Combination of extracorporeal membrane oxygenation and in-line hemofiltration for the acute hyperkalemic cardiac arrest in a patient with Duchenne muscular dystrophy following orthopedic surgery: a case report / 대한마취과학회지

BACKGROUND: Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy that anesthesiologists can encounter in the operation room, and patients with DMD are susceptible to complications such as rhabdomyolysis, hyperkalemic cardiac arrest, and hyperthermia during the perioperative period. Acute onset of hyperkalemic cardiac arrest is a crisis because of the difficulty in achieving satisfactory resuscitation owing to the sustained hyperkalemia accompanied by rhabdomyolysis. CASE: We here report a case of a 13-year-old boy who had multiple leg fractures and other trauma after a car accident and who had suffered from acute hyperkalemic cardiac arrest. He was refractory to cardiopulmonary resuscitation and showed sustained hyperkalemia. With extracorporeal membrane oxygenation and in-line hemofiltration, he recovered from repeated cardiac arrest and hyperkalemia. CONCLUSIONS: Combining ECMO and in-line hemofiltration might be a safe and effective technique for refractory hyperkalemic cardiac arrest and rhabdomyolysis in patients with DMD.

Combination of extracorporeal membrane oxygenation and in-line hemofiltration for the acute hyperkalemic cardiac arrest in a patient with Duchenne muscular dystrophy following orthopedic surgery: a case report / 대한마취과학회지

BACKGROUND@#Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy that anesthesiologists can encounter in the operation room, and patients with DMD are susceptible to complications such as rhabdomyolysis, hyperkalemic cardiac arrest, and hyperthermia during the perioperative period. Acute onset of hyperkalemic cardiac arrest is a crisis because of the difficulty in achieving satisfactory resuscitation owing to the sustained hyperkalemia accompanied by rhabdomyolysis.CASE: We here report a case of a 13-year-old boy who had multiple leg fractures and other trauma after a car accident and who had suffered from acute hyperkalemic cardiac arrest. He was refractory to cardiopulmonary resuscitation and showed sustained hyperkalemia. With extracorporeal membrane oxygenation and in-line hemofiltration, he recovered from repeated cardiac arrest and hyperkalemia.@*CONCLUSIONS@#Combining ECMO and in-line hemofiltration might be a safe and effective technique for refractory hyperkalemic cardiac arrest and rhabdomyolysis in patients with DMD.

Congenital Syphilis Presenting with Only Nephrotic Syndrome: Reemergence of a Forgotten Disease

Syphilis infection has re-emerged after years of declining incidence. The prevalence of congenital syphilis (CS) has increased in Korea and other countries during the last few decades. Untreated infants develop symptoms such as rhinorrhea, anemia, jaundice, cutaneous lesions, hepatosplenomegaly, and pseudoparalysis within weeks or months. Significant renal disease is uncommon in CS, and clinical renal involvement varies from mild transient proteinuria to frank nephrosis. We report a 2-month-old infant with CS who presented with only nephrotic syndrome (NS). The previously healthy infant presented with NS and showed no other syphilitic manifestations. Remission of the NS was achieved with adequate penicillin treatment. No recurrence of proteinuria was observed during the 1 year of follow-up. Although rare, this long forgotten disease continues to affect pregnant women, resulting in prenatal or postnatal mortality. We still consider the possibility of syphilitic nephropathy and therefore serologic testing for congenital NS.

Social Support and Health Status based on Characteristics of Leisure Activity of Middle-Aged Women / 기본간호학회지

PURPOSE: The purpose of this study was to identify social support and health status based on characteristics of leisure activity in middle-aged women. METHODS: Participants were 148 middle-aged women living in the capital area. Data were collected through self-report questionnaires which were constructed to include leisure activity characteristics, social support and Brodman's CMI. Data were analyzed using t-test, and ANOVA, with SPSS/WIN 14.0. RESULTS: Social support was different depending on leisure type, leisure partner, length of participation in present activity, regularity, and motivation to start activity. Health status was different depending on the length of participation in present activity, and regularity. CONCLUSION: Because social support and health status depend on characteristics of leisure activity, further study in nursing one how to resolve the physical, psychological, social and health problems that middle-aged women might experience through various leisure activities.

Analysis of Telephone Counseling Service on Child Health / 아동간호학회지

This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

Diapers and Infant Skin Health / 아동간호학회지

Diaper dermatitis, or commonly called "diaper rash", is among the most prevalent cutaneous disorders of infancy and early childhood and important issue in nursing. The term itself is not diagnostic since it encompasses a variety of acute inflammatory reactions which are best regarded as a family of disorders arising from a combination of factors specifically attributable to the use of diapers. Intensive study of the rash process has shown that skin wetness and fecal enzyme activity are damaging to skin and lead to the development of diaper rash. This suggests that it is important to keep urine away from babies' skin, so that the skin remains as dry as possible and maintains its barrier function abilities. Controlling the urine will also minimize the mixing of urine and feces within the diaper, which helps prevent the increased activity of enzymes that attack the skin and cause irritation. Therefore, a diaper that keeps the skin drier and limits the mixing of urine and feces will help prevent the conditions that lead to diaper rash. Since their introduction about 35 years ago, disposable baby diapers have undergone many design and performance changes. In particular, the performance of diapers was advanced by the introduction of absorbent gel materials(AGMs) to provide advantages in skin care, dryness, and leakage protection. Especially, important was the introduction of AGM which increased the absorbent capacity of the diaper several fold and yielded marked reductions in the degree of skin hydration occurring under the diaper. Studies show not only drier skin but more stable skin pH and less dermatitis with AGM diapers than with home-laundered cloth diapers or single-use diapers without AGM. Minimizing diaper area skin wetness is important for managing and preventing diaper rash. To minimize wetness, parents should use super absorbent diapers, change them frequently, and gently clean the perineal area with each diaper change. In addition to the skin care benefits, disposable diapers are also better than cloth diapers in minimizing the risk of diarrhea outbreaks among infants and toddlers in day-care environments by reducing fecal contamination and minimizing the potential for transmission of gastro-intestinal tract disease in day-care settings. Furthermore, disposable diapers in the hospital provide nursing, health care, and other advantages over cloth diapers: convenience for nurses and parents, and better containment than cloth with less handling, decreasing the chance of spreading infections. These benefits extend from the care of infants in hospitals to children at home or in day care centers.

Clinical Competency for Directing of Registered Nurses's National Examination: focused on Fundamental, Medical-Surgical, Psychiatric, women's health, community, Pediatric, and Administrative Nursing / 간호학회지

For producing large numbers of professional nurses who could manage 21th century's human health, it is necessary to review the direction of registered nursed' national examination which evaluates the nursing education and is granted a licence. For adapting to social expectation of the nurse, we have to nurture the nurses' problem solving capability in clinical setting. Seven divisions of Korean Academy of Nursing suggested clinical competency according to their categories. This paper was presented in the workshop for setting up direction of registered nurses' national examination. We expect that this paper would be more refine and confirm through reviewing subdivisions' learning objectives and discussing clinical minimum level of competence contents with clinical leaders.

An Analysis on Curriculum Content of Child Nursing in Korea / 아동간호학회지

The purpose of nursing education is to prepare the professional practitioner as nurse who will be interested in the health and the related aspects of community and will assume responsibility for contributing toward the improvement of the health for the all. This means that nursing education must provide opportunities for the development of knowledge, skills, and attitudes which make this possible. Consequently, this approach has relevance for nursing education. Faculty engaged in endless debates about what is to be included, and to what death, and what will be given short shrift as a result. Thus, it can be seen why there is so much confusion and lack of agreement between the emphasis and objectives in nursing. This study attempted to review and identify the curriculum content of child nursing in Korea to build and develop the standard curriculum contents for national board examination for nurses and child's health needs for the coming 21st century. The questionnaire was consisted of items for selection and organization of the knowledge components and type of unit with weigh to be attained in child nursing. Response of 34% of nursing program in university and junior college. Content analysis was done by using consensual validation of essential knowledge for curriculum content to identify what is obvious or trivial. This study pointed out that it is not yet apparent that demographic fact has greatly influenced child nursing curriculum content. In a similar vein the majority of content of child nursing devote little time and weigh to social and epidemically significant to child health. It seems to be needed that the content of child nursing may push the paradigm shift in nursing education such as health promotion and prevention for postretinal roles of child and family. In conclusion, it is time to convoke and content and standardization on job analysis for national board exam for nurses in Korea.

Surfactant replacement therapy in neonatal respiratory distress syndrome

No abstract available.

A Case of Lissencephaly with West Syndrome

No abstract available.

The Clinical study of Acute Poisoning in Children

No abstract available.