• Title/Summary/Keyword: experience report

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Ruptured pseudoaneurysm of the internal maxillary artery in zygomaticomaxillary fracture: a case report

  • Lim, Soo Yeon;Lee, Hyun Gun;Kim, Kyu Nam;Kim, Hoon;Oh, Dong Hyun;Koh, In Chang
    • Archives of Craniofacial Surgery
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    • v.23 no.2
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    • pp.89-92
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    • 2022
  • Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

Clinical application of genome-wide single nucleotide polymorphism genotyping and karyomapping for preimplantation genetic testing of Charcot-Marie-Tooth disease

  • Kim, Min Jee;Park, Sun Ok;Hong, Ye Seul;Park, Eun A;Lee, Yu Bin;Choi, Byung-Ok;Lee, Kyung-Ah;Yu, Eun Jeong;Kang, Inn Soo
    • Journal of Genetic Medicine
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    • v.19 no.1
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    • pp.7-13
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    • 2022
  • Purpose: Preimplantation genetic testing for monogenic disorders (PGT-M) has been successfully used to prevent couples with monogenic disorders from passing them on to their child. Charcot-Marie-Tooth Disease (CMT) is a genetic disorder characterized by progressive extremity muscle degeneration and loss of sensory function. For the first time in Korea, we report our experience of applying single nucleotide polymorphism genotyping and karyomapping for PGT-M of CMT disease. Materials and Methods: Prior to clinical PGT-M, preclinical tests were performed using genotypes of affected families to identify informative single-nucleotide polymorphisms associated with mutant alleles. We performed five cycles of in vitro fertilization PGT-M in four couples with CMT1A, CMT2A, and CMT2S in CHA Fertility Center, Seoul Station. Results: From July 2020 through August 2021, five cycles of PGT-M with karyomapping in four cases with CMT1 and CMT2 were analyzed retrospectively. A total of 17 blastocysts were biopsied and 15 embryos were successfully diagnosed (88.2%). Ten out of 15 embryos were diagnosed as unaffected (66.7%). Five cycles of PGT-M resulted in four transfer cycles, in which four embryos were transferred. Three clinical pregnancies were achieved (75%) and the prenatal diagnosis by amniocentesis for all three women confirmed PGT-M of karyomapping. One woman delivered a healthy baby uneventfully and two pregnancies are currently ongoing. Conclusion: This is the first report in Korea on the application of karyomapping in PGT-M for CMT patients. This study shows that karyomapping is an efficient, reliable and accurate diagnostic method for PGT-M in various types of CMT diseases.

Bony Union of Osteochondral Lesion of the Talus after Bone Marrow Aspirate Concentrate and Matrix-Induced Chondrogenesis: A Case Report (골수흡인물 농축액 및 기질유래연골형성 수술 이후 관찰된 거골의 골연골병변의 골유합: 증례 보고)

  • Tae Hun Song;Jin Soo Suh;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.148-153
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    • 2023
  • Traditionally, arthroscopic microfracture and autologous osteochondral autograft transplantation have been the primary surgical treatments for osteochondral lesions of the talus. On the other hand, recent advancements have introduced alternative approaches, such as autologous chondrocyte transplantation, matrix-derived autologous chondrocyte transplantation, intra-articular injection of concentrated bone marrow aspirate concentrate, and the use of fibrin glue to address chondral defects. Furthermore, some studies have explored a combination of bone marrow aspirate and matrix-derived chondrogenesis. In light of these developments, this report presents a case study of a young male patient in his early twenties with a relatively large osteochondral lesion exceeding 1.5 cm2 on the medial talar dome. Instead of removing the osteochondral lesion, a surgical approach was employed to retain the lesion while addressing the unstable cartilage in the affected area. This approach involved a combination of bone marrow aspirate concentrate and matrix-derived chondrogenesis. The treatment yielded favorable clinical outcomes and ultimately successfully induced the bony union of osteochondral lesions. This paper reports the author's experience with this innovative approach with a review of the relevant literature.

Virtual reality education program including three-dimensional individualized liver model and education videos: A pilot case report in a patient with hepatocellular carcinoma

  • Jinsoo Rhu;Soyoung Lim;Danbee Kang;Juhee Cho;Heesuk Lee;Gyu-Seong Choi;Jong Man Kim;Jae-Won Joh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.285-288
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    • 2022
  • Three-dimensional (3D) modeling of the liver can be especially useful for both the surgeon and patient to understand the actual location of the tumor and planning the resection plane. Virtual reality (VR) can enhance the understanding of 3D structures and create an environment where the user can focus on contents provided. In the present study, a VR platform was developed using Unreal Engine 4 software (Epic Games, Potomac, MD, USA). Patient's liver based on magnetic resonance image was imported as a 3D model that could distinguish liver parenchyma, vascular structure, and cancer. Preoperative education videos for patients were developed. They could be viewed inside the VR platform. To evaluate the usefulness of VR education program for patients undergoing liver resection for hepatocellular carcinoma, a randomized clinical trial evaluating the knowledge and anxiety of the patient was designed. The case presented in this report was the first experience of performing the VR education program and examining the knowledge and anxiety using questionnaires. When the knowledge score increased, the anxiety score also increased after the education program. Based on findings of this pilot case study, the timing and place where the questionnaire will be answered can be modified for formal initiation of the randomized controlled study to examine the usefulness of VR in patient education.

Nonabsorbable Barbed Sutures for Diastasis Recti. A Useful Device with Unexpected Risk: Two Case Reports

  • Lorenzo Giorgi;Veronica Ponti;Filippo Boriani;Andrea Margara
    • Archives of Plastic Surgery
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    • v.51 no.5
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    • pp.474-479
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    • 2024
  • The introduction of nonabsorbable barbed sutures in plastic surgery has allowed the achievement of significant results in terms of efficacy and short- and long-term outcomes. However, a nonabsorbable material with no antibacterial coating could act as a substrate for subclinical bacterial colonization and thereby determine recurrent subacute and chronic infective-inflammatory processes. The authors report a clinical experience of subacute infectious complications after two cases of diastasis recti surgical correction. The authors present a two-case series in which a nonabsorbable barbed suture was used for the repair of diastasis recti. The postoperative course was complicated by surgical site infection. The origin of the infectious process was clearly localized in the fascial suture used for diastasis correction. The suture was colonized by bacteria resulting in the formation of multiple granulomas of the abdominal wall a few months postoperatively. In both the reported cases, the patients partially responded to the antibiotic targeted therapy and reoperation was required. The microbiological analyses confirmed the colonization of sutures by Staphylococcus aureus. Barbed nonabsorbable sutures should be avoided for diastasis recti surgical correction to minimize the risk of infectious suture-related complications. The paper's main novel aspect is that this is the first clinical report describing infectious complications after surgical correction of diastasis recti with barbed polypropylene sutures. The risk of microbiological subclinical colonization of polypropylene suture untreated with antibacterial coating, therefore, should be taken into account.

The Problems for Application of Nursing Process in Clinical Experience of Nursing Students (임상실습에서 학생들이 경험하는 간호과정 적용문제)

  • Yang Young-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.58-71
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    • 1999
  • Nursing process is an essential part for nursing practice. Nursing faculty members must focus on the clinical application for students and try to identify the possible problems that students might face in the fields. The purpose of this study is to examine the actual condition of nursing process education in curricula and to investigate the response of students in clinical experience of nursing process. From 462 students in the 6 associate programs(ADN) and the 6 baccalaureate programs (BSN) data was collected by questionnaire. The results were as followed. 1. Seven programs (58.3%) opened the nursing process in mainly sophomore (BSN) or freshman(ADN). If not opened, the nursing process was taught at the major subjects(espcially fundamental nursing or adult nursing). 2. All Students responded they we supposed to use nursing process in preparing the case report. The majority(94.6%) used NANDA lists for nursing diagnosis and 55.7% of subjects consulted the Korean terms by KNA when translating. The tutors for nursing process in clinical settings were the professor in charge of the subject (68.6) or clinical instructors (48.1%) , assistants(34%). 3. The problems in clinical application that students experienced consisted of 17 items and the mean was 2.27. The biggest problem was 'the lack of the model for RN of applying the nursing process in clinical settings'(2.97). Next the big problem was 'the lack of the competency for implementing the established nursing plans'(2.69). All items were significantly different according to the level of educational programs(ADN or BSN). ADN students had more problems in applying the each step of nursing process and BSN students perceived the NANDA as a guidance of nursing diagnosis and the inconsistency of advices from several instructors or practicum to be mere problematic. 4. The mean of merits after application of nursing process was relatively fair (2.82). The best merit was 'they can identify nursing problems more exactly'(3.07). The second high merit was 'they can study the rational of nursing action' (3.03). BSN than ADN and the subjects of second year than of one year in clinical experience perceived the use of nursing process to be better. Based on this results we need to enforce the application of nursing diagnosis in the class. The use of sample cases can be the efficient method. Students can identify the possible health problems for patient from the cases in imaginary world and discuss them each other. Also we can use the discussion session after practice every other day or as needed. All this is on the good interaction between tutor and student. We must consider to have enough time for student to seize the essence of the nursing process.

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Recognition and Experience of Sexual Harassment of Female Teachers in Middle and High School ($\cdot$고등학교 여교사들의 직장내 성희롱에 대한 인식 및 경험)

  • Oh Hee Jin;Koh Hyo Jung
    • Journal of Korean Public Health Nursing
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    • v.17 no.2
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    • pp.238-254
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    • 2003
  • The objective of this study was to provide baseline information useful for developing education programs to prevent sexual harassment in schools. Survey of recognition and experiences of sexual harassment and analysis of factors associated with sexual harassment were conducted. The data were collected using questionnaires from December 9 through 28, 2002. A total of 737 female teachers in Daegu participated in the survey. The data were analyzed with descriptive analysis, ANOVA, and T-test using SPSS /WIN 11.0. The study results were as follows: 1. As to the characteristics related to sexual harassment, $51.3\%$ of the female teachers had no experience of preventive education about sexual harassment, $37.2\%$ of the female teachers perceived that enactment of related laws had little influence on the prevalence of sexual harassment, and $59.8\%$ thought strict punishments are required. For teachers who have experienced sexual harassment in schools, $39.8\%$ thought that they must report to the counseling office or female teachers' meeting. On the other hand, $35.7\%$ answered that they would take passive actions such as talking to their friends or colleagues. 2. As to the mode of sexual harassment, participants regarded physical harassment $(4.06\pm0.78)$ as the prominent forms of sexual harassment, followed by visual harassment $(4.04\pm0.77)$, and verbal harassment $(3.86\pm0.81)$. Among physical harassment. 'touching a body part (shoulder, hip, hand, etc)(4.58) was recognized as prominent forms of physical harassment, while 'blocking one's path or impeding one's movement (3.48)' was recognized as least prominent forms of physical harassment. 3. As to the experiences of sexual harassment, $79.8\%$ of the female teachers had experienced sexual harassment. According to the characteristics of schools. public junior high school $(87.8\%)$, private high school $(83.4\%)$ and bisexual school $(82.5\%)$ had higher rates of sexual harassment. 4. As to the characteristics of experiences in sexual harassment. $65.3\%$ thought that sexual harassment was not serious, but $18.9\%$ thought it was serious and $2.2\%$ thought as very serious. 5. As to the characteristics of sexual harassers, $378.6\%$ were 'colleague teachers' and $8.6\%$ were 'principals and/or vice-principals'. Ninety-three percent of sexual harassers were , male' and $40.2\%$ of them were 'in their 40s'. In most cases. the offender of the sexual harassment was male teachers in the same schools. And more than half of the female teachers replied they had never had any education related to sexual harassment. which means that systematic education is quite urgent.

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A Comparison of the Clinical Competence, Knowledge of Patient Safety Management and Confidence of Patient Safety Management according to Clinical Practice Experience of Nursing Students

  • Lim, Jae-Ran;Song, Hyo-Suk
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.7
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    • pp.65-73
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    • 2021
  • The purpose of this study is to cornpare the differences in clinical competence, knowledge of patient safety management and confidence of patient safety management according to the clinical practice experience of nursing students, Of the 73 nursing students who experienced clinical practice and 35 nursing students who did not experience, a total of 108 students in the third grade were analyzed, In the results of this study, clinical competence(t=.88, p=.377) knowledge of patient safety management(t=-.29, p=.773), and confidence of patient safety management(t=1.11, p=.267) the difference between was not statistically significant in the two groups. In the two groups, the score of the sub-area according to each variable is the lowest. First, the sub-area of the nursing process a lowest score in clinical competence, and the second, the sub-area of measuring knowledge about concept of near miss was the Knowledge of patient safety management. The score was the lowest in, and thirdly, the sub-area of writing an incident report when an error occurred had the lowest score in confidence of patient safety management. Therefore, in order to improve the quality of clinical competence of nursing students, it is necessary to develop a strategic educational guideline to improve the clinical practice education environment, to improve patient safety management capabilities and to cultivate correct attitudes toward patient safety management.

Nursing students' experience of visiting the National Institute for Scientific Investigation (간호대학생의 국립과학수사연구소 탐방 경험)

  • Kim, Mi-Hwa
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.3
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    • pp.35-41
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    • 2021
  • The purpose is a qualitative study on the search for career paths of nursing students after visiting the National Institute of Science and Investigation. Participants in this study were 13 people who participated in the National Institute of Science and Investigation visit program during a club event for 3rd graders at a university in M city, Gyeongsangbuk-do. Data collection was made through a self-report within 48 hours of visiting the National Institute of Science and Investigation. The collected data were analyzed using Krippendorff's phenomenological method. As a result of analyzing the experiences of nursing students' visits to the National Institute of Forensic Science, 3 categories, 6 themes, and 20 meaningful statements were identified. The three categories were derived from "Beyond the boundaries of the nursing profession," "The difference between drama and reality", and "Challenge in a new field". As a result of this study, it was confirmed that the experience of visiting the National Institute of Forensic Science provided an understanding of forensic nurses and had opportunities for various social participation attitudes as nurses. In addition, it is expected to be used as basic data useful for career guidance and student counseling in the future, and it is expected to be used as basic data for educational demand structure and educational development for forensic nurses.

Explaining Variance in Children's Recall of a Stressful Experience: Influence of Cognitive and Emotional Individual Differences (스트레스적 경험에 대한 아동 기억의 신뢰성과 인지 및 정서적 개인차 특성들과의 관계)

  • Seungjin Lee
    • Korean Journal of Culture and Social Issue
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    • v.19 no.3
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    • pp.343-365
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    • 2013
  • This study examined the effects of various individual differences on children's memory of a stressful experience. The participants for the current study were children (N=85) aged 4-9 years those who experienced a naturally occurring stressful experience from a dental procedure. There was overall negative relation between the level of stress and children's memory performance. However, more interestingly, the results of this study provided some further evidence that several cognitive (i.e., receptive language ability and working memory capacity) and emotional (i.e., children's general anxiety condition, children's self-report of pain and anxiety about the event) individual difference factors were associated with variations in children's remembering across ages. The results suggest that the relation between stress and children's memory might be impacted in part by children's various individual characteristics. Furthermore, the findings are discussed in the applied context that based on the results clinical and legal professionals can tailor interviews to best meet children's needs and capabilities, and create developmentally and individually sensitive guidelines for interviewing children in the legal system.

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