No abstract available.
Arthroplasty, Replacement, Hip*

PURPOSE: This is a descriptive study that provides basic material to improve occupational health nurses' work conditions and industrial performance status. METHODS: The 955 nurses who participated in the training program to understand the purpose of this study from January 2009 to December 2010 conducted by the Korean Association of Occupational Health Nurses agreed to be subjects for the study. The questionnaire included the general characteristics, work conditions and performance of occupational health management. The data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis. RESULTS: Occupational health management performance of the subjects averaged 3.11 points and detailed area by health management 3.64 points, environment management 2.91 points and occupational management 2.77 points. Health management performance of those factors affecting the duration of occupational health nurse (beta=.199), type of industry (beta=.126), average annual income (beta=-.277) to 11.4% (F=3.175, p<.001) were found to be a significant determinant. CONCLUSION: Occupational health nurses are the core workforce of occupational health through the prevention of occupational disease and industrial accidents. Findings of this study can be an important resource to increase appropriate occupational health nurses' work conditions and performance of occupational health management.
Accidents, Occupational ; Occupational Diseases ; Occupational Health ; Surveys and Questionnaires

BACKGROUND: To evaluate the clinical outcome of revision of primary shoulder replacement by using reverse total shoulder arthroplasty (RTSA). METHODS: Seven patients underwent revision RTSA with a mean follow-up of 22.1 months (range, 12 to 54 months). Their mean age at the time of operation was 75.5 years (range, 70 to 80 years). Assessments were performed on the preoperative and postoperative visual analogue scale (VAS) score, muscle strength, range of motion, University of California at Los Angeles (UCLA) score, Constant score, subjective satisfaction and the anteroposterior and axillary views of the glenohumeral joint. The primary operation was hemiarthroplasty in 5 patients, total shoulder replacement in 1 patient, and reverse shoulder arthroplasty in 1 patient. The cause of revision surgery was infection in 2 patients, humeral stem loosening in 2 patients, glenoid arthropathy in 2 patients, and glenoid loosening in 1 patient. The mean duration from primary operation to revision surgery was 52 months (range, 27 to 120 months). RESULTS: The VAS score for pain during motion was improved from 7.3 preoperatively to 2.1 postoperatively (p = 0.03). There were increases in the mean active forward flexion (from 62.1° to 92.8°), abduction (from 70° to 87.1°), external rotation (from 44.2° to 47.4°), and internal rotation (from L5 to L4; p > 0.05) postoperatively. Performance in activities of daily living improved (p > 0.05), except for lifting 10 lb above the shoulder (from 1.2 to 1.1; p = 0.434). Overall, 5 of 7 patients were satisfied with the results of revision surgery. The mean Constant score improved from 44.8 preoperatively to 57.1 postoperatively (p = 0.018). The mean UCLA score improved from 12.8 preoperatively to 22.8 postoperatively (p = 0.027). In the postoperative radiological evaluation, no radiolucency was observed around the base plate or humeral stem. CONCLUSIONS: Pain could be reduced after revision RTSA, but improvements in range of motion and function were difficult to achieve. We think that the patients' satisfaction was relatively high despite the low function score due to the preoperative severe pain and marked limitation of range of motion.
Activities of Daily Living ; Arthroplasty* ; California ; Follow-Up Studies ; Hemiarthroplasty ; Humans ; Lifting ; Muscle Strength ; Range of Motion, Articular ; Shoulder Joint ; Shoulder*

PURPOSE: This study evaluated the clinical and radiological outcomes of semiconstrained total elbow arthroplasty. MATERIALS AND METHODS: Thirty-nine elbows with semiconstrained total elbow arthroplasty and who were followed up for at least 3 years were enrolled in this study. There were 29 and 10 cases in the non-traumatic arthritis and traumatic arthritis groups, respectively. The mean age at the time of surgery was 53.9 years, and the mean follow-up period was 54 months. RESULTS: At the last follow-up, the pain score during motion decreased from 7.37 to 1.23. The Mayo elbow performance score was 86. The mean loss of terminal extension improved from 32degrees to 11degrees and the mean maximum flexion improved from 90.3degrees to 125.2degrees. Radiology analysis, 15 elbows showed radiolucency and 8 elbows showed loosening. There were 13 cases of radiolucency and 7 cases of loosening in the non-traumatic arthritis group. In the traumatic arthritis group, there were 2 cases of radiolucency and 1 case of loosening. CONCLUSION: Semiconstrained total elbow arthroplasty for non-traumatic and traumatic arthritis of the elbow produced satisfactory functional results. The non-traumatic arthritis group had a higher incidence of radiolucency and loosening than the traumatic group.
Arthritis* ; Arthroplasty* ; Elbow* ; Follow-Up Studies ; Incidence

OBJECTIVE: The goal of this study is to investigate the effect of subacromial bursa injection of hyaluronate in patients with adhesive capsulitis of shoulder. METHOD: Fifty nine patients with adhesive capsulitis of shoulder were injected with hyaluronate (Hyruan , LG chemical) 2.5 ml to subacromial bursa once a week for 5 weeks and randomly selected twenty eight patients among them were injected with Depomedrol 20 mg only at first week. The effect of hyaluronate injection was evaluated by pain (Visaul analogue scale), night pain, range of motion of shoulder, functional activities of daily living and patient's self satisfaction at preinjection, every week after first injection until 5th week, 8th and 12th week. RESULTS: Visual analogue scale and night pain were significantly decreased at 5th and 12th week compared with preinjection status. The range of motion of shoulder and functional activities of daily living significantly improved at 5th week and 12th week. Eighty eight percent (N=52) of patients reported as a little improved, improved or much improved at 5th week. No significant serious side effect of injection was found until 12th week. CONCLUSION: Hyaluronate injection into subacromial bursa decreased pain and improved shoulder range of motion. It also improved functional activities of daily living of patients with adhesive capsulitis. So it is effective and safe for those patients, especially who cannot receive corticosteroid intra articular injection.
Activities of Daily Living ; Adhesives* ; Bursitis* ; Humans ; Prospective Studies* ; Range of Motion, Articular ; Shoulder Joint* ; Shoulder*

Background: The aim of this study was to assess whether the anteroposterior coverage of the acromion reflecting acromial morphology affects the rotator cuff tear (RCT) and tear size, in addition to the lateral coverage. Methods: Medical records of 356 patients with RCTs, concentric osteoarthritis, and calcific tendinitis identified using threedimensional computed tomography between January 2016 and December 2017 were retrospectively analyzed. The patients were divided into group A (those with RCTs) and group B (those with concentric osteoarthritis or calcific tendinitis). Subsequently, group A was subdivided into three categories according to the size of RCTs: small-to-medium, large, and massive. The lateral coverage was measured through the lateral acromial angle (LAA) and critical shoulder angle (CSA), whereas the anteroposterior coverage was measured via the acromial tilt (AT), acromiohumeral interval (AHI) in the sagittal view, and anteroposterior coverage index (APCI) as a new radiologic parameter. Results: Between groups A and B, CSA (34.5° ± 3.4° and 30.8° ± 3.4°, respectively), APCI (0.83 ± 0.10 and 0.75 ± 0.08, respectively), and AHI (6.3 ± 2.0 mm and 7.8 ± 1.8 mm, respectively) were significantly different (all p < 0.001), whereas LAA and AT did not show a significant difference between the groups (p = 0.089 and p = 0.665, respectively). The independent predictive radiologic parameters of the RCT were the CSA, APCI, and AHI (p < 0.001, p < 0.001, and p = 0.043, respectively); among these, the APCI showed the highest regression coefficient (odds ratio = 2.82). The parameters associated with the size of RCTs were CSA (p = 0.022) and AHI, of which AHI, in particular, had the most significant effect on both small-to-medium and large tears (all p < 0.001). Conclusions Large CSA, high APCI, and low AHI were predictors of RCTs, with the APCI showing the strongest correlation. In addition to the large CSA, low AHI also correlated with the size of RCTs and affected the entire size groups. We suggest that both the lateral coverage and anteroposterior coverage of the acromion should be considered essential factors for predicting the presence of RCTs and tear size.

BACKGROUND: Isolated heterotopic gastric mucosa of the upper esophagus(HGME), often referred to as inlet patch, is an asyptomatic benign lesion. It may, however, cause retrosternal chest pain and dysphagea, and rarely produce complications such as ulceration and stricture. It may be suspected on characteristic finding of endoscopy, and the diagnosis is usually proved by biposy. We studied several characteristics of HGME. METHOD: From January 1996 to May 1997, endoscopy was performed on 2000 consecutive patients (1068 male, 932 female). HGME was seen 25 patients(12 male, 13 female) among 2000 patients. RESULT: Prevalence of HGME is 1.25%. There was no significant difference of the prevalence of HGME between male and female. HGME was presented as a velvety and salmon-pink patch with a distict border from the normally pale squamous cell mucosa of the esophagus, and was seen as multiple lesions in 8 patients among 25 patients. Thirty three locailzed gastric mucosal patches, varying in size 3 mm to 30 mm in the longest diameter, were detected within or just below of upper esophageal spincter in all the twenty five patients. Biopsy specimens taken from the miucosal patches demonstrated gastric mucosa. Among 25 patients with HGME, four patients complained foreign body sensation on throat or heartburn, without other diseases such as GERD, gastritis or peptic ulcer. CONCLUSION: Further studies of a large scale about pathogenesis, prevalence, and complication of HGME will be required.
Bays ; Biopsy ; Chest Pain ; Constriction, Pathologic ; Diagnosis ; Endoscopy ; Esophagus* ; Female ; Foreign Bodies ; Gastric Mucosa* ; Gastritis ; Gastroesophageal Reflux ; Heartburn ; Humans ; Male ; Mucous Membrane ; Peptic Ulcer ; Pharynx ; Prevalence ; Sensation ; Ulcer

PURPOSE: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. METHODS: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). RESULTS: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. CONCLUSION: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.
Accreditation* ; Community Health Nursing* ; Education* ; Education, Nursing* ; Electronic Mail ; Humans ; Nursing* ; Public Health ; Public Health Practice ; Students, Nursing

STUDY DESIGN: A retrospective analysis of the fatal case who had toxic shock syndrome after spinal fusion. OBJECTIVES: To call orthopaedic surgeon's attention to that toxic shock syndrome may be present despite the absence of clinically apparent infection after orthopaedic surgery. SUMMARY OF LITERATURE REVIEW: Toxic shock syndrome is an acute febrile illness with severe multisystem derangement and the rate of fatality is 10 to 15 percents. It develops most commonly in young women, and is usually associated with menstruating women who use tampons. Orthopaedic procedures have not been considered as risk factor of toxic shock syndrome, and there have been few reports of toxic shock syndrome associated with bone manipulation and implants. MATERIALS AND METHODS: A twenty-seven-year-old woman who was admitted for T12 bursting fracture, right hemothorax, and left distal radius fracture from traffic accident. After resolving of hemothorax, she recieved spinal fusion with pedicle screw instrumentation on three weeks after trauma. At perioperative period, she was in menstrual period and used the tampons. In the evening of the eighth postoperative day, the patient had a temperature elevated up to 39.3degree C, accompanied with malaise, chills, nausea, vomiting, and dehydration. Laboratory evaluation revealed pyuria on urinalysis, but the others were unremakable. The surgical wound had an entirely benign appearance without erythema, fluctuation, and drainage. RESULTS: The patient continued to do poorly, and then she died at ten days after the surgery. CONCLUSIONS: We report a fatal case with toxic shock syndrome after spinal surgery, and also serve to remind orthopaedic surgeons that toxin-producing organisms may be present despite the absence of surgical wound infection.
Accidents, Traffic ; Chills ; Dehydration ; Drainage ; Erythema ; Female ; Hemothorax ; Humans ; Nausea ; Perioperative Period ; Pyuria ; Radius Fractures ; Retrospective Studies ; Risk Factors ; Shock, Septic* ; Spinal Fusion* ; Surgical Wound Infection ; Urinalysis ; Vomiting ; Wounds and Injuries

BACKGROUND: The currently available reverse shoulder arthroplasty (RSA) designs can be classified into medial glenoid/medial humerus (MGMH), lateral glenoid/medial humerus (LGMH), and medial glenoid/lateral humerus (MGLH) prosthesis designs. The purpose of this study was to radiologically analyze the effect of different RSA designs on humeral position following RSA. METHODS: A total of 50 patients who underwent primary RSA were retrospectively analyzed. Among 50 patients, 33 patients (group A: MGMH) underwent RSA with Aequalis system (Wright, Inc, Bloomington, MN, USA), 6 (group B: LGMH) with Aequalis system using bony increased offset, and 11 (group C: MGLH) with Aequalis Ascend Flex system. The acromiohumeral distance, acromioepiphyseal distance (AED), lateral humeral offset (LHO), LHO from the center of rotation (LHO(COR)), and deltoid length were radiologically measured to quantify the distalization and lateralization of the humerus. RESULTS: The increment in postoperative AED was 19.92 ± 3.93 mm in group A, 24.52 ± 5.25 mm in group B, and 25.97 ± 5.29 mm in group C, respectively (p=0.001). The increment in postoperative LHO was 0.13 ± 6.30 mm, 8.00 ± 12.14 mm, and 7.42 ± 6.88 mm, respectively (p=0.005). The increment in postoperative LHOCOR was 20.76 ± 6.06 mm, 22.04 ± 5.15 mm, and 28.11 ± 4.14 mm, respectively (p=0.002). CONCLUSIONS: The radiologic analysis of the effect of different RSA designs on humeral position following RSA showed significant differences in the increment in postoperative AED, LHO, and LHO(COR) between the 3 groups. Therefore, MGLH design seems to be more effective for humeral distalization and lateralization compared to original Grammont design.
Arthroplasty ; Humans ; Humerus ; Prosthesis Design ; Retrospective Studies ; Shoulder