• Title/Summary/Keyword: Fluid Management

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Application of Diagnostic Laboratory Tests in the Field of Oral Medicine: A Narrative Review

  • Ji Woon, Park;Yeong-Gwan, Im
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.101-111
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    • 2022
  • The purpose of laboratory tests in the field of oral medicine can be divided into two categories: (1) medical evaluation of patients with systemic diseases that are planning to receive dental care and (2) diagnosis of patients with certain oral diseases. First, laboratory tests are commonly used to evaluate patients with systemic diseases who need dental management. A combination of multiple tests is usually prescribed as a test panel to diagnose and assess a specific disease. Test panels closely related to oral medicine include those for rheumatoid arthritis, connective tissue disease/lupus, liver function, thyroid screening, anemia, and bleeding disorders. Second, laboratory tests are used as auxiliary diagnostic methods for certain oral diseases. They often provide crucial diagnostic information for infectious diseases caused by bacteria, fungi, and viruses that are associated with pathology in the oral and maxillofacial regions. Laboratory tests for infectious diseases are composed of growth-dependent methods, immunologic assays, and molecular biology. As the field develops, further application of laboratory tests, including synovial fluid analysis in temporomandibular joint disorders, salivary diagnostics, and hematologic biomarkers associated with temporomandibular disorders and orofacial pain conditions, is currently under scrutiny for their reliability as diagnostic tools.

The Effect of Problem-Based Learning for Patient Safety on Self-Leadership, Patient Safety Competencies, and Reflective Thinking of Nursing Students

  • Park, Jung-Ha;Yun, Ji-Ah;Park, Kyoung-Duck
    • International journal of advanced smart convergence
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    • v.11 no.2
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    • pp.194-204
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    • 2022
  • This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

Management of a trauma patient with alcohol withdrawal who developed neuroleptic malignant syndrome in Korea: a case report

  • Byungchul Yu;Ji Yeon Lee;Yong Beom Kim;Hee Yeon Park;Junsu Jung;Youn Yi Jo
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.249-252
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    • 2023
  • Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7℃ after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.

Posttraumatic bilateral thigh Morel-Lavallée lesions without an underlying bone fracture in the United Kingdom: a case report

  • Sarah Razaq;James Geffner;Asma Khan;Harry Mee;Cynthia Udensi;Fahim Anwar
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.269-275
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    • 2023
  • A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.

Spanning Multiple Online Communities and Knowledge Contribution: The Cross-Level Moderating Effects of Environmental Scanning and Membership Fluidity

  • Yongsuk Kim
    • Asia pacific journal of information systems
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    • v.33 no.2
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    • pp.418-443
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    • 2023
  • Many organizations facilitate a host of online knowledge sharing communities to assist internal knowledge sharing and operation. The permeable boundaries and voluntary structures of online communities allow individuals to span community boundaries and affect member resources and structures. Although much research has been done on members' knowledge contribution in online communities, relatively little is known about how a member's contribution to a community is shaped by the cross-level interactions of member's external boundary spanning and the community's environmental scanning or membership fluidity. Drawing from the theoretical lens of boundary spanning and the external view of online communities, we take a multi-level approach in the analysis of the activities of 1,992 members of 126 communities internal to a global company. We find that a member's external boundary spanning activity (e.g., external knowledge acquisition via reading posts) has a positive effect, though at a decreasing rate, on subsequent internal knowledge contribution (e.g., posting replies in the member's home community). This positive effect is stronger in communities that are more active in environmental scanning or have fluid membership and weaker in communities that are less active in environmental scanning or have stable membership.

Feasibility and performance limitations of Supercritical carbon dioxide direct-cycle micro modular reactors in primary frequency control scenarios

  • Seongmin Son;Jeong Ik Lee
    • Nuclear Engineering and Technology
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    • v.56 no.4
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    • pp.1254-1266
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    • 2024
  • This study investigates the application of supercritical carbon dioxide (S-CO2) direct-cycle micro modular reactors (MMRs) in primary frequency control (PFC), which is a scenario characterized by significant load fluctuations that has received less attention compared to secondary load-following. Using a modified GAMMA + code and a deep neural network-based turbomachinery off-design model, the authors conducted an analysis to assess the behavior of the reactor core and fluid system under different PFC scenarios. The results indicate that the acceptable range for sudden relative electricity output (REO) fluctuations is approximately 20%p which aligns with the performance of combined-cycle gas turbines (CCGTs) and open-cycle gas turbines (OCGTs). In S-CO2 direct-cycle MMRs, the control of the core operates passively within the operational range by managing coolant density through inventory control. However, when PFC exceeds 35%p, system control failure is observed, suggesting the need for improved control strategies. These findings affirm the potential of S-CO2 direct-cycle MMRs in PFC operations, representing an advancement in the management of grid fluctuations while ensuring reliable and carbon-free power generation.

Outpatient Chest Tube Management with Using a Panda Pneumothorax Set with a Heimlich Valve (Panda Pneumothorax Set with Heimlich Valve에 의한 외래에서의 흉관 관리)

  • Choi, Soon-Ho;Lee, Mi-Kyung;Ryu, Dae-Woong
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.497-501
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    • 2009
  • Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

Dental Management of Pediatric Hydrocephalus (소아 수두증 환자의 치과적 관리)

  • Kim, Mijun;Park, Howon;Lee, Juhyun;Seo, Hyunwoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.228-234
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    • 2017
  • Hydrocephalus is a condition in which the volume of cerebrospinal fluid in the cerebral ventricles is abnormally elevated. Hydrocephalus patients may show macrocephaly and delayed development. Ventriculoperitoneal shunt is the most commonly used treatment but ventriculoatrial shunt is another treatment option. This report discusses the dental management process employed for a 7-year, 6-month old patient with ventriculoperitoneal shunt-treated hydrocephalus. This patient showed dental caries on the deciduous molars, facial swelling, macrocephaly and delayed development. Pulpectomy was performed on the deciduous molars under nitrous oxide sedation and mild protective stabilization. This patient did not appear to have any specific complications until the latest follow-up and was scheduled for the management of overall oral hygiene, development of permanent teeth, and craniofacial asymmetry through periodic follow-up. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force to the catheter running along the patient's neck to prevent the displacement of the catheter. A referral to a neurosurgeon is recommended for patients with ventriculoatrial shunts for prophylactic antibiotics. As hydrocephalus patients grow, they may show craniofacial asymmetry or differences in the calcification of the permanent teeth, and require periodic oral and craniofacial assessment.

Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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Numerical Analysis on Self-Burial Mechanism of Submarine Pipeline with Spoiler under Steady Flow (정상흐름 하에서 스포일러 부착형 해저파이프라인의 자가매설 기구에 관한 수치해석)

  • Lee, Woo Dong;Hur, Dong Soo;Kim, Han Sol;Jo, Hyo Jae
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.28 no.3
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    • pp.146-159
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    • 2016
  • This study used Navier-Stokes Solver(LES-WASS-2D) for analyzing hydrodynamic characteristics with high order in order to analyze self-burial mechanism of pipeline with spoiler under steady flow. For the validity and effectiveness of numerical model used, it was compared and analyzed with the experiment to show flow characteristics around the pipeline with and without the spoiler. And the hydraulic(flow, vortex, and pressure) and force characteristics were numerically analyzed around the pipeline according to the incident velocity, and shape and arrangement of spoiler. Primarily, if the spoiler is attached to the pipeline, the projected area is increased resulting in higher flow velocity toward the back and strong vortex caused by wake stream in the back. Secondly, the spoiler causes vertically asymmetric flow and vorticity fields and thus asymmetric pressure field. It increases the asymmetry of force on the pipe and thus develops large downward fluid force. Both of them are the causes of selfburying of the pipeline with spoiler.