In general, soft tissue and bone tumors are diagnosed clinically by physical findings, laboratory data, and X-ray findings with only limited reliability, and a definite diagnosis must be supported by histopathological evidence. For this purpose, open biopsy routinely has been carried out, but there have been many disadvantages and sometimes followed by surgical complications. The present study was undertaken to compare the cytologic findings of soft tissue and bone lesions with the histological findings. The specimen were obtained by fine needle aspiration and Franklin-Silverman needle. For cytodiagnosis Stormby's cell block of aspirates were utilized. For histological diagnosis small tissue fragments obtained by the Franklin-Silvermans cutting needle were used. Then, the diagnostic accuracy of 3 different methods were compared, and the clinical applicability of those methods as adjunctive diagnostic procedures in the diagnosis of the soft tissue and bone tumors were assessed. The results obtained were as follows: l. In 15 out of the 20 cases (75%) in which clinically and roentgenologically the soft tissue and bone tumors were suspected, sufficient material was aspirated to enable detailed cytological diagnosis possible by fine needle aspiration. ln 13 out of the 15 cases, diagnosis could be made by cytologic findings, which was similar to histologic findings of tissue obtained by Franklin-Silverman needle. 2. In 6 out of the 20 cases, sufficient tissue fluid for cell block preparation were obtained from the tumor tissues. In 5 cases, cytologic findings of cell blocks were consistent with that ot the tissue obtained by Silverman needle. But in one case malignancy was susupected by cytodiagnostic method, and definite diagnosis could not be made. Finally the lesion was found to be malignant schwannoma through the histological study of tissue specimen obtained by Franklin-Silverman needle biopsy. 3. In 19 out of the 20 cases, diagnosis could be made by Franklin-Silverman needle biopsy. 4. Diagnostic accuracy of the lesions by clinical and roentgenological method was 75%, which overall diagnostic accuracy of 3 methods were 86.7% in aspiration cytology, 83.3% in cytodiagosis of cell block and 95% of histodiagnosis of tissue specimen obtained by Franklin-Silverman needle. Through this study it is found that cytodiagnostic method of aspirates and histodiagnosis of the small tissue specimen by Franklin-Silverman needle are very useful adjunctive methods in enhancing the diagnostic accuracy of the soft tissue and bone lesion prior to open biopsy trial.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cytodiagnosis ; Diagnosis ; Methods ; Needles ; Neurilemmoma

In this study, author tried to clarify the chronological and histological change of the growing spine after posterior cement fixation in dogs. The material used for the study consisted of 24 male mongrel dogs, aged 8 weeks. Lumbar spines, from 3rd to 5th were fixed posteriorly with bone cement (Zimmer Co. U.S.A.). After posterior spinai fixation with bone cement, there dogs at a time were sacrificed every 4 weeks up to 32 weeks, and histologic changes of intervertebral disc, growth plate and the vertebral bodies were observed after hematoxylin & eosin stainning with light microscope. The results obtained were as follows: 1. Thinning of the growth plate and distortion of the cartilage columns developed gradually after posterior cement fixation of the spine, but premature closure of the growth plate did not develop and the growth of the vertebral body continued till 32 weeks after operation. 2. Intervertebral disc thinned posteriorly and widened anteriorly without any changes in subchondral cortices, though there is some bony atrophy in the body which is represented by the thinning and coarseness of bony spicules. 3. At 16 weeks the cartilage layer of the vertebral end plate became thinner, and at 32 weeks there were profound degenerative changes in the cartilages. 4. After fixation of the spine, the nucleus pulposus gradually degraded and was replaced by fibrous tissues, and began to adhere to the vertebral end plate at 24 weeks and completely adhered to it at 32 weeks after fixation. 5. The direction of the horizontally arranged annulus fibrosus began to derange from 24 weeks after fixation, and at 32 weeks all the fibers of the annulus fibrosus were vertically arranged completely. Through this study it is found that posterior spinal fixation with bone cement affects growths of the vertebral growth plate, and end plate slightly, but there were no cessation of cartilaginous growth which might later cause the vertebral deformity. Also it is clarified that posterior fixation of e spine with cement develops noticeable degenerative changes in the intervertebrai disc and thereby develops the lordotic curve of the cemented segment of the spine.
Animals ; Atrophy ; Cartilage ; Congenital Abnormalities ; Dogs ; Eosine Yellowish-(YS) ; Growth Plate ; Hematoxylin ; Humans ; Intervertebral Disc ; Male ; Spine

The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

PURPOSE: This study aimed to identify variables influencing the health-related quality of life (HRQoL) of adults with epilepsy in order to establish a structural model and design an intervention strategy to improve patients' HRQoL. METHODS: The selected subjects were 212 patients with epilepsy aged between 18 and 70 years who were currently receiving treatment from hospital, general hospital, and clinic. They were surveyed using a structured questionnaire. RESULTS: The goodness of fit measures of the final hypothetical model were as follows: χ2/df=2.51, GFI=.91, AGFI=.90, CFI=.96, SRMR=.04, NFI=.93, and RMSEA=.08. The major variables influencing the HRQoL of adults with epilepsy were epilepsy self-efficacy, depression, social support, and side effects of anti-epileptic drugs (AEDs), which were significant in the mentioned order, whereas the duration of AEDs use and perceived stigma did not show any effects. Six variables accounted for 75.6% of HRQoL. Variables having a direct and total effect on the HRQoL of adults with epilepsy were the side effects of AEDs, social support, epilepsy self-efficacy, and depression, and those with an indirect effect were the side effects of AEDs and social support. CONCLUSION: It is necessary to accurately identify the side effects of AEDs in adults with epilepsy and accurately observe the physical changes caused by depression. In addition, it is imperative to establish an active and effective nursing intervention program to strengthen the self-efficacy of the patients and to improve their quality of life through social support provided by family members and medical professionals.
Adult* ; Depression ; Epilepsy* ; Hospitals, General ; Humans ; Models, Structural ; Nursing ; Quality of Life*

PURPOSE: The purpose of this study was to analyze factors affecting burnout among clinical nurses according to Positive Psychological Capital. METHODS: The study design was a descriptive survey and questionnaires were collected from 412 clinical nurses who worked in a general hospital in "J" city. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffe test, Pearson Correlation, and hierarchical multiple regression. RESULTS: In Model individual characteristics accounted for 27.8% of the influence on burnout. In model II with the addition of the 4 factors; Self-efficacy, Hope, Resilience, Optimism, individual characteristics accounted for 48.5% of the influence on burnout. Optimism and Resilience of the Positive Psychological Capital sub-variables were statistically useful as factors influencing burnout. CONCLUSION: The results indicate that it is necessary to develop active human resource management and educational programs to decrease burnout and strengthen the Positive Psychological Capital of the nurses.
Hospitals, General ; Humans ; Surveys and Questionnaires

Tuberculosis of the puboischium is an uncommon entity. The two constant features in tubereulosis of the pubis are limping and abscess formation. This disesse should be differentiated from other diseases such as osteitis pubis, suppurative osteomyelitis, postpartum synphysiolysis, and adolescent osteochondritis. Kirker advocated that wide excision of the lesion for the treatment of this disease is the best method. However, Nicholson(1953) reported that the lesion has a good prognosis snd responds well to simple curettage. Since the first reports by Thilesen(1855) and by Heinnies(1888), there were paucity of reports. Also in Korea, there have been no report about this disease. The five patients who were treated at the Ksng-Nsm St. Marys Hospitsl between 1982 and 1987 were reported. The results were as follows ; 1. Four patients were boys and one was a female. 2. All cases had clinically abscess, tenderness at the lesion, and limp. 3. Lesions in four cases responded well to simple curettage and18 months of chemotherapy. However, in one case fusion of the symphysis using a plate was performed because of tuberculosis-induced instability of the sacroiliac joint. 4. In a child, destroyed symphysis pubis was well restituted after treatment. Through the cases it is concluded that simple curettage and anti-tuberculous chemotherapy are good treatment modality for tuberculosis of the puboischium.
Abscess ; Adolescent ; Child ; Curettage ; Drug Therapy ; Female ; Humans ; Korea ; Methods ; Osteitis ; Osteochondritis ; Osteomyelitis ; Postpartum Period ; Prognosis ; Pubic Bone ; Sacroiliac Joint ; Tuberculosis

Fractures of the hip in children are rare. The reported incidence is low. It is known that the force required to fracture the bone in childhood is of great magnitude. Rang(1983) reported several important differences between childhood and adult fractures. And Morrissy (1980) also reported differences in treatment. The complications of the femoral neck fractures in children are avascular necorsis, premature epiphyseal closure, nonunion, coxa vara, and infection. The reported incidence of avascular necrosis varies from 20 to 60 percent. Many methods of trestment for this complications are introduced up to now. However, a definite method could not be found. Therefore, we reported two cases of femoral neck fracture which complicated the avascular necrosis for whom non-weight bearing trestment after osteosynthesis were given for 16 and 25 months, respectively. In these two cases, we could obtain the following results. Fracture union was not hindered by avasculsr necrosis of the femoral head. Non-weight bearing could prevent the collapse of necrotic head, and seemed to help revascularization of the necrotic head.
Adult ; Child ; Coxa Vara ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Methods ; Necrosis ; Prognosis

The etiology of congenital dislocation of the hip is still the subject of much discussion. Genetic growth disturbance, intrauterine and postnatal mechanical influences are considered as possible factors. According to Hass, typical congenital dislocation of the hip is not primarily a congenital disease. The occurance rate of C.D.H in sister or brother has been reported higher than others. But there have been no report about this cases. Two cases of C.D.H. in sister have been treated at Kang-Nam St. Mary's Hospital. Both of them were treated by traction and closed reduction under arthrography. Pavlik harness was applied in younger case after removel of hip spica cast. Clinically and radiologically the results were good during the follow-up period.
Arthrography ; Dislocations ; Follow-Up Studies ; Hip Dislocation ; Hip ; Humans ; Siblings ; Traction

PURPOSE: The purpose of this research was to develop and test the validity and reliability of the Service Orientation Scale for Health Care Organization. METHODS: The Service Orientation Scale for Health Care Organization, SERV*OR, was developed through forward-backward translation methods. Internal consistency and reliability, construct and criterion validity were calculated using SPSS Statistics WIN 17.0. Survey data were collected from 283 clinical nurses in a general hospital in J province. RESULTS: The Service Orientation Scale for Health Care Organization showed reliable internal consistency with Cronbach's alpha's for the total scale ranging from .85~.91. Factor loading of the 30 items on four sub-scales ranged from .67~.83. The sub scales were named service leadership, service system, customer focus, and service control. Item convergent and discriminant validity were also established for the Service Orientation Scale for Health Care Organization. Criterion validity showed a significant correlation with customer orientation. CONCLUSION: The findings of the study demonstrate that the Service Orientation Scale for Health Care Organization has satisfactory construct and criterion validity, and reliability and can be used to measure service orientation.
Delivery of Health Care* ; Hospitals, General ; Leadership ; Reproducibility of Results* ; Weights and Measures

PURPOSE: This study was done to identify the effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit (ICU) nurses. METHODS: A cross-sectional survey was used and data were collected from 203 ICU nurses working in two advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and Hierarchical multiple regression with SPSSWIN 23.0 program. RESULTS: The sub-domains of nursephysician collaboration were as follows: 3.77±0.51 for sharing of patient information, 3.36±0.65 for decision-making process on the cure or care, and 3.20±0.72 for relationship between nurse and physician. Nurse-physician collaboration was significantly positively correlated with nursing performance and organizational commitment. Regression analysis showed that nurse-physician collaboration explained an additional 24.9%p of nursing performance and an additional 13.4%p of organizational commitment. 'Sharing of patient information' and 'Relationship between nurse and physician' were significant predictors of nursing performance. 'Relationship between nurse and physician' was a significant predictor of organizational commitment. CONCLUSION: These results provide evidence that the collaboration between nurses and physicians should be enhanced in terms of sharing patient information and mutual respect, to improve nursing performance and organizational commitment of ICU nurses.
Cooperative Behavior ; Critical Care ; Cross-Sectional Studies ; Hospitals, General ; Humans ; Intensive Care Units ; Nursing ; Work Performance