The Effects of a Simulation-Based High Flow Nasal Cannula Oxygen Therapy Training Program on the Knowledge, Clinical Performance and Educational Satisfaction of Clinical Nurses / 임상간호연구

Purpose@#The aim of this study was to develop a simulation-based High Flow Nasal Cannula Oxygen Therapy training program based on NLN/ISF to identify the effect on knowledge, clinical performance, and educational satisfaction compared to a group who had traditional High Flow Nasal Cannula Oxygen Therapy training after applying it to clinical nurses. @*Methods@#31 experimental groups and 33 control groups were conducted from August 2019 to September 2019 for inexperienced nurses over 4 months to 5 years with no experience using high-flow oxygen therapy. Educational programs were developed in scenarios according to Airvo2 and Optiflow, such as facilitator, participant, educational condition, design, characteristics, and educational outcomes. The education application was conducted in advanced for knowledge and clinical performance ability after watching therapy video. Since then, a total of 90 minutes have been conducted for respiratory failure theory training, airvo2 and optiflow simulation training, and debriefing. After applying the education, the medical institution measured nurses’ knowledge, clinical performance, and education satisfaction. Data were analyzed using descriptive statistics, with the SPSS/WIN 22.0 program. @*Results@#Both knowledge and educational satisfaction were higher in the experimental group than in the control group (t=-14.09, p<.001), (t=-12.99, p<.001). The clinical performance for both use of Optiflow and Airvo2 were higher in the experimental group than in the control group (t=-11.39, p<.001), (t=-11.38, p<.001) . @*Conclusion@#Results showed that the simulation-based High Flow Nasal Cannula Oxygen Therapy training was effective with the experimental group having increased scores for every area of this study.

A Case of Sponataneous Regressing Retroperitoneal Fibrosis after Ureteral Stent Insertion / 대한신장학회잡지

A 76 year old man was admitted because of periumbilical aMominal pain and nausea for 20days before admission. Initial serum creatinine level was 6.1mg/dL. Radioisotope renography showed obstruc- tive uropathy in both ureters. Retrograde pyelography of the left kidney revealed about 1cm of filling defect on the level of L5. Percutaneous nephrostomography of the right kidney revealed ureteral stricture in the lower ureter. In order to preserve renal function, a double J stent was inserted into each ureter. Serum creatinine level decreased to 1.5mg/dL after the insertion of ureteral stents. 12 weeks later, both stents were removed. 3 months after removal of the ureteral stents, retroperitoneal fibrosis and hydronephrosis disappeared in follow up abdominal CT. Recent his serum creatinine has shown about 1.5mg/dL. The patient is under continuing observation with serum creatinine level and sonography for detection of recurrence. This is a rare case of retroperitoneal fibrosis which showed spontaneous regression after ureteral stent insertion for 12 weeks without ureterolysis or corticosteroid therapy. In this case, the ureteral stent played a important role in preserving renal function by relieving ureteral obstruction. But the key point was that in the early stage in the early stage of retroperitoneal fibrosis, it was thaught having reversible process. There are some reports that ureteral obstruction was relieved only by correction of fluid and electrolytes balance or ureter diversion such as percutaneous nephro-stomy. Corticosteroid therapy promotes this rever-sible change in early stage of this disease by immunosuppression and antiinflammatory reaction. But once fibrosis has established in late stage of retroperitoneal fibrosis, corticosteroid is not effective for reducing the fibrosis and ureteral obstruction. In that case, operation is the choice for preservation of renal function. We reported an idiopathic retroperitoneal fibrosis case which showed spontaneous regression after preserving renal function by double J stent insertion without ureterolysis or corticosteroid therapy. We thought that idiopathic retroperitoneal fibrosis is a reversible process in the early stage.

A Case of Bronchial Lipoma with Extrabronchial Growth causing Middle Lobe Syndrome and Pneumonia / 결핵

Benign pulmonary tumors are rare entities, and among them bronchial lipomas are the most uncommon. Up to date, about 80 cases have been reported in the English literature. But, the bronchial lipoma with extrabronchial growth causing middle lobe syndrome and pneumonia is extremely rare. Bronchial lipomas, mainly arising from normal fatty tissue of the proximal portion of the lobar or segmental bronchi, are histologically benign. But if diagnosis and treatments are delayed, they can produce extensive pulmonary parenchymal damage and irreversible brochiectasis distally. So whenever possible, the treatment of choice is resection by means of bronchoscopy via early diagnosis. But if endoscopic removal is not possible because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy or if the nature of the tumor is unclear, surgery is necessary, with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma. We present a case of bronchial lipoma with extrabronchial growth, with a review of the literature and report of an unusual case.