OBJECTIVE: This study was designed to evaluate the effect of nasogastric tube on swallowing function in stroke patients with dysphagia. METHOD: Twelve stroke patients with dysphagia were included in this study. We evaluated the Functional Dysphagia Scale using videofluoroscopic swallowing study. Swallowing tasks were composed of swallowing 5 cc of thick food and same volume of fluid on nasogastric tube insertion state and then nasogastric tube removal state. RESULTS: As the result of measuring oral phase score before and after removing nasogastric tube, all of 12 patients showed no significant difference. There was statistically significant increase in score of residue in piriform sinuses on thick food swallowing after removing nasogastric tube (p<0.05). After removing nasogastric tube, aspiration was decreased on fluid swallowing in cases of 2 patients, while aspiration on thick food swallowing was increased in cases of 2 patients, compared with nasogastic tube insertion state. CONCLUSION: As the result of this study, the stroke patients with dysphagia on nasogastric tube were increased on fluid aspiration due to rapid descending and inhibition of epiglottic closure compared with the removal state of nasogastric tube. And there was significant increased in scores of residue in piriform sinuses on thick food swallowing and aspiration pneumonia after removing nasogastric tube.
Deglutition Disorders* ; Deglutition* ; Humans ; Pneumonia, Aspiration ; Pyriform Sinus ; Stroke*

The purpose of this study was to identify the level of self-disclosure and clinical competency and the relationships between self-disclosure and clinical competency in nursing students. The subjects were consisted of 662 nursing students from six universities and five junior colleges. The data were collected conveniently by self reporting questionnaires given to the students from September 13 to October 23, 1999. The instruments for this study were JSDQ and clinical competency measurement tool. The data were analyzed by SAS/PC program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. The results of this study are as follows : 1. The mean score for the level of self- disclosure was 3.29+/-0.98. 2. The mean score for the level of clinical competency was 3.93+/-1.00. The mean score for the dimension of skills, professional attitudes, teaching and coordinating, nursing process, interpersonal relationships were 4.09+/-0.77, 4.08+/-0.82, 3.97+/- 0.90, 3.77+/-0.76 and 3.37+/- 0.75 respectively. 3. The statistically significant difference in the score of the self-disclosure according to the educational background (F=9.42, p<.01), grade (F=5.59, p<.01), religion (F=2.68, p<.05), satisfaction of nursing major (F=14.20, p<.0001), and satisfaction of nursing practice (F=5.42, p<.01) was obtained. 4. The statistically significant difference in the score of the clinical competency according to the grade (F=32.44, p<.0001), achieved performance records (F=3.52, p<.05), satisfaction of nursing major (F=12.06, p<.0001), satisfaction of nursing practice (F=27.35, p<.0001) was obtained. 5. The data shows the positive correlations between self-disclosure and skill (r=.3231, p<.0001), between self- disclosure and teaching/coordinating (r=.1912, p<.0001), between self-disclosure and interpersonal relationship (r=.3064, p<.0001), between self-disclosure and professional attitude (r=.2789, p<.0001), between self-disclosure and nursing process (r=.2766, p<.0001).
Disclosure ; Humans ; Nursing Process ; Nursing* ; Surveys and Questionnaires ; Self Report ; Students, Nursing*

The purpose of this study was to identify the level of self-disclosure and clinical competency and the relationships between self-disclosure and clinical competency in nursing students. The subjects were consisted of 662 nursing students from six universities and five junior colleges. The data were collected conveniently by self reporting questionnaires given to the students from September 13 to October 23, 1999. The instruments for this study were JSDQ and clinical competency measurement tool. The data were analyzed by SAS/PC program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. The results of this study are as follows : 1. The mean score for the level of self- disclosure was 3.29+/-0.98. 2. The mean score for the level of clinical competency was 3.93+/-1.00. The mean score for the dimension of skills, professional attitudes, teaching and coordinating, nursing process, interpersonal relationships were 4.09+/-0.77, 4.08+/-0.82, 3.97+/- 0.90, 3.77+/-0.76 and 3.37+/- 0.75 respectively. 3. The statistically significant difference in the score of the self-disclosure according to the educational background (F=9.42, p<.01), grade (F=5.59, p<.01), religion (F=2.68, p<.05), satisfaction of nursing major (F=14.20, p<.0001), and satisfaction of nursing practice (F=5.42, p<.01) was obtained. 4. The statistically significant difference in the score of the clinical competency according to the grade (F=32.44, p<.0001), achieved performance records (F=3.52, p<.05), satisfaction of nursing major (F=12.06, p<.0001), satisfaction of nursing practice (F=27.35, p<.0001) was obtained. 5. The data shows the positive correlations between self-disclosure and skill (r=.3231, p<.0001), between self- disclosure and teaching/coordinating (r=.1912, p<.0001), between self-disclosure and interpersonal relationship (r=.3064, p<.0001), between self-disclosure and professional attitude (r=.2789, p<.0001), between self-disclosure and nursing process (r=.2766, p<.0001).
Disclosure ; Humans ; Nursing Process ; Nursing* ; Surveys and Questionnaires ; Self Report ; Students, Nursing*

BACKGROUND: Percutaneous cannulation of internal jugular vein is difficult in pediatric patients because of its small size and anatomic variation. The aim of this study is to investigate cross-sectional area and relative anatomy of right internal jugular vein with respect to the carotid artery in two approaches and thereby to find ideal cannulation site in young children. METHODS: The cross-sectional area of right internal jugular vein and the degree of the carotid artery overlap was evaluated in 47 children using ultrasound at two levels; 1) at the cricoid cartilage (high approach) and 2) at the junction of the two heads of the sternocleidomastoid muscle (low approach). RESULTS: The cross-sectional area was significantly larger by about 28.8% in the low approach than that of the high approach (P < 0.01). The internal jugular vein was partially overlapping the carotid artery in 48.9% and completely overlapping in 42.6% in the low approach and in 44.7% and 34.0% in the high approach respectively. The carotid artery overlap was significantly higher in the low approach when compared with the high approach (P < 0.02). CONCLUSIONS: In terms of cross-sectional area, the low approach with larger size is optimal for internal jugular vein cannulation. Although the degree of the carotid artery overlap was higher at the low approach, the internal jugular vein was partially or completely covering the carotid artery in most patients in both approaches. When attempting to cannulate the internal jugular vein, clinicians should be aware of the large anatomic variations.
Anatomic Variation ; Carotid Arteries ; Catheterization ; Child ; Cricoid Cartilage ; Head ; Humans ; Jugular Veins ; Muscles

Both Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) are important genital mycoplasmas which are found in the cervix, vagina and the urogenital tracts of females. It has been associated with various disease states including non-gonococcal urethritis, spontaneous abortion, low birth weight and chorioamnionitis. Moreover they can be transmitted up to 40% of infants born to infected mothers. The culture methods which is commonly used for the determination of above mycoplasmas requires special culture media and can take up to 7 days. Recently the polymerase chain reaction (PCR) has been successfully applied for the detection of pathogenic microorganisms. In this study, M. hominis and U. urealyticum were determined using PCR in 70 vaginal swabs and 48 urine samples. In a total of seventy vaginal swabs, thirteen (18.5%) and twenty four (34.3%) samples were positive for M. hominis and U. urealyticum, respectively. In forty eight urine samples, M. hominis and U. urealyticum were found in 3 cases (6.3%), respectively. Among vaginal swab and urine samples, one case was found to be coinfectious state. Amplified DNA bands were more frequently found in vaginal swabs than urine samples. This study shows that PCR is a relatively simple, fast and practical tool for the detection of M. hominis and U. urealyticum in a clinical materials instead of culture method.
Abortion, Spontaneous ; Cervix Uteri ; Chorioamnionitis ; Culture Media ; DNA ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Mothers ; Mycoplasma ; Mycoplasma hominis ; Polymerase Chain Reaction* ; Pregnancy ; Ureaplasma urealyticum ; Urethritis ; Vagina

PURPOSE: The purpose of this study was to identify the effects of structured self-debriefing using 3S models on the clinical competency, self-efficacy, and educational satisfaction in nursing students after simulation. METHODS: For this study, 76 third-year undergraduate nursing students from S university were invited. They were divided into two groups, which consisted of a self-debriefing (SDG=41) group and an instructor-led debriefing group (ILDG=35). Collected data was analyzed using Chi-square, t-test, and an independent t-test with the PASW statistics 18.0 for Windows Program. RESULTS: Clinical competency was generally high in the SDG, and statistically significant differences between the SDG and the ILDG occurred after simulations 3, 4, and 5. There were no statistically significant differences in self-efficacy and educational satisfaction between the SDG and the ILDG. However, educational satisfaction in the SDG was slightly higher, while self-efficacy was low compared to the ILDG. CONCLUSION: The results indicate that the method of structured self-debriefing using a 3S model can be effective in improving clinical competency. Further studies need to be investigated.
Humans ; Nursing* ; Patient Simulation ; Students, Nursing*

PURPOSE: This study was designed to determine whether transabdominal ultrasound can detect different hepatic stiffness between patients with cirrhosis and control subjects. MATERIALS AND METHODS: Sevent-three patients (Child-Pugh class A stage) with liver cirrhosis and 57 control subjects were included in this study. All patients were subdivided arbitrarily into two groups: early cirrhosis (n = 53) and overt cirrhosis (n = 20). Two sagittal images of the left lobe of the liver were obtained in the left hepatic vein level during the resting state and at full inspiration while pushing their belly out, by abdominal US (i.e., resting and stress image). The length between the inferior hepatic angle and the midpoint of the liver dome was measured in all images for the evaluation of liver distortion. The elongation was calculated by a formula: (L2-L1/L1) x 100(%); where L1 and L2 are the length of the liver for both the resting and stress image. The calculated elongated length (L2-L1, EL) and elongation rate were compared between cirrhotic patients and control subjects. RESULTS: For the control subjects, early cirrhosis, and overt cirrhosis groups, the mean ELs (elongation rate) were 2.34+/-0.98 cm (30.2+/-13.2%), 1.18+/-0.73 cm (14.9+/-9.5%) and 0.53+/-0.54 cm (6.3+/-6.6%), respectively. This difference among the three groups was statistically significant (p < 0.05). A possible best cut-off value of liver elongation rate is 17% for the prediction of cirrhosis (sensitivity: 90%, specificity: 75.3%). CONCLUSION: The liver of patients with liver cirrhosis is stiffer than that of control subjects. Calculation of the elongation rate in the left lobe of the liver during a respiratory maneuver may be used as an ancillary method of US for the evaluation of liver cirrhosis.
Fibrosis ; Hepatic Veins ; Humans ; Liver ; Liver Cirrhosis ; Respiration

BACKGROUND: This study is aimed at describing the outcomes of the management of the patients, caregivers, and healthcare workers (HCWs) who are exposed to the pandemic influenza (H1N1 2009) virus and at evaluating the adequacy in exposure management and infection control. METHODS: From July 2009 to January 2010, for 7 a month period, we managed patients and healthcare workers without any respiratory protective devices, who came within 1 m distance of H1N1-positive individuals for more than 1 h and performed a 1-week follow-up. RESULTS: The total of 157 cases with exposure to pandemic influenza (H1N1 2009) virus and exposed individuals of 907 were reported. Of the exposed individuals who were under management, 15 were confirmed to be infected with the infection rate being 1.7%. The confirmed individuals did not have a secondary infection after the exposure. Rates of infection of the exposed patients and healthcare workers were 1.8% and 1.6%, respectively, and these figures were not statistically significant. CONCLUSION: The exposure management results at the hospital revealed that the infection had spread by contact with individuals who were positive for the infection. The high incidence of early exposure to the virus warrants the need to ensure the use of protective equipment and the adoption of assertive teaching methods that have long lasting effects.
Adoption ; Caregivers ; Coinfection ; Delivery of Health Care ; Dietary Sucrose ; Follow-Up Studies ; Humans ; Incidence ; Influenza, Human ; Pandemics ; Porphyrins ; Respiratory Protective Devices ; Teaching ; Viruses

Spontaneous coronary artery dissection(SCD) is a rare entity that is infrequently diasnosed antemortem. The majority of patients have presented with acute myocardial infaction or sudden death. the etiology, prognosis and treatment of this entity remain ill-defined. We report two cases of SCD which were diagnosed by coronary agniogram and intracoronary ultrasound.
Coronary Vessels* ; Death, Sudden ; Humans ; Prognosis ; Ultrasonography

PURPOSE: To report a case of Miller Fisher syndrome in a pediatric patient with gastroenteritis associated with seroconversion of Campylobacter jejuni titer during the development of neurological symptoms and positive anti-GQ1b IgG. CASE SUMMARY: An 8-year-old male patient visited our clinic with bilateral ophthalmoplegia, diplopia, and ptosis of the right upper lid. He had experienced gastroenteritis one week previous, and antibodies to Campylobacter jejuni were detected in his plasma. Ophthalmic examination revealed a corrected visual acuity of 20/20 in both eyes. Ocular motor examination revealed limitations in all positions of gaze. Neurologic examination demonstrated areflexia and ataxia. The serologic anti-GQ1b IgG test was positive. Intravenous immunoglobulin and steroid pulse therapy were started. Extraocular movement, ptosis, and ataxia gradually improved after one month of treatment. CONCLUSIONS: We confirmed a case of Miller Fisher syndrome in a pediatric patient with bilateral ophthalmoplegia, ptosis, and a positive anti-GQ1b antibody test.
Antibodies ; Ataxia ; Campylobacter jejuni ; Child ; Diplopia ; Gastroenteritis ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Male ; Miller Fisher Syndrome* ; Neurologic Examination ; Ophthalmoplegia ; Plasma ; Visual Acuity