There are many difficulties in operative technique of total knee replacement of bony ankylotic knee, because it accompanies the deformity of the knee, contracture of soft tissue and bony ankylosis. It is said that there are poor gaining of post-operative range of motion and development of many problems in wound healing. We performed conversion TKR in seventeen patients who had fused knee between Jan. 1985 and Dec. 1991. After follow up of average three years and four months, we analyse the results. Sixteen patients were women and one was man. There were eight cases of tuberculosis knees, seven cases of septic knees and two cases of posttraumatic arthritis. Thirteen cases had previous knee surgery and in another four cases knee fusion developed spontaneously. Average age of patients were 35 years old. Operation was performed between ten months and twenty years averaging nine years after knee fusion. When blood chemistry and physical examination showed no findings of infection, operation was performed. We used bone cement in 8 cases and autogenous bone graft in 4 cases for large bone defect. For release of soft tissue contracture, in 8 cases, we lengthened quadriceps tendon with the method of V-Y advancement technique and in another 4 cases, performed patella tendon transfer from tibial tuberosity. Operative time was between three hours and four hours fifteen minutes, average three hours and fourty minutes. The results of these patients were as follows; 1. The postoperative average range of motion was 72° (20°-125°). The average extension lag was 9. 2. The average Hospital for Special Surgery knee rating score improved from 57 preoperatively to 84 postoperatively. 3. There were two patients who had pain on walking, but radiologically and clinically there were no loosening signs. 4. In three patients who had poor gaining of range of motion after operation, we performed arthroscopic adhesiolysis. There were two cases of transient peroneal nerve palsy which were recovered within 1 month and in another two case of deep infection with β-hemolytic streptococcus and pseudomonas, we performed knee fusion after one year ten months and one month after TKR. In conclusion, conversion TKR is a successful procedure which can obtain the restoration of function of the fused knee, especially in the cases that have adequate soft tissue condition, extensor mechanism and good bone stock.
Ankylosis ; Arthritis ; Arthroplasty, Replacement, Knee ; Chemistry ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Methods ; Operative Time ; Paralysis ; Patellar Ligament ; Peroneal Nerve ; Physical Examination ; Pseudomonas ; Range of Motion, Articular ; Streptococcus ; Tendons ; Transplants ; Tuberculosis ; Walking ; Wound Healing

BACKGROUND: The measurement of nonspecific bronchial hyperreactivity is valuable for diagnosis and management of bronchial asthma. Methacholine or histamine is used for the pharmacologic provocation test. Usually a methacholine bronchial provocation test is performed by a dosing technique with counted number of breaths. A dosimeter is indispensable in the dosing technique. Recently a timed tidal breathing technique which dose not need an expensive dosimeter was introduced. We measured the degree of nonspecific bronchial hyperreactivity to histamine using a simple timed tidal breathing technique. METHOD: Forty two healthy volunteers, 12 patients with bronchial asthma(BA), 10 patients with rhinitis(RH) and 10 patients with upper respiratory infection(URI) participated in the study. The subject's nose was clipped and inhalation continued during tidal breathing for 2 minutes via a face mask. FEV1 was measured at 30 seconds, 90 seconds after inhalation and inhalation of next solution was continued until there was a fall in FEV1 of 20%. Histamine PC20 was defined as the concentration at 20% fall of FEV1 and it was obtained from the log dose-response curve by linear interpolation. RESULTS: Inhalation of serial dilution of histamine could be performed in all patients without significant side of effects. The geometric mean±standard deviation of histamine PC20 in healthy volunteers is 8.27±2.22mg/ml, BA group 0.33±3.02mg/ml, RH group 0.85 ±3.24mg/ml, and URI group 1.47±1.98mg/ml. CONCLUSION: Histamine bronchial provocation test using timed tidal breath method is a simple and suitable tool for management of patients with bronchial hyperreactivity.
Asthma ; Bronchial Hyperreactivity ; Bronchial Provocation Tests* ; Diagnosis ; Healthy Volunteers ; Histamine* ; Humans ; Inhalation ; Masks ; Methacholine Chloride ; Nose ; Respiration*

No abstract available.
Neuroma*

PURPOSE: The aim of this study was to investigate the relationships between the hemodialysis unit nurses' experience of verbal abuse, job stress, burnout, and turnover intention, and to identify the explained variances for turnover intention. METHODS: The research design was a descriptive survey using a probability sampling. The data were measured using self-report questionnaires from 231 hemodialysis unit nurses in seven cities in Korea and were analyzed with SPSS 20.0. RESULTS: The mean scores were 2.45±0.62 (out of 5) for experience of verbal abuse, 2.40±0.26 (out of 4) for job stress, 2.31±0.48 (out of 4) for burnout, and 3.16±0.05 (out of 5) for turnover intention. There were significant correlations among the experience of verbal abuse, job stress, burnout, and turnover intention within the hemodialysis unit nurses. Factors influencing turnover intention were 'burnout' (β=.42, p<.001) and 'job stress' (β=.17, p=.015)which explained 42% of the variance (F=15.98, p<.001). CONCLUSION: Results suggest that in order to reduce nurses' turnover intention, nurse managers should explore strategies to reduce nurses' burnout and job stress in nurses in hemodialysis units.
Humans ; Intention* ; Korea ; Nurse Administrators ; Renal Dialysis* ; Research Design

PURPOSE: The purpose of this study was to compare hospitalized patients in comprehensive nursing care units and general care units as to satisfaction with nursing care and factors influencing their intent to revisit the hospital METHODS: A cross-sectional study was conducted with 178 patients who had been hospitalized in a comprehensive nursing care unit and a general care unit in one hospital. Participants completed self-report questionnaires. Data were analyzed using SPSS 21.0. RESULTS: There was a significant difference between the comprehensive nursing care unit and general care unit for intent to revisit the hospital (p=.036). Factors influencing intent to revisit the hospital for patients in the comprehensive nursing care unit were 'satisfaction with nursing care' (p<.001) and 'use of additional costs for comprehensive nursing care' (p=.041). The factor influencing intent to revisit hospital for patients in the general care unit was 'satisfaction with nursing care' (p<.001). CONCLUSION: Findings indicate that comprehensive nursing care service in which all care is provided by nursing staff only, without family or private caregivers, increases intent to revisit the hospital. These results can be used as the foundation of reviewing the operation and expansion of comprehensive nursing care service.
Caregivers ; Cross-Sectional Studies ; Humans ; Nursing Care* ; Nursing Staff ; Nursing* ; Patient Satisfaction

PURPOSE: This study aims to investigate the relationships between knowledge on advance directive, attitudes towards the withdrawal of life-sustaining treatment and quality of life among hemodialysis patients. METHODS: A descriptive correlational study was conducted with 103 hemodialysis patients. Data were collected using a structured questionnaire from May to September of 2016, and analysed by using descriptive statistics, t-test, ANOVA and Pearson correlation coefficient. RESULTS: The participants' knowledge level on advance directive was 5.47±2.08 out of 9, the attitudes towards the withdrawal of life-sustaining treatment was 3.22±0.49 out of 5, and the quality of life was 3.35±0.92 out of 6. The knowledge on advance directive was positively correlated with attitudes towards the withdrawal of life-sustaining treatment (r=.21, p=.037) and quality of life (r=.21, p=.036). CONCLUSION: According to the results of this study, the level of knowledge on advance directive is preferred to improve the quality of life of hemodialysis patients. It is needed to support and maintain ongoing education opportunities in order to improve the level of knowledge on advance directive among patients undergoing hemodialysis.
Advance Directives* ; Education ; Humans ; Quality of Life* ; Renal Dialysis*

PURPOSE: This study was done to explore the predictors asssociated with Korean women smokers' intentions to quit smoking. METHODS: This study was a cross-sectional study including 3,578 women smokers. Data from the 2010 Community Health Survey conducted by the Korea Centers for Disease Control and Prevention were examined and analyzed using SPSS 21.0 for multiple logistic regression. RESULTS: Of the women smokers 52.2% reported having an intention to quit smoking but only 3.9% had received education in smoking cessation. In the logistic analysis, factors associated with intention to quit smoking were age (Odds ratio and 95% [confidence interval]: 0.97 [0.96-0.98]), health-related quality of life (OR=2.39 [1.14-5.03]), perceived stress (OR=1.11 [1.00-1.22]), marital status (OR=0.93 [.86-1.00]), age of starting to smoke (OR=1.14 [1.04-1.24]), number of cigarettes per day (OR=0.84 [0.76-0.93]), exposure to smoking-quitting campaigns (OR=1.48 [1.22-1.80]), previous attempts at weight-control (OR=1.37 [1.15-1.63]), frequency of alcohol use (OR=1.16 [1.01-1.34]), hypercholesterolemia (OR=1.62 [1.18-2.24]), experiences of trying to quit smoking (OR=4.04 [3.45-4.73]), and regular medical check-up (OR=1.13 [1.03-1.43]). CONCLUSION: Identifying factors associated with the intentions to quit smoking provides possibilities for shaping effective policies and programs to increase smoking cessation among Korean women.
Centers for Disease Control and Prevention (U.S.) ; Cross-Sectional Studies ; Education ; Female ; Health Surveys ; Humans ; Hypercholesterolemia ; Intention* ; Korea ; Logistic Models ; Marital Status ; Quality of Life ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Products

Fifteen cases of ventricular septal defect with aortic insufficiency were diagnosed radiographically andconfirmed after operation at Seoul National University Hospital in recent two and half years since 1979.Cineangiographies of ascending aorta and left ventricle were done in those cases and revealed some characteristicfindings. The resuls of the analysis are as follow; 1. Among the 15 cases, 14 cases were male and 1 case wasfemale. Age distribution was from 7 years to 23 years. 2. Those 15 cases were corresponded to 8% among total 193cases of ventricular septal defect, to 11% among total 135 cases of aortic insufficiency and especially to 48%among 48 cases of aortic in sufficiency below age of 20 years. 3. After operation, 11 cases were confirmed assubpulmonary type ventricular septal defect and 4 cases as subcristal type. The sizeds of the ventricular septaldefects were ranged between 0.6 and 2.5cm in diameter. 4. Regurgitation of contrast media was noticed in cineaortography of all cases, and the grades of regurgitation were II-III/IV in 13 cases. 5. Various types ofherniated aortic cusp through ventricular septal defect were seen. In the cases of subpulmonary ventricular septaldefect characteristic saccular aneurysm was found in 7 cases. Asymmetry or mild bulging of aortic sinus was foundin the cases of subcristal ventricular septal defect. 6. Infundibular stenosis was found in 3 cases with rightventriculography and those were caused by the herniated saccular aneurysm of aortic cusp. 7. It is essential forthe diagnosis of ventricular septal defect with aortic insufficiency to undertake biplane cineangiography ofascending aorta and left ventricle in long axial view and right ventriculograhy should be done in suspicion ofinfundibular pulmonary stenosis.
Age Distribution ; Aneurysm ; Aorta ; Cineangiography ; Constriction, Pathologic ; Contrast Media ; Diagnosis ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Male ; Pulmonary Valve Stenosis ; Seoul ; Sinus of Valsalva

Primary pulmonary tuberculosis is one of the common pulmonary disease affecting children in Korea. Simple chest film is essential in diagnosis of primary pulmonary tuberculosis, but it is difficult to interpret the findings in some cases. Authors reviewed chest films of 162 cases of clinically confirmed primary pulmonary tuberculosis from April 1978 to June 1981 at Seoul National University Hospital. The results are as follows; 1. Lymph node enlargement, either hilar or mediastinal, was found in 82.7% and pulmonary parenchymal infiltration in74%. 2. Incidence of unilateral and bilateral hilar lymph node enlargement is about 50% (81cases) and 30% (49cases) respectively. Incidence of unilateral and bilateral mediastinal lymph node enlargement is about 21% (34cases) and 4.3% (7 cases), more common in right side. 3. Pulmonary parenchymal lesion is demonstrated in 74% (120cases). The pattern of primary focus is as follows in order; patchy infiltration 47% (76 cases) linear-streaky infiltration 15% (25 cases), lobar or segmental homogenous infiltration 9% (14 cases), nodular infiltration 4% (7cases). The primary focus of right lung is two times as common as that of left. 4. Calcification in primary focusis noted in about 27% in pulmonary parenchyma and 49% in hilum. 5. Plerual effusion is identified in 10%, but pleural effusion without pulmonary parenchymal lesion or lymph node enlargement is noted in only 2% (3 cases).
Child ; Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Diseases ; Lymph Nodes ; Pleural Effusion ; Seoul ; Thorax ; Tuberculosis, Pulmonary

Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completelyfrom the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; andusually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases ofdouble-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department ofRadiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to thesegmental combinations, the height of conus the relationship of great arteries, the location of ventricular septaldefects, and associated anomalies. The resuslts were as follows; 1. Among 44 cases, 36 cases had normal cardiacposition, 4 cases had dextrocardia with situs inversus, 2 cases had dextrocardia with situs solitus, 1 case hadlevocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were[S.D.D] in 36 cases, [I.L.L] in 3 cases, [I.D.D] in 2 cases, [S.D.L], [S.L.L] and [A,D,D] in 1 case respectively.3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lowerthan pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2cases. 4. The relation of the great arteries were normal in 15 cases, side-by side in 13 cases, dextromalpositionin 13 cases, and levomal position in 3 cases. 5, The position of the ventricular septal defects with respect tothe origins of the great arteries is subaortic (type A & type B) in 23 cases, subpulmonary (type C) in 13 cases,double committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations arepulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C,left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery in 4, interrupted IVC in 1,obstructive VSD in 2, ASD in 4, PDA in 4, right aortic arch with levocardia in 5, and ectopic spleen withmesocardia in 1 case. 7. Biplane cinecardioangiogram must be performed in both ventricles to define the VSD andits relationship to the great arteries, and, if necessary, should also be performed in the aorta to rule outcoarctation and coronary artery abnormalities, and in the pulmonary artery to visiualize pulmonary venous returnand mitral valve. Angiography is of crucial importance in differentiating double-outlet right ventricle fromtetralogy of Fallot and complete transposition of the great arteries.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Valve ; Aortic Valve Stenosis ; Arteries ; Constriction, Pathologic ; Conus Snail ; Coronary Vessels ; Dextrocardia ; Double Outlet Right Ventricle ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Heterotaxy Syndrome ; Levocardia ; Mitral Valve ; Pulmonary Artery ; Pulmonary Valve ; Seoul ; Situs Inversus ; Spleen