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

This study was performed by the necessity of objective information upon change of pulmonary function after surgical correction of spinal deformity in scoliotic patients. It is relatively well known that deformity of spinal curvature affects the pulmonary functions, especially lung volume or vital capacity, due to restriction of the thoracic cage. It is carried out the comparative study between preoperative and postoperative pulmonary functions in thirty two cases of thoracic scoliosis, all who were treated with Harrington instrumentation and posterior fusion at Department of Orthopedic Surgery, Seoul, National University Hospital from 1969 to 1983. The age distribution of patients was from 6 years to 21 years and female was more involved two times than male. Following observations were obtained: Following observations were obtained: 1. Pre-and postoperative angle of scoliosis were 77.5° and 39.2° with correction rate of 48.2%. 2. Preoperative vital capacity was 64.2% and postoperative value was 74.8%, 2 years and 2 months after operation in average. 3. Postoperative vital capacity was significantly increased compared to preoperative value in patients with scoliosis (p<0.05). 4. Ther was no definite pattern of obstructive pulmonary disease in patients with scoliotic deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Humans ; Lung ; Lung Diseases, Obstructive ; Male ; Orthopedics ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spinal Curvatures ; Vital Capacity

Congenital scoliosis is a disease characterized by its rigid and progressive curve. It is usually resistant to conservative treatment and early surgical fusion has been reommended. The indication for conservative treatment with brace is much limited but present mainly as a delaying tactic to maintain 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 17 patients (18 curves) with congenital scoliosis who were treated with brace with average follow-up of 4.3years (at least 2 years) from Jan. 1968 to Dec. 1983 and the following results were obtained. 1. The interval from the time when scoliosis was observed to the time of brace application was less than 1 year in 10 patients (58.8%). 2. The average age was 6.6 years ranging from 0.2 years to 14.1 years. The average initial curve was 40.5 degrees. 3. The average final amount of correction was 3.6 degrees (8.7%). 4. The lumbosacral curve gave the best correction. The correction effect of brace treatment was less effective in the thoracic curves. 5. The correction was more effective in the patients younger than 10 years. 6. The shorter the curve, the more correction was obtained. 7. The type of failure of formation gave much more correction than the type of failure of segmentation. 8. The brace treatment was more effective in the patients whose curves were less than 50 degrees in younger age and with the anomaly of failure of formation. Bracing would delay spine fusion until more ideal time even in severe curves or anomalies of failure of segmentation. 9. Spine fusion should be done early regardless of age for progressive curves even with brace treament.
Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Spinal Curvatures ; Spine

This paper is aimed to study the incidence, age and sex distribution, and type of lateral meniscal lesion including discoid meniscus in Korea. It is reported higher incidence of lateral meniscal lesion in Korea. 132 cases with meniscal lesions were surgically treated at the Department of Orthopedic Surgery, Seoul National University Hospital between 1973 and 1982. Of the 98 patients who had lateral meniscal lesions, forty-four (44.9%) were found to have a discoid meniscus. The mean age of the patients with discoid meniscus was 17.9 years, and 30 patients of them were younger than 20 years of age. The patients with discoid meniscus were followed after meniscectomy for an average of 6 months. The summary of this study are as follows: l. Over-all incidence of discoid meniscus were 44 cases (33.3%) out of 132 cases of the meniscal disease. All forty-four cases had a lateral discoid meniscus, and they formed 44.9% among 98 cases of lateral meniscal injury. 2. The discoid meniscus was most frequent in the age group between 11 and 20 years old (65.9%), and was more prevalent in female by a ratio of 1.4. 3. Qf the 26 patients with torn discoid meniscus, twelve (46.2%) denied the history of trauma. 4. Symptom of click sound was present in 42 cases (95.5%), and the rate of positive McMurray sign was 81.8%.
Clinical Study ; Female ; Humans ; Incidence ; Korea ; Orthopedics ; Seoul ; Sex Distribution

Stabilization of the unstable spine created by the posterior decompression is as important as the decompression itself in the treatment of spinal stenosis. The purpose of this study is to evaluate the effectiveness of C-D pedicle screw fixation in stabilization after lumbar decompression, in reduction of spondylolisthesis and in restoration of the lumbar sagittal curvature. C-D pedicle screw fixation was performed in 102 spinal stenosis patients after posterior lumbar decompression and fusion during the period from March 1987 to December 1988. Their age ranged from 15 to 72 years with an average of 49.1 years. There were 34 males and 68 females. The follow up was from 6 to 21 months with an average of 12.5 months. The causes of spinal stenosis were degenerative in 50 patients, spondylolisthesis in 39, iatrogenic in 9 and degenerative lumbar scoliosis in 4. Objective clinical results showed significant improvement of claudication, SLR limitation, motor weakness, sensory and DTR changes in most patients. Following results were obtained from the study of C-D pedicle screw fixation after posterior decompression in lumbar spinal stenosis.1. C-D pedicle screws provide the secure fixation that allows early ambulation and shorter hospital stay. 2. C-D pedicle screws enable the reduction of spodylolisthesis at the time of posterior stabilization. 3. C-D pedicle screw fixation is successful in the restoration and maintenance of sagittal curvature of the lumbar spine. 4. C-D pedicle screw fixation enables the correction of scoliosis at the time of posterior decompression.
Decompression ; Early Ambulation ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Pedicle Screws ; Scoliosis ; Spinal Stenosis ; Spine ; Spondylolisthesis

BACKGROUND: Laser therapy for various skin conditions is one of the most common procedures in dermatology. Recently, several articles described the use of 1064 nm Q-switched Nd:YAG lasers for the treatment of benign skin lesions. Such treatment is known to trigger its therapeutic effect through a photoacoustic effect and selective photothermolysis effect. However, only a limited number of articles have dealt with the theoretical base of the photoacoustic effect of the 1064 nm Q-switched Nd:YAG laser. OBJECTIVE: To compare the wound repair process and nonselective tissue heat damage induced by three different laser modalities: the CO2 laser, Er:YAG laser, and 1064 nm Q-switched Nd:YAG laser. METHODS: We irradiated the skin of an albino rat (Sprague Dawley(R), 200~250 g) with CO2, Er:YAG, and 1064 nm Q-switched Nd:YAG lasers. Skin biopsy specimens of the irradiated areas were collected on the first, fifth, and tenth day after laser exposure. For histologic analysis, the specimens were stained with the H&E, Verhoff-Van Gieson, and Masson's trichrome protocols. RESULTS: Compared with other laser modalities, rat skin irradiated by the 1064 nm Q-switched Nd:YAG laser showed the least amount of heat damage and the quickest tissue repair response to the damage. CONCLUSION: A 1064 nm Q-switched Nd:YAG laser with a photoacoustic effect capable of ablating the epidermis and dermis can be a proper treatment modality for the removal of benign skin lesions. The 1064 nm Q-switched Nd:YAG laser may be considered as an alternative treatment option for the treatment of benign skin lesions.
Animals ; Biopsy ; Dermatology ; Dermis ; Epidermis ; Hot Temperature ; Laser Therapy ; Lasers, Gas ; Rats* ; Skin* ; Wounds and Injuries*

Postoperative total blindness was seen in a 48 year old male who had a laparotomy for traumatic perforation of intestine. General inhalation anesthesia of ether-oxygen-mask with semiclosed system was applied after initial ketamine administration. This unhappy ocular complication could be occur secondary to excessive prolonged external compression to eyeballs with mask or/and prolonged postoperative hypotension.
Anesthesia, General* ; Anesthesia, Inhalation ; Blindness* ; Humans ; Hypotension ; Intestines ; Ketamine ; Laparotomy ; Male ; Masks

PURPOSE: We experimentally induced hepatic infarction in rabbits to evaluate MR findings of liver parenchyma and capsule and its changes with time and to confirm the capsular structure correlating with its histologic findings. MATERIALS AND METHODS: After ligation of hepatic artery, vein and duct of right inferior posterior lobe of liver, T1, T2 weighted and enahnced T1 weighted image were obtained at several time intervals. Histologic samples were taken of two rabbits or more at each time intervals. RESULTS: During the first several days, the signal intensity of the ischemic necrosis showed strong high signal intensity relative to normal liver on both T1 and T2 weighted images. After 2 weeks however, the necrotic areas gradually changed to isointensity or low signal intensity. Capsular structure was observed as slightly high signal intensity compare to ischemic areas on both enhanced T1 and T2 weighted images in six cases, and five cases of 12, respectively. From the first day, homogeneous coagulation necrosis without hemorrhage or liquefaction was observed. Fibrous thickening with rich vascularity was observed along the surface of the necrotic area after two weeks. CONCLUSION: During the first several days, the signal intensity of the ischemic necrosis showed strong high signal intensity on both T1 and T2 weighted images and gradually changed to isointensity or low signal intensity. Liver capsule was shown and slightly high signal intensity along the surface of the necrotic area and could be explained by fibrous thickening of the liver capsule end the rich vascularity within in it.
Hemorrhage ; Hepatic Artery ; Infarction* ; Ligation ; Liver* ; Magnetic Resonance Imaging* ; Necrosis ; Rabbits ; Veins

Stevens-Johnson syndrome (SJS) is a rare disease in which extensive toxic epidermolysis occursafter medication. Skin and mucous membranes are involved in about 90% of SJS cases, and webbingof mouth corners (microstomia) may occur when they are affected. Few reports have been issuedon microstomia in SJS, and no consensus has been reached regarding treatment methods,timings, or results. We encountered a case of microstomia following SJS after ofloxacin medicationin a 22-year-old woman treated by commissuroplasty using a lozenge-shaped excision. Wepresent an appropriate correction method and surgical timing for microstomia following SJS.

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients’ satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5–14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.