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

No abstract available.
Congenital Hypothyroidism* ; Thyroid Dysgenesis*

No abstract available.
Fractures, Spontaneous* ; Osteoporosis*

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals

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

Twin pregnancies represent a high risk obstetric population with perinatal morbidity and mortality much greater than that of singleton pregnancies. A retrospective dinical evaluation was attempted to analyse 211 cases of twin pregnancies in Chunchon Sacred Heart Hospital of Hallym University from Jan. l. 1988 to Dec. 31. 1997. The results were as follows. 1) The incidence of twin pregnancy was 1 in 93.9 deliveries. 2) The age of mother ranged from 19 to 42 years and predominant age group was 26-30 which covers 43.1% of all. 3) Nullipara was 61.1% and multipara was 38.9%. 4) The predominant gestational age group at delivery was 36-37 weeks, 33.2%. 5) In presentation, both cephalic combination was 46.4%, cephalic-breech was 26.1%. 6) The birth weight was less than 2500gm in 64.9% of the 1st babies and 70.6% of the 2nd babies, respectively. 7) The rate of cesarean section was 89.0%. The indications of cesarean section were malpresention (48.9%), elective cesarean section(38.8%), and toxemia(9.0%). 8) In 23 cases of vaginal delivery, the average duration of labor was 7.0 hours and 43.5% of 2nd baby was delivered within 5 min after 1st baby delivery, 9) The most frequent maternal complications during pregnancy were anemia(36.0%), preterm labor(34.6%) and preeclamsia(17.5%). 10) The perinatal mortality rate of the first and second twins was 10.4% and 12.3%, respectively. The main causes of perinatal death were prematurity(52.1%) and stillborn(22.9%). 11) Both female was 43.6%, both male was 39.3%, and opposite sex was 17.1% in infant.
Birth Weight ; Cesarean Section ; Female ; Gangwon-do ; Gestational Age ; Heart ; Humans ; Incidence ; Infant ; Male ; Mortality ; Mothers ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin* ; Retrospective Studies

BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

No abstract available.
Leptospira interrogans* ; Leptospira*

PURPOSE: This study was conducted to determine the risk factors among patients with depression with Crohn's disease. METHODS: Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, chi2-test, Wilcoxon rank sum test, and logistic regression analyses. RESULTS: The incidence rate of depression (BDI-II> or =14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<18.5Kg/m2), disease duration (> or =3 years), CDAI (> or =150 scores), frequency of hospital admission (> or =2), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression. CONCLUSION: Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.
Adult ; Arthralgia/etiology ; Body Mass Index ; Crohn Disease/complications/drug therapy/*psychology ; *Depression ; Female ; Humans ; Logistic Models ; Male ; Mesalamine/therapeutic use ; Quality of Life ; Questionnaires ; Risk Factors ; Socioeconomic Factors ; Stomatitis/etiology ; Young Adult

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor