Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

The National Forensic Hospital is the only forensic psychiatric hospital in Korea. As of January 2016, the average number of patients assigned to each psychiatrist is more than 120. In this situation, the role of psychopharmacologic treatment becomes very important. To investigate the prescription patterns of major psychotropic medications (i.e., antipsychotics, mood stabilizers, and antidepressants), we reviewed the medical records of the patients diagnosed with schizophrenia and schizoaffective disorder who were admitted in January 2016. The data from 418 patients (403 with schizophrenia and 15 with schizoaffective disorder) were retrospectively collected and analyzed. The average number of major psychotropic medications prescribed for each patient during hospitalization was as follows: antipsychotics, 3.5±1.8; mood stabilizers, 0.5±0.7; and antidepressants, 0.5±0.8. The three most frequently prescribed antipsychotics were risperidone (21.7%), olanzapine (15.5%), and quetiapine (14.4%). More than half of the patients (233, 55.9%) were prescribed an antipsychotic polypharmacy regimen. This study found that patients with schizophrenia and schizoaffective disorder in forensic psychiatric hospital tend to be prescribed many psychotropic medications.
Antidepressive Agents ; Antipsychotic Agents ; Forensic Psychiatry ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Korea ; Medical Records ; Polypharmacy ; Prescriptions ; Psychiatry ; Psychopharmacology ; Psychotic Disorders* ; Quetiapine Fumarate ; Retrospective Studies ; Risperidone ; Schizophrenia*

Purpose: To introduce a method of correcting lower eyelid epiblepharon with severe epicanthal fold combined with minimal incision of medial epicanthoplasty (Hiraga method) and to report its clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid epiblepharon and minimal incision of medial epicanthus from January 2015 and January 2019. Seventy-eight eyes of 39 patients were analyzed for surgical outcomes, subjective symptoms, recurrence, and complications for more than six months of the follow-up period. Results: A total of 39 patients (14 male, 25 female) were included in the analysis. The mean patient age was 8.4 ± 4.3 years, and the mean postoperative follow-up was 14 ± 5.2 months. Eyelid shape and function were well maintained in 39 patients (100%), with no recurrence during follow-up. Conclusions For patients with lower eyelid epiblepharon with severe medial epicanthal fold, lower eyelid epiblepharon with a minimal incision of medial epicanthoplasty (Hiraga method) is a simple surgical technique to prevent recurrence of medial cilia touch, showing successful results without complications.

During administration of anesthesia, intraoperative blood pressure control is very important. Sometimes a hypertensive or anti-hypertensive agent is used in order to maintain blood pressure at an adequate level; alpha-agonist and beta-blocker are drugs frequently used. Alpha-agonists are used in various ways including their application together with local anesthetics during an operation for the purpose of vasoconstriction, to control systemic absorption of local anesthetics, to extend the duration of action, or to reduce bleeding from the surgical site. In addition, alpha-agonists are used in cardiopulmonary resuscitation. Beta-blockers are used widely as a therapeutic agent for hypertension, angina, and arrhythmia, and to lower portal pressure in liver cirrhosis. Here, we are reporting the case of acute pulmonary edema that occurred after the administration of phenylephrine, in order to maintain blood pressure in a 52-year-old female patient with liver cirrhosis. The patient was underwent emergent decompressive craniectomy for intracranial hemorrhage without acknowledging her long-term use of a beta-blocker medication.
Absorption ; Anesthesia ; Anesthetics, Local ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiopulmonary Resuscitation ; Decompressive Craniectomy ; Female ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Liver Cirrhosis ; Middle Aged ; Phenylephrine ; Portal Pressure ; Pulmonary Edema ; Vasoconstriction

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

No abstract available.
Drug Therapy, Combination* ; Melphalan* ; Multiple Myeloma* ; Prednisone* ; Vincristine*

Sporadic spastic paraplegia (SSP) and hereditary spastic paraplegia (HSP) belong to a clinical and genetically heterogeneous group of disorders characterized by progressive spasticity and weakness in the lower extremities. The symptoms are associated with pyramidal tract dysfunction and degeneration of the corticospinal tracts. Parkinsonism is uncommon in SSP/HSP patients. However, both disorders are associated with damage to the nigrostriatal dopaminergic system. In the present study, the clinical features of patients with SSP/HSP were investigated, and nigrostriatal dopaminergic binding potential was assessed using dopamine transporter (DAT) single-photon emission computer tomography (SPECT). Nine patients with spastic paraplegia participated in the present study. The subjects underwent DAT SPECT using the agent [2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3,2,1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato (3-)-N2,N20,S2,S20]oxo-[IR-(exo-exo)])-[99mTc]technetium ([99mTc]TRODAT-1). The [99mTc]TRODAT-1 SPECT images of five patients appeared normal, whereas the images of four patients revealed reduced striatal ligand uptake. Among the four patients with reduced uptake, two had parkinsonism, and one exhibited periodic limb movements and restless leg syndrome. Our DAT SPECT imaging study shows that reduced DAT density may be observed in patients with parkinsonism. The results of the present study offer an explanation for the spectrum of spastic paraplegia symptoms and the progression of the disorder.
Adult ; Aged ; Brain/*radionuclide imaging ; Dopamine Plasma Membrane Transport Proteins/metabolism ; Female ; Humans ; Male ; Middle Aged ; Organotechnetium Compounds/diagnostic use ; Paraplegia/diagnosis/genetics/*radionuclide imaging ; Parkinsonian Disorders/complications/genetics/*radionuclide imaging ; Pyramidal Tracts ; Radiopharmaceuticals/diagnostic use ; Spastic Paraplegia, Hereditary/diagnosis/genetics/*radionuclide imaging ; Tomography, Emission-Computed, Single-Photon