• Journal of Nutrition and Health
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• v.49 no.3
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• pp.189-200
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• 2016

Purpose: This study analyzed job importance, job performance, and job satisfaction in 38 dietitians working at geriatric hospitals and elderly healthcare facilities in Jeju surveyed from September 15-24, 2014 with the aim of providing basic data for improving the quality of meals and nutrition management for elderly patients. Methods: Data were analyzed using descriptive analysis, ${\chi}^2$-test, t-test, ANOVA, and Pearson's correlation coefficients using the SPSS Win program (version 12.0). Results: Regarding job importance, the average score was 4.29 (out of 5), indicating that hygiene and safety management scored the highest at 4.77 (out of 5), and nutrition management scored the lowest at3.86. In terms of job performance of subjects, the average score was 2.87 (out of 5), indicating that cooking operation management scored the highest at 4.42 (out of 5). Regarding the Importance-Performance Analysis (IPA) of job importance and job performance, hygiene and safety management and cooking operation management scored high for importance and performance (B quadrant) menu management, human resource management, and nutrition management scored low for importance and performance (C quadrant) and purchasing management and financial management were included inD quadrant and A quadrant, respectively. For the level of job satisfaction of subjects, the average score was 3.37 (out of 5), indicating that relationships with colleagues scored the highest at 3.72, and improving professionalism scored the lowest at 2.95. Additionally, job importance and performance of subjects were positively correlated withjob satisfaction (r = 0.395, r = 0.386, both p < 0.05). Conclusion: In conclusion, scores for job importance and job performance of nutrition management were low, and job satisfaction of improving professionalism scored low. Therefore, continuous training and education programs of nutrition management should be provided to improve professionalism of dietitians at geriatric hospitals and elderly healthcare facilities.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.138-144
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• 2010

Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.1-6
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• 2008

Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone. Materials and Methods: From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon(60 cases) and autologous bone-patellar tendon-bone(BPTB)(60 cases). The mean followed up period of hamstring tendon group was 42 months(range $24{\sim}69$ months) and patellar tendon group was 52 months(range $24{\sim}84$ months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients' satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer. Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative, or mildly positive in 85%(51 cases) of the hamstring tendon group and 90%(54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8%(5 cases) and 5%(3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85%(51 cases) and 90%(54 cases)(p>0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87%(52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83%(50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7%(4 cases) in the hamstring tendon group and 10%(6 cases) in the patellar tendon group. Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.50-55
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• 2013

Purpose: The purpose of this study was to compare the clinical results of absorbable knot-tying and absorbable knotless suture anchors in arthroscopic Bankart repair. Materials and Methods: This study compared the patients who underwent arthroscopic Bankart repairs using absorbable knottying suture anchors (59 patients: KT Group), and absorbable knotless suture anchors (52 patients: KL Group). Preoperative and postoperative evaluations were performed by Rowe scores, patient satisfaction score, visual analogue scale (VAS), American shoulder and elbow surgeons (ASES) score, range of motion (ROM), and re-dislocation rate. Results: Postoperative VAS, Rowe scores, ASES score were significantly not different between the 2 groups (VAS: p=0.250, Rowe score: p=0.412, ASES: p=0.052). Mean postoperative VAS was 0.5 in KT Group and 0.8 in KL Group (p=0.250), and limited ROM was noted only in one patient in KL Group. Mean Rowe score was 94.3 in KT Group and 96.3 in KL Group (p=0.412), and mean ASES score was 97.3 in KT Group and 94.0 in KL Group (p=0.052). Re-dislocation rate were no different between the 2 groups. Conclusion: There were no differences in clinical outcomes and re-dislocation rate between Knot-Tying and Knotless repairs.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.169-175
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• 2003

Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.39-44
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• 2007

Purpose: To evaluate the results of subtalar arthroscopy and to define the indications for the procedure. Materials and Methods: Fifty-four patients were followed up for more than 1 year after subtalar arthroscopy. The mean age was 40 years, and the mean follow-up period was 18 months. Preoperative diagnoses included sinus tarsi syndrome in 19 cases, degenerative arthritis in 13 cases, calcaneal fracture in 10 cases, arthrofibrosis in 5 cases, os trigonum syndrome in 3 cases, talar fracture in 3 cases, talocalcaneal coalition in 3 cases and calcaneal tumor in 1 case. Clinically AOFAS ankle-hindfoot scale and satisfaction of the patients were evaluated. Results: There were 23 synovectomies, 13 subtalar fusions, 11 diagnostic arthroscopies, 5 adhesiolyses, 4 loose body removals, 3 excisions of os trigonum and 1 arthroscopic reduction of fracture. Twenty-five ankle arthroscopies and 11 modified Brostrom's operations were performed for the accompaning 17 ankle impingment syndromes, 11 chronic ankle instabilities and 7 osteochondral lesions of talus. AOFAS ankle-hindfoot scale was increased from 33 points preoperatively to 77 points postoperatively in subtalar fusion group, and was increased from 69 points preoperatively to 89 points postoperatively in other-than-fusion group. Ninety one percent of patients were satisfied with the procedures. There were no serious complications related to the subtalar arthroscopy. Conclusion: Subtalar arthroscopy appears to be safe and highly accurate procedure for subtalar pathology, although it requires technical expertise.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.365-373
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• 2007

Destruction of oral soft and hard tissues and resulting problems seriously affect the life quality of xerostomic patients. Although artificial saliva is the only regimen for xerostomic patients with totally abolished salivary glands, currently available artificial salivas give restricted satisfaction to patients. The purpose of this study was to contribute to the development of ideal artificial saliva through comparing viscosity and wettability between CMC solutions and human saliva. Commercially-available CMC is dissolved in simulated salivary buffer (SSB) and distilled deionized water (DDW). Various properties of human whole saliva, human glandular saliva, and a CMC-based saliva substitutes known as Salivart and Moi-Stir were compared with those of CMC solutions. Viscosity was measured with a cone-and-plate digital viscometer at six different shear rates, while wettability on acrylic resin and Co-Cr alloy was determined by the contact angle. The obtained results were as follows: 1. The viscosity of CMC solutions was proportional to CMC concentration, with 0.5% CMC solution displaying similar viscosity to stimulated whole saliva. Where as a decrease in contact angle was found with increasing CMC concentration. 2. The viscosity of human saliva was found to be inversely proportional to shear rate, a non-Newtonian (pseudoplastic) trait of biological fluids. The mean viscosity values at various shear rates increased as follows: stimulated parotid saliva, stimulated whole saliva, unstimulated whole saliva, stimulated submandibular-sublingual saliva. 3. Contact angles of human saliva on the tested solid phases were inversely correlated with viscosity, namely decreasing in the order stimulated parotid saliva, stimulated whole saliva, unstimulated whole saliva, stimulated submandibular-sublingual saliva. 4. Boiled CMC dissolved in SSB (CMC-SSB) had a lower viscosity than CMC-SSB (P < 0.01 at shear rate of $90s^{-1}$). 5. For human saliva, contact angles on acrylic resin were significantly lower than those on Co-Cr alloy (P < 0.01). 6. Comparing CMC solutions with human saliva, the contact angles between acrylic resin and human saliva solutions were significantly lower than those between acrylic resin and CMC solutions, including Salivart and Moi-Stir (P <0.01). The effectiveness of CMC solutions in terms of their rheological properties was objectively confirmed, indicating a vital role for CMC in the development of effective salivary substitutes.

• Sleep Medicine and Psychophysiology
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• v.18 no.2
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• pp.76-81
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• 2011

Objectives: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. Methods: 176 drug-free male patients confirmed as OSAS (average age=$43{\pm}11$ years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was $39.6{\pm}26.0$. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. Results: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05).Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. Conclusion: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.103-108
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• 2004

Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.