• Title/Summary/Keyword: 술기

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Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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Arthroscopic All Inside Repair of Lateral Meniscus Root Tear -Technical note- (외측 반월상 연골 경골 후방 부착부 파열의 관절경적 All-Inside 봉합술 - 수술술기 -)

  • Ahn, Jin-Hwan;Lee, Dong-Hoon;Chang, Moon-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.63-68
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    • 2007
  • Purpose: The authors introduce a new technique of arthroscopic all inside repair using anterolateral and anteromedial portals for lateral meniscus root complete radial tear in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. Operative technique: Arthroscope is placed through anteromedial portal and suture hook ($Linvatec^{TM}$, Largo, Florida, USA) is delivered through anterolateral portal. By rotating the suture hook, it penetrates posterior horn of the torn meniscus from femoral to tibial surface for vertical orientation. PDS No. 1 ($Ethicon^{TM}$, Somerville, NJ, USA) is delivered through the suture hook, and then it is withdrawn. Both end of PDS No. 1 are taken out through the anterolateral portal. MAXON 2-0 ($Syneture^{TM}$, Norwalk, Connecticut, USA) is used to penetrates remnant of tibial attachment of the torn meniscus from tibial to femoral surface in a same manner. MAXON 2-0 is changed for PDS No. 1 from tibial to femoral surface by shuttle relay technique. PDS No. 1 is tied using SMC (Samsung Medical Center) knot. Conclusion: All inside repair is a useful technique to achieve anatomical repair and to restore the hoop tension in lateral meniscus root complete radial tear.

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Effects of Mentoring Education Program on Nursing Students before their Clinical Practice (임상실습전 멘토링 교육프로그램의 효과 -간호대학생을 중심으로-)

  • Park, Su Ho;Yoo, Hana
    • Journal of Practical Engineering Education
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    • v.12 no.1
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    • pp.109-116
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    • 2020
  • The effects of mentoring education bring positive effects such as mentees' capacity building, knowledge improvement and positive attitude. The major difficulties that nursing college students experience in clinical practice are low adaptability, lack of confidence, etc. Therefore, this study developed mentoring education program to improve the problem-solving ability, learning attitude, and confidence in nursing skill before clinical practice for nursing college students and evaluated their effectiveness. In order to develop the program, a group of experts consisting of professors and clinical nurses selected 11 topics after discussing nursing skills and knowledge, which were most required in clinical practice. The program involved 14 mentors who operated practice, counseling, video clips, and contextual discussions for two days to a group of 9 to 10 people. Nursing college students who received the mentoring education program showed a significant increase in learning attitude and confidence in performance of nursing skills, but there was no statistically significant difference in problem-solving ability. This study is meaningful in that it has improved the educational effect by using mentoring methods, away from formal in-school practice education. In the future, it will be necessary to evaluate whether the mentoring education program affect the problem-solving ability of nursing students by applying it before, during, and after clinical practice rather than in a short period.

Contents Analysis on the Health Information of Major Daily Newspaper and TV in Korea (우리나라 주요(主要) 일간지(日刊紙) 및 TV 건강정보(健康情報)의 내용분석(內容分析))

  • Lee, Moo-Sik;Lim, Kyn-Kwang;Na, Baeg-Ju;Kim, Keon-Yeop;Yoo, In-Sook
    • Proceedings of the KAIS Fall Conference
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    • 2009.05a
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    • pp.114-118
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    • 2009
  • 주요 일간지와 KBS 1 9시 뉴스에서 다루고 있는 건강관련 기사의 내용을 분석하여, 건강관련 정보의 경향을 파악하여, 건강 예보제 실시를 위한 현황 분석을 위해 본 연구를 실시하였다. 1. 일간지 건강정보 내용분석 결과요약: 기사 보도 분야에서는 생활건강(47.8%), 사회(14.6%), 종합(7.7%), 국제(4.7%), 경제(1.5%) 순이었고, 3/4분기에서만 국제와 경제 분야가 종합분야 보다 많이 보도 되었으며, 기타 분야가 22.9%로 많은 비율을 차지하였다. 건강정보를 대상 성별별로 분류 하였을 시 남녀 모두에 해당되는 자료가 대다수였고(87.9%), 여성이 대상인 정보(8.0%)가 남성(4.1%)보다 많았으며, 생애 주기별 대상으로 분류 하였을 시에 역시 특별히 구분되지 않은 모든 연령층에 해당 정보가 가장 많았고(60.8%), 성인(19.8%), 학동기 어린이(7.3%), 청소년 (4.9%), 노인(4.9%), 영유아(3.3%) 순이었다. 일간지별 기사의 주제를 조사한 결과 두 일간지의 총합은 병의 원인 및 위험인자(15.5%)가 가장 많이 보도 되었는데, 조선일보는 건강증진, 치료 및 술기, 투약, 기타의 순이었고, 한겨레신문은 건강증진, 행정, 치료 및 술기, 투약 순이었으며 각 주제별로 분기별로 약간의 차이를 나타내었다. 예측성에 관한 내용분석을 보면 예보성은 있는 경우(76.2%)가 없는 경우보다 많았고, 예보성의 정보는 알림성, 예측성, 행사성의 순이었고 예측성의 경우 건강형태가 가장 많았으나 한겨레 신문의 경우 기타에 속하는 경우가 가장 많았다. 사 ICD-10 체계, 21대 분류로 질병에 관한 기사를 분류한 결과 신생물(14.5%), 특정 감염성 및 기생충성 질환(13.6%), 정신 및 행동장애(9.5%)의 순이었으며 두 일간지간의 차이를 보였다. 2. TV 뉴스 건강정보 내용분석 결과요약: 건강정보의 대상 특징 성별은 모두 해당되는 경우가 265회 중 238회 (89.8%)로 가장 많았고, 생애주기별 대상으로 보면 모든 연령층에 해당 되는 것이 154회(58.1%)로 가장 많았다. 건강정보의 주제에 대해서 조사한 결과 병의 원인 및 위험인자가 73회(27.5%), 역학(역학조사 및 보도성)이 64회 (24.2%), 행정이 30회(11.3%), 증상 및 호소가 27회(10.2%) 등의 빈도순으로 조사 되었다. 건강정보의 내용의 분야를 보면 대분류로는 질병관리 분야가 102회(38.5%), 보건의료제도 및 행정 분야가 52회(19.6%), 보건행태 및 기타 42회(15.8%), 생활환경분야 39회(14.7%)의 빈도순으로 나타났다. 건강정보 내용을 질병의 분류 ICD-10 체계로 분석한 결과는 특정감염성 및 기생충성 질환 48회(26.8%), 소화기계의 질환, 손산, 중독 및 외인에 의한 특정기타 결과, 건강상태 및 보건서비스 접촉에 주는 요인 등의 빈도순으로 조사되었다.

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Educational Effects of Traditional Classroom Instruction and Video Self-instruction (VSI) for Cardiopulmonary Resuscitation(CPR) in Boy's High School Students (고등학교 남학생에서 심폐소생술에 대한 전통적교실학습과 영상자가학습의 교육효과)

  • Park, Sang-Sub;Baek, Hong-Seok;An, Ju-Yeong
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.13-24
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    • 2011
  • Objectives: The purpose of this study is to compare educational effects between traditional classroom instruction and video self-instruction (VSI) for cardiopulmonary resuscitation (CPR) in boy's high school students. Methods: This study was carried out targeting totally 96 boy students(47 people for experimental group, 49 people for control group) in the second grade of high school where is located in G city of G province from July 9-10, 2009. The experimental group and control group were arbitrarily selected two classes in the second grade. One class was assigned to the experimental group. another class was assigned to the control group. The experimental group was educated with VSI for CPR. The control group was educated with traditional classroom instructions for CPR. The analysis was performed with SPSS WIN (version 12.0) program using frequency chi-square($x^2$) test, independent samples t-test, and paired t-test. Results: After instructions, the knowledge, attitude, self-confidence, and skill performance accuracy scores on CPR increased statistically in both group. The increases of self-confidence ($2.40{\pm}0.73$) and skill performance accuracy score ($2.67{\pm}0.29$) in the experiment group were significantly higher than those ($2.01{\pm}0.96$ and $2.54{\pm}0.31$) in the control group, respectively. Conclusion: This study suggested that VSI was more effective than traditional classroom education for self-confidence and skill-performance accuracy in CPR. To confirm it, more studies are warranted.

Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units (시뮬레이션 학습을 위한 호흡곤란증후군 환아 시나리오 개발 및 학습 수행 평가)

  • Lee, Myung-Nam;Kim, Hee-Soon;Jung, Hyun-Chul;Kim, Young-Hee;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.1-11
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    • 2013
  • Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

Arthroscopic Technique of Bone Defect in Anterior Shoulder Instability (골 결손이 동반된 전방 견관절 불안정성에서 관절경적인 수술 술기)

  • Ko, Sang-Hun;Park, Ki-Bong
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.102-108
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    • 2009
  • Purpose: The bone defects that are associated with shoulder anterior instability may be the causes of failure of arthroscopic surgery. For the treatment of traumatic shoulder instability, we tried to determine the arthroscopic techniques that can be used for the bone defect of the glenoid and the humeral head. The purpose of this study is to assess the surgical techniques for the arthroscopic reconstruction of the shoulder with anterior instability and bone defects. Materials and Methods: We analyzed the articles that have been recently published on anterior shoulder instability and we assessed the arthroscopic surgical techniques. We compared the articles and the methods of arthroscopic surgical techniques for treating bone defects of the anteroinferior glenoid and the posterolateral humeral head, which were considered as the causes of recurrence of shoulder instability. Results: There are the anteroinferior bone defects of the glenoid and Hill-Sachs lesions in the bone defects that appear in patients with anterior shoulder instability. These bone defects are currently the causes of failure of arthroscopic surgery. Conclusion: Open shoulder surgery may be the treatment of the choice for a shoulder with instability and significant bone defects of the glenoid and the humeral head. But efforts are being made to overcome the weaknesses of open surgery by the use of arthroscopy.

Correlation Between Physical Features of 6th-Grade Elementary School Children and Chest Compression Depth (초등학교 6학년 학생의 체격과 흉부압박 깊이 간의 상관 관계 분석)

  • Uhm, Tai-Hwan; Park, Jeong-Hyun;Roh, Sang-Gyun;Moon, Tae-Young;Kim, Jee-Hee
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2009.04a
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    • pp.493-499
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    • 2009
  • 응급의료에 관한 법률에 따라 구조 및 응급처치에 관한 교육의 대상자로 일반시민인 구급차등의 운전자, 여객자동차운송사업용 자동차의 운전자, 보건교사, 경찰공무원 등에게 심폐소생술 교육을 실시하여 26,900명이 과정을 수료(한국, 2007)하였으나 초중고 학교 교과과정 중에는 체계적인 응급처치 교육이 없고 교육강사, 교육장비 등이 취약(한국, 2005)하여 교육체계의 확립이 필요한 실정이다. Kerschaver 등(1989)은 학생들을 대상으로 심폐소생술 훈련을 하는 것은 효과적이고 11살 부터 단순화한 내용으로 보다 쉽게 교육을 시작할 수 있을 것이라고 했으며 Lester 등 (1996)은 지식과 술기 능력 간에는 상관이 없으나 중학교 1학년 때가 적절한 훈련시기라고 했고 Urey 등(2003)은 의무과목으로 6-7살 초등학생을 위한 응급처치 프로그램, Lubrano 등(2005)은 8-11살 학생을 대상으로 하는 응급처치 교육 프로그램의 운영을 보고했다. 박 등(2006)은 초등학교 5-6학년 학생과 성인 간의 심폐소생술 교육 효과를 분석하여 학생군이 과정에 대한 이해는 우수했으나 술기에서는 적절한 흉부압박이 미흡했다는 결과를 제시하여 초등학생을 대상으로 하는 이론 교육이 효과가 있었으나 실습 교육은 체격에 제한을 받는다는 점을 시사했다. 체격은 물리적으로 측정, 확인할 수 있는 사람 몸의 상태로써 성별, 키, 몸무게 등의 전체적인 것과 각 부위의 크기, 모양, 비율 등의 부분적인 것으로 구분할 수 있으나 여기서는 키, 몸무게가 흉부압박에 영향을 끼쳤다고 볼 수 있다. 따라서 본 연구에서는 초등학교 6학년 학생을 대상으로 체격조건(키, 몸무게)과 성인 마네킨 흉부압박 깊이 간의 상관관계를 밝히고 회귀식을 도출하여 효과적인 심폐소생술이 가능한 대상을 제시하고자 한다.

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A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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