The Meanings of Hands among Clinical Nurses in a Tertiary Hospital / 중환자간호학회지

PURPOSE: The purpose of this study was to explore and describe the meanings of hands among clinical nurses.METHODS: A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis.RESULTS: A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included “meaning as an instrument,” “meaning of infection control,” and “meaning of caring.”CONCLUSION: Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

Ultrasound-Guided Percutaneous Release of the Trigger Thumb

PURPOSE: Trigger thumb is a common condition with a prevalence rate up to 3% among the adults. The main pathophysiology is locking of the flexor tendon at the A1 pulley. Treatments include nonsteroidal anti-inflammatory drug, steroid injection, and surgical A1 pulley release. The purpose of this study was to evaluate the safety and effectiveness of ultrasound-guided percutaneous release of trigger thumb. METHODS: The author prospectively reviewed 37 patients who had undergone ultrasound-guided percutaneous release by the same surgeon from January 2012 to June 2014. The effect of ultrasound-guided A1 pulley release was evaluated by using visual analogue scale (VAS) score, disabilities of arm, shoulder, and hand (DASH) score, and grip and pinch strengths preoperatively and at 12weeks after the surgery. In addition, complications related with the procedure were evaluated. RESULTS: Triggering and locking were resolved in all patients after surgery. VAS and DASH improved from 5.0±1.8 and 45.8±16.9 preoperatively to 0.3±0.6 and 16.2±6.3 at 12 weeks, respectively (p=0.019 and p=0.021). Grip and pinch strengths statistically improved from33.5±8.6 kg and 36.7±8.1 kg, preoperatively 46.2±6.1 kg and 47.1±7.4 kg, respectively (p=0.026 and p=0.041). Complications such as incomplete resection, neurologic symptoms or wound infection were not found throughout the period of the study. CONCLUSION: Ultrasound-guided percutaneous A1 pulley release provides complete relief of symptoms with no major complication in trigger thumb.

The Effect and Satisfaction Level of an Out-of-hospital Delivery and Neonatal Care Education Program for Emergency Medical Service Providers

PURPOSE: Emergency medical service (EMS) providers often care for pregnant women at risk for out-of-hospital delivery and born-before-arrival neonates. As the increase in mortality and morbidity from out-of-hospital delivery is well established, this study sought to determine whether a delivery and neonatal care education program could impact the knowledge and practice of EMS providers. METHODS: EMS providers working in the southeast Gyeonggi province in South Korea received an education program for out-of-hospital delivery and neonatal care. The program consisted of a pretest, didactic, mannequin training, and posttest. Six months after the education program a follow-up survey was administered. A paired t-test was then used to compare pretest and posttest scores. Overall, 56 EMS providers completed the study. RESULTS: The pretest average score was 80.4 and the posttest average score was 92.9 (p<0.001). The percentage of correct answers on each question was relatively and equally elevated in the posttest, regardless of the participant's certification. Participants expressed their satisfaction with the education program and this appraisal was maintained in the 6-month follow-up survey. CONCLUSION: These results suggest that EMS providers can benefit from a didactic and training session regarding out-of-hospital delivery and neonatal care. Further studies are needed, however, to develop the reliability and validity of the test and to determine its clinical applications.

Reconstruction of Large Bone and Soft Tissue Defect Combined with Infection in the Lower Extremity with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition

PURPOSE: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. MATERIALS AND METHODS: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. RESULTS: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. CONCLUSION: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.

Reconstruction with Vascularized Fibular Epiphyseal Transplantation of Humeral Head Deformity by Septic Arthritis

PURPOSE: To report the clinical and radiological result of the vascularized fibular epiphyseal transplantation in the treatment of humeral head deformity by septic arthritis. MATERIAL & METHODS: A 3 years old male who has humeral head deformity and bone defect by septic arthritis on neonatal period. We replaced bone defect as vascularized fibular epiphyseal transplantation and lengthened humerus shaft for humerus discrepancy. We followed it up for 14 years. RESULT: We saw the callus formation 2 months after surgery and obtained bone union, one year after surgery. The transplanted fibular bone got hypertrophy. We could check full range of motion on lt. shoulder and The bone deformity was not worsened and The graft did not displaced on last follow up. CONCLUSION: Humeral head reconstruction by vascularized fibular epiphyseal transplantation showed good clinical outcome.

Multiple Glomus Tumor in Brachial Plexus: A Case Report / 대한골관절종양학회지

Glomus tumor is a kind of vascular tumor that arises from the glomus body, which regulates skin temperature and is placed in the skin and the subcutaneous area. It is a benign tumor that usually presents in the subungal area. It is relatively common in areas other than the fingers, but its occurrence in peripheral nerves is known to be comparatively rare. We report our experience with a case of glomus tumor arising from the brachial plexus, a rare site of occurrence for glomus tumors.

The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach

PURPOSE: To evaluate clinical and radiological results of surgical treatment of distal femur medial condyle fracture using lateral anatomical plate of opposite side through medial approach. MATERIALS AND METHODS: This study reviewed the results of 9 cases of distal femur medial condyle fracture treated with lateral anatomical plate of opposite side through medial approach from December 2005 to June 2007, after a follow up of more than 12 months. There were 2 males and 7 females with a mean age of 63.1 (57~72) years. The clinical results were evaluated using the Schatzker's criteria, and the radiographic results were evaluated using the bone union time. RESULTS: Using the Schatzker's criteria, 7 cases of the 9 patients (78%) showed exellent results. The mean time for bone union was 13.4 (11~15) weeks. There were 3 cases of pain on full weight bearing same as previous operative state by degenerative osteoarthritis. There weren't complications as joint stiffness, infection, varus & rotational deformity, malunion, nonunion, and metal failure. CONCLUSION: Plate fixation using medial approach provides the proper anatomical reduction and stronger fixation, and outcome good results.

Operative Treatment with Locking Compression Plate (LCP) in Proximal Humerus Fracture

PURPOSE: To evaluate the clinical and radiographic results of the treatment of a proximal humerus fracture with a locking compression plate(LCP). MATERIALS AND METHODS: This study reviewed the results of 24 cases of a proximal humerus fracture treated with a LCP from January 2005 to April 2007, after a follow up of more than 12 months. There were 8 males and 16 females with a mean age of 68.9(33-90) years. The clinical results were evaluated using the Neer's evaluation criteria, and the radiographic results were evaluated using the bone union time and Paavoleinen method. RESULTS: The mean time for bone union was 11.9 weeks. Using the Neer's functional evaluation, 21 cases of the 24 patients (87%) showed excellent or satisfactory results. Twenty two cases (91%) showed good results according to the Paavoleinen method. The complications encountered were metal failure (1 patient), AVN of the humeral head (1 patient) and joint stiffness (1 patient). CONCLUSION: The LCP demonstrated good results in the treatment of a proximal humerus fracture and has relatively fewer complications than other internal fixators.

Operative Treatment with ITST in Femur Trochanteric Fracture

PURPOSE: To evaluate the clinical and radiographic results of treatment of trochanteric fracture with ITST (Intertrochanteric/ Subtrochanteric) nail. MATERIALS AND METHODS: We reviewed the results of 40 cases of trochanteric fracture treated with ITST from January 2006 to May 2007, which could be followed up for more than 12 months. The cases include 13 males and 27 females, and the mean age is 75.6 years old. The clinical results were evaluated by Ceder mobility assessment, and the radiographic results were evaluated by the change of femoral neck-shaft angle and sliding of lag screw. RESULTS: The mean bone union time is 13.5 weeks. Thirty four cases (85%) were recovered to pre-injury state of walking ability. The change of neck-shaft angle was an average of 5.21degrees and the sliding distance of lag screw was an average of 5.78 mm. Complications were occurred in 4 patients (10%). CONCLUSION: The ITST nail were seen good results in treatment of trochanteric fracture and has relatively less complications than other internal fixator.

Operative Treatment with the Plate Fixation in Intraarticular Calcaneal Fractures / 대한족부족관절학회지

PURPOSE: We evaluated the results of operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures. MATERIALS AND METHODS: From August 2003 to July 2006, twenty intraarticular calcaneal fractures which were operated with open reduction and internal fixation with F or H plates and screws were evaluated retrospectively. According to the Essex-Lopresti classification, 3 cases were tongue type and 16 were joint depression type. With the Sanders classification, 2 cases were II A type, 7 were II B, 5 were III AB, 2 were III AC and 3 were IV. We have analysed the Bohler angle, Gissane angle, and calcaneal width in radiologic evaluation, and evaluated clinical result according to the Creighton-Nebraska Health Foundation Score. RESULTS: Radiologic changes showed as follows: Bohler angle improved from 5.8 degrees to 25.9 degrees, Gissane angle from 119.0 degrees to 113.3 degrees, and calcaneal width from 50.4 mm to 37.8 mm. In the clinical results, excellent cases were noted in 8 cases, good in 8 cases, fair in 2 cases, poor in 1 case. CONCLUSION: Operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures was thought to be a useful operative method allowing anatomical reduction.

Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann

PURPOSE: To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult. MATERIALS AND METHODS: We have studied the results in 33 cases with the plate, 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang's criteria, radiological union time and operation time. RESULTS: The clinical outcome that was good or excellent according to the Kang's criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases, 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate, 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin. CONCLUSION: In the treatment of adult clavicle shaft fracture, two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.

Cytogenetic study on 37 patients with Down syndrome / 대한산부인과학회잡지

No abstract available.