PURPOSE: This study was to investigate patient safety perception and patient participation, and to provide basic data for the development of patient participation education programs.METHODS: The subjects of this study were 183 patients with at least one experience of the Hemato-oncology Department at a tertiary hospital in Seoul. Data were collected from April 11, 2019 to May 7, 2019 using structured questionnaires including patient safety perception and patient participation.RESULTS: The patient safety perception score was 4.23±0.48 out of 5. The patient participation score was 4.30±0.53 out of 5. Patient safety perception was significantly different according to age (p=.008), education (p=.045), employment status (p=.031), marital state (p=.037), medical department (p=.004), comorbidity (p=.046), and patient participation education (p=.010). Patient participation was significantly difference in age (p=.020), education (p=.004) and employment status (p=.005). The correlation between the patient safety perception and patient participation was statistically significant (r=.75, p < .001).CONCLUSION: It is necessary to improve the system for medical staff, patients and medical institutions in order to enable patients to communicate with medical staff in a satisfactory manner and participate in patient safety activities.
Comorbidity ; Education ; Employment ; Humans ; Medical Staff ; Patient Participation ; Patient Safety ; Seoul ; Tertiary Care Centers

Subcutaneous emphysema is a complication of the pneumoperitoneum necessary to perform laparoscopy and will be seen more often as laparoscopic techniques are applied to a growing number of intraabdominal procedures. We report a case of subcutaneous emphysema and hypercarbia without pneumothorax or pneumomediastinum during laparoscopic cholecystectomy, which was treated by multiple puncture with 18G needle on emphysematous site. The suspected cause is inadvertent subcutaneous insufflation of carbon dioxide through the trocar sites by increased intra-abdominal pressure for the establishment of pneumoperitoneum. Immediate recognition, evaluation, and treatment of subcutaneous emphysema is necessary since this can be life-threatening complication.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Insufflation ; Laparoscopy ; Mediastinal Emphysema ; Needles ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Subcutaneous Emphysema* ; Surgical Instruments

BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

An exercise stress test using the bicycle ergometer was carried out in Korea University Hospital in 121 untrained apparently healthy male Koreans with the ages ranging from 20 to 69 years. The graded exercise test consisted of 12 minutes' work on the bicycle ergometer, 4 minutes with each work load, such as 50 W, 100W and 150W, and an additional time with the maximal load to the point of voluntary exhaustion or until other symptoms of exercise intolerance appeared. During the graded exercise a bipolar electrocardiogram from the forehead to the V 5 position(lead CH5) was monitored with an oscilloscope with the sweep speed of 50mm per second and recorded for the analysis. The results obtained were summarized as follows. 1. Heart rates were measured before and during the graded exercise at 50W, 100W, 150W and maximal work loads, and those of the 98 cases with no significant ST segment depression in the exercise ECG are presented. Mean heart rates per minute on 150W load by age group were: 171.0 in the 20-29 year-old group, 170.8 in the 30~39 year-old group, 168.0 in the 40-49year-old group, 162.9 in the 50-59 year-old group and 153.6 in the 60-69 year-old group. Mean heart rates per minute on maximal work load by age group were: 186.0 in the 20-29 year-old group, 178.8 in the 30-39 year-old group, 174.7 in the 40-49 year-old group, 166.0 in the 50-59 year-old group and 161.8 in the 60-69 year-old group. 2. The maximal working capacities by age group were: 266.3W in the 29-29 year-old group, 186.1W in the 30-39 year-old group, 182.2W in the 40-49 year-old group, 160.0W in the 50-59 year-old group and 161.8W in the 60-69 year-old group. 3. More than 1mm ST segment depression 0.08 second after the J point was seen in 10.7% and that 0.06 second after the J point in 19.1%. 4. Electrocardiographic QX/QT ratios ranging from 50 to 59% were seen in 21.5% and more than 60% in 0.8% of the cases. 5. Arrhythmias observed during the exercise test included premature ventricular contraction (2.5%), atrial premature contraction(1.7%) and nodal premature contraction(0.8%). 6. Distressing symtoms experienced during the graded exercise test were dizziness(6.6%) and leg pain(5.8%). Excessive sweating(3.3%), hypotension(1.7%) and nausea and vomiting (0.8%) were noticed immediately after the maximal exercise was finished.
Arrhythmias, Cardiac ; Depression ; Electrocardiography ; Exercise Test* ; Forehead ; Heart Rate ; Humans ; Korea ; Leg ; Male* ; Nausea ; Ventricular Premature Complexes ; Vomiting

No abstract available.
Lymphedema*

No abstract available.
Free Tissue Flaps* ; Maxilla*

Exposure with the tibial tubercle osteotomy was done for ten revisions and one primary total knee replacements out of 200 total knee arthroplasties performed from 1985 to 1996. The cases were analyzed with regard to complications and technical considerations. The preoperative diagnoses were infected total knee arthroplasty in seven, aseptic loosening in three and one ankylosed knee. Eixtensive exposure was achieved enough for debridement and reimplantation. The tubercle was fixed with two or three 3.5mm screws. The average duration of follow up was 30 months. Post operative knee flexion averaged 87 degrees. There were two complications, one avulsion of the fragment and one tibial fracture. The advantage of this procedure included wide exposure for difficult knee surgeries and more proximal fixation for improved flexion.
Arthroplasty* ; Arthroplasty, Replacement, Knee ; Debridement ; Diagnosis ; Follow-Up Studies ; Knee* ; Osteotomy* ; Replantation ; Tibial Fractures

BACKGROUND: Tumor necrosis factor-alpha(TNF-alpha) has been thought to play a major role in neurological injury during global brain ischemia and subsequent reperfusion following resuscitation in cardiac arrest. So, we hypothesized that the elevation in TNF-alpha was dependent upon the duration of the global brain ischemia, and related to delayed neuronal damage. METHODS: Fourteen rats were divided two groups ; 1 minute-cardiac arrest group(n=7) and 3 minute-cardiac arrest group(n=7). we induced cardiac arrest by chest compression and damping of tracheal tube for 1 minute and 3 minutes respectively. And then, resuscitation was initiated. To measure the plasma activity of TNF-alpha, blood samples were drawn before and at the end of cardiac arrest, and 30, 60, 90, and 120 minutes after initiation reperfusion. At 72 hours after resuscitation, the ND(neurologic deficit) score was determined and the histopathologic outcome of hippocampal CA1 neuron was observed by the percent dead hippocampal CA1 neurons. RESULTS: 1. TNF-alpha level during the early reperfusion period(<2h) was significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(p=0.0001). 2. There was a no significant difference of neurologic deficit score between 1 min- and 3 min-cardiac arrest. 3. Percent dead hippocampal neurons were significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(9.1+/-1.2% vs 1.2+/-0.9%, p<0.05). CONCLUSION: The results suggest that longer duration of global brain ischemia causes a more profound increase in plasma TNF-alpha level during the early reperfusion period(<2h) and more delayed neuronal damage than lessor duration of global brain ischemia, and that increase in TNF-alpha level during the early reperfusion period(<2h) is related to delayed neuronal damage.
Animals ; Brain Ischemia ; Brain* ; Heart Arrest* ; Heart Arrest, Induced ; Necrosis ; Neurologic Manifestations ; Neurons ; Plasma ; Rats* ; Reperfusion ; Reperfusion Injury* ; Resuscitation ; Thorax ; Tumor Necrosis Factor-alpha*

Sudden hearing deterioration may occur in our population, but it is difficult to explain the exact pathophysiology and the cause. Magnetic resonance imaging (MRI) in sudden sensorineural hearing loss (SSNHL) is usually useful to evaluate neural lesions such as acoustic schwannoma and hemorrhage in labyrinth. Recently some cases of SSNHL caused by intralabyrintine hemorrhage were reported by the advance of MRI. In the case of intralabyrintine hemorrhage, MRI showed a hyperintense signal in the labyrinth on the pre-contrast and contrast enhanced T1-weighted image and relatively weak intensity on T2-weighted image. The prognosis SSNHL by intralabyrintine hemorrhage is generally known to be poor. We report a case of sudden deafness with intralabyrintine hemorrhage who has a history of anticoagulant administration, with a review of literature.
Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Hemorrhage* ; Magnetic Resonance Imaging ; Neuroma, Acoustic ; Prognosis

BACKGROUND: Several studies have been performed to evaluate the efficacy of dietary n-3 fatty acid for patients with renal dysfunction. While about 40% to 80% of patients with end-stage renal disease (ESRD) complain about pruritus and xerosis, there are few reports on the effects of topical n-3 fatty acid on these symptoms. OBJECTIVE: In order to investigate the possible beneficial effects of topical n-3 fatty acid, oils extracted from chia (Salvia hispanica) seed were formulated into topical products, the effects of which were measured. METHODS: Five healthy volunteers having xerotic pruritus symptoms and 5 patients with pruritus caused by either ESRD or diabetes were involved in this study. A topical formulation containing 4% chia seed oils were applied for an 8-week duration. Subjective itching symptoms were assessed on a 6-point scale, as were other skin functions, namely transepidermal water loss and skin capacitance. RESULTS: After the 8 weeks of application, significant improvements in skin hydration, lichen simplex chronicus, and prurigo nodularis were observed in all patients. A similar improvement was also observed among healthy volunteers with xerotic pruritus. Improvement of epidermal permeability barrier function and skin hydration, represented by trans-epidermal water loss and skin capacitance, respectively, were also observed. No adverse effects were observed in all the tested patients and volunteers. CONCLUSION: Chia seed oil can be used as an adjuvant moisturizing agent for pruritic skin, including that of ESRD patients.
alpha-Linolenic Acid ; Fatty Acids, Omega-3 ; Humans ; Kidney Failure, Chronic ; Methylmethacrylates ; Neurodermatitis ; Oils ; Permeability ; Polystyrenes ; Prurigo ; Pruritus ; Seeds ; Skin ; Water Loss, Insensible