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.
Hypnotics and Sedatives ; Light

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

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

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.

BACKGROUND AND PURPOSE: Little is known about the relationships between provoking risk factors, prognosis, and optimal duration of anticoagulation in patients with cerebral venous thrombosis (CVT), especially in Asians. We aimed to investigate whether the prognosis and required duration of anticoagulation in CVT patients differ according to the provoking risk factors. METHODS: Prospectively recorded data from a tertiary medical center in South Korea were retrospectively reviewed. CVTs were categorized into three groups: unprovoked, those with possibly resolved provoking factors (PR), and those with persistent provoking factors (PP). The baseline characteristics, treatment, and prognosis of patients in these three groups were analyzed. RESULTS: From 2000 to 2015, 61 patients presented with CVT: 19 (31.1%) unprovoked, 11 (18.0%) with PR, and 31 (50.9%) with PP. The patients in our cohort had a slight female predominance and lower frequency of oral contraceptive use compared to Western cohorts. Median follow-up and duration of anticoagulation were 35 and 8 months, respectively. Despite the similarities in baseline characteristics, deaths (n=3; P=0.256) and recurrences (n=7; P=0.020) were observed only in the PP group. The median intervals to death and recurrence were 9 and 13 months, respectively. Death was associated with underlying disease activity, not with CVT progression. Recurrences in the PP group were associated with lack of anticoagulation (P=0.012). CONCLUSIONS: Although the prognosis of CVT is generally benign in Koreans, recurrence and death were observed in patients with persistent risk factors, suggesting their need for long-term treatment with anticoagulants.
Anticoagulants ; Asian Continental Ancestry Group ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Korea ; Prognosis* ; Prospective Studies ; Recurrence ; Retrospective Studies ; Risk Factors* ; Venous Thrombosis*

BACKGROUND: Nasotracheal intubation may cause epistaxis, displacement of adenoids, polyps and intranasal foreign bodies, and bacteremia. So, the goal of this study is to see whether nasotracheal tube with balloon could reduce the incidences of epistaxis and impingement during nasotracheal intubation or not. METHODS: Eighty patients of ASA 1 or 2 classification, scheduled for oromaxillary surgical procedures, were randomly classified into two groups. 40 patients of each group received either nasotracheal RAE(Ring-Adair-Elwyn) tube only or nasotracheal RAE tube with balloon. Esophageal stethoscope was used to provide balloon. Each group was subdivided into two, one with intranasal spray of epinephrine solution 1:50,000 and the other one without intranasal spray of epinephrine solution. Intranasal spray of epinephrine was performed just before intubation. The incidences of epistaxis and the feeling of smooth passage of nasotracheal tube were compared between two groups. RESULTS: During nasotracheal intubation using nasotracheal RAE tube, 18 out of 40 patients without balloon and 9 out of 40 patients with balloon (P<0.05) were seen with epistaxis. Impingement during intubation was felt in 15 patients of group without balloon and in 7 patients of group with balloon (P<0.05). Those results did not differ significantly between the subgroups with and without intranasal spray of epinephrine solution. CONCLUSIONS: We concluded that nasotracheal RAE tube with balloon reduce the incidences of epistaxis and impingement during nasotracheal intubation, but intranasal spray of epinephrine solution 1:50,000 show no influence to reduce the incidence of epistaxis.
Adenoids ; Bacteremia ; Classification ; Epinephrine ; Epistaxis* ; Foreign Bodies ; Humans ; Incidence ; Intubation* ; Polyps ; Stethoscopes