In this study, we developed MobileNurseTM; a prototype of mobile nursing information system using PDA. MobileNurseTM is designed to communicate with hospital information system(HIS) via mobile support station(MSS) which interchanges and stores clinical data. MobileNurseTM consists of 3 components. The first component is medical order checking module. It enables nurses to retrieve patients' information such as physicians' orders and test results at anywhere or anytime. The second component is nursing recording module which helps nurses to record the results of their practices at bedside. On the autosynchronization of MSS and PDA, the data in PDA and MSS can be interchanged and updated respectively. The last component is nursing unit care planing module. It is helpful for retrieving the nursing care plans of patients that are expected to be done, such as patients' discharge, consultation, or transfer. With use of PDA in clinical environment, nurses can spend more time on caring for patients by reducing time-consuming, redundant paperwork. It is promising that this 'point-of-care system enables nurses to improve the quality of nursing care.
Humans ; Information Systems* ; Nursing Care ; Nursing Records ; Nursing* ; Patient Care Planning

Background and Objectives: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is one phenotype of the diffuse type. In spite of surgical and medical treatment, the polyp recurrence rate is high. Recently biologics are concerned as a therapeutic option of it. To figure out adverse events associated with the dupilumab injection in adult patients with CRSwNP.Subjects and Method Retrospective chart review of patients that were treated with dupilumab from January 2022 to December 2022 for CRSwNP was performed. Results: Of 40 patients (23 of male and 17 of female), 8 patients (20.0%) experienced 9 patients (22.5%) adverse events. The most common adverse event was skin reaction (3 patients, 7.5%), followed by 2 of pruritis, 2 of epistaxis. Three patients quit dupilumab after the adverse events, 4 patients continued, and 1 patient hold the next injection. Conclusion Dupilumab is reported to be relatively safe medication. However, physician should notice that adverse events including skin rash can occur after dupilumab injection.

A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.
Cardiomyopathies ; Cardiomyopathy, Hypertrophic* ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Middle Aged

We aimed to compare fentanyl, remifentanil and dexmedetomidine with respect to hemodynamic stability, postoperative pain control and achievement of sedation at the postanesthetic care unit (PACU). In this randomized double-blind study, 90 consecutive total laparoscopic hysterectomy patients scheduled for elective surgery were randomly assigned to receive fentanyl (1.0 µg/kg) over 1 minute followed by a 0.4 µg/kg/hr infusion (FK group, n = 30), or remifentanil (1.0 µg/kg) over 1 minute followed by a 0.08 µg/kg/min infusion (RK group, n = 30), or dexmedetomidine (1 µg/kg) over 10 minutes followed by a 0.5 µg/kg/hr infusion (DK group, n = 30) initiating at the end of main procedures of the operation to the time in the PACU. A single dose of intravenous ketorolac (30 mg) was given to all patients at the end of surgery. We respectively evaluated the pain VAS scores, the modified OAA/S scores, the BIS, the vital signs and the perioperative side effects to compare the efficacy of fentanyl, remifentanil and dexmedetomidine. Compared with other groups, the modified OAA/S scores were significantly lower in DK group at 0, 5 and 10 minutes after arrival at the PACU (P < 0.05), whereas the pain VAS and BIS were not significantly different from other groups. The blood pressure and heart rate in the DK group were significantly lower than those of other groups at the PACU (P < 0.05). DK group, at sedative doses, had the better postoperative hemodynamic stability than RK group or FK group and demonstrated a similar effect of pain control as RK group and FK group with patient awareness during sedation in the PACU. (World Health Organization registry, KCT0001524).
Blood Pressure ; Dexmedetomidine* ; Double-Blind Method ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy ; Ketorolac ; Pain, Postoperative* ; Vital Signs

A non-steroidal anti-inflammatory drug (NSAID) has many adverse effects including cardiovascular (CV) risk. Diclofenac among the nonselective NSAIDs has the highest CV risk such as congestive heart failure, which resulted commonly from the impaired cardiac pumping due to a disrupted excitation-contraction (E-C) coupling. We investigated the effects of diclofenac on the L-type calcium channels which are essential to the E-C coupling at the level of single ventricular myocytes isolated from neonatal rat heart, using the whole-cell voltage-clamp technique. Only diclofenac of three NSAIDs, including naproxen and ibuprofen, significantly reduced inward whole cell currents. At concentrations higher than 3 micrometer, diclofenac inhibited reversibly the Na+ current and did irreversibly the L-type Ca2+ channels-mediated inward current (IC50=12.89+/-0.43 micrometer) in a dose-dependent manner. However, nifedipine, a well-known L-type channel blocker, effectively inhibited the L-type Ca2+ currents but not the Na+ current. Our finding may explain that diclofenac causes the CV risk by the inhibition of L-type Ca2+ channel, leading to the impairment of E-C coupling in cardiac myocytes.
Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Calcium Channels, L-Type ; Diclofenac ; Heart ; Heart Failure ; Ibuprofen ; Muscle Cells ; Myocytes, Cardiac ; Naproxen ; Nifedipine ; Patch-Clamp Techniques ; Rats