PURPOSE: We investigated the relationship between patient safety culture and safety care activity, and identified factors for safety care activity of entry-level nurses. METHODS: The subjects of the study were 204 entry-level nurses working at five general and advanced hospitals with over 500 beds located in C and D City. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson's correlation and hierarchical multiple regression with SPSS/WIN 18.0 program. RESULTS: Perception of patient safety culture had significant correlations with safety care activity. Multiple regression analysis showed that demographic variables of quality of nursing on patient safety and health state of entry-level nurses affected safety care activity. In addition, patient safety culture in ward and communication affected safety care activity. These factors explained 38% of variance. CONCLUSION: Based on the results of the study, patient safety culture promotion strategies to facilitate supportive work environment and effective communication are needed.
Humans ; Patient Safety

The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

This study was planned by the necessities of basic information about the effects of Korean Ginseng upon fracture healing and biomechanical properties of bone. Three hundred white mice were used for this study, and we could have tested the biomechanical properties in one hundred and nintyfour. The bones of the white mice were evaluated by testing gross stability, radiological appearance, and biomechanical properties. It appears that Korean Ginseng has an excellent effect upon early phase of fracture healing of the bone. The summary of this study are as follows: 1. With near maximal dose, Korean Ginseng showed very excellent effect upon early phase of the fracture healing. 2. There was no apparent effect on remodeling phase of the fracture healing with Korean Ginseng of near maximal dose. 3. Korean Ginseng appeared to have no effect on fracture healing with minimal dose. 4. Upon biomechanical properties of the bone, Korean Ginseng was seemed to be effective with near maximal dose. But, there was no definite evidence for that.
Animals ; Fracture Healing ; Mice ; Panax

To develop a survival prediction model and to use it as a therapeutic guideline a series of 66 cases with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage were analyzed retrospectively. They were classified into the benign and fatal groups according to their final outcomes. Fourteen indices obtained from the initial CT scans were final outcomes. Fourteen indices obtained from the initial CT scans were subjected to multivariate discriminant analysis. The resultant discriminant function(Z) included the amount of hematoma in the parenchyme(AH), bicaudate cerebroventricular index(BCCI) maximum fourth ventricular width(FVW), and third cerebroventricular ratio(TCR) in an order of decreasing discriminating power and was as follows: Z = -3.2639 + 0.3508 X 10(-1) X AH + 6.8816 X BCCI + 0.1139 X FVW-5.7794 X TCR. This function predicted survivability with accuracy of 84.9% when it was applied to the original subjects. The conclusion is that AH, BCCI, FVW, and TCR are the potent predictors of the survival of patients with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed*

The authors present the one case of a 22-year-old man admitted with intermittent quadriparesis and respiratory difficulty. On investigation, atlantoaxial instability and upper cervical cord compression due to abnormal soft tissue were revealed. We have performed transoral decompression and biopsy, and then posterior transarticular facet screw fixation with interspinous wiring and fusion. We could obtain immediate and long-term postoperative stability with Philadelphia collar only. The pathologic examination reveald connective soft tissue hypertrophy due to chronic mechanical irritation.
Biopsy ; Decompression* ; Humans ; Hypertrophy ; Quadriplegia ; Young Adult

Tarsal tunnel syndrome is relatively an uncommon and usually under-recognized or misdiagnosed condition. We report a case of posterior tarsal tunnel syndrome caused by a ganglion . A 58-year-old woman complained of burning and tingling sensation along the left sole and presented weakness, muscle atrophy, and Tinel's sign in the left foot. Electrodiagnostic study revealed prolonged terminal latency, reduced compound muscle action potential, absent sensory nelve potential, and denervation potentials. After removal of the ganglion, patient's symptoms improved and the electrodiagnostic study performed after two months showed significant improvement.
Action Potentials ; Atrophy ; Burns ; Denervation ; Female ; Foot ; Ganglion Cysts* ; Humans ; Middle Aged ; Muscle Weakness ; Sensation ; Tarsal Tunnel Syndrome*

The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations from the 1990 Finance Report of the self-employed health insurance programs. both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household. The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would e integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.
Family Characteristics ; Humans ; Insurance ; Insurance, Health* ; Korea* ; Urban Health

Air can be used as a carrier for volatile agent, ether, with a clear airway, normal pulmonary function and normal oxygenation. In 1858 John Snow, the Father of British Anesthesia stated in his book on Chloroform and Other Anesthetics that he believed it to be almost impossible for death to occur from ether administered with ordinary intelligence and attention. Today ether is probably still the safest anesthetic drug we possess. Ether is cheap and easily obtained; with controlled respiration 3% is adequate. Recovery smooth and rapid. Vomiting may be no different from other agents. Most machines depend upon cylinders of oxygen and other gases, and there are difficulties of refilling cylinders and the cost of transporting them. In such circumstances the E.M.O. Inhaler, allowing ether to be vaporized in known concentrations in air, has many advantages as an alternative to the open method administration. From all types of patients chosen at random 22 patients were studied for ether-air anesthesia. Anesthesia was induced with intravenous thiopental and subsequent endotracheal intubation was performed within 30 seconds with the aid of intravenous succinylcholine. SatO2, PaO2, pH, and Base E. were measured 3 times during pre-anesthesia, immediately after the intubation, and post-operatively by Radiometer, using the oxy-hemoglobin dissociation curve and the Siggard-Anderson alignment nomogram. Vital signs were recorded every 5 minutes. It is the purpose of this paper to present this series of 22 anesthetics by the use of the E.M.O. Inhaler with air and to discuss the possibility of hypoxia, advantages and limitations that became apparent. The results obtained may be summarized as follows. 1. It is essential that endotracheal intubation by carried out rapidly and that everything necessary be ready and immediately at hand before starting the anesthetic. 2. In all patients ventilated room air during anesthetic induction, no significant decreases of PaO2 and SatO2 were observed immediately after the endotracheal intubation. 3. The duration of any period of complete apnea inflicted on the patient must be carefully controlled. 4. 100% oxygen prevented the possibility of hypoxia on extubation after all the reflexes had returned. 5. Ether-air anesthesia is recommended without hesitation for use where economy and portability of anesthetic machine are needed.
Anesthesia* ; Anesthetics ; Anoxia ; Apnea ; Chloroform ; Ether ; Fathers ; Gases ; Hand ; Humans ; Hydrogen-Ion Concentration ; Intelligence ; Intubation ; Intubation, Intratracheal ; Nebulizers and Vaporizers ; Nomograms ; Oxygen ; Reflex ; Respiration ; Snow ; Succinylcholine ; Thiopental ; Vital Signs ; Vomiting

No abstract available.
Folic Acid Deficiency* ; Folic Acid* ; Polyneuropathies*

Atlato-axial instability is a serious condition that often requires operation. Atlanto-axial subluxation may cause severe symptoms; and threaten the intergrity of the spinal cord, leading to quadriplegia or sudden death. A techique of combining C1-C2 posterior screw fixation with a supplemental bone wire fusion has been advocated for the management of atlantoaxial instability. It was used in 9 patients with this disorder. Patients ages ranged from 20 years to 52 years; follow-up period ranged from 3 to 16 months with a mean of 9.8 months. All nine patients gained immediate rigid fixation of C1,2 with this technique. Of these 9 patients, instability occurred due to trauma in seven, os odotoideum in one and os odontoideum with trauma in another one. One patient was presented with nonunion and C1,2 instability after a Halovest applications a result of type II odontoid fracture. All 9 patients were placed in a philedelphia collar for 12weeks and all achieved solid fusion. Posterior atlantoaxial facet screw fixation provides immediate multidirectional rigid fixation of C1,2 and is mechanically superior to siring or clamp fixation. This technique maximizes success without the need for a supplemental rigid external orthosis.
Bone Wires ; Death, Sudden ; Follow-Up Studies ; Humans ; Orthotic Devices ; Quadriplegia ; Spinal Cord ; Spinal Fusion ; Transplants*