PURPOSE: We investigated the relationship between patient safety culture and safety care activity, and identified factors for safety care activity of entry-level nurses. METHODS: The subjects of the study were 204 entry-level nurses working at five general and advanced hospitals with over 500 beds located in C and D City. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson's correlation and hierarchical multiple regression with SPSS/WIN 18.0 program. RESULTS: Perception of patient safety culture had significant correlations with safety care activity. Multiple regression analysis showed that demographic variables of quality of nursing on patient safety and health state of entry-level nurses affected safety care activity. In addition, patient safety culture in ward and communication affected safety care activity. These factors explained 38% of variance. CONCLUSION: Based on the results of the study, patient safety culture promotion strategies to facilitate supportive work environment and effective communication are needed.
Humans ; Patient Safety

Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

BACKGROUND: The purpose of this study was to investigate the characteristics of and to analyze the factors re-lated to the cost of the resolution of a medical dispute. METHODS: We have reviewed 2,346 cases reported to the Korean Medical Association(KMA)mutual-aid association from Nov. 1. 1981 to Oct. 31. 1994. RESULTS: The percentage rate of reported cases of were related field as follows .' obstetric gynecology(OBGYN) 31.9%, general practitice 28.1%, general surgery 13.3%, orthopedics 6.9% and internal medicine 6.4% 1,829 cases (80.0%) were settled out of court and without public intervention. 310 cases(13.2%) were settled by the police, the public procurators office or the court. The mean settlement amount per case was 9,340,000 won with annual growth rate 10.8%, and median settlement amount was 5,890,000 won. The mean settlement amount for OBGYN was 930,000 won, surgical group 8,900,000 won, medical group 7,710,000 won, and general practitice 7,490,000 won. The cases of medical dispute according to the types of medical care were : operation 21.1%, injection 18.0%, treat-ment and care 18.0%, delivery 13.0%, artificial abortion 10.3%, Cesarian section 7.2% and anesthesia 2.5%. The mean settlement amount according to the types of medical care were: delivery and Cesarian section 15,190,000 won, operation and anesthesia 9,500,000 won, others 6,610,000 won, and injection and medication 6,230,000 won. The mean settlement amount that was settled out of court without public intervention was 7,940,000 won. The mean settlement with public intervention in the court was 17,290,000 won. The cases of medical dispute according to the patients status were .' death 37.5%, complications 20.8%, disability 12.2% and others 28.9%. The mean settlement amout for death was 16,150,000 won, disability 9,430,000 won, others 4,850,000 won and complications 3,550,000 won. The mean settlement amount where doctors have asserted that the outcome was inevitable or have not agreed that it was their fault was higher than the cost of cases where they had admitted responsibility. The settlement amout where there was a misdiagnosis present had not shown to be higher than when the misdiagnosis was absent. The mean settlement amount for cases where multiple doctors were involved was higher than for cases of a single doctor. The mean settlement amount for disturbing the medical practice and suspension of are high. The mean settlement amount for complications was lower than others, and the mean settlement amount for disability and death presented were high. Concerning the types of care, the mean settlement amount for operation/anesthesia, delivery/ Cesarian sections were higher than for injection/medication. Concerning the type of settlement, the mean settlement amount in the police and public procurators office was higher than in out of court without public intervention. CONCLUSIONS: The mean settlement amount depended on the patient's status, the type of settlement, and the disturbance of medical practice regardless of the doctors misdiagnosis, fault, and standard care. Therefore, a reason-able method of resolution for medical dispute is needed.
Anesthesia ; Diagnostic Errors ; Dissent and Disputes ; Humans ; Internal Medicine ; Malpractice* ; Orthopedics ; Police

No abstract available.
Leptospira interrogans* ; Leptospira*

The objective of the present study was to determine the prevalence and type of nutritional ergogenic aids use, and to determine the frequency, reasons for use of nutritional ergogenic aids. Thirty-four male bodybuilders (mean age = 27.0 years), twenty-four male weight lifters (mean age = 20.9 years) participated in the study. Participants completed a comprehensive survey detailing their usage patterns. In this study, 78.1% of bodybuilders and 79.2% of weight lifters reported using nutritional ergogenic aids. The most frequently taken nutritional ergogenic aids, in ranking order, were protein/amino acid powders (79.4%), multivitamin/minerals (67.7%) and creatine (67.6%) for bodybuilders, in contrast to sports drinks (100.0%), protein/amino acid powders (50.5%) and creatine (50.5%) for weight lifters. Over the half of the respondents, 79.4% of bodybuilders and 50.6% of weight lifters, used protein/amino acid powders to gain muscle mass and to stay healthy. Bodybuilders, 67.6% and weight lifters, 41.7%, used multivitamin/minerals to stay healthy and for energy. The intakes of most vitamin and minerals through diet and nutritional ergogenic aids were much greater than RDA. Vitamin B1, vitamin B2, niacin, vitamin B6 and folate intakes were ranged at 400-900%. Vitamin C intake was 1285.4% (for bodybuilders) and 1322.6% (for weight lifters). The correct answer rate of nutritional ergogenic aids was 46.0% for bodybuilders and 52.0% for weight lifters. Both bodybuilders and weight lifters took highly nutritional ergogenic aids and it tended to be taken irrespective of scientific background. Specific sport nutrition education applicable to athletes, especially strength athletes, is recommended. The findings of this investigation could be used to enable the professionals (sports dietician and physician) to identify common misconceptions regarding nutritional ergogenic aids and to implement educational programs.
Ascorbic Acid ; Athletes ; Creatine ; Surveys and Questionnaires ; Diet ; Folic Acid ; Humans ; Male ; Minerals ; Muscles ; Niacin ; Nutrition Policy ; Powders ; Prevalence ; Riboflavin ; Sports ; Thiamine ; Vitamin B 6 ; Vitamins

This study was conducted with 20 female gymnasts to examine the relationship between eating patterns, diet menstrual function and hematological status. According to the baseline data a nutrition counseling and education program was developed and evaluated improved the nutritional status and health of female gymnasts. Mean body weight at the onset of the study was 42.1+/-7.0kg and was reduced to 41.8+/-6.1kg after the nutrition counseling and education program. The percent of body fat was significantly reduced from 13.9+/-3.7% to 13.1+/-3.1%(p<0.01) skinfold thickness of subscapular and thighs was reduced significantly(p<0.01, p<0.05) Mean daily intake levels of energy, protein calcium iron thiamin riboflavin and niacin were significantly elevated after the nutrition counseling and education program but were lower than the Recommenced Dietary Allowances. For the nutrition knowledge and food habits, the posttest mean scores showed a significant increase. The hematological status(hematocrit, serum ferritin) and the early follicle level of estradiol were elevated to a mild degree although it was not significant,. The follicular stimulating hormone level was elevated significantly(p<0.01) Gymnastica has been one of the sports implicated by the medical profession as having probable detrimental effects. The implications of such training to childs growth and maturation have yet to be determined . Most female athletes, however, experience poor nutritional status and delayed puberty The priorities were to prepared a more effective nutrition program and education material status and delayed puberty. The priorities were prepared a more effective nutrition program and educational material for athletes coaches and adminstrators to prepare guidelines for the team physicians and coaches to follow for the physical and physiological examinations of female athletes.
Adipose Tissue ; Athletes ; Body Weight ; Calcium ; Child ; Counseling ; Diet ; Eating ; Education* ; Estradiol ; Female* ; Food Habits ; Humans ; Iron ; Niacin ; Nutritional Status ; Puberty, Delayed ; Riboflavin ; Skinfold Thickness ; Sports ; Thigh

The increased knowledge of the cutaneous circulation of the body and refinements in surgical technique have provided the basis for the successful microvascular transfer of various muscle, skin and myocutaneous free flap. We have found the tensor fascia lata(TFL) inyocutaneous flap to be reliable one and its transfer as a free flap. The TFL myocutaneous free flap was first introduced by Hill et al in 1978 and our two cases report were first introduced in Korea. Two cases of microvascular TFL myocutaneous free flap transfer were performed at the department of Orthopaedic Surgery of Hanyang University Hospital and satisfactory result was obtained from the one of those.
Fascia Lata ; Fascia ; Free Tissue Flaps ; Korea ; Skin

Reconstructive surgeries for old ligament injuries of the knee vary according to the site and nature of injury as well as the age, health, physical demand and cartilage condition of the patients. No single best procedure is present for any old ligament injuries, but the most adaptable technique should be applied according to accurate diagnosis and experiences of surgeon. We reviewed our experiences of several reconstructive surgeries for the 38 cases with chronic ligamentous instabilities and summarized as following. 1) The most prevalent age of the patients was the third decades and males were 5.3 times more common than females. 2) Traffic accidents was the most common cause. 3) Tear of anterior cruciate ligament and medial collateral ligament appeared to be the most common injury. 4) Results at final follow up was not seemed to be affected by severity or location of ligament injury. 5) Intraarticular reconstruction without combined extraarticular reconstruction was not considered to be effective enough for anterior cruciate ligament deficient knee. 6) Although the number of cases was not large enough, we reviewed various reconstructive surgical techniques for comparison and evaluated the effects.
Accidents, Traffic ; Anterior Cruciate Ligament ; Cartilage ; Collateral Ligaments ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Male ; Tears

Wear of polyethylene liner and osteolysis appear to be topical problems after long-term follow-up in total hip arthroplasty(THA). Age and activity of patients, manufacturing procedure of polyethylene liner, thickness of the liner, position of acetabular cup, and material of artificial femoral head have of effects on the degree of wear. In addition, conformity, congruency and micromotion between liner and metal cup are likely to be related to the wear. The purpose of this study is 1) to determine the stress caused by contact between metal and polyethylene components, 2) to evaluate the effects of conformity, congruency, and fixation between metal and polyethylene components, on contact stress in acetabular cups and 3) to identify the design parameters of the commercial acetabular cup within the constraints imposed by the overall functional requirements of total joint replacement. The specimens applied to six different commercial cups made in five companies. The methods was performed on dynamic test and static test to rely on load conditions, estimated the gap between the components through LM. The results showed H-G II cup had the most excellent congruency because of the narrowest interval between two components.
Acetabulum ; Head ; Hip ; Humans ; Joints ; Osteolysis ; Polyethylene*

PURPOSE: The purpose of this study is to investigate to effect of adrenal insufficiency on the results of TKA. MATERIALS AND METHODS: A total of 89 patients (89 knees) treated with TKA from March, 2008 to October, 2008 were enrolled in this study. Levels of serum cortisol and adrenocorticotropic hormone (ACTH) were checked preoperatively. Hydrocortisone 50~75 mg was injected to adrenal insufficient group at 7:00 AM and 4:00 PM on operative day and the following day. We evaluated the range of motion, the knee society knee score and function score at preoperatively and 2 years follow up, and compared the results between non-adrenal insufficiency group (NAI) and adrenal insufficiency group (AI). RESULTS: Cortisol and ACTH levels were reduced in 36 of 89 patients. All of 36 patients of low cortisol level do not stimulated in ACTH stimulation test. In the adrenal insufficiency group the knee society score (KSS) improved from 49.8 to 86.8 and the knee society functional score (KSFS) from 42.6 to 89.5 at 2 years follow-up. In the control group KSS rose from 51.9 to 84.3 and KSFS from 49.4 to 88.6 during the same period. In adrenal insufficient patients, there were no postoperative complication to include mortality, infection, periprosthetic fracture except skin lesions during operation or postoperatively. There was a case of rupture of quadriceps tendon on the 10th postoperative day which was treated with primary repair. CONCLUSION: Based on our study, there was no increased operative and postoperative complications except skin lesions and 1 case quadricepse tendon rupture in patients with adrenal insufficiency group.
Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Arthroplasty ; Follow-Up Studies ; Humans ; Hydrocortisone ; Knee ; Periprosthetic Fractures ; Postoperative Complications ; Range of Motion, Articular ; Rupture ; Skin ; Tendons