We have attempted to define the acetabular remodelling after varus derotation osteotomy and limitations of pelvic osteotomy in the treatment of DDH. We studied the case of thirty eight patients (42 hips) who were divided into three groups according to age at operation and into two groups, subluxation with acetabular dyaplasia and complete dislocation. The cases were evaluated the influence of femoral remodeling, age, acetabular response and instability and requirement of other additional surgery. The length of follow up ranged from two to fourteen years. A return to a valgus femoral neck shaft angle by remodeling was observed in case without avascular necrosis of femoral head. Acetabular correction by remodeling occurred in case of well reduced the femoral head in the socket. Acetabular remodeling was observed even in age of 8. Twenty eight of 42 hips which were complete dislocation required no pelvic osteotomy. A varus derotation osteotomy is a necessary procedure for hip stability and open reduction in treatment of DDH. Good results should be anticipated in patient whose femoral head was well seated in the acetablum.
Acetabulum ; Dislocations ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Osteotomy

PURPOSE: To evaluate and compare the diagnostic findings and usefulness of MRI and MR arthrogram in recurrent anterior dislocation of the shoulder. MATERIALS AND METHODS: MRI and MR arthrogram of thirty-two cases of thirty patients with recurrent anterior dislocation of the shoulder were retrospectively analyzed to evaluate glenohumeral ligaments, pattern of labral injury, bony Bankart lesion, capsular stripping, Hill-Sachs lesion, and loose body. RESULTS: Labral abnormalities was detected on MRI in 23 cases(72%) and MR arthrogram in 22 cases(69%) as labral tear, detachment, and deficiency. All cases involved anteroinferior labrum. On MR arthrogram, labral abnormalities was confined to anteroinferior portion in 4 cases(18%), extended into midglenoid level in 13 cases(59%), and that into anterosuperior portion in 5 cases(23%). Capsular stripping was noted on MRI in 6 cases(19%) and MR arthrogram in 12 cases(38%). Loose body was detected only on MR arthrogram in 5 cases (16%). Bony Bankart lesion and Hill-Sachs lesion was detected equally on MRI and MR arthrogram in 2 cases (6%) and 21 cases(66%) respectively. We obtained identical findings on both MR arthrogram and operation field in 6 patients. CONCLUSION: MRI with its excellent soft tissue contrast resolution and multiplanar imaging capafility helps detection of labral injury in recurrent anterior dislocation of the shoulder. MR arthrogram is slightly invasive, but shows good artatomic details of labral-ligamentous-capsular relationship and thus provides accurate detec- tion of pattern of labral injury, capsular stripping, and loose body.
Dislocations* ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Retrospective Studies ; Shoulder*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

No abstract available.
Dilatation* ; Mammary Arteries* ; Transplants*

To evaluate the health risk of the workplace environment of a general hospital toward the hospital workers, a questionnaire survey on the perception of risk at the workplace environment and environmental measurements at 27 locations with 240 workers in the hospital were made from October 25th, 1993 to October 30th, 1994. The results were as follows; 1. By the environmental measurements, 86 workers(36%) were found to be exposed to poor or harmful degree of general illumination, 193 workers(80%) were exposed to poor or harmful local illumination, 34 workers(14%) were exposed to poor or harmful degree of thermal condition and l80 workers(75%) were exposed to poor or harmful noise level, but nobody was exposed to poor or harmful dust and toluene concentration. Also nobody was exposed to poor or harmful level of radiation or anticancer/antibiotic agents. 2. The subjective perceptions on the environmental conditions felt by the workers were different from the objective findings by the environmental measurements. The workers underscored the poor illumination state and overscored the dust concentrations. Also workers oversensitized about the thermal condition, the noise level, the radiation level, the toluene concentration and anticancer/antibiotic agents. 3. The sources of noise were the dialogue(179 workers) and the office instruments(131workers). The sources of dust came from the clothes(108 workers) and the building materials(79 workers). 4. The questionnaire survey showed that the 28 workers were exposed to poor or harmful level of the antibiotics, 10 workers to alkali or acid and 6 workers to drug dust in the pharmacy but the above findings could not be proved by the environmental measurements.
Alkalies ; Anti-Bacterial Agents ; Dust ; Hospitals, General* ; Lighting ; Noise ; Pharmacy ; Surveys and Questionnaires ; Toluene

The study consists of an analysis of 39 cases of all kinds of granulomatous lesions in the colon observed at our X-ray department during 3year period between Jan. 1960. and the end of. 1962. Of these 39, 13 cases were Crohn's disease of the colon and 15 cases were tuberculous colitis. The remaining 11 cases were due to ulcerative colitis 3, amoebic colitis 4, and non-specific pericolitis 4. 17 males and 22 females were seen and, the peak incidence was from 40 to 49 years of age. The diagnosis of each granulomatous lesion was confirmed by tissue examination obtained by exploratory celiotomy or by biopsy. Crohn's disease and tuberculos colitis were more frequently encountered in the large bowel rather than in the ileo-cecal region. Granulomatous lesions in the colon must be differentiated from a number of causes of large bowel pathology e. g. carcinoma or lymphoma. The diseases with which it is more commonly confused are ulcerative colitis, tuberculous colitis, Crohn's disease and amoebic colitis. X-ray features of each of these granulomatous lesions are presented in detail and the points of differential diagnosis are discussed.
Adult ; Colonic Diseases/*diagnosis ; Diagnosis, Differential ; Granuloma/*diagnosis ; Human ; Middle Aged

PURPOSE: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.
Clinical Competence ; Humans ; Judgment ; Research Design ; Statistics as Topic ; Students, Nursing ; Surveys and Questionnaires

To find the characteristics of the subjective symptoms and its related factors among the patients with the cervicobrachial syndrome, an interview survey was made toward 137 patients complaining the symptoms in cervicobrachial area out of 313 workers occupied in a microwave-oven assembling factory from December 1993 to February 1994. Results were as follows : 1. The patients were classified by the severity of the syndrome as 6 persons (4.4%) at grade I (the mildest grade), 48 persons (35.0%) at grade II, 47 persons (34.4%) at grade III-1, 11 persons (8.0%) at grade III-2 and 25 persons (18.2%) at grade IV. 2. Only 3.6% of the total patients under the study felt the main symptoms of the cervicobrachial syndrome 36 months before this study, and then the number of patients increased gradually, but the incidence of the syndrome increased suddenly from 25.1% to 74.9% since the factory had elevated the height of the belt conveyer-worktables from 75.0cm to 87.7 cm 13 months before the study. 3. Although the higher percentage of the female workers felt the subjective symptoms including the pain at the neck and shoulder, the discomfort or pain at the back and the discomfort or pain at the wrist or the finger than male workers significantly (p<0.05). The male workers, however, showed more abnormal X-ray findings than the female workers significantly (p<0.05). 4. Between the prevalence of the cervicbbrachial syndrome and the number of actual workers occupied at the factory during last-24 months, a negative correlation (r=-0.508~r=-0.665) was observed. 5. The measured workplace environment of the studied factory (average temperature: 13.3 degrees C, average noise: 78.8 dB, average illumination: 241.4 Lux) was the poorer condition than the recommended level (17degrees C or more, lower than 75 dB and 400 Lux or more). 6. Neither items to check the cervicobrachial syndrome during the entrance and health maintenance examinations nor early treatment program for the syndrome were found, at the factory. In conclusion, the primary cause of the cervicobrachial syndrome of the workers were considered due to their repeated monotonous motions on the neck, the shoulder, the arms and the hands for a long duration (2-3 years) with the uncomfortable working posture under the uncomfortable workplace environments, and the condition got aggravated due to the inappropriated health management program for its secondary prevention.
Arm ; Female ; Fingers ; Hand ; Humans ; Incidence ; Lighting ; Male ; Neck ; Noise ; Posture ; Prevalence ; Questionnaires* ; Secondary Prevention ; Shoulder ; Wrist

No abstract available.
Child* ; Humans ; Pheochromocytoma*

PURPOSE: The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness. METHOD: This study used Walker and Avant's process of concept analysis. RESULTS: 1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions 3. There are consequences occuring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other. CONCLUSION: Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.
*Assertiveness ; Communication ; Humans ; Interpersonal Relations ; Self Concept