INTRODUCTION: The purpose of this study was to investigate the changes in the concern and attitudes of Nursing students toward the disabled before and after the disability experience program. METHOD: 151 Nursing students with clinical practice in National rehabilitation hospital were conveniently selected as the subject. All subjects had experience the disability program, and their attitudes toward the disabled were measured before and after the 3hours' program. Collected data were analyzed by SPSS 11.0 with paired t-test. RESULTS: 1. The concern toward the disabled after their disability experience program was more positive than before(t= -4.930, p= .000). 2. The attitudes toward the disabled after their disability experience program was more positive than before(t=5.892, p=.000). 3. The appreciation of daily life after their disability experience program was higher than before(t=- -8.563, p= .000). CONCLUSION: In summary, the disability experience program should be effective in order to promote the positive attitude toward the disabled. Therefore expansion of this program is of profound significant.
Humans ; Nursing* ; Rehabilitation ; Students, Nursing*

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

Background: During robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position, aeration loss leads to perioperative atelectasis. Recently developed ventilator mode pressure-controlled ventilation volume-guaranteed (PCV-VG) mode could provide adequate ventilation with lower inspiratory pressure compared to volume-controlled ventilation (VCV); we hypothesized that PCV-VG mode may be beneficial in reducing perioperative atelectasis via low tidal volume (VT ) of 6 mL/kg ventilation during robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position. We applied lung ultrasound score (LUS) for detecting perioperative atelectasis. We aimed to compare perioperative atelectasis between VCV and PCV-VG with a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position using LUS. Methods: Patients scheduled for robotic gynecologic surgery were randomly allocated to the VCV (n = 41) or PCV-VG group (n = 41). LUS, ventilatory, and hemodynamic parameters were evaluated at T1 (before induction), T2 (10 minutes after induction in the supine position), T3 (10 minutes after desufflation of CO2 in the supine position), and T4 (30 minutes after emergence from anesthesia in the recovery room). Results: Eighty patients (40 with PCV-VG and 40 with VCV) were included. Demographic data showed no significant differences between the groups. The total LUS has changed from baseline to T4, 0.63 (95% confidence interval [CI], 0.32, 0.94) to 1.77 (95% CI, 1.42, 2.21) in the VCV group and 0.86 (95% CI, 0.56, 1.16) to 1.43 (95% CI, 1.08, 1.78) in the PCV-VG group (P = 0.170). In both groups, total LUS increased significantly compared to the baseline values. Conclusion Using a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position, our study showed no evidence that PCV-VG ventilation was superior to VCV in terms of perioperative atelectasis.

No abstract available.
Anesthesia, General* ; Humans ; Multiple System Atrophy*

No abstract available.
Anesthesia, General* ; Humans ; Multiple System Atrophy*

No abstract available.
Hypnotics and Sedatives ; Light

BACKGROUND: A correct estimate of the tracheal tube insertion depth can prevent complications, including endobronchial intubation and vocal cord trauma. We evaluated a new topographical method for endotracheal tube positioning relative to the carina, using a well-known prior topographical method for comparison. METHODS: One hundred adult (male 50, female 50) patients were studied. The comparison topographic length (in cm) was measured by adding the distance between the right mouth corner and the right mandibular angle to the distance between the right mandibular angle and the center of the sternal manubrium. The new endotracheal tube insertion depth (in cm) was determined by adding the distance between the right mouth corner and the vocal cords, measured with the endotracheal tube itself, to the distance between the thyroid prominence and the manubriosternal joint, and then subtracting 4 cm. After intubation, the endotracheal tube was positioned properly at the right mouth corner and the endotracheal tube tip was evaluated using a fiberoptic bronchoscope at the carina. RESULTS: The distances from the tip of the endotracheal tube to the carina were not significantly different between the methods in the same gender. However, our method allowed endotracheal tube tip placement between 3 cm and 5 cm, above the carina more frequently than the prior method in males. CONCLUSIONS: The new topographical method can be used as a guide to positioning the endotracheal tubes.
Adult ; Bronchoscopes ; Female ; Humans ; Intubation ; Joints ; Manubrium ; Mouth ; Thyroid Gland ; Vocal Cords

Background: and Purpose This study aimed to investigate the applicability of deep learning (DL) model using diffusion-weighted imaging (DWI) data to predict the severity of aphasia at an early stage in acute stroke patients. Methods: We retrospectively analyzed consecutive patients with aphasia caused by acute ischemic stroke in the left middle cerebral artery territory, who visited Asan Medical Center between 2011 and 2013. To implement the DL model to predict the severity of post-stroke aphasia, we designed a deep feed-forward network and utilized the lesion occupying ratio from DWI data and established clinical variables to estimate the aphasia quotient (AQ) score (range, 0 to 100) of the Korean version of the Western Aphasia Battery. To evaluate the performance of the DL model, we analyzed Cohen’s weighted kappa with linear weights for the categorized AQ score (0–25, very severe; 26–50, severe; 51–75, moderate; ≥76, mild) and Pearson’s correlation coefficient for continuous values. Results: We identified 225 post-stroke aphasia patients, of whom 176 were included and analyzed. For the categorized AQ score, Cohen’s weighted kappa coefficient was 0.59 (95% confidence interval [CI], 0.42 to 0.76; P<0.001). For continuous AQ score, the correlation coefficient between true AQ scores and model-estimated values was 0.72 (95% CI, 0.55 to 0.83; P<0.001). Conclusions DL approaches using DWI data may be feasible and useful for estimating the severity of aphasia in the early stage of stroke.

PURPOSE: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. MATERIALS AND METHODS: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. RESULTS: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p<0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p<0.05). CONCLUSION: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.
Bone Density ; Bone Diseases, Metabolic ; Extremities ; Femur ; Foot ; Foot Diseases ; Gait ; Hip ; Humans ; Joints ; Lower Extremity ; Muscular Atrophy ; Neck ; Osteoporosis ; Osteoporotic Fractures

Pulmonary thromboembolism is a leading cause of morbidity and mortality. Many patients dying of pulmonary thromboembolism have serious underlying illness such as cancer and congestive heart failure. Cancer patients are prone to both thrombotic and tumor embolism. In cancer patients, tumor pulmonary embolism and thrombotic pulmonary embolism can be associated with dyspnea, cor pulmonale and pulmonary hypertension. We presented a female patient of 63 year-old age of a hepatoma with inferior vena cava thrombosis. She had been transferred to the intensive care umt in state of refractory hypoxemia with 100% oxygen inhalation. Perfusion scan showed 60.71% defect in right lung and 39.28% defect in left lower lung field. Heparin infusion was done with the impression of pulmoary embolism without effect. Initial hemodynamic data with insertion of pulmonary ery catheter showed that cardiac index, 1.62 L/minute/M2, right atrial pressure, 28 mmHg, pulmonary capillary wedge pressure 14 mmHg. Cardiac index did not increase in spite of dobutamine and dopamine infusion. Right atrial pressure increased to 29 mmHg but pulmonary capillary wedge pressure was 11 mmHg with fluid administration. Echocardiogram revealed that mass, 7X8 cm of size, was in right heart in connection to inferior vena cava thrombus. Tumor embolism from hepatoma would be suspected in our patient, but we did not confirm that case with the biopsy or autopsy. Echocardiography with pulmoary artery catheter insertion would be helpful to diagnose the disease which was suspected of pulmonary embolism and tumor embolism in cancer patient.
Anoxia ; Arteries ; Atrial Pressure ; Autopsy ; Biopsy ; Carcinoma, Hepatocellular* ; Catheters ; Dobutamine ; Dopamine ; Dyspnea ; Echocardiography ; Embolism ; Female ; Heart Failure ; Heart* ; Hemodynamics ; Heparin ; Humans ; Hypertension, Pulmonary ; Inhalation ; Critical Care ; Lung ; Middle Aged ; Mortality ; Neoplastic Cells, Circulating* ; Oxygen ; Perfusion ; Pulmonary Embolism ; Pulmonary Heart Disease ; Pulmonary Wedge Pressure ; Thrombosis* ; Vena Cava, Inferior*