BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
California ; Clavicle* ; Joints ; Skin

PURPOSE: The descriptive-correlational study was undertaken in order to investigate the relationships between critical thinking disposition and critical thinking skill in clinical nurses. METHODS: A convenience sample of 50 registered nurses was obtained from E University Hospital. The instruments used in this study were general characteristics, California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skill Test(CCTST) developed by Facione & Facione (1994). The data were analyzed by descriptive statistics, t-test, ANOVA, Duncan test and Pearson's Correlation Coefficient with SPSS 12.0 Program. RESULTS: 1) There was a statistically significant difference in critical thinking disposition according to age (F=3.23, p=.03) and educational background (F=39.07, p=.00). 2) There was a statistically significant difference in critical thinking skill according to age (F=3.40, p=.02), educational background(F=32.51, p=.00), and period of professional nursing experience(F=3.56, p=.02). CONCLUSION: A significant positive correlation between critical thinking disposition and critical thinking skill was found(r=.68, p=.00). Critical thinking disposition and critical thinking skill according to age and educational background had statistically significant differences. Therefore, it is needed to emphasize the necessity of continuous education and training of nurses which prepare their critical thinking ability.
California ; Education ; Nursing ; Thinking*

BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
California ; Clavicle ; Joints ; Skin

PURPOSE: The purpose of this study was to evaluate radiological and clinical outcomes and to analyze factors associated with nonunion after conservative management in patients with distal clavicle fracture. MATERIALS AND METHODS: We analyzed 29 cases. Neer type, coracoclavicular distance (CCD), initial displacement, comminution, union, and presence of bony union were evaluated by plain radiographs. Clinical outcomes according to University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and subjective shoulder value (SSV) scores were assessed. RESULTS: Six cases (20.7%) had developed nonunion. Three cases had asymptomatic nonunion. Mean UCLA, ASES, and SSV scores were 30.9, 88.3, and 87.0 in the union group and 26.7, 76.2, and 70.8 in the nonunion group. Although the nonunion group had inferior clinical outcome compared to the union group, there was no significant difference between the two groups. Older age and more CCD showed correlation with nonunion (p=0.047, p=0.007). CONCLUSION: Conservative management of distal clavicle fractures provided satisfactory clinical outcomes. The rate of symptomatic nonunion was 10.4%. Occurrence of nonunion showed correlation with older age and more CCD.
California ; Clavicle* ; Elbow ; Humans ; Shoulder

PURPOSE: This study was aimed to evaluate the efficacy of an eye-tracking system, in terms of the amount of decentration. Comparison was made between two LASIK groups operated with and without the use of eye-tracking system. METHODS: An eye-tracking system was used in 41 eyes(Group 1) and patient fixation alone without an eye-tracking system in 41 eyes(Group 2). Corneal topography(Humphrey ATLAS(TM) Corneal Topography System; Zeiss Humphrey Systems, Dublin, California, U.S.A.) was performed before surgery and 3 months postoperatively. The amount of ablation decentration was measured on the difference map obtained from the axial map. RESULTS: The mean +/-SD of decentration was 0.38 +/-0.23 mm in group 1, and 0.49 +/-0.24 mm in group 2(p=0.047). The amount of decentration was graded as follows: grade I(<0.5 mm); Grade II(0.5~1.0 mm); Grade III(>1.0 mm). Grade I, there was a significantly less decentration in group 1(p=0.037). For grade II, however, there was no significant difference between the two groups(p=0.766). CONCLUSIONS: Using eye-tracking system alone may not be effective in decreasing moderate decentration. Good fixation of the patients seemed to be as effective as an eye tracking system in achieving good ablation centration.
California ; Corneal Topography ; Humans ; Keratomileusis, Laser In Situ*

OBJECTIVES: Despite increasing availability of global positioning system (GPS), no research has been conducted to analyze GPS data for exposure opportunities associated with time at indoor and outdoor microenvironments. We developed location-based and time-weighted spatial measures that incorporate indoor and outdoor time-location data collected by GPS. METHODS: Time-location data were drawn from 38 female subjects in California who wore a GPS device for seven days. Ambient standard deviational ellipse was determined based on outdoor locations and time duration, while indoor time weighted standard deviational ellipse (SDE) was developed to incorporate indoor and outdoor times and locations data into the ellipse measure. RESULTS: Our findings indicated that there was considerable difference in the sizes of exposure potential measures when indoor time was taken into consideration, and that they were associated with day type (weekday/weekend) and employment status. CONCLUSIONS: This study provides evidence that time-location weighted measure may provide better accuracy in assessing exposure opportunities at different microenvironments. The use of GPS likely improves the geographical details and accuracy of time-location data, and further development of such location-time weighted spatial measure is encouraged.
California ; Employment ; Female ; Geographic Information Systems* ; Humans

To know recent research works in neurosurgical fields and to analyze neurosurgery related sites on the internet, authors have been searching sites on the web offering the neurosurgical resources. From December 1995 to October 1996 we used a modem(28.8Kbps) and thereafter connected to a LAN(local area network). Under the environment of Windows 95, we used web browsers with Netscape 2.02 and Netterm 2.89. We got an medical information with PC journals or seminars and graded the neurosurgical center/institutes from A to E according to the quality of web sites. We could use the internet resources more rapidly in the early morning than noon or evening. Best sites for neurosurgeon were MedMark(http://www.medmark.bit.co.kr/neurosur.html) and Neurosource (http://www.neurosource.com/). The more comprehensive academic neurosurgical site among all web were the Massachusetts General Hospital(http://neurosurgery.mgh.harvard.edu/) and the University North California (http://sunsite.unc.edu/Neuro/uncns/home.html). In 89 neurosurgical center/institutes, 72 sites(80.9%) couldn't supply sufficient information. In conclusion, there are many webs related to neurosurgery on the internet, but useful sites for neurosurgeon are not common. It is necessary to make an effort to find available sites offering more information in the future.
California ; Internet* ; Massachusetts ; Neurosurgery ; Web Browser

PURPOSE: The purpose of this study is to evaluate the radiologic and clinical outcomes after tension band wire fixation of Neer type II distal clavicle fractures. MATERIALS AND METHODS: Twenty-six patients with Neer type II distal clavicle fractures who underwent tension band wire fixation from March 2002 to May 2011 were included in the study. Fifteen cases were classified as Neer type IIa and 11 cases as type IIb. The postoperative mean follow-up period was 14.3 months. Clinical and radiologic evaluation was performed at two weeks, six weeks, three months, six months, and 12 months postoperatively. RESULTS: Bony union on X-rays was observed at an average of 11.7 weeks (range 8-20 weeks) postoperatively. The overall visual analogue scale score for pain was 1.23+/-2.75 postoperatively. The overall postoperative University of California at Los Angeles score increased to 33.5+/-2.15 from the preoperative score of 21.6+/-1.91 (p<0.05). CONCLUSION: Among various methods of treatment for Neer type II distal clavicle fracture, K-wire and tension band fixation was used and relatively satisfactory radiological and clinical results were obtained. This surgical method yields excellent clinical results, owing to its relatively easy technique, fewer complications, and allowance of early rehabilitation.
California ; Clavicle* ; Follow-Up Studies ; Humans ; Rehabilitation

PURPOSE: The purposes of this study were to investigate the relationship between partial thickness articular side tear of the subscapularis tendon and anterior internal impingement, and to evaluate the clinical outcomes. MATERIALS AND METHODS: We reviewed 27 cases who underwent surgery for tears in the deep surface of the subscapularis tendon. On arthroscopic examination, fraying or tear less than 10% thickness of the subscapularis tendon was observed in 9 cases, 10-30% in 5, more than 30% in 5, and longitudinal tear in 8. Tears were treated with debridement only in 21 cases, arthroscopic repair in 5, and open repair in 1. Labral or SLAP repair was also performed in 6 cases. Analysis was done by the preoperative clinical test, coracoid index and coracohumeral distance from the MR images, associated lesion and the presence or absence of anterior internal impingement on arthroscopic evaluation. Clinical results were assessed using the University of California at Los Angeles shoulder rating scale. RESULTS: Anterior labral lesions were present in 59% of the cases. Hawkins test was positive in 16 cases (59%). Among these cases, labral lesions were seen in 14 (88%). The results were satisfactory in 81%. CONCLUSION: We thought that anterior internal impingement between the partial thickness tear of the subscapularis tendon and the anterior glenoid labrum may cause shoulder pain and possibly induce progression of tear in deep surface of the subscapularis tendon, and Hawkins test is helpful for diagnosis. Satisfactory outcomes could be obtained with debridement or repair in partial tear of the deep surface of the subscapularis tendon.
California ; Debridement ; Diagnosis ; Shoulder ; Shoulder Pain ; Tendons*

OBJECTIVES: The purpose of present study is to identify the differences between temperament and character traits among adolescents classified by ego resilience and ego control level. METHODS: A Junior Temperament and Character Inventory (TCI) was performed on participants, and a California Child Q-Test (CCQ) was tested for by the parents of the adolescent participants. RESULTS: The result of the factor analysis and discriminant analysis show that the participants are classified into three different groups based on CCQ score and item response patterns. The three groups are named the ego resilience group, the undercontrolled group, and the overcontrolled group. The ego resilience group indicates that they have a high level of interest and curiosity but yet they are not easily tempered. Moreover, they behave proactively with a reasonable level of responsibility in order to improve themselves. In contrast, among the undercontrolled group, it is observed that, although the group shows even higher level of interest, curiosity and honesty, they are careless, more impulsive, and have a lack of delayed gratification and shame. CONCLUSION: The overcontrolled group shows that they are the most cautious and reflective group among the three but also show emotional instability such as strong criticism and passive-aggressiveness. In this study, implications and limitations are discussed.
Adolescent ; California ; Child ; Ego ; Exploratory Behavior ; Humans ; Parents ; Temperament