Long segmental fixation with TSRH posterior instrumentation for 19 patients who had unstable thoracolumbar fracture was performed between October 1992 and April 1995. The patients were followed for an average of 22 months. Measurements of the deformity angle, kyphosis, vertebral height, and the intervertebral angle were made. The patients were divided into 2 groups according to configurations of instruments for lower segmental fixation. For one group, only hooks were used, and for the others group pedicular screws and lateral offset hooks were used together at the same segment. Therefore, the purpose of this study is to anlyze the correctability following long segmental fixation and to compare one segmental fixation using both screws and lateral offset hook systems with two segmental fixation using hook systems for distal fixation. There was an overall correction of kyphosis at follow-up of 6.9degrees (27.1%) after a loss of 4.3degrees from operative correction. Overall correction of deformity angle was 8.2degrees (32.2%). Loss of vertebral height at final follow-up was 4.4%. And loss of intervertebral angle was 2.0degrees at follow-up. There was no difference of overall results between the hook group and the pedicular screw with lateral offset hook group. However, there was a significant improvement of the correction of kyphosis and restoration of vertebral height in patients who underwent operation within 7 days after injury, as compared to delayed operation. Therefore, the timing of surgery is the most important factor in order to correct the deformity caused by unstable thoracolumbar fractures. There was no significant loss of correction and no metallic failure. Therefore, rodding long with the method of one segment distal fixation using screws and lateral offset hook together can provide excellent correctability, maintenance of correction, preservation of distal lumbar joints, prevention of implant failure and complication.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Kyphosis

No abstract available.
Purpura*

No abstract available.
Hyperbilirubinemia, Neonatal*

In order to evaluate the possible roles of secretory proteases in the pathogenesis of amoebic keratitis, we purified and characterized a serine protease secreted by Acanthamoeba lugdunensis KA/E2, isolated from a Korean keratitis patient. The ammonium sulfate-precipitated culture supernatant of the isolate was purified by sequential chromatography on CM-Sepharose, Sephacryl S-200, and mono Q-anion exchange column. The purified 33 kDa protease had a pH optimum of 8.5 and a temperature optimum of 55 degrees C. Phenylmethylsulfonylfluoride and 4- (2- Aminoethyl) -benzenesulfonyl-fluoride, both serine protease specific inhibitors, inhibited almost completely the activity of the 33 kDa protease whereas other classes of inhibitors did not affect its activity. The 33 kDa enzyme degraded various extracellular matrix proteins and serum proteins. Our results strongly suggest that the 33 kDa serine protease secreted from this keratopathogenic Acanthamoeba play important roles in the pathogenesis of amoebic keratitis, such as in corneal tissue invasion, immune evasion and nutrient uptake.
Acanthamoeba/*enzymology/isolation & purification/pathogenicity ; Acanthamoeba Keratitis/*parasitology ; Animals ; Cornea/parasitology ; Humans ; Hydrogen-Ion Concentration ; Korea ; Serine Endopeptidases/chemistry/*isolation & purification/*metabolism ; Substrate Specificity ; Temperature ; Virulence Factors

Congenital vertical talus is dufficult to correct and tends to recur. Reduction of the deformed talon-avicular joint is rarely possible by conservative means alone and consequently surgical reduction is usually necessary. The technique of Kumar, Cowell and Ramsey(TAL, capsular release, open reduction of navicular, and K-wire fixation) was combined with or without tendon transfer using Tibialis anterior(Grice operation) in 11 feet of seven children(bilateral in four) under the age of four(2 girls and 5 boys), and followed them for average 41 months. Three of them were combined with cerebral palsy, syringomyelia, and multiple joint stiffness with camptodactyly. In preoperative radiograms, all of their tali are so distorted plantarward and medially as to be almost vertical. The talus was in an equinus position also but to a lesser degrees. The forefoot was dorsiflexed at the midtarsal joint and the navicular lay on the dorsal aspect of the talar head. Seven feet are corrected normally after operation, but four feet were recurred and soft tissue releasing techniques combined with extraarticular subtalar arthrodesis or triple arthrodesis were planned after their skeletal maturity.
Arthrodesis ; Cerebral Palsy ; Female ; Foot ; Head ; Humans ; Joint Capsule Release ; Joints ; Syringomyelia ; Talus ; Tendon Transfer

PURPOSE: This study has been carried out in order to develop and verify the effects of self-leadership reinforcement program for hospital nurses. METHODS: The research design was a non-equivalent control group pre-posttest design. Participants were 64 individuals (32 in each group), all of whom were nurses working at a university hospital, with less than five years of job experience. Experimental group was provided with two hours of self-leadership reinforcement program, once per week, for four weeks. The questionnaire for pre and post test included general characteristics, transfer motivation for learning, self-leadership, communication ability, clinical nursing competency, organizational commitment, and turnover intentions. RESULTS: There was a significant difference in self-leadership scores between experimental group and control group (F=15.10, p < .001). There was also a significant difference between the experimental group and the control group in terms of transfer motivation for learning (t=−5.44 p < .001), communication ability (F=15.29, p < .001), clinical nursing competency (F=15.23, p < .001), and organizational commitment scores (F=7.21, p=.009). CONCLUSION: The self-leadership reinforcement program developed in this study was effective in improving self-leadership, communication ability, clinical nursing competency, and organizational commitment. Thus, by implementing the program at clinical levels, it will be a basis for nursing personnel resource administration.
Communication ; Intention ; Learning ; Motivation ; Nursing ; Research Design

PURPOSE: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. METHODS: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. RESULTS: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. CONCLUSION: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.
Adult ; Assertiveness ; Cerebral Infarction ; Health Promotion ; Humans ; Myocardial Infarction ; Smoke* ; Tobacco Smoke Pollution ; Vascular Diseases*

Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole

Purpose: This study aimed to assess dementia awareness and educational needs among elderly care facility workers and to explore their experiences in caring for older adults with dementia through a mixed-methods approach. Methods: From May 1 to 31, 2023, 311 workers from dementia-related institutions in S City participated in a survey. Following the quantitative phase, 10 individuals participated in focus group interviews to further explore their experiences and needs. Quantitative data were analyzed using SPSS/WIN 25.0, and thematic analysis was applied to qualitative data. Results: The average dementia awareness score was 0.83±0.13 (out of 12), with the highest correct response rate (93%) in the "prevention and t reatment" category. The most requested education topics included managing "agitation and aggression" and improving "communication" skills. Qualitative analysis revealed two main themes with five subthemes, capturing staff experiences in dementia care and their perceived educational needs. Conclusion The findings highlight a strong demand for practical, structured training programs tailored to address behavioral management and communication challenges faced by facility staff.

Purpose: This study aimed to assess dementia awareness and educational needs among elderly care facility workers and to explore their experiences in caring for older adults with dementia through a mixed-methods approach. Methods: From May 1 to 31, 2023, 311 workers from dementia-related institutions in S City participated in a survey. Following the quantitative phase, 10 individuals participated in focus group interviews to further explore their experiences and needs. Quantitative data were analyzed using SPSS/WIN 25.0, and thematic analysis was applied to qualitative data. Results: The average dementia awareness score was 0.83±0.13 (out of 12), with the highest correct response rate (93%) in the "prevention and t reatment" category. The most requested education topics included managing "agitation and aggression" and improving "communication" skills. Qualitative analysis revealed two main themes with five subthemes, capturing staff experiences in dementia care and their perceived educational needs. Conclusion The findings highlight a strong demand for practical, structured training programs tailored to address behavioral management and communication challenges faced by facility staff.