No abstract available.

PURPOSE: The purpose of this study was to develop a vital signs e-book for undergraduate student nurses and evaluate the content, system and student satisfaction. METHOD: This study was done in three stages, the development of a vital signs e-book, implementation and evaluation. The subjects were 73 undergraduate student nurses in Y university. RESULT: Thirty one learning objectives were used to create the contents. A set of 5 chapters and 18 subsections were defined after validation from nurse educators. The e-book is available at http://123.134.207.23/ebook/vitalsigns. Analysis of the questionnaires showed a mean score for content, system and students satisfaction of 3.17 +/- .73, 3.11 +/-.79, and 2.96 +/-.74 respectively out of a possible 4 points. CONCLUSION: Nurse educators should provide quality and effective web-based courses that meet undergraduate student nurses' learning needs and they should incorporate web-based learning into traditional teaching to meet the demands of nursing education.
Respiration ; Pulse ; *Physical Examination ; *Internet ; *Education, Nursing ; *Computer-Assisted Instruction

Live-born cases of partial trisomy 12q are rare, and only a few fetuses with this unbalanced translocation have survived to term. To our knowledge, only about 40 patients have been reported as having 12q duplication, and among them are no Korean reports. Here, we report the first Korean case of siblings with a 12q24.22q24.33 duplication. An 11-year-old boy visited our clinic for short stature. He was born small for his gestational age and had distinctive facial features, a history of surgery for anorectal malformation, psychomotor delay, intellectual disabilities, and attention-deficit/hyperactivity disorder (ADHD). He had an older sister with similar clinical features. The chromosomal microarray of the patient and his sister showed identical results: a 16.2 Mb duplication of 12q24.22q24.33. They had an identical cutoff point, but their symptoms were not. Symptoms common to both included growth retardation, psychomotor delay, intellectual disability, ADHD, and small for their gestational age.

The purpose of this study is to develop an internet based hospice information service system as a solution to the problems identified in our previous studies. Databases and homepage were designed and developed for the information needed for the hospice care and these services were available through the Internet. The hospice information service system has three subsystems. Frrst subsystem, which is training and education for the hospice care personnel includes general hospice information, pain and symptom management, the role of hospice care program information, and hospice care standard. Second subsystem which is patient management includes patient's general information, medical record, nursing record, major symptoms and nursing care plan, statistical data management, and hospice care facilities. Third subsystem includes Q and A for patient, family members, and hospice care team members. The system was tested through providing hospice care to the terminally ill patients and their family members by home visiting nurses. Through this study, it was found that hospice information system is very effective for those who need hospice care at home. But in order for the system to be more effective, system needs to be upgraded with more information on spiritual and social welfare and specialists who provided spiritual care and social welfare need to be included in the hospice care team.
Education ; Home Care Services ; Hospice Care ; Hospices* ; House Calls ; Humans ; Information Services* ; Information Systems ; Internet* ; Medical Records ; Nursing Records ; Patient Care Planning ; Social Welfare ; Specialization ; Terminally Ill

BACKGROUND: Critical illness that requires major surgery is often associated with non-thyroidal illness syndrome (NTIS). The characteristic feature of NTIS is low serum triiodothyronine (T3) levels, and in severe illness, the levels of serum thyroxine (T4) are also low in the absence of a rise in thyroid stimulating hormone (TSH). However, little is known about the changes in thyroid hormones during and after liver transplantation (LT). This study was conducted in order to evaluate the intra- or postoperative changes in thyroid hormones. METHODS: Twenty-two patients who underwent LT were enrolled. Serum levels of triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), free T3 (FT3) and free T4 (FT4) were measured immediately after the induction of anesthesia (T1), at the end of the anhepatic period (T2), at the end of the surgical procedure (T3), and at 24 hours (T4) and 120 hours postoperatively (T5). RESULTS: The mean levels of T3, T4, FT3, FT4 and TSH were significantly decreased throughout the study when compared with the T1 value. The mean levels of T3, T4 FT3 and TSH were below the normal range from T2, T4 and T5. CONCLUSIONS: We suggest that LT may induce NTIS by at least postoperative day 5. In the future, longer follow-up studies, and the effects of thyroid hormones on the prognosis and determination of the advantages and disadvantages of T3 replacement therapy to these patients will be required.
Anesthesia ; Critical Illness ; Euthyroid Sick Syndromes ; Humans ; Liver Transplantation* ; Prognosis ; Reference Values ; Thyroid Hormones* ; Thyrotropin ; Thyroxine ; Triiodothyronine

PURPOSE: Neonatal immune hemolytic jaundice due to blood group incompatibility is important to treat properly because of an early rise and a high peak of serum bilirubin level and a risk of kernicterus. The conventional therapeutic modalities for neonatal immune hemolytic jaundice due to blood group incompatibility are phototherapy and exchange transfusion. We evaluated the effect of intravenous immune globulin (IVIG) therapy on hyperbilirubinemia due to ABO incompatibility. METHODS: This study included 6 infants with hyperbilirubinemia due to ABO incompatibility who were admitted to the nursery of Eulji Medical Center, Nowon Hospital, from January 2000 to February 2001. All 6 infants had a positive direct Coombs test. Their serum bilirubin levels were above 12 mg/dl within 24hours of age and above 20 mg/dl after 24hours of age. They were treated with intensive phototherapy and IVIG. RESULTS: We classified the effective group when a decline in serum bilirubin level was more than 2 mg/dl in 3-4 hours after IVIG therapy, and the ineffective group when there was a decline in serum bilirubin level less than 2 mg/dl, a re-rise after the initial response to IVIG, or a decline after the combined therapy with intensive phototherapy and IVIG equal or less than that after intensive phototherapy alone. In the effective group (n=2), the average decline in serum bilirebin level was 4.1 mg/dl in 3-4 hours and 8.1 mg/dl in 12-16 hours after IVIG therapy, while in the ineffective group (n=4), the average decline was 1.9 mg/dl and 2.7 mg/dl, respectively. Five among 6 infants were treated with IVIG therapy and 1 infant was treated with exchange transfusion. No serious side effect was detected during and after IVIG therapy. CONCLUSION: We demonstrated the effectiveness of IVIG therapy in 2 infants out of six who were treated with intensive phototherapy and IVIG for hyperbilirubinemia due to ABO incompatibility. IVIG therapy could be considered if hyperbilirubinemia due to ABO incompatibility does not respond to intensive phototherapy alone. Further prospective and randomized studies would be needed.
Bilirubin ; Blood Group Incompatibility ; Coombs Test ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous* ; Infant ; Jaundice* ; Kernicterus ; Nurseries ; Phototherapy

Actinomycosis is a rare chronic suppurative infectious disease caused by Actinomyces spp. Actinomyces are anaerobic Gram-positive bacteria that colonize the mouth, digestive tract, and genital tract. Thoracic actinomycosis is caused by the aspiration of oropharyngeal materials or the spread of cervicofacial infections. Therefore, poor oral hygiene, smoking, and immunodeficiency are risk factors. Actinomycoses are frequently misdiagnosed as anatomical malignancies and thus assessments of the diseases underlying malignancies are often complicated by the presence of actinomycoses. Here, we report a case of mediastinal actinomycosis presenting with clinical and radiological features of metastatic pancreatic cancer. Clinicians should consider the presence of actinomycosis when cancer patients fail to respond to anti-cancer treatments.
Actinomyces ; Actinomycosis* ; Colon ; Communicable Diseases ; Gastrointestinal Tract ; Gram-Positive Bacteria ; Humans ; Lymph Nodes* ; Mouth ; Neoplasm Metastasis* ; Oral Hygiene ; Pancreatic Neoplasms* ; Risk Factors ; Smoke ; Smoking

Undetected endobronchial intubation during general anesthesia can cause serious complications. However, it is very difficult to determine the exact location of the endotracheal tube when it is positioned in the middle of the trachea. We experienced a patient who showed hypoxia caused by the positioning of the endobronchial tube. We think that the tube might have been advanced from the upper part of the carina into the right main bronchus while the neck was being flexed by the neurosurgeon for achieving better surgical exposure.
Anesthesia, General ; Anoxia ; Bronchi ; Humans ; Intubation ; Neck ; Trachea

OBJECTIVES: The survival rate of all childhood cancers has been increasing, and latent effects on childhood cancer survivors have been gaining researchers' attention. It has been shown that childhood cancer survivors experience social maladaptation and a decreased quality of life. Although neuroblastoma is one of the most common solid cancers in childhood, there are few reports on psychosocial status in neuroblastoma survivors. The purpose of this study was to investigate temporal changes in psychosocial status in neuroblastoma survivors. METHODS: This study was conducted by undertaking retrospective chart reviews of neuroblastoma survivors that were treated between January 1997 and February 2016 at Samsung Medical Center, Seoul, Korea. Among the 54 survivors identified, data for 28 patients who underwent psychological evaluation before and after treatment completion were selected for further analysis. We compared intelligence score, Korea-Child Behavior Checklist (K-CBCL), and Korean Personality Rating Scale for Children (K-PRC) scores before and after treatment completion. Time derivatives for each variable were calculated to identify temporal changes in scores. RESULTS: After treatment completion, K-CBCL scores for total competence (t=−2.34, p=0.044), somatic complaints (t=−2.43, p=0.022), and thought problems (t=−3.03, p=0.006) were higher than the scores prior to treatment. Familial relationship in K-PRC was significantly improved after treatment (t=2.11, p=0.045). Time derivatives of the significant K-CBCL subscales, except for the withdrawal and externalizing symptom scores, showed a tendency to increase with time. CONCLUSION: Although familial relationship and social competence improved after treatment, the levels of somatic complaints and thought problems increased following neuroblastoma treatment.
Checklist ; Child ; Humans ; Intelligence ; Korea ; Mental Competency ; Mortuary Practice ; Neuroblastoma* ; Quality of Life ; Retrospective Studies ; Seoul ; Social Skills ; Survival Rate ; Survivors*

Aplasia cutis congenita (ACC) is a rare congenital defect in which localized or widespread areas of the skin are absent at birth. In the majority of cases, it is limited to the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformations can be associated with ACC. We present herein the case of a new born male with unilateral absence of skin on the extensor surface of the right lower leg. There was no associated malformation or skin disease such as blistering or nail abnormailty. According to the classification outlined by Frieden, the condition was diagnosed as type VII aplasia cutis congenita. The treatment of this large ulcer was conservative, wet dressing and prophylactic topical antibiotics. On follow up after 2 years showed that the patient was nearly cured of the ulcer and had only minimal scar formation.
Anti-Bacterial Agents ; Bandages ; Blister ; Cicatrix ; Congenital Abnormalities ; Ectodermal Dysplasia ; Follow-Up Studies ; Humans ; Leg ; Male ; Nails ; Parturition ; Scalp ; Skin ; Skin Diseases ; Ulcer