The high osteogenic potential in children can lead to the spontaneous regeneration of a significant bone loss, however, the site documented in the previous reports was limited to the diaphysis in long bones. We report an exceptional case of a spontaneous regeneration of the whole lateral malleolus, including epiphysis, physis, and metaphysic, after traumatic loss in a three-year-old boy. This case emphasizes the importance of attempts to save as much of the cartilaginous tissues and the periosteum as possible, which have a great osteogenic potential, in themanagement of open would in childrhood.
Child ; Diaphyses ; Epiphyses ; Follow-Up Studies ; Humans ; Male ; Metaphysics ; Periosteum ; Regeneration

This study was conducted to determine the impacts of perceived stress and self-compassion on the quality of life of nursing students. Methods: Data were collected from 180 nursing students between 11 October and 26 October 2018 from a college in A city. A total of 157 questionnaires were analyzed using descriptive statistics, t-tests, a one-way ANOVA, Pearson correlation, and stepwise multiple regression. Results: The findings show that perceived stress had a significant negative correlation with quality of life (r=-.73, p<.001). However, self-compassion showed a significant positive correlation with quality of life (r=.66, p<.001). The factors influencing quality of life included perceived stress, self-compassion, state of health, and satisfaction with school life, with perceived stress being the most influential factor (β=-.42), followed by self-compassion (β=.30), which together had an explanatory power of 64.0%. Moreover, there was a mediating effect of self-compassion in the relationship between perceived stress and quality of life. Conclusion: The results of this study indicate that nursing college students should search for ways to reduce their perceived stress as well as increase self-compassion with meditation programs in order to improve their quality of life.

Purpose: The purpose of this study was to investigate the effects of saline gargling on mouth dryness and sore throat for patients with thyroidectomy. Methods: A randomized controlled trial design was used with 53 participants assigned to either an intervention (n=27, saline gargling) or a control group (n=26, wet gauze). Pre-test dry mouth and sore throat were measured immediately after exiting the ward from OR. Post-test dry mouth and sore throat were measured at 1.50, 3.50, and 5.50 hours after exiting the ward from OR. Comprehensive sore throat was measured 24 hours after surgery. To analyze the data, χ2 test and independent t-test were used. Results: Subjective dry mouth was lower in the experimental group than the control group (t=-2.19, p=.033). There were no significant differences in the objective dry mouth and sore throat scores between the two groups. The comprehensive sore throat score was lower in the experimental group than the control group (t=-2.65, p=.011). Conclusion Saline gargling is expected to be used as a nursing intervention method in patients undergoing thyroidectomy to alleviate the subjective dry mouth after 3.50 hours and sore throat after 5.50 hours and lasting 24 hours.

Purpose: This study examined the effects of a loving-kindness and compassion meditation program on the empathy, emotion, and stress of nursing college students. Methods: A pre-posttest experimental design with a non-equivalent control group was applied. The participants were 39 nursing college students (experimental group: 19, control group: 20). The loving-kindness and compassion meditation program for nursing college students took 8 weeks. Data was collected from February 2016 to March 2016, and was analyzed by Chi-square test and independent t-test using IBM SPSS/WIN 19.0. Results: The difference between the experiment group and control group was statistically significant in empathy, negative affect, and perceived stress. Conclusion The results indicate that the loving-kindness and compassion meditation program was effective for empathy improvement and stress management of nursing college students.

Hypernatremia, defined as a rise in the serum sodium concentration to a value exceeding 145 mM/L, is a common electrolyte disorder. Diabetes insipidus is a common cause of hypernatremia, caused by impaired production or reduced responses to vasopressin. The resultant morbidity may be inconsequential, serious, or even life-threatening. However, hypernatremia rarely occurs during anesthesia and surgery. A 45-year-old female patient with craniopharyngioma was scheduled for tumor resection. Hypernatremia (serum sodium, 170 mM/L) occurred suddenly at the end of the surgery. To treat hypernatremia, 0.45% normal saline was used. Although serum sodium concentration was reduced faster than expected, the patient did not have any complications.
Anesthesia ; Anesthesia, General ; Craniopharyngioma ; Diabetes Insipidus ; Female ; Humans ; Hypernatremia ; Sodium ; Vasopressins

PURPOSE: This study was to identify factors that affect breast cancer patients' intentions to participate in cancer rehabilitation therapy. Such findings could be utilized early in the rehabilitation process to improve treatment outcomes and quality of life. METHODS: A cross-sectional study of 300 breast cancer patients (> or =20 years old) receiving post-surgery outpatient care was used. A self-administrated survey was conducted from June 15 to July 25, 2012. The questionnaire included basic subject data, physical symptoms, optimism, and social support. RESULTS: A binary logistic regression analysis revealed that a short post-surgery period (<12 months), having undergone an axillary lymph node dissection, and high physical symptoms were factors that significantly affected participants' intentions to undergo rehabilitation. CONCLUSION: By accurately assessing the factors associated with each patient's decisions regarding cancer rehabilitation therapy at an early stage of treatment and then implementing such individualized rehabilitation, the quality of life for breast cancer patients can be substantially improved.
Ambulatory Care ; Breast Neoplasms* ; Cross-Sectional Studies ; Humans ; Intention ; Logistic Models ; Lymph Node Excision ; Quality of Life ; Rehabilitation* ; Surveys and Questionnaires

PURPOSE: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). METHODS: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and χ² test were used to analyze the data. RESULTS: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p=.016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p=.084). CONCLUSION: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.
Baths ; Chlorhexidine ; Critical Care ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Incidence ; Intensive Care Units ; Nursing ; Tertiary Care Centers

Purpose: We used the Bayley Scales of Infant and Toddler Development (BSID)-III to analyze the incidence and risk factors of developmental delay in very-low-birth-weight infants without severe brain lesions. We further examined the correlation between the cumulative dexamethasone dose and developmental assessment results. Methods: We retrospectively analyzed data of preterm infants (birth weight <1,500 g) admitted to our neonatal intensive care unit between January 2014 to December 2020. The BSID-III scores obtained between the corrected ages of 12 and 24 months and after 24 months were analyzed. Developmental delay was defined as a composite score of <85 for the cognition, language, and motor domains. Univariate and multivariate analyses of developmental delay risk factors and developmental changes from the first to second BSID-III were performed. Correlations between the accumulated dexamethasone dose used for bronchopulmonary dysplasia (BPD) and the first and second test scores were analyzed. Results: Seventy-one and thirty-six infants completed the first and second tests, respectively. In both tests, developmental delay was most commonly observed in the language domain (26.8%, 47.2%). In multivariate analysis, mild BPD was identified as a developmental delay risk factor (P<0.05), whereas prenatal steroid use reduced the developmental delay risk (P<0.05). All domain scores were lower in the second test than in the first test. The cognition and language domain scores in the second test decreased with increasing cumulative dexamethasone doses. Conclusion Very-low-birth-weight infants typically experience language delay, which can persist as they age.

Purpose: Since premature infants are sensitive to the changes in blood glucose levels and body temperature, maintaining these parameters is important to avoid the risk of infections. The authors implemented the Golden Hour protocol (GHP) that aims to close the final incubator within one hour of birth by implementing early treatment steps for premature infants after birth, such as maintaining body temperature, securing airway, and rapidly administering glucose fluid and prophylactic antibiotics by securing breathing and rapid blood vessels. This study investigated the effect of GHP application on the short- and long-term clinical outcomes. Methods: We retrospectively analyzed the medical records between 2017 and 2018 before GHP application and between 2019 and 2020 after GHP application in preterm infants aged 24 weeks or older and those aged less than 33 weeks who were admitted to the neonatal intensive care unit. Results: Overall, 117 GHP patients and 81 patients without GHP were compared and analyzed. Peripheral vascularization time and prophylactic antibiotic administration time were shortened in the GHP-treated group (P=0.007 and P=0.008). In the short-term results, the GHP-treated group showed reduced hypothermia upon arrival at the neonatal intensive care unit (P=0.002), and the blood glucose level at 1 hour of hospitalization was higher (P=0.012). Furthermore, the incidence of neonatal necrotizing enteritis decreased (P=0.043). As a long-term result, the incidence of BPD was reduced (P=0.004). Conclusion We confirmed that applying GHP improved short- and long-term clinical outcomes in premature infants aged <33 weeks age of gestation, and we expect to improve the treatment quality by actively using it for postnatal treatment.

PURPOSE: To evaluate the effect of repeated debulking surgery for high-grade pseudomyxoma peritonei (PMP) originating from the appendix.METHODS: Between January 1998 and December 2014, fifty patients, who underwent debulking surgery for high-grade PMP originating from the appendix, were obtained from a prospectively collected database and retrospectively analyzed. Two groups according to the number of operations were divided and analyzed.RESULTS: A total of 118 operations were performed. Thirty-one patients received more than two operations. The median interval between operations was 18.2 months (range, 2–170 months). Complications developed after 26 operations (22.0%), including ileus (n=10), intra-abdominal fluid collection (n=7), surgical site infection (n=5), and others. There were two mortalities within 30 days after operation. Between two groups of patients who received one operation only and patients who received more than two operations, transfusion, diversion operation, and postoperative complication rate showed statistically significant differences. Two groups of patients had no differences in overall survival rates.CONCLUSION: Our results indicate that the number of operations does not affect the survival rate of high-grade appendiceal PMP, in which repeated debulking surgery is vital to relieve symptoms of the tumor burden.
Appendix ; Cytoreduction Surgical Procedures ; Humans ; Ileus ; Mortality ; Postoperative Complications ; Prospective Studies ; Pseudomyxoma Peritonei ; Recurrence ; Retrospective Studies ; Surgical Wound Infection ; Survival Rate ; Tumor Burden