Purpose: This study was attempted to identify the importance and performance of person-centered care in nurses in intensive care units (ICU) at general hospitals and to derive the priority of practical person-centered care needs and intervention by analysing their needs. Methods: A total of 156 ICU nurses who wrote a written consent participated in a survey questionnaire on person-centered critical care nursing (PCCN). The collected data were analyzed using paired t-test, Borich’s needs assessment, and the Locus for Focus Model. Results: All 15 items of person-centered care in ICU nurses were found to be significantly higher in perception of importance than performance level (t=17.98, p<.001). According to the analysis of Borich's needs and the Locus of Focus Model, person-centered care items with highest priority in ICU were therapeutic contact, comfort words and actions, and efforts to empathize with patients in the compassion category. Conclusion As a strategy to improve the person-centered nursing performance of ICU nurses in the ‘individuality’, it is necessary for ICU nurses to recognize the ICU patients as an individualized person, not as a disease or machine-dependent entity. Also, it is necessary to develop programs to improve the ICU nurses' compassion competence because ‘compassion’ was a top priority according to Borich's needs assessment model and the Locus for Focus Model.

Cantrell's syndrome is a rare congenital anomaly, consists of five malformations. There are the midline abdominal wall defect, the defect of sterna lower part, an agenesis of the anterior part of the diaphragm, an absence of the diaphragmatic pericardium, and the congenital intracardiac problem. We diagnosed Cantrell's syndrome with left ventricular diverticulum in a female neonate with no perinatal problems. She experienced an one-staged operation and discharged with no complications. We report a case with brief review of the literature.
Abdominal Wall ; Diaphragm ; Diverticulum* ; Female ; Humans ; Infant, Newborn* ; Pericardium

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss

PURPOSE: Parenteral nutrition (PN)-associated cholestasis (PNAC) is one of the most common complications in very low birth weight infants (VLBWIs). The aim of this study is to evaluate the risk factors of PNAC in VBLWIs. METHODS: We retrospectively reviewed the medical records of 322 VLBWIs admitted to the neonatal intensive care unit of our hospital from July 1, 2009 to December 31, 2013. We excluded 72 dead infants; 6 infants were transferred to another hospital, and 57 infants were transferred to our hospital at 2 weeks after birth. The infants were divided into the cholestasis and the non-cholestasis groups. PNAC was defined as a direct bilirubin level of ≥2.0 mg/dL in infants administered with PN for ≥2 weeks. RESULTS: A total of 187 VLBWI were enrolled in this study; of these, 46 infants developed PNAC. Multivariate logistic regression analysis showed that the risk factors of PNAC in VLBWI were longer duration of antimicrobial use (odds ratio [OR] 4.49, 95% confidence interval [95% CI] 4.42-4.58), longer duration of PN (OR 2.68, 95% CI 2.41-3.00), long-term lack of enteral nutrition (OR 2.89, 95% CI 2.43-3.37), occurrence of necrotizing enterocolitis (OR 2.40, 95% CI 2.16-2.83), and gastrointestinal operation (OR 2.19, 95% CI 2.03-2.58). CONCLUSION: The results of this study suggest that shorter PN, aggressive enteral nutrition, and appropriate antimicrobial use are important strategies in preventing PNAC.
Bilirubin ; Cholestasis* ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Medical Records ; Parenteral Nutrition ; Parturition ; Retrospective Studies ; Risk Factors

BACKGROUND & SIGNIFICANCE: Focal seizures are usually due to an underlying structural lesion of the brain but occasionally caused by metabolic disturbances such as nonketotic hyperglycemia (NKH). Reflex focal seizures associated with NKH have been reported. CASE: The 69 year-old man was admitted in our hospital due to clonic movements of the right leg. His seizures did not occur spontaneously but were provoked by active or passive movements and tactile stimulation of the affected leg. The convulsive movements of the right leg often spread to the left leg without involving any other parts of his body. The seizures regressed with the control of hyperglycemia only. COMMENT: We report a patient presented with reflex focal seizures as the initial manifest-ation of NKH.
Aged ; Brain ; Humans ; Hyperglycemia* ; Leg ; Reflex* ; Seizures*

Pressure controlled ventilation has been proposed to recruit closed alveolar units and improve oxygenation through changing the inspiratory flow pattern from a square wave as used with volume controlled ventilation to a rapidly exponentially decaying curve and through maintaining airway pressure at a constant level throughout the inspiratory phase. The purpose of this study was to evaluate the cardiorespiratory efficacy of pressure controlled ventilation in severe respiratory failure. Cardiorespiratory values were measured in ten patients with severe respiratory failure on volume controlled and pressure controlled ventilation. Tidal volume, ventilatory rate, PEEP, inspiratory:expiratory ratio and FIO2 were maintained at the same level for both ventilatory modalities. Changing from volume controlled ventilation to pressure controlled ventilation was associated with significant improvement in PaO2 and decrease in peak inspiratory pressure. There were no significant changes in other cardiorespiratory values, such as arterial blood pressure, heart rate, inspiratory pause pressure and static compliance. These results suggest that pressure controlled ventilation may be a beneficial ventilatory modality in the treatment of severe respiratory failure compared to volume controlled ventilation.
Arterial Pressure ; Compliance ; Heart Rate ; Humans ; Oxygen ; Respiratory Insufficiency* ; Tidal Volume ; Ventilation*

PURPOSE: Anorectal malformations are often associated with other anomalies, reporting frequency with 40-70%. Gastrointestinal anomalies have been known to be relatively less common than associated anomalies of other organ system. This study was performed to assess a distinctive feature of cases associated with esophageal atresia. METHODS: Clinical data (from January 2000 through December 2011) on the 196 subjects with anorectal malformations, managed in our Hospital, were reviewed. Total 14 neonates were identified with accompanying esophageal atresia and retrospective analysis was conducted. RESULTS: The incidence was 7.1% and there were 8 male and 6 female subjects. Only 2 cases were associated with esophageal atresia without tracheoesophageal fistula. Although variable cases of anorectal malformation in female subjects, almost cases were anorectal malformations with rectourethral fistula in male. Other associated anomalies were identified in all cases, with more than 3 anomalies in 10 cases. There were 4 VACTERL (Vertebral abnormalities, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal and Limb anomalies) associations accounting for 28.6%, but could not identify chromosomal anomaly. Most cases were managed with staged procedure, usually primary repair of esophageal atresia and diverting colostomy. Overall mortality rate was 21.4%, mainly caused by heart problems. CONCLUSION: This study shows that early diagnosis and rational surgical approach with multidisciplinary plan are mandatory in managing anorectal malformations with esophageal atresia, when considering a high frequency of associated anomaly and a relative high mortality.
Accounting ; Anus, Imperforate ; Colostomy ; Early Diagnosis ; Esophageal Atresia ; Extremities ; Female ; Fistula ; Heart ; Humans ; Incidence ; Infant, Newborn ; Male ; Retrospective Studies ; Tracheoesophageal Fistula

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation

The risk factors associated with neonatal scalp abscess include electrode insertion for fetal scalp monitoring, traumatic scalp lacerations, and sepsis or meningitis. We report a case of neonatal scalp abscess with extension to dura mater, although our patient had no known risk factors. A 18-day-old, full-term baby was referred to the our hospital to evaluate a swelling over his left occipital scalp. A full sepsis work-up was performed and all were negative. Cranial sonography revealed echogenic cystic mass with peripheral vascularity consistent with ruptured epidermoid cyst or scalp abscess. The computed tomography (CT) scan of head was performed because of possibility of ruptured epidermoid cyt and revealed 2.0x2.0 cm sized hyperattenuating mass with suspicious intracranial extension. The magnetic resonance imaging (MRI) of head revealed the presence of 1.4x1.1 cm sized peripheral rim enhancing mass at left occipital area consistent with scalp abscess. And also, the lesion was suspicious dural exposure at left temporal area. Clinicians should be aware that scalp abscess may occur without any risk factors and perform diagnostic workup including a complete sepsis evaluation, cerebrospinal fluid analysis (CSF), and cranial imaging study to screen for intracranial extension.
Abscess* ; Cerebrospinal Fluid ; Dura Mater* ; Electrodes ; Epidermal Cyst ; Head ; Humans ; Infant, Newborn* ; Lacerations ; Magnetic Resonance Imaging ; Meningitis ; Risk Factors ; Scalp* ; Sepsis