The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

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: This study was done to determine the effects of walking exercise training(WET) on metabolic syndrome risk factors and body composition in obese middle school girls. METHOD: A non-equivalent pretest-posttest experimental design was used. Twenty seven subjects participated in this study from one women's middle school in Busan. The participants were purposely allocated to an experimental group (n=14) and a control group (n=13). The experimental group participated in 30-60 minutes of WET with 55 to 75% of a maximal heart rate six days a week for 12 weeks. RESULTS: The prevalence of individual risk factors on metabolic syndrome were improved in the experimental group after the intervention. The high waist circumference(WC), high triglyceride(TG), low high density lipoprotein cholesterol(HDL-C), high blood pressure(BP) and high fasting glucose(FG) were 21.4, 21.4, 14.3, 28.6 and 7.2%, respectively. There were significant differences in WC (F=22.24, p<.001), TG (F=5.34, p=0.30), body weight(F=21.99, p<.001), fat mass(F=19.17, p<.001), and % body fat(F=17.93, p<.001) between the experimental and control group after the intervention. However, there were no significant differences in HDL-C, FG and BP between the experimental and control group after the intervention. CONCLUSION: These results indicate that WET is effective in decreasing risk factors of the metabolic syndrome and body composition components in obese middle school girls. These findings suggest that WET can be useful as a nursing intervention in the prevention of obesity-related disorders in obese adolescents.
*Walking ; Risk Factors ; Obesity/*rehabilitation ; Metabolic Syndrome X/*blood/prevention & control ; Lipids/blood ; Humans ; Female ; *Exercise ; *Body Composition ; Blood Pressure ; Blood Glucose/analysis ; Adolescent

PURPOSE: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. METHODS: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. RESULTS: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of 19.19+/-4.58 points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. CONCLUSION: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.
Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Parents ; Child Health ; Surveys and Questionnaires

Slipped capital femoral epiphysis is a rare disease in Korea, but the incidence has being increased according to the changes of body contour and life style. Now we have more concern about slipped capital femoral epiphysis, especially the factors which contribute to the final result of treatment. Many factors such as severity of slip, stability of slipped epiphysis, whether closed reduction was done or not, whether severe complication like avascular necrosis or chondrolysis has occurred or not have effect on the result. We analyzed 20 cases of slipped capital femoral epiphysis, which occurred in 16 adolescence in view of which factors contributed to the final satisfactory result. In our study, the difference in the duration of symptoms, instability of slipped epiphysis, patients age, association with obesity or acute trauma and the number of pins had much effect on the final results and whether the reduction was done or not, the kinds of pins and association with endocrinopathy made a little difference. But further studies are necessary because the number of cases is not sufficient and the length of follow up period is not long.
Adolescent ; Epiphyses ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Life Style ; Necrosis ; Obesity ; Rare Diseases ; Slipped Capital Femoral Epiphyses*

Among patients scheduled for elective surgery at the Kyung Hee University Hospital, 15 patients undergoing open thoracotomy were selected. Two different ventilatory modes were employed and compared to the one-lung ventilation(control). First, 10 cmH2O of continuous positive airway pressure was applied to the unventilated lung while patients were under one lung ventilation with 50% oxygen(CPAP 10 cmH2O). Second, 10 cmH2O of positive end expiratory pressure to the ventilated lung and 10 cmH2O of continuous positive airway pressure to the unventilated lung were applied while patients were under one lung ventilation with 50% oxygen(CPAP/PEEP). Arterial oxygen tension, alveolar-arterial oxygen difference (A-aDO2) and intrapulmonary shunt fraction of two different ventilatory modes were observed and compared to control group, and CPAP/PEEP group to CPAP 10 cmHO group. The RESULTs were as followed: 1) Mean PaO2 in CPAP 10 cmH2O and CPAP/PEEP were 138+/-42 mmHg and 177+/-44 mmHg, respectively, and were significantly increased as compared to 100+/-29 mmHg of control group(P<0.05). Comparing the PaO2 of CPAP 10 cmH2O and CPAP/PEEP, there was statistically significant increase in CPAP/PEEP(P<0.05). 2) A-aDO2 in CPAP 10 cmH2O and CPAP/PEEP were 175+/-43 mmHg and 131+42 mmHg, respectively, and were significantly decreased as compared to 213+/-32 mmHg of control group(P<0.05). Shunt percentages(Qsp/QT) were measured as 23.7+/-5.8% in control group, 18.3+/-6.0% in CPAP 10 cmH2O, 13.0+/-4.3% in CPAP/PEEP. Shunt percentages of CPAP 10 cmH2O and CPAP/PEEP were decreased significantly as compared to the control group(P<0.05). Comparing the A-a DO2 and the shunt percentages of CPAP 10 cmH2O and CPAP/PEEP, there was statistically significant decrease in CPAP/PEEP(P<0.05). Based on the above RESULTs, the application of appropriate continuous positive airway pressure to the unventilated lung and 10 cmH2O of positive end expiratory pressure to the ventilated lung during one lung ventilation is thought to be more effective than only continuous positive airway pressure to the unventilated lung in preventing hypoxemia.
Anoxia ; Continuous Positive Airway Pressure ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Positive-Pressure Respiration ; Thoracotomy

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

PURPOSE: This study was conducted to discover the related factors of neonatal suckling in the initiation of breastfeeding in primiparous mothers and to provide basic data for promoting nursing intervention strategies to improve the practice of breastfeeding. METHOD: The subjects of this study were 71 primiparous mothers who had normal vaginal deliveries at one obstetric hospital in P metropolitan city and one delivery center in J city. The collected data was analyzed using the SPSS program. RESULT: The average IBFAT (Infant Breastfeeding Assessment Tool) score was 9.6+/-2.3. The general characteristics studied that had a significant influence on neonatal suckling in the initiation of breastfeeding were the place of delivery (ex: Hospital, Postnatal Unit), whether oxytocin was used, no usage of analgesic medication, amount of satisfaction after the first breastfeeding weight of the newborns and the Apgar score at one minute. CONCLUSIONS: A higher IBFAT score was related to primiparous mothers who had a hospital delivery, received oxytocin, received maternal labour analgesics, neonatal weight, Apgar score at one minute, and satisfaction after the first breastfeeding.
Analgesics ; Apgar Score ; Breast Feeding* ; Humans ; Infant, Newborn ; Mothers* ; Nursing ; Oxytocin

PURPOSE: The purpose of this study was to investigate knowledge related to child obesity of child daycare center workers. METHODS: The participants in this study were 360 child daycare center workers in 2 cities in South Gyeongsang Province. Data were collected from February to June, 2011, using self-report questionnaires including questions about the general characteristics of the daycare center workers and their knowledge related to child obesity. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data with the SPSS WIN 16.0 program. RESULTS: The knowledge scores of child daycare center workers about child obesity averaged 74.8. The domains of diet (0.87 points) and prevention (0.86 points) had high scores, while, the domains of general characteristics (0.64 points) and diagnosis (0.59 points) had low scores. CONCLUSION: These results indicate that obese education programs for child daycare center workers should be developed in order to identify and teach children with obesity appropriately.
Child ; Child Day Care Centers ; Diet ; Humans ; Obesity ; Child Health ; Surveys and Questionnaires

PURPOSE: The aim of this study was to investigate nursing students' awareness of biomedical ethics and attitudes toward death of terminal patients. METHODS: A structured questionnaire was developed to examine nursing students' biomedical ethics. Their attitudes toward terminal patients' death were measured by using the Collett-Lester Fear of Death Scale. Surveys were conducted with 660 nursing students enrolled at a three-year college located in Daejeon, Korea. Data were analyzed using descriptive statistics, Wilcoxon rank sum test and Kruskall Waills test. RESULTS: Students who have experienced biomedical ethics conflicts, agreed to prohibition of cardiopulmonary resuscitation (CPR) and have no religion exhibited more negative attitudes toward death compared to students without the above characteristics. Of the participants, 81.2% answered that life sustaining treatment for terminal patients should be discontinued and 76.4% replied that CPR on terminal patients should be prohibited. The majority of the correspondents stated that the two measures above are necessary "for patients' peaceful and dignified death". CONCLUSION: Study results indicate the need to establish a firm biomedical ethics value to help nursing students form a positive attitude toward death. It also seems necessary to offer students related training before going into clinical practice, if possible. The training program should be developed by considering students' religion, school year, experience with biomedical ethics conflicts and opinion about CPR on terminal patients. The program should also include an opportunity for students to experience terminal patient care in advance via simulation practice on standardized patients.
Attitude to Death ; Bioethics ; Cardiopulmonary Resuscitation ; Humans ; Korea ; Patient Care ; Students, Nursing ; Surveys and Questionnaires