PURPOSE: This study was to identify the relations of interpersonal attitude and communication competence of new community health nurses. METHODS: The research design was a correlational study. The data were collected from 136 visiting nurses using a structured questionnaire and analyzed using independent t-test, Pearson's correlation coefficient, and multiple regression with the SPSS/WIN 20.0 program. RESULTS: The type of interpersonal attitude in subjects was I+U+ and the score of communication competence was 3.6. Among 15 sub-dimensions, the highest score was responsiveness and the lowest was assertiveness. There were no significant differences in communication competence by general characteristics. Factors influencing on communication competence in new visiting nurses were interpersonal attitude I+(I am OK) (beta=.34) and I-(I am not OK) (beta=-.28). CONCLUSION: Education program, stressing the self-awareness, is necessary to increase positive interpersonal attitude and communication competence for reemployment of community health nurses. Furthermore, in order to reinforce assertiveness, institutional support should be accompanied with the efforts of individual level.
Assertiveness ; Community Health Centers* ; Education ; Mental Competency* ; Nurses, Community Health* ; Surveys and Questionnaires ; Research Design

No abstract available.

No abstract available.
Giant Cell Tumors* ; Giant Cells* ; Ribs*

A retrospective review of 102 patients with metastatic bone tumor seen at Hanyang University Hospital from 1986 to 1990 was performed. We analyzed the cases in the aspects of primary lesions, age and sex distributions, locations and number of metastatic foci, compared with those in the previous reports in Korea. l. 54.9% of the patients were male and 45.1% were female. The incidence of the metastatic bone tumors in female compared with the previous incidence before 1980's years was relatively increased. The peak age was in the 6th decade. The incidence younger than 50 years was decreased, and the incidence older than the 7th decade was relatively increased. 2. The main primary cancers were lung(40.2%), liver(11.8%), breast(10.8%), unknown(8.8%), and uterine cervix(6.9%) etc. In cases of lung cancer, the frequent histologic types were adenocarci noma, squamous cell carcinoma, and small cell carcinoma. 3. The vertebrae(56.9%), ribs(40.2%), femur(17.6%), pelvis(15.7%) were relatively frequent sites of metastasis which involved multiple metastasis. 4. Single metastasis(62.4%) was more frequent than multiple metastasis(37.6%). 5. In the primary cancers, the incidence in hepatoma of male was increasing, the incidence in lung cancer of female was relatively increasing, but the incidence in stomach cancer was decreasing.
Carcinoma, Hepatocellular ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Male ; Neoplasm Metastasis ; Noma ; Retrospective Studies ; Sex Distribution ; Stomach Neoplasms

No abstract available.
Korea* ; Seoul*

A case of fibrocalcifying pseudotumor occuring at a very unusual site, the intraosseous region of axis, is presented. Previous reports of similar lesions in skull base, intracranial parenchyme, soft tissue around spine, mediastinum, and pleura have been described under the designation 'fibro-osseouslesions' and 'calcifying pseudoneoplasm' The etiology, pathogenesis and natural course of the lesion are still unknown. Bvt the lesion is probably benign nature and reactive lesion rather than neo-plastic. Authors performed resection of lamina, spinous process, and a portion of pedicles and occipitocervical fusion to prevent spinal cord compression due to cortical expansion or fracture. Microscopically, amorphous, basophilic, hyaline, and chondroid calcifying masses were rimmed by palisading histiocytes and foreign body-type giant cells. No evidence of malignancy was found.
Axis, Cervical Vertebra* ; Basophils ; Giant Cells, Foreign-Body ; Histiocytes ; Hyalin ; Mediastinum ; Pleura ; Skull Base ; Spinal Cord Compression ; Spine

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

We performed a retrospective study of 12,307 patients who visited the emergency room of St. Paul's Hospital, secondary medical center, from January 1 to December 31,1996. The results were as follows : 1. Of 12,307 total patients, male to female ratio was 1.16:1 but after 7th decade, there were more female than male. And 3rd decade was the peak age group. 2. The majority o(patients visited our emergency room from noon to midnight (65% of total patients). 3. On average,33.7 patients visited our emergency room per day. Most patients visited on Sundays and other holidays(average 43.3 per day). 4. By monthly distribution, the patients Increased slightly during May, June, July, August and September. 5. Disease to injury ratio was 2.6:1. In disease, male to female ratio was 1 :1 and in injury, the male prominence had a the ratio 1.8:1 In 2nd decade, disease to injury ratio was higher (1.4:1) than that of other decade. And there were mostly disease patients in the group under 1 year old (19.2: 1). 6. Of 12,307 total patients,5,458 patients received only Intern's treatment (44.3%). In 3rd decade, the ratio of Intern's treatment was higher (54.4%). 7, The patients were categorized as follows, Infernal medicine 28.1%, Pediatrics 18.2fo, Orthopedic surgery 13.2%, Plastic surgery 7.4% etc. 8. Averaged admission rate was 25.3% and the rate of general surgery was the highest (49.5%). The rate of admission to intensive care unit (ICU) was 5.5% of total visiting patients and 21.8% of total admission patients. 9. The total patients transferred from other hospitals were 1152 (9.4%), 3.16 per day. The majority used non-emergency vehicles and only 8.5% of patients used the rescue service or ambulances. 10. The average transit time spent in the emergency room was 182 minutes. The longest was 246 minutes in March and the shortest 127 minutes in January.
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Male ; Orthopedics ; Pediatrics ; Retrospective Studies ; Surgery, Plastic

STUDY DESIGN: We retrospectively reviewed nine patients of lumbar extraforaminal disc herniation which underwent conservative or surgical treatment. OBJECTIVES: We evaluated the clinical characteristics, accuracy of diagnostic methods, and result of conservative or surgical treatment for the lumbar extraforaminal disc herniation. SUMMARY OF BACKGROUND DATA: Lumbar extraforaminal disc herniation represents an important component of lumbar disc herniation because of the difficulty in diagnosis and the difference in clinical characteristics and surgical approaches in contrast to usual intracanalicular disc herniation. MATERIALS AND METHODS: Nine patients which we have experienced from March 1994 to February 1997 were evaluated by physical examination, magnetic resonance imaging, EMG, and disco-enhanced computed tomogram. There were 4 males and 5 females, and average age was 42.4 years. RESULTS: The level of herniation was 4 cases at L4-5 and 5 at L5-S1. Radiating pain was chief complaint but low back pain was absent or mild. Accuracy of disco-enhanced computed tomogram was superior to that of magnetic resonance imaging. The results of conservative treatment were good in 2 cases(40%), fair in 2 cases(40%), and poor in 1 case(20%). And those of surgical treatment including partial laminectomy, medial facetectomy, and discectomy or extraforaminal approach were excellent in 3 cases(75%), good in 1 case(25%) according to the grading of MacNab. CONCLUSIONS: Lumbar extraforaminal disc herniation represents compressive symptoms of upper lumbar root of the involved level characteristically. Location and degree of disc herniation is an important tractor for determining the surgical approach, and disco-enhanced computed tomogram is a definite diagnostic method.
Diagnosis* ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Retrospective Studies

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*