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 Small Bowel Lymphangiectasia that Presented with Gastrointestinal Bleeding and was Treated by Small Bowel Resection / 대한내과학회지

Intestinal lymphangiectasia (IL) is a rare disorder, characterized by dilatation of intestinal lymphatics and leakage from ruptured lacteals to the intestinal lumen. Primary IL may be due to a congenital malformation of the lymphatic system, whereas secondary IL is caused by decreased lymph flow from thoracic ductsdue to elevated left subclavian vein pressure as a result of a preceding inflammatory or neoplastic disease. IL can present as protein-losing enteropathy with clinical manifestations of hypoproteinemia, hypoalbuminemia, edema, ascites, or pleural effusions. In very rare cases, it can present as severe intestinal bleeding. We experienced a 48-year-old woman presenting with recurring hematochezia and melena. She was diagnosed bydouble balloon enteroscopy, and surgical resection was needed to stop bleeding. In conclusion, IL can present clinically as painless chronic blood loss. If IL is locally distributed, surgical resection may be needed to control bleeding and to exclude other underlying causes in some patients.

A Case of Tuberculous Peritonitis Confirmed by Laparoscopic Biopsy in a Patient Receiving Maintenance Hemodialysis Patient after Renal Transplantation / 대한이식학회지

Tuberculosis is an opportunistic infection that causes significant morbidity and mortality in recipients of renal transplants. Although tuberculous peritonitis is easily diagnosed by paracentesis, it is difficult to diagnosis in the absence of ascites. Laparotomy and laparoscopic biopsies are needed for the diagnosis of tuberculous peritonitis. According to recent reports, the latter has a better outcome because of fewer associated complications. A case of tuberculous peritonitis in a renal transplant patient is reported that was diagnosed by laparoscopic peritoneal biopsy

A case of hepatocellular carcinoma combined with solitary parathyroid metastasis / 대한내과학회지

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide1). Extrahepatic metastasis of HCC is now increasing due to prolonged survival. Most extrahepatic HCC occurs in patients with advanced stages. The lung, abdominal lymph nodes, and bone are common sites of extrahepatic metastasis. However, the parathyroid gland has not been reported as a metastatic focus. We report the first case of parathyroid metastasis as the first single metastasis site of HCC and microscopic tumor-to-tumor metastasis to a parathyroid adenoma.

Association between nasogastric tube insertion and aspiration pneumonia in drug intoxication / 대한내과학회지

BACKGROUND/AIMS: The clinical usefulness of nasogastric tube insertion in poisoning patients is controversial. This study compared the incidence of aspiration pneumonia between patients with or without nasogastric tubes. METHODS: We retrospectively reviewed the clinical reports of poisoning patients seen from January 2006 to December 2007. We classified the patients into groups with and without nasogastric tube insertion and evaluated the incidence and risk factors of aspiration pneumonia. RESULTS: Ultimately, 63 patients were included. The incidence of aspiration pneumonia was higher in patients with nasogastric tube insertion than in patients without nasogastric tube insertion (conscious patients: 58.8% vs. 11.8%, p=0.010; unconscious patients: 72.2% vs. 27.3%, p=0.027). Nasogastric tube insertion was a significant risk factor for developing aspiration pneumonia (odds ratio 3.54; 95% confidence interval 1.74~12.34). CONCLUSIONS: Nasogastric tube insertion did not prevent aspiration pneumonia, but was a risk factor. The results have implications in the development of a hypothesis about why a nasogastric tube increases the risk of aspiration pneumonia. This study has important limitations stemming mostly from other compounding factors and its retrospective design.

The Distinction of Cleanup Works of Hebei Spirit Oil Spill in Peak Expiratory Flow between Pre-works and Post-works / 가정의학회지

BACKGROUND: There were debates on the relationship between peak expiratory flow (PEF) and oil spill cleanup activity. The aim of this study was to compare the distinction of PEF among pre-works and post-works in Hebei Spirit oil. METHODS: The study subjects were participators of cleanup works. The questionaire on symptoms was done. And PEF was measured. The subjects were sampled on random basis. We then used a logistic regression analysis to evaluate the effects of cleanup works on PEF. RESULTS: Only 66 (35.3%) participants versus 121 showed with low values in PEF before cleanup works. But, 78 (80.1%) participants versus 20 significantly showed with low values in PEF after cleanup works (P = 0.002). On our analysis, measuring their own PEF after cleanup works (Odds ratio [OR], 2.328; 95% confidence interval [CI], 1.218 to 6.624), female gender (OR, 5.841; 95% CI, 3.571 to 9.557), the number of working days on cleanup activities (OR, 2.760; 95% CI, 1.364 to 7.900), and residents (OR, 4.610; 95% CI, 2.488 to 8.544) were shown to be significant risk factors for low value of peak expiratory flow. CONCLUSION: Our results suggest that exposure to petroleum in cleanup works are associated with a significant low value in PEF. But, the heterogeneity of pre-works and post-works groups is a limitation of the study.

Dengue Fever Mimicking Acute Appendicitis: A Case Report / 감염과화학요법

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.

Dengue Fever Mimicking Acute Appendicitis: A Case Report / 감염과화학요법

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.