• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.53-57
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• 2016

Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

• Childhood Kidney Diseases
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• v.24 no.1
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• pp.19-26
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• 2020

Acute kidney injury (AKI) is common in critically ill children, and is associated with increased mortality and long-term renal sequelae. The definition of pediatric AKI was standardized based on elevation in serum creatinine levels or decrease in urine output; accordingly, epidemiological studies have ensued. Although new biomarkers appear to detect AKI earlier and predict prognosis more accurately than traditional markers, they are not frequently used in clinical setting. There is no validated pharmacological intervention for AKI, so prevention and early detection are the mainstays of treatment. For high risk or early stage AKI patients, optimization of volume status and blood pressure, avoidance of nephrotoxins, and sufficient nutritional support are necessary, and have been demonstrated to be effective in preventing the occurrence of AKI and improving prognosis. Nevertheless, renal replacement therapy is needed when conservative care fails.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.129-133
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• 2018

Background: A few cases of moyamoya syndrome associated with thyrotoxicosis have been reported. However, studies on the association of hyperthyroidism with moyamoya syndrome are insufficient. Case Report: Here we report a case of hyperthyroidism associated with moyamoya syndrome in a 41-year-old woman with aphasia and right side weakness. Brain imaging revealed acute cerebral infarction of left middle cerebral artery territory and occlusion of bilateral distal internal carotid arteries. Conclusion: Antithyroid medication stabilized the patient's neurologic deterioration, suggesting that thyrotoxicosis could aggravate acute cerebral infarction caused by moyamoya syndrome.

• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.37-45
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• 2017

Purpose: The purpose of this study was to identify the relationships between death anxiety and terminal care performance of nurses at long term care hospitals. Methods: Data were collected from 148 nurses working at 12 long term care hospitals in Busan from March 16, 2016 through May 16, 2016. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, $Scheff{\acute{e}}$ test and Pearson's correlation coefficient with SPSS 18.0 for Windows. Results: Terminal care performance was positively correlated with anxiety about other people's death (r=0.310, $P{\leq}0.001$) and that of their own death (r=0.250, P=0.002). Conclusion: It appears necessary to develop a systematical educational program for terminal care nurses of to reduce their death anxiety and improve their terminal care performance.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.56-66
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• 2023

Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

• The Korean Nurse
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• v.35 no.4
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• pp.51-56
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• 1996

This research was an attempt to restructure the curriculum of pediatric clinical education on the base of the analysis of the pediatric clnical experience of nursing students acquired according to the traditional hospital-based pediatric clinical education and the evaluation of its results. As the focus of health care changes, pediatric clinical education the future necessitates changes in the traditional clinical experince at all levels. The traditional concentration of clinical experience within an acute care setting must be restructured to include the expanding future roles of the nurse and the changes in the health care structure. In order to meet the need for restructuring, it is inevitably necessary to adopt an organizational design for pediatric clinical experience that is not all traditional. The additional experiences and variety of settings will enhance the quality of pediatric clinical experience. And as a matter of course this organizational change will enhance the student learning experience by giving them the opportunity to observe normal growth and development, preventive health care measures, and the role of the nurse outside the acute care setting. As the nursing's focus changes to meet the challenges of the future the faculty must apply themselves to these changes to prepare students for the future. Students must be ready to fill the many roles that nurses will hold in the future.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.105-117
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• 2015

Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.