiting time for heart transplantation. Deployment of the early extubation ECMO strategy was associated with reductions in delirium and infection in this population., Graphical Abstract

Purpose To investigate the impact of length of autogenic training (AT) use, alone and with the addition of adjunct treatments, on intensity and duration of primary headache in adults age 19 and older. Methods We searched articles published in English and Korean from 1926 to 2016. A search of seven domestic and foreign databases was conducted from September 25, 2016 to December 30, 2016 using the search terms “autogenic training,” “autogen,” “relaxation,” and “headache.” The search was documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search yielded a total of 262 papers; a multi-step screening and selection process ultimately yielded six articles of randomized controlled trials (RCTs) for the systematic review. Cochrane’s Risk of Bias Tool was used to evaluate the quality of the selected papers. Results Five of the six studies demonstrated statistically significant reduction in headache by AT-only or biofeedback-assisted AT. The reviewed studies varied in characteristics of subjects, length of autogenic training and practice, use of adjunct therapies, and use of headache measures. Conclusions The small number of studies retrieved in this review, with their variations in AT interventions used, in AT training/practice time, and headache measures used, did not facilitate rigorous evaluation of the effectiveness of specific AT approaches nor of the optimum length of AT practice for reduction of headache. More research is needed on the effectiveness of AT-only for headache, the most effective duration of autogenic training and practice, and the type(s) of headache for which it is most effective.

East Asians are prone to higher systemic exposure and increased risk of bleeding compared to other races after administration of antiplatelet agent(s). The aim of this systematic review was to compare and evaluate the appropriateness of a lower dose versus standard dose of ticagrelor in East Asians. A systematic search was conducted in PubMed, EMBASE, and Cochrane databases for studies comparing low versus standard doses of ticagrelor in East Asian populations; a total of seven studies were included in the review. Pharmacokinetic (PK), pharmacodynamic (PD), clinical efficacy, and safety data were collected. PK data demonstrated that the Cmax and area under the curve (AUC) of ticagrelor increased dose-proportionally. PD data indicated that while the low dose of ticagrelor resulted in less antiplatelet activity in three of the five PD studies, in the other studies, there were no differences between low and standard doses. There were two clinical studies included in this review, which showed that the efficacy was similar between the low and standard doses, but both studies were limited by the number of patients included. While there were generally greater incidence of adverse events observed in the standard ticagrelor dose, the magnitude or actual difference between the two doses is difficult to determine due to lack of consistent data. In East Asians, the appropriateness of the low-dose ticagrelor cannot be determined based on the currently available evidence. Additional large-scale and longer duration studies are warranted.

ObjectiveThis study aimed to determine the gender factors that influence regular exercise in patients with non-insulin-dependent diabetes mellitus (NIDDM) in Korea.MethodsA total of 1,432 patients with NIDDM were recruited using raw data from the Korea National Health and Nutrition Survey conducted between 2016 and 2018. SAS 9.4 was adopted for data analyses, and the distributional difference was measured with multinomial logistic regression and Rao-Scott x2 statistics to identify the factors that influence the regular physical activities of patients. that the analysis only provides associations.ResultsBased on general characteristics, health behaviors, and conditions, patients with NIDDM in Korea were less physically active. In addition, patients with higher educational attainment, higher income, and higher subjective health conditions had a higher odds ratio for regular exercise. Meanwhile, the ratio was lower for smokers and those stressed up.ConclusionA professional guide for the initial phase of training and consistent management is required to increase the involvement of patients with NIDDM in regular exercise. Therefore, it is important to maintain their motivation to continue exercising. Rather than providing a universal guideline, it is more important to provide customized programs and management plans which reflect factors that influence their engagement in physical activities, such as individual physical strength, stress level, alcohol consumption, and arthritis.

// Do Yeon Lee 1 , Chul Ju Hwang 1 , Ji Yeon Choi 1 , Mi Hee Park 1 , Min Ji Song 1 , Ki Wan Oh 1 , Sang Bae Han 1 , Woo Kyu Park 2 , Hee Yeong Cho 2 , Sung Yun Cho 2 , Hye Byn Park 2 , Min Jong Song 3 and Jin Tae Hong 1 1 College of Pharmacy and Medical Research Center, Chungbuk National University, Heungduk-gu, Chungbuk 361-951, Republic of Korea 2 Korea Research Institute of Chemical Technology, Yuseong-gu, Daejeon 34114, Republic of Korea 3 Department of Obstetrics and Gynecology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Jung-gu, Daejeon 301-723, Republic of Korea Correspondence to: Jin Tae Hong, email: jinthong@chungbuk.ac.kr Keywords: Alzheimer’s disease, STAT3, neuroinflammation, amyloidogenesis, KRICT-9 Received: January 09, 2017 Accepted: June 24, 2017 Published: August 02, 2017 ABSTRACT Alzheimer’s disease (AD) is one of the most common forms of dementia and is characterized by neuroinflammation and amyloidogenesis. Here we investigated the effects of KRICT-9 on neuroinflammation and amyloidogenesis in in vitro and in vivo AD models. We found that KRICT-9 decreased lipopolysaccharide (LPS)-induced inflammation in microglial BV-2 cells and astrocytes while reducing nitric oxide generation and expression of inflammatory marker proteins (iNOS and COX-2) as well as APP, BACE1, C99, Iba-1, and GFAP. KRICT-9 also inhibited β-secretase. Pull-down assays and docking model analyses indicated that KRICT-9 binds to the DNA binding domain of signal transducer and activator of transcription 3 (STAT3). KRICT-9 also decreased β-secretase activity and Aβ levels in tissues from LPS-induced mice brains, and it reversed memory impairment in mice. These experiments demonstrated that KRICT-9 protects against LPS-induced neuroinflammation and amyloidogenesis by inhibiting STAT3 activity. This suggests KRICT-9 or KRICT-9-inspired reagents could be used as therapeutic agents to treat AD.

We describe a non-invasive and non-contact viscosity measurement system using a compact optical fiber heterodyne interferometry. The proposed system consists of a fiber based pulse laser for surface acoustic wave (SAW) excitation and a lensed fiber for probing laser. When the pulsed laser illuminates onto the oil surface, the SAW is generated by photoacoustic effect and it propagates along the surface. The interference of probing laser reflected on the sample surface has the information of the surface movement. We can calculate the propagation velocity of SAW from the detected interference signal. The propagated SAW contains the information of liquid properties (viscosity and elasticity). For the preliminary measurements, an industrial engine oil and a polydimethylsiloxane (PDMS) are used. We can measure the viscosity of them without noncontact, successfully.

Constructed wetlands (CWs) have been accepted as an attractive and economic alternative to a variety of pollution control and provided potentially valuable wildlife habitat in urban and suburban areas, as well as esthetic value within the local natural environment. CWs are known eco-friendly technology to solve the problem of the climate change and urbanization issues. Numerous studies have been published on the various aspects of a CW. However, there are current limitations about the CW operations such as few design guidelines, poor performance results regarding the simple construction. Therefore, the objective of this research was to suggest an appropriate design and maintenance guidelines for a CW by thorough investigation of site monitoring results. The research also concentrated in redefining and reclassifying CWs, based on literatures made by the Ministry of Environment (MOE) and other organizations. Investigation at 43 CWs in Korea was performed by using collected data and by performing site survey from 2013 to 2014. Based on the results, the best practices among the investigated CWs provided water treatment, wildlife habitat, environmental education, and leisure. Also these CWs conducted a regular maintenance such as vegetation, sediment dredging and cleaning of facilities. Results obtained are intended for use by academics and any organizations involved in CW management.

본 연구는 심뇌혈관질환자들을 대상으로 소득수준과 교육수준이 건강행태에 미치는 영향을 분석하여 질병관리와 예방에 도움을 주는 방안을 제시하는데 있다. 2010-2011 국민건강영양조사 원시자료를 이용하여 30세 이상의 심뇌혈관질환자 3,687명을 대상으로 건강행태, 일반적(사회인구학적) 특성, 신체계측 및 혈액검사를 소득수준별, 교육수준별로 상관관계를 분석하였다. 본 연구의 결과, 소득수준과 교육수준이 낮을수록 심뇌혈관질환의 유병율이 높고, 현재흡연에서의 OR(95% CI) 값은 고소득자 0.71(0.52-0.96), 고교육자 0.41(0.29-0.58)로 소득과 교육수준이 낮을수록 건강수준의 감소와 관계되는 현재흡연과의 상관성이 높았다. 한편 1개월음주와 고위험음주에서 고소득자의 OR(95% CI) 값은 각각 1.55(1.22-1.95), 1.42(1.11-1.82)로 음주율이 고소득자에서 높았으나 교육수준에서는 유의한 차이가 없었다. 걷기운동의 실천율은 소득과 교육수준 모두 유의한 차이가 없었다. 따라서 소득수준이 높은 환자군에서는 절주홍보를 강조하고, 소득과 교육수준이 낮은 환자군에서는 금연의 중요성을 강조하는 것 이외에도 서비스공급을 위한 제도적인 뒷받침이 필요할 것으로 보인다. 【The aim of this study was to help disease management and prevention by analyzing the effects of income and education levels on the health of cardio-cerebrovascular patients. Using the raw data of 2010-2011 Korea Health & Nutrition Examination Survey, the correlations of health behaviors, general (socio-demographic) characteristics, body measurements, and blood test results of 3,687 cardio-cerebrovascular patients aged 30 or older were analyzed based on their income and education levels. The results suggested that lower income and education levels were correlated with a high prevalence of cardio-cerebrovascular diseases. In addition, the OR values (95% CI) of current smoking were 0.71 (0.52-0.96) for patients with a high-income and 0.41 (0.29-0.58) for those with a high level of education, showing a strong correlation between lower levels of income and education and current smoking, which is related to health deterioration. In terms of one-month drinking and high risk drinking, the OR values (95% CI) of the patients with a high income were 1.55(1.22-1.95) and 1.42(1.11-1.82), respectively. Drinking was more prevalent among high-income patients but had no correlation with the education level. The practice of walking had no significant correlation with both income and education levels. Therefore, it is imperative to emphasize the importance of temperance to high-income patients, and the importance of quitting smoking to low-income patients, as well as to provide institutional support.】

Background The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. Methods Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. Results Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65years or older compared with groups aged 20–44years or 45–64years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. Conclusions The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population.

In the recent years, consumers have become increasingly concerned about the authenticity and labeling claims associated with meat and meat based products. In this study, investigating geographical origin authenticity of pork, 323 samples of pork belly were collected from Korea, USA, Germany, Austria, Netherlands and Belgium. These were analyzed for twenty-nine macro and trace elements using inductively coupled plasma-optical emission spectroscopy (ICP-OES), and ICP-mass spectrometry (MS). The applied analytical techniques were validated by quality assurance parameters in which the values of correlation coefficient, limits of detection and quantification, precision, and spiking recovery confirmed that the methods were well efficient and in accordance to the criteria set by the Association of Official Analytical Chemists (AOAC) for metals analysis. From the results of multivariate analyses, it was found that the trace elements are promising constituents which could be used to accurately determine the inter-continental provenance of pork.

PURPOSE: Wheezing following viral lower respiratory tract infections (LRTIs) in children

Since attackers easily have been making malware using dedicated malware generation tools, the number of malware is increasing rapidly. However, it is hard to analyze all malwares because of rise in high-volume of malwares. For this reason, many researchers have proposed the malware classification methods for classifying new and well-known types of malwares in order to focus on analyzing new malwares. The existing methods mostly try to find out good features which are used as a criterion of calculating a similarity between malwares for improving a classification accuracy. So, these methods extract the features including malicious behavior information by performing static and dynamic analysis, but analyzing many malwares itself spends too much time and efforts. In this paper, we propose a malware classification method for finding new types from large scale malwares using generic malware information. Proposed method can be used for a pre-step so as to help the existing methods reduce the spending time in analysis and classification for malwares. It improve the classificaion accuracy of malwares by using an imphash and proved a classification accuracy based on the imphash is more than 99i¾ź% while maintaining a low false positive rate.

Materials processing by ultrashort pulsed laser is actively being applied to micromachining technology due to its advantages with regard to non-thermal machining. In this study, materials processing with ultrashort pulses was studied by using the high repetition rate of a 800 nm Ti:sapphire regenerative amplifier. This revealed that the highly precise micromachining of metallic thin film and bulk glass with a minimal heat affected zone (HAZ) could be obtained by using near damage threshold energy. Grooves with diffraction limited sub-micrometer width were obtained with widths of 620 nm on Cr thin film and 800 nm on a soda-lime glass substrate. The machined patterns were investigated through SEM images. We also phenomenologically examined the influence of variations of parameters and proposed the optimal process conditions for microfabrication.

Background/Objectives: This cross-sectional study was performed with 105 undergraduate nursing students in three universities in Korea. Methods/Statistical analysis: The majority of participants were trained in emergency treatments such as basic life support (BLS) or other types of CPR education. Participants had received BLS training within 1 year, and their demographic variables, self-efficacy, and BLS satisfaction were examined. Collected data were analyzed using descriptive statistics, Pearson’s correlations and hierarchical regression with SPSS 21.0. Findings: Results showed a statistically significant correlation between BLS education satisfaction and CPR self-efficacy, which is the largest contributor to CPR-related self-efficacy with r =.784 (p < .01). Study variables were entered into a two-block hierarchical regression model . Students’ factors were grouped in Block 1, which represented 0.7% of variance of CPR-related self-efficacy. Amount of CPR education and BLS learning satisfaction and CPR education factors were grouped in Block 2. Education factors in Block 2 increased in variance to 60.6% with F = 40.556 (p < .001). Examining the beta scores of individual factors, BLS learning satisfaction was the greatest contributor to the variance (B = .559, s = .780, and p < .001). Improvements/Applications: Since the relationship between self-efficacy and learning satisfaction has been proven, education with multidimensional strategy to improve student’s learning satisfaction will bring improved results in emergency.

Picosecond laser-induced structural change in z-cut sapphire wafer were investigated through Raman spectroscopy and transmission electron microscopy. The broadening at 417 cm-1 and the presence of a new Raman peak near 420 cm-1 were observed.

Femtosecond-direct-laser induced poling is demonstrated in a silver containing glass. The diffusion of the photo-induced species inside the irradiated area enables the creation of a permanent electric field, responsible of efficient second-harmonic generation.

Hyperkalemia is often detected in young infants, particularly in association with acute pyelonephritis or a urinary tract anomaly. Cases of hyperkalemia in this population may also be due to transient pseudohypoaldosteronism, or immaturity of renal tubules in handling potassium excretion. Symptoms of hyperkalemia are nonspecific, but are predominantly related to skeletal or cardiac muscle dysfunction, and can be fatal. Therefore, treatment has to be initiated immediately. Administration of fludrocortisone for hyperkalemia is appropriate in cases with hypoaldosteronism, but is challenging in young infants with hyperkalemia due to renal tubular immaturity, without pseudohypoaldosteronism. We report the case of a 25-day-old male presenting with persistent hyperkalemia with normal serum aldosterone, who was admitted with a first episode of pyelonephritis and unilateral high-grade vesicoureteral reflux. The patient was treated successfully with fludrocortisone.

Received : 7 July 2014, Revised : 8 August 2014 Accepted : 27 August 2014 Correspondence : Jihyun Jeon, M.D. Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, 569, Nonhyon-ro, Gangnam-gu Seoul 135-081, Korea Tel : +82-2-3468-2643, Fax : +82-2-3468-3000 E-mail : g-daughter@hanmail.net Copyrightc By The Korean Society of Perinatology 대 한 주 산 회 지 제25권 제3호, 2014 Korean J Perinatol Vol.25, No.3, Sep., 2014 http://dx.doi.org/10.14734/kjp.2014.25.3.153 원저 : 임상

Purpose: This study was conducted to identify factors that affect nursing performance; Those factors are personal characteristics, sub-categories of empowerment and job satisfaction of clinical nurses. Methods: Data were collected from November 24, 2012 to March 11, 2013, and participants were 451 hospital nurses in 6 hospitals. Descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. Results: Nurses who were older, married, highly educated, in the position of charge nurse, and with longer clinical careers showed relatively higher empowerment, higher job satisfaction, and higher nursing performance than others. Also, there were strong correlations between nursing performance and empowerment (r=.576)/ job satisfaction (r=.617). Factors predicted nursing performance were relationship with coworkers (β=.398), duty (β =.181), promotion system (β=.134), and turnover intention (β=-.109). Factors predicting job satisfaction were competency of empowerment (β=.249), and clinical career (β=.151). These 6 factors explained 55.2% of the variance in nursing performance (F=93.37

전 세계적으로 자살은 중요한 사망원인으로 부각되고 있다. 특히 우리나라의 경우 경제협력기구(Organization for Economic Cooperation and Development, 이하 OECD)의 보고에 의하면, 2010년 한국의 자살률은 OECD 국가 중 가장 높고 서구 국가들에 비해 빠른 증가세를 보이고 있다. 또한 통계 청에서 발표한 2011년 사망원인 통계결과에 의하면 자살률 은 10년 전보다 2배 이상 증가하였고 10년간 전체 사망원인의 8위에서 4위로 상승하였다. 특히 10대, 20대, 30대에서는 자 살이 사망원인 중 1위를 차지하고 있어 국가적 차원에서 이 에 대한 체계적 대책 마련이 시급한 실정이다. 정신질환은 자살의 중요한 위험요인으로 자살자의 90%에 서 자살 전에 하나 이상의 정신장애 진단 범주를 만족시킬 수 있는 증상을 보였다고 한다. 뿐만 아니라 거의 모든 정 신장애는 자살 위험을 증가시키며, 정신질환을 가진 환자는 일반 인구에 비해 자살의 위험이 3~12배 높다고 한다. 정 신질환 중 알코올 사용장애는 기분장애 다음으로 자살과의 연관성이 높은 정신과 질환이다. 알코올 사용장애는 세계적으로 가장 흔한 정신질환으로 대부분의 지역에서 해결해야 할 신체적, 정신적 장애의 중요 한 원인이 되고 있다. 우리나라의 경우, 알코올 의존의 평생 유병률이 10.3%, 알코올 남용 포함시 25.5%로 정신질환 중 유병률이 가장 높은 질환에 속한다. 알코올 사용장애 환자 에서의 자살률은 일반 인구에 비해 심각한 것으로, 국외 연 구에 따르면 알코올 의존 환자에서의 자살시도의 평생 유병 률은 약 40%로 매우 높았다. 알코올 사용장애 질환 자체의 높은 유병률과 자살과의 깊은 연관성을 보았을 때, 자살문제 를 효과적으로 예방하기 위해서는 자살의 고위험군으로서 알코올 사용장애 환자의 자살 위험인자를 파악하고 이에 따 른 체계적인 접근이 매우 중요하다. 알코올 사용장애 환자의 자살 위험인자에 대한 이전 국외 ORIGINAL ARTICLE

연구배경: 폐쇄관을 이용한 기관내 흡인은 임상적으로 중한 환자에게 생리적인 이점이 있지만, 병원성 균주에 의한 기관지 내의 집락화가 증가될 수 있다는 보고가 있다. 비용증가는 폐쇄흡인의 또 다른 제한점이다. 본 연구는 폐쇄흡인 및 개방흡인에 따른 병원균주의 집락화와 인공환기관련폐렴의 빈도와 가격효율성을 비교해보고자 시행되었다. 방법: 각각 한 달의 간격을 사이에 두고 내과계 중환자실에 입원한 환자들을 대상으로 다중사용 개방흡인, 단일사용 개방흡인, 다중사용 폐쇄흡인을 순차적으로 시행하였다. 비용, MRSA의 기관지내 집락화, 인공환기폐렴의 발생률을 분석하였다. 결과: 106명의 환자가 연구 대상으로 포함이 되었고, 이 중 20명의 환자가 다중사용 개방흡인을, 42명이 단일사용 개방흡인을, 44명이 다중사용 폐쇄흡인술을 시행받았다. MRSA의 집락화와 인공환기관련폐렴의 빈도는 세 군간에 의미있는 차이를 보이지 않았다. 입원 일당 소모되는 비용은 다중사용 개방흡인이 $10.58, 단일사용 개방흡인이 $28.27, 다중사용 폐쇄흡인의 경우 $23.76인 것으로 나타났다. 결론: 다중사용 폐쇄흡인을 매 48시간마다 교환하는 경우 MRSA 집락화와 인공환기폐렴 발생 빈도는 비슷하였고, 기관내 흡인술에 있어서 비용면에서도 효율적인 방법임을 알 수 있었다.

Purpose : Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. Methods : All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. Results : This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median 34.2±11.6 months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). Conclusion : We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.