PURPOSE: This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. METHODS: Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. RESULTS: Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers. Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. CONCLUSION: Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.
Education, Nursing ; Fluid Therapy ; Humans ; Hyperglycemia ; Hypoglycemia ; Massage ; Nursing Assessment ; Oxygen ; Parents ; Patient Simulation ; Pediatric Nursing ; Students, Nursing ; Suction ; Symptom Assessment ; Videotape Recording ; Vital Signs

An endotracheal tube (ETT) may be thought of as a mechanical burden to a spontaneously breathing patient because increases in airway resistance might result in increases in the work of breathing,when diameter of airway is decreased in the intubated patient compared with his own tracheal diameter. We hypothesized that air removal from ETT cuff would permit the airflow between ETT and tracheal wall and could make the airway resistance decrease. Postanesthetic patients after abdominal surgery were divided into two groups. ETT cuff was inflated in group 1 (n=25) and deflated in group 2 (n=25), while 5 l/min of oxygen was delivered through the ETT via a simple oxygen supplement device without a gas reservoir. The effects of balloon on gas exchange and respiratory pattern were evaluated at 5 and 30 minutes after admission to the recovery room. Postanesthetic PaO2 was increased compared to preanesthetic value with oxygen supply. PaCO2 values revealed no significant changes in preanesthetic and postanesthetic periods. Postanesthetic respiratory rate was increased significantly but there was no difference between two groups. However, there were three hypoxemic patients whose PaO2 were below 70mmHg in group 1. It was concluded that the use of balloon of ETT in postanesthetic recovery period might contribute to airway resistance and the work of breathing. Although almost of patients could make compensations to overcome the effects of balloon, there is a risk of postoperative hypoxemia if compensated inadequately.
Airway Resistance ; Anoxia ; Humans ; Oil and Gas Fields ; Oxygen ; Recovery Room ; Respiration ; Respiratory Rate ; Work of Breathing

PURPOSE: To evaluate the efficacy of endonasal revision using triamcinolone-soaked nasal packing in patients exhibiting recurrence of epiphora after endoscopic dacryocystorhinostomy. CASE SUMMARY: Four patients (4 eyes) who presented with the chief complaint of recurrence of epiphora after endoscopic dacryocystorhinostomy underwent endonasal revision under local anesthesia. On nasal endoscopy, granulation tissue and membranous tissue around the osseous foramen was removed during endonasal revision. According to the operator's judgement, the osseous foramen was additionally expanded. Following insertion of a silicone tube, triamcinolone-soaked nasal packing was used for intra-nasal packing. The silicone tube was removed after follow-up of more than 12 weeks. Immediately after removing the silicone tube, there was free passage of saline on lacrimal syringing as well as complete resolution of epiphora. At over 6 months of follow-up after tube removal, there was no recurrence of epiphora in any of the 4 patients. CONCLUSIONS: Triamcinolone-soaked nasal packing may be considered in patients with failed endoscopic dacryocystorhinostomy.
Anesthesia, Local ; Dacryocystorhinostomy* ; Endoscopy ; Follow-Up Studies ; Granulation Tissue ; Humans ; Lacrimal Apparatus Diseases ; Recurrence ; Silicon ; Silicones ; Triamcinolone

No abstract available.
Pulmonary Ventilation*

No abstract available.
Embolism, Air ; Magnetic Resonance Imaging

BACKGROUND: Intermittent positive pressure is required to overcome pulmonary airway resistance during inspiration and to deliver an adequate tidal volume. Previous animal experiments have shown that mechanical ventilation may worsen the lung injury when high airway pressure and large tidal volume are required to achieve adequate ventilation and oxygenation. Many ventilatory strategies have been developed to minimize airway pressure increase for the less compliant lung. Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. METHODS: Pressure controlled ventilation (PC) has been compared with hybrid ventilation (HV) which consists of PC and ITPV in 7 rabbits. A reverse thrust catheter (RTC) was introduced into an endotracheal tube (ETT) through an adapter and positioned just above the carina inside the ETT. Fresh gas flowed continuously along the gap between inner cannula and outer cap in the expiratory direction. Gas was intermittently re-directed into the lung as a tidal volume by a valve on the expiratory circuit with ventilatory mode of PC to make HV. Peak inspiratory pressure (PIP) and dead space (VD) at various respiratory rates (RR) of 20/min, 40/min, 80/min and 120/min were compared between PC and HV while maintaining normal PaCO2. RESULTS: The PIPs of PC were 12.4 +/- 3.4 cmH2O, 9.0 +/- 2.7 cmH2O, 8.8 +/- 2.7 cmH2O, and 7.6 +/- 2.5 cmH2O at RR of 20/min, 40/min, 80/min and 120/min, respectively. The PIPs of HV were 9.2 +/- 3.2 cmH2O, 6.2 +/- 1.7 cmH2O, 5.0 +/- 2.0 cmH2O, and 4.5 +/- 1.8 cmH2O at the same RR of 20/min, 40/min, 80/min and 120/min, respectively. The VDS of HV were lower than those of PC. CONCLUSION: It can be concluded that ITPV can be applied as a HV to minimize airway pressure under the setting of PC.
Airway Resistance ; Animal Experimentation ; Catheters ; Lung ; Lung Injury ; Oxygen ; Pulmonary Ventilation ; Rabbits* ; Respiration, Artificial ; Respiratory Rate ; Tidal Volume ; Ventilation*

PURPOSE: Birth rate of preterm twins has gradually increased recently, and preterm twins have higher morbidity and higher mortality compared with term twins. Hence, we carried out the study to find out whether there were differences in mortality and morbidity according to birth order. METHODS: We examined the medical records of premature babies, who were born under 37 weeks of gestational age from January, 2004 to December, 2009. Among 226 twins (113 pairs),we compared the following parameters between the first-born twins and the second-born twins: birth weight, Apgar score at 1 & 5 minutes, days of ventilator use, days of total oxygenation use, hemoglobin after birth, maximum total bilirubin within 4 weeks, mortality, and morbidities including transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), brain white matter disease (WMD), necrotizing enterocolitis (NEC), and sepsis. RESULTS: There were no difference between birth weight, Apgar score at 1 & 5 minute, duration of ventilator use, duration of total oxygenation use, hemoglobin after the birth, maximum total bilirubin and morbidities. Moreover, there were no statistical differences in mortality between the first twin and the second (3.5% vs. 4.4%, P=0.734). Subdivided into preterm twins less than 32 weeks of gestational age, mortalities were 13.3% vs. 16.7% (P=0.718). There were no differences in morbidity and other factors between two groups. CONCLUSION: According to our study, there were no notable statistical differences in mortality and morbidity based on birth order of preterm twins. However, larger studies are necessary.
Apgar Score ; Bilirubin ; Birth Order ; Birth Rate ; Birth Weight ; Brain ; Bronchopulmonary Dysplasia ; Cesarean Section ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemoglobins ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Leukoencephalopathies ; Medical Records ; Oxygen ; Parturition ; Pregnancy ; Retinopathy of Prematurity ; Transient Tachypnea of the Newborn ; Twins ; Ventilators, Mechanical

PURPOSE: To investigate the clinical characteristics of idiopathic orbital inflammatory disease (IOI) with paranasal sinusitis. METHODS: This study is a retrospective, comparative case series of patients who were diagnosed with IOI between January 2009 and December 2016. This study included patients with available medical and radiologic data at diagnosis and who participated in follow-up for more than 12 months after treatment. The patients were divided into two groups according to accompaniment of paranasal sinusitis and were compared. RESULTS: Among 101 patients with IOI, 13 (12.9%) were identified to have paranasal sinusitis. The incidence of pain was higher in patients with sinusitis (69.2%) than in patients without sinusitis (25.0%, p = 0.003). More patients with paranasal sinusitis experienced recurrence after systemic steroid therapy (69.2%) than in the other group (34.1%, p = 0.033). Additional immunosuppressants and/or radiation therapy were needed only in 9.1% patients without sinusitis but in 38.5% patients with sinusitis (p = 0.039). CONCLUSIONS: IOI patients with sinusitis showed a significantly higher recurrence rate. More careful follow-up of patients during steroid tapering and treatment of sinusitis might be helpful to prevent recurrence of IOI.
Diagnosis ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Incidence ; Inflammation* ; Orbit* ; Recurrence ; Retrospective Studies ; Sinusitis*

OBJECTIVES: The aim of this study was to compare differences in perception and knowledge of child abuse and child disciplinary practices according to the history of child abuse victimization. METHODS: A questionnaire survey on child abuse was conducted with 491 adults raising children. We compared the perception and knowledge of child abuse and child disciplinary practices between two groups of adults with and without a history of childhood abuse victimization. RESULTS: The group with a history of childhood abuse had lower levels of knowledge of child abuse (F=6.990, p<0.01) and engaged in more negative disciplinary practices (F=5.974, p<0.05) than those without. However, no differences in the perception of child abuse were observed between the two groups. CONCLUSION: The results suggest that adults with a history of childhood abuse have lower levels of knowledge of child abuse and use more negative disciplinary practices in raising their children. This highlights the need to administer not only educational but also more direct hands-on interventions to vulnerable parents in order to foster healthy parenting and disciplinary practices.
Adult ; Child ; Child Abuse ; Child ; Crime Victims ; Humans ; Parenting ; Parents

Metronidazole is an antimicrobial agent widely used for the treatment of trichomoniasis, giardiasis, amebiasis, and anaerobic bacterial infections. It has been reported that metronidazole-induced neurotoxicity is associated with responsible lesions on brain MRI. We report 2 patients with metronidazole-induced neurotoxicity, who had no responsible lesions on brain MRI for their neurological deficits. The pathogenic mechanisms are discussed.
Amebiasis ; Bacterial Infections ; Brain ; Giardiasis ; Humans ; Magnetic Resonance Imaging ; Metronidazole