No abstract available.
Child* ; Colon* ; Constipation* ; Enema* ; Fecal Incontinence* ; Humans

Many unsolved probIems still remain in these in management of trochanteric fracture of hip, especially unstable type of trochanteric fracture. Among many cases of the trochanteric fracture treated during period from Jan. 1963 to July, 1973 at Busan National University Hospital, six patient has severe sequelae such as coxa vara deformity, shortening of the affected limb and ankylosis of the hip joint, which were analyzed clinically and results obtained were as follow. 1. It is the most important factor that the medial and the posterior cortex is good alignment in reduction with internal fixation and maintainance of unstable trochanteric fracture. 2. It is dangerous for the unstable type of trochanteric fracture to be reducted and maintained with only screws or plates. Jewett nail is more effective than the S-P nail and Thornton plate in internal fixation of unstable type of trochanteric franture. 3. The posterior fragments can hardly be found in A-P view but easily in lateral view 4. In cases that had not good alignments between posterior fragments the distaI fragment displaced medially and migration of the naiI, distraction of the pIate, malunion have developed in spite of prolonged immobilization in cast. 5. In one case that the severe coxa vara deformity have been developed. we performed the transverse osteotomy & fixed with Blount-V-blade plate like device. The result was good but the shortening of the limb could not prevent.
Ankylosis ; Busan ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Hip Joint ; Hip ; Humans ; Immobilization ; Osteotomy

OBJECTIVES: With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. METHODS: 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. RESULTS: In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. CONCLUSIONS: This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Health Behavior ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Sleep Initiation and Maintenance Disorders ; Survivors

OBJECTIVES: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. METHODS: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. RESULTS: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. CONCLUSIONS: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.
*Hospital Mortality ; Hospitals/*statistics & numerical data ; Humans ; Logistic Models ; Outcome Assessment (Health Care)/standards ; Quality of Health Care/standards ; Republic of Korea

PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

PURPOSE: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. METHODS: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. RESULTS: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. CONCLUSION: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.
Delivery of Health Care ; Home Nursing ; Insurance, Long-Term Care ; Long-Term Care ; National Health Programs ; Nursing Care

No abstract available.
Antigens, Surface* ; Leukemia*

PURPOSE: This study was conducted to develop a Web-based learning program on cardiopulmonary emergency care for clinical nurses and to evaluate learners' responses. METHODS: Based on the assessment of learning needs of clinical nurses, a total of three self-directed learning modules were developed according to the procedure of the ADDIE (assessment, design, development, implementation, & evaluation) model. RESULTS: Each learning module included the emergency treatments and drugs used in the real patients' situations with cardiopulmonary crisis, which had been adopted from the emergency department of a C University hospital located in G-city. Real video clips for endotracheal intubation and ACLS (advanced cardiac life support) were developed with the help of the staff of the department of emergency medicine using a human simulator, SimMan(R). The program published on the Web was evaluated by 20 clinical nurses who are working in the emergency department and wards of a C-University hospital. About 80% of the respondents were satisfied with the program contents, design, and learning strategy. CONCLUSION: Web-based learning programs on cardiopulmonary emergency care are needed for clinical nurses as educational material for staff education to increase their knowledge for making immediate clinical decisions and in giving skilled care in emergency situations.
Advanced Cardiac Life Support ; Computer-Assisted Instruction ; Surveys and Questionnaires ; Education, Nursing ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Emergency Treatment ; Humans ; Intubation, Intratracheal ; Learning

Purpose : Shortness is the most frequent and quite disturbing characteristics of patients with Turner syndrome. The aim of this study was to evaluate the factors affecting final adult height(FAH) in these patients. METHODS : The study group was comprised of 19 patients who were diagnosed as Turner syndrome and attained FAH. We analyzed the influences of various factors on FAH in GH treated group with those in GH untreated group. Results : Nineteen patients were enrolled; thirteen received GH treatment and six did not. The mean duration of GH treatment was 24.3 months(range : 9 to 50 months), and the mean dosage of GH was 0.98+/-0.35IU/kg/wk in GH treated group. The mean growth velocity during GH treatment was 5.6+/-1.8 cm/yr, which was significantly higher than that during pretreatment period(P<0.05). In GH treated group, the mean chronological age, bone age, mean height, and height SD score at GH therapy were 13.7+/-1.7yr, 11.3+/-1.9yr, 129.7+/-7.9cm, and -4.1+/-1.1, respectively, which were not statistically different from those at diagnosis of GH untreated group. In GH treated group, the mean FAH and FAH SD score were 144.8+/-5.0cm, and -3.2+/-0.9, respectively, which showed no significant difference compared with those of GH untreated group. Analyzing the factor affecting FAH in all Turner girls of both groups together, parental height, chronological age, bone age, and bone age delay at diagnosis(or at the initiation of GH therapy) were not related to FAH. Height and height SD score at diagnosis(or at the initiation of therapy) were positively related to FAH(P<0.05, r=0.72). CONCLUSION : The results suggest that GH treatment dose not improve FAH in patients with Turner syndrome, despite increased growth velocity during GH treatment, which might come from intermittern GH therapy. This should be remained to be clarified with more Turner patients who attained FAH.
Adult* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Parents ; Turner Syndrome*

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Liver Diseases* ; Liver* ; Prevalence*