PURPOSE: This study conducted to identify the effect of learning organization construction and learning orientation on organizational effectiveness among hospital nurses. Method: Data was collected from convenient sample of 296 nurses who worked for the major hospitals in Seoul, Gyeonggi-do and Gangwoen-do. The self-reported questionnaire was used to assess the general characteristics, the level of the learning organization construction, learning orientation and organizational effectiveness. The data were analyzed using descriptive statistics, pearson's correlation coefficient and multiple regression. Result: The mean score of learning organization construction was 3.61(+/-.32), learning orientation got 3.26(+/-.39), and organizational effectiveness obtained 3.38(+/-.42). The learning organization construction affects of organizational effectiveness by 44.18% and learning orientation by 37.43%. CONCLUSION: This finding indicates that learning organization construction and learning orientation affects the nurses' organizational effectiveness in hospital.
Learning ; Orientation ; Surveys and Questionnaires

No abstract available.
Down Syndrome*

PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.
Coronary Angiography ; Coronary Artery Disease ; Dipyridamole* ; Follow-Up Studies ; Humans ; Perfusion ; Prognosis ; Proportional Hazards Models ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. METHODS: The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group I : patients receiving conservative management, group II : patients treated with pericardiocentesis, group III : patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. RESULTS: Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3(75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. CONCLUSION: In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be inquired as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.
Advanced Trauma Life Support Care ; Cardiac Tamponade ; Catheters ; Echocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Pericardial Effusion* ; Pericardiocentesis ; Thoracic Injuries ; Thoracotomy ; Thorax

BACKGROUND AND OBJECTIVES: Exophthalmos from Graves' disease can result in visual disturbance and cosmetic deformity. Surgical treatment of this disorder is possible through a transnasal endoscopic approach or transantral approach. We aimed to evaluate the efficacy of the transnasal endoscopic orbital decompression and transantral orbital decompression in the management of dysthyroid orbitopathy. MATERIALS AND METHODS: Transnasal endoscopic orbital decompression or transantral orbital decompression was performed on 25 orbits in 14 patients for treatment of progressive exophthalmos or visual loss. Transantral orbital decompression was performed on seven patients simultaneously. RESULTS: Proptosis was reduced an average of 2.8 mm (range 0.5 to 6 mm) by transnasal endoscopic decompression alone and of 3.5 mm (range 0.5 to 8 mm) by transnasal endoscopic decompression and transantral decompression. In five patients who complained of visual disturbance, visual acuity was improved in three of them, and stationary in two of them postoperatively. Four patients who had no diplopia preoperatively developed diplopia after the decompression. Among them the diplopia was only temporary in three patients and the remaining one was referred to an ophthalmologist for correction of persistent diplopia. CONCLUSION: Orbital decomprerssion can be performed successfully via the transantral and transnasal endoscopic approach without significant complications and external scar.
Cicatrix ; Congenital Abnormalities ; Decompression* ; Diplopia ; Exophthalmos ; Graves Disease ; Humans ; Orbit* ; Visual Acuity

PURPOSE: The authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients after surgery for colorectal cancer. METHODS: Three hundred fifty-two patients were enrolled prospectively. Nutritional risk screening 2002 (NRS 2002) score was calculated through interview with patient on admission. Clinical characteristics, tumor status and surgical procedure were recorded. RESULTS: The prevalence of patients at nutritional risk was 28.1 per cent according to the NRS 2002. The rate of postoperative complication was 27%. There was a significant difference in postoperative complication rates between patients at nutritional risk and those not at risk (37.4% vs. 22.9%, P = 0.006). Nutritional risk was identified as an independent predictor of postoperative complications (odds ratio, 3.05; P = 0.045). Nutritional risk increased the rate of anastomotic leakage (P = 0.027) and wound infection (P = 0.01). CONCLUSION: NRS may be a prognostic factor for postoperative complication after surgery for colorectal cancer. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces postoperative complication rates.
Anastomotic Leak ; Colorectal Neoplasms* ; Humans ; Malnutrition ; Mass Screening ; Postoperative Complications ; Prevalence ; Wound Infection

The healthy cities approach emphasizes the role of the leadership of local governments in promoting the health of the population in city settings. The concept emerged from public health strategies declared in the Ottawa Charter for Health Promotion, and reflects the characteristics of the third public health revolution. The Korean healthy cities movement, characterized by voluntary participation of local governments in the Alliance for Healthy Cities, has grown rapidly in recent years. A strong push of the healthy cities movement by a local government without a profound commitment to the vision may hinder the effective and sustainable development of the movement. By reviewing the historical background and significance of the healthy cities movement and its underlying concepts, and illustrating the main strategies and goals of the movement, that is, the development of partnerships, community participation and empowerment, and working in networks for stimulating change, this article argues that the healthy cities movement is a potent vehicle for implementing the new paradigm of public health introduced to local governments. We also argue that the Korean healthy cities movement needs more active participants and more support of the central government and other related stakeholders.
Consumer Participation ; Health Promotion ; Korea ; Local Government ; Natural Resources ; Power (Psychology) ; Public Health ; Vision, Ocular

PURPOSE: Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients. MATERIALS AND METHODS: The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed. RESULTS: We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients. CONCLUSION: Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.
Asian Continental Ancestry Group ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sample Size ; Survival Rate ; Venous Thromboembolism*

No abstract available.

STUDY DESIGN: A retrospective study. OBJECTIVES: To introduce an endoscopic anterior release and posterior total spondylectomy, and the evaluation of its clinical efficacy. SUMMARY OF LITERATURE REVIEW: A total spondylectomy was introduced for the treatment of primary and metastatic tumors of the spine, with many authors having reported favorable clinical results with its use. Endoscopic surgery has been used for various spinal disorders, including disc diseases or scoliosis, and has been widely used as it offers a minimally invasive technique, with a small surgical incision and very few complications. MATERIAL AND METHODS: Three primary spinal tumor cases were reviewed. The first case was a patient with a Ewing's sarcoma of the sacrum; the second was a giant cell tumor of the sacrum and the last was a giant cell tumor of the T10 vertebra. An endoscopic anterior release was initially performed, including the ligation and release of blood vessels, and soft tissue release, using laparoscopies for the 2 sacral tumors and a thoracoscopy for the thoracic tumor. The total spondylectomy were performed via a posterior approach. In two cases, the one with the Ewing's sarcoma of sacrum and the other with the giant cell tumor of the T10 vertebra, the reconstructions were performed using strut allografts and instrumentations. The average follow-up period was 19 months. RESULTS: Intraoperatively, the endoscopic anterior release made it possible to successful finish the anterior releases, with minimal incisions and blood losses. It also allowed a safer and faster posterior total spondylectomy, without significant complication. At the last follow-up, all patients had favorable clinical results, with no local recurrence in any case or fusions in the two cases that had to undergo reconstruction. CONCLUSION: Endoscopic anterior release and a posterior total spondylectomy was a favorable surgical procedure for primary tumors of spine. It made possible the safe and efficient finish the anterior release and posterior total excision of the affected vertebrae, using small incisions and with no complications.
Allografts ; Blood Vessels ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Laparoscopy ; Ligation ; Recurrence ; Retrospective Studies ; Sacrum ; Sarcoma, Ewing ; Scoliosis ; Spine* ; Thoracoscopy