PURPOSE: This study aims to examine the levels of the perception and work performance of patient safety based on the healthcare accreditation criteria among long-term care hospital nurses. METHODS: A cross-sectional study was performed using questionnaires. Out of 205 criteria, 39 items relevant to patient safety were selectively adapted for this study. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. RESULTS: The mean scores of perception and work performance were 4.36 and 4.24 out of 5, respectively, and the difference between them was significantly different (t=5.78, P<.001). The two variables were both significantly higher among those nurses who were older, married, head nurses, had many nursing experiences, and aware of Healthcare Accreditation than the other nurses. Positive correlations were observed between perception and work performance in all three sub-systems. The relations between these two in the patient care system was the most highly correlated (r=.894, P<.001). The lowest scores of perception and work performances were fire-related criteria (i.e., reporting). CONCLUSION: Overall, subject's perception proves to be higher than their work performance. It is necessary to develop some viable environment and training programs to enhance their work performance up to the level of their perception of patient safety.
Accreditation ; Cross-Sectional Studies ; Delivery of Health Care ; Education ; Humans ; Long-Term Care* ; Nursing ; Nursing, Supervisory ; Patient Care ; Patient Safety* ; Work Performance*

In 1868 Charcot described the joint in tabes dorsalis, which since then has been designated as Charcot neuroarthrophathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthrophthy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indifference of pain, leprosy, and intra articular use of steroid, etc. Authors present a case of Charcot spine due to tabes dorsalis.
Diabetes Mellitus ; Joints ; Leprosy ; Spine ; Syringomyelia ; Tabes Dorsalis

The authors has been reviewed the 123 cases, 119 patients of ankle fracture that were treated through the admission and outpatient Department of Orthopedic Surgery, Chungnam National University, from September, 1974 to January, 1982. The summary of the' results were follows: l. Among the 123 cases, male was 94 cases(76.4%), female was 29 cases, and the average age of the patients was 34.9 years. 2. The causes of the injury was traffic accidents, fall or slip downs and sports injuries in orders. 3. By the Lauge-Hansens classification, pronation-external rotation ty'pe and supination-adduction type were more common than the others. 4. Open reduction and internal fixation were more commonly used in its treatment than that of the closed method. 5. The better radiological assessment could be achieved by. obtaining the anatomical reduction and the reduction was more satisfactorily by the use of the key role of the lateral malleolus. 6. The overall results were more supported by the radiological results than the clinical results.
Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Chungcheongnam-do ; Classification ; Clinical Study ; Female ; Humans ; Male ; Methods ; Orthopedics ; Outpatients

Background: Due to the importance of the cold chain related to vaccine transportation, it is necessary to establish a blood cold chain operation strategy by checking the status of blood transportation from blood donation to transfusion. Methods: The blood transportation system and blood storage facilities were checked by inspecting the Korean Red Cross (KRC) Blood Centers and its affiliated supplier and Hanmaeum Blood Center. The status of the cold chain was evaluated through an interview with the quality control manager or blood supply team leader. For the hospital, the status was investigated from the perspective of the 30-min rule. A questionnaire survey was conducted for medical technicians and nurses working at the hospital. Results: Data on temperature during transport of blood components were computerized, and all standards were met. A nationwide network that could supply blood from the blood supply center to the hospitals within 2 hours was established. The frequency of temperature monitoring in the blood transport box and constant temperature check in the transport box during long-distance transport were evaluated. Conclusion This study confirmed that blood storage and transportation in Korea complied with the cold chain standards of high-income countries or higher. The evaluation of the cold chain is a constantly evolving process requiring continuous attention. When standards for storage and transportation of blood products are established, strict regulations and examinations will be required.

Convalescent plasma therapy has been used to achieve passive immunization against diverse infectious agents by administering pathogen-specific antibodies. Coronavirus disease 19 (COVID-19), which originated in Wuhan, China, has recently become a major concern all over the world. There are no specific treatment recommendations for COVID-19 because of the lack of knowledge and evidence about this virus. Convalescent plasma therapy can be used as an empirical and investigational treatment for COVID-19, and so we briefly describe the main issues related to convalescent plasma therapy from the perspective of transfusion medicine.

BACKGROUND: Blood supply circumstances in Korea have changed in recent decades because of blood supplier diversification and restructuring of hospital blood donation centers. The purpose of this study is to understand the current status of hospital blood donation centers and their satisfaction levels with the Korean Red Cross Blood Center (KRCBC) and compare with the previous results for sustainable development of the blood supply system. METHODS: During one month in November 2014, we conducted a questionnaire survey through e-mail in 64 hospital blood donation centers which are approved by government. The response rate was 97% (62/64 hospitals). Responses from 62 hospitals were analyzed. RESULTS: The number of hospital blood donation centers were reduced by half from 129 in 2004 to 64 in 2014. There was no blood donation center in hospitals less than 400 beds, except 2 hospitals; 23 hospital (37.1%) blood banks collected no blood components. More than 80% of hospitals were satisfied with the KRCBC service such as donor record lookup and nucleic acid amplification Test (NAT) results lookup. Hospitals with more than 1,000 beds replied that they would not take account of transferring the collection services to KRCBC because of the directed and autologous donation and unexpected emergency blood transfusion. CONCLUSION: The government should be the subject of national blood policy and establish a committee or agency for its comprehensive and consistent execution through close cooperation with the KRCBC and hospitals.
Blood Banks ; Blood Donors* ; Blood Transfusion ; Natural Resources ; Electronic Mail ; Emergencies ; Humans ; Korea ; Nucleic Acid Amplification Techniques ; Red Cross* ; Tissue Donors

Background and objective: With recent advances in technology and miniaturization of equipment, the trans-radial approach has currently been advocated as an alternative method for coronary angioplasty. We tried to evaluate the feasibility of trans-radial coronary intervention (TRCI). MATERIALS AND METHODS: 138 Allen-positive cases (159 lesions) underwent TRCI with currently available devices. Mean age was 60.8 + 9.2 years and 67% were men. Clinical diagnoses were AMI in 49, unstable angina in 48, stable angina in 28, OMI in 9 and 4 cases of restenotic lesions. RESULTS: Technical success was achieved in 124 cases (89.9%). Among the 124 successful cases, left and right radial arteries were used in 93 cases (110 lesions) and in 31 cases (35 lesions), respectively. The size of the guiding catheter used for TRCI was 6 Fr in 100 cases (80.7%), 7 Fr in 21 cases (16.9%), and 8 Fr in 3 cases (2.4%). Stent implantation and rotational atherectomy were successfully performed in 75 cases (86 lesions) and 10 cases (12 lesions), respectively. The reasons of failure were puncture failure in 2 cases, guiding failure in 6 cases, guide-wire crossing failure in 4 cases who had chronic total occlusion, and suboptimal results in 2 cases. Major cardiac complications occurred in 3 cases, one case of each cardiac death, nonfatal myocardial infarction and coronary artery perforation. No major entry site complications were seen with only non-ischemic radial artery occlusions in 3 cases (2.8%). CONCLUSION: TRCI is feasible with currently available devices and is safe with a relatively acceptable procedural success rate and low complications.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Atherectomy, Coronary ; Catheters ; Coronary Vessels ; Death ; Diagnosis ; Gangwon-do* ; Humans ; Male ; Miniaturization ; Myocardial Infarction ; Punctures ; Radial Artery ; Stents

BACKGROUND AND OBJECTIVES: Practical concerns about transradial approach are increasing in consideration of high procedural success rate, low local complications, and patient's convenience. There was no available data about repeated-use of radial artery for coronary procedures. We evaluate the changes of radial arterial diameter and procedural outcomes of repeated transradial procedure. MATERIALS AND METHOD: Of consecutive 1771 transradial coronary procedures, 117 patients received repeated transradial procedures through the same radial artery. Radial arterial diameter, vascular access time and procedural outcomes were evaluated in between the group of first-use and repeated-use of radial artery. RESULTS: Among 117 patients of second transradial coronary procedure in the repeated-use group, 47 patients (41.6%) underwent coronary intervention and 66 patients (58.4%) underwent coronary angiography. The right radial approach was used in 82.9% of the cases. There was no significant difference in radial artery mean diameter between pre-procedure and 1 day after procedure in patients with first-use and repeated-use group. There was no significant change of radial arterial diameter after first-use depending on the SAR (the ratio of sheath outer diameter to radial artery inner diameter). However, after repeated-use of radial artery, there was significant reduction of radial arterial diameter 1 day after procedure in the patients with SAR more than 0.9 (p<0.05). In repeated-use group, the mean radial arterial diameter was 2.63 +/- 0.35mm mm before the procedure and 2.51 +/- 0.29mm during follow-up (136 +/- 123 days) (p<0.05). There was no significant difference of the vascular access time between the first-use and repeated-use procedures (2.9+/-3.1 vs 3.3+/-3.6 minutes, p<0.05). The procedural success and vascular complication rate of repeated-use of radial artery were as similar to those of the first-use, but total occlusion of radial artery was higher in the repeated-use group (2.6% vs 0.7%, p<0.05). CONCLUSION: The diameter of radial artery after transradial procedures was significantly reduced during follow-up and the incidence of asymptomatic radial artery occlusion was more frequent after repeated-use. However, repeated-use of radial artery was feasible in most patients with high procedural success rate and low vascular complications.
Coronary Angiography ; Follow-Up Studies ; Humans ; Incidence ; Radial Artery*

BACKGROUND AND OBJECTIVES: Recent data about trans-radial approach showed its usefulness in achieving the high procedural success rate and low local complications even though the size of the radial artery is small compared to that of the femoral artery. Therefore, we want to evaluate the size of the radial artery and the feasibility of the trans-radial coronary angiography as a routine technique. MATERIALS AND METHOD: Trans-radial coronary angiography (TRCA) was successful in 619 cases. The size of the radial artery was measured using 2D-ultrasonography. TRCA was tried with 4 Fr catheters. We divided the cases into two groups; early phase, 106 cases and late phase, 513 cases and compared the procedure time, catheter number used, and complications between 2 groups. RESULTS: The size of the radial artery was 2.7+/-0.4 mm in diameter and this of the men was larger than that of women (p 0.05). TRCA was performed successfully in 513 cases among 521 cases of late phase (98.5%) and crossover to femoral artery occurred in 8 cases (1.5%). The fluoroscopic time and total procedure time of the late phase (6.5+/-4.0 min, 22.9+/-11.3 min) were significantly lower than those of early phase (11.5+/-6.3 min, 31.2+/-13.7 min) (p<0.01). The average number of catheters used for coronary angiography was 1.8+/-1.0. There were 6 cases (1%) of radial artery occlusion and 1 case (0.2%) of radial artery perforation without hand ischemia. CONCLUSION: Based on the adequate size of the radial artery, high success rate and low complications, TRCA might be a safe and become a routine diagnostic technique.
Catheters ; Coronary Angiography* ; Female ; Femoral Artery ; Gangwon-do* ; Hand ; Humans ; Ischemia ; Male ; Radial Artery

Aortoesophageal fistula secondary to thoracic aortic aneurysm is an uncommon cause of gastrointestinal bleeding and is uniformly fatal without surgical intervention. We report a case of aortoesophageal fistula in an 83-year-old male who presented with massive hematemesis after 4 days of NSAID use. Endoscopy showed a kissing esophageal ulcer with a pulsating mass lesion in the mid esophagus. HRCT showed a fusiform aortic aneurysm in the descending aorta that was affecting the mid esophagus.
Aged, 80 and over ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Endoscopy ; Esophageal Fistula ; Esophagus ; Fistula ; Hematemesis ; Hemorrhage ; Humans ; Male ; Ulcer