• Title/Summary/Keyword: 술기

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Treatment of Hallux Valgus with Modified McBride Procedure and Proximal Metatarsal Crescentic Osteotomy (McBride씨 변형 술식과 근위 중족골 반월형 절골술을 이용한 무지 외반증의 치료)

  • Lee, Ju-Hong;Park, Jong-Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.81-86
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    • 2005
  • Propose: This study was retrospectively to review the surgical results for moderate to severe hallux valgus corrected with a modified McBride procedure and proximal metatarsal crescentic osteotomy. Materials and Methods: Between August 1997 and August 2001, 15 patients with 22 bunion underwent surgical correction and were followed for an average 29.3 months (range, 18 to 53 months). Clinical results were evaluated with AOFAS clinical rating system for hallux and radiological measurements were done preoperatively and at a minimum of 12 months postoperatively. Results: The average AOFAS clinical rating score improved from 47.5 to 86.0. Union of the osteotomy site occurred at 9.5 weeks except one delayed union. The hallux valgus angle improved an from $36.5^{\circ}$ to $15.7^{\circ}$ and the intermetatarsal angle improved from $17.4^{\circ}$ to $8.6^{\circ}$ on average. Dorsiflexion of the first metatarsal at the osteotomy site was present in three (13.6%) with average $4^{\circ}$. Complications were two recurred deformity, one hallux varus and one painful transfer lesion. There was a high level of satisfaction with clinical results in 11 patients (73.3%) with 17 feets and cosmesis in 18 feets (81.8%). Conclusion: Modified McBride procedure and proximal metatarsal crescentic osteotomy based on careful patient selection and meticulous technique showed satisfactory outcome for moderate to severe hallux valgus.

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Effect of Human Patient Simulator-based Education on Self-directed Learning and Collective Efficacy (환자시뮬레이터활용교육에서의 자기주도적 학습능력과 집단효능감의 변화)

  • Jun, Hoa-Yun;Cho, Young-Im;Park, Kyung-Eun;Kim, Ji-Mee
    • The Journal of the Korea Contents Association
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    • v.12 no.5
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    • pp.293-302
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    • 2012
  • The purpose of this study was to identify the effect of human patient simulator(HPS)-based education on self-directed learning(SDL) and collective efficacy(CE) for nursing students. This study design was one group pre-posttest. The subjects were 2nd grade 92 students enrolling in the integrated practice. They have no previous experience of HPS-based education. HPS-based education included team based learning, skill training, taking a high-fidelity simulation with Medical Education Technologies, Inc (METI) simulator and being debriefed during 12 weeks. The pretest and posttest were conducted to understand the improvement in SDL and CE. After the subjects had participated in the HPS-based education, they showed statistically significant higher SDL(t=4.24, p=0.000) than before. However, there was no significant change in CE. Based on the results, this study suggests that SDL for nursing students were significantly improved by HPS-base education.

Autologous Chondrocyte Implantation (자가연골 세포이식)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.159-166
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    • 2008
  • Articular cartilage is a unique tissue with no vascular, nerve, or lymphatic supply. This uniqueness may be one of the reasons why chondral injuries will hardly heal and may progress to osteoarthritis over time. Currently, there are several surgical options for the treatment of articular cartilage lesions. Although there is some discrepancy as to which procedures work best in certain patients. The spectrum of treatment alternatives for articular cartilage defects can range from simple lavage and debridement, drilling, micro-fracturing, and abrasion to osteochondral grafting and autologous chondrocyte implantation. In 1984, for the first time, results of autologous chondrocyte implantation in a rabbit model were presented, showing hyaline cartilage repair. Clinical study using autologous cultured chondrocyte implantation in chondral defects of the human knee has been reported in 23 patients in 1994. In 14 out of 16 patients treated for chondral injuries on the femoral condyles, the results were good to excellent. It is important for the surgeon to understand the autologous chondrocyte implantation technique and to be aware on the postoperative management. Attention to surgical technique and selection of appropriate patient for the autologous chondrocyte implantation will provide with the best results.

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Single Bundle PCL Reconstruction with Remnant Preservation (잔여 조직을 보존한 단일 다발 후방십자인대 보강재건술)

  • Lee, Dong Chul;Kim, Won-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.125-131
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    • 2011
  • Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

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Development and Effects of Simulation Educational Program for Nursing Students (간호대학생들을 위한 시뮬레이션 교육프로그램 개발 및 적용효과)

  • Im, Kyung Ja;Yang, Bok Sun;Kim, Yoon Lee
    • Journal of Digital Convergence
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    • v.16 no.2
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    • pp.203-213
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    • 2018
  • Purpose. This study was conducted to identify effects of the high fidelity simulation for nursing students. Methods. A non-equivalent quasi-experimental design was used to experimental group (N=43) and control group (N=39) for 8 weeks, 5 times from September 26 to November 9, 2013. Clinical performance was measured by using standardized patients. Critical thinking was measured through the questionnaire and clinical judgement was measured through observation by Lasater's rubric. Results. Clinical performance (F=211.15, p<.001), critical thinking (t=3.00, p<.004) and clinical judgement (t=7.60, p<.001) were significantly higher in experimental group with simulation education program than control group. Conclusion. Simulation education program were effective to improve clinical performance, critical thinking disposition and clinical judgement for nursing students.

A Report on Educative Effect of Basic Life Support Training for Students in a College of Korean Medicine: Attitudes, Knowledge, and Skills (한의과대학생 대상 기본심폐소생술 교육 효과: 태도, 지식 및 술기 영역에서)

  • Kim, Mi-Kyung;Seo, Jun-Seok;Lee, Seung-Chul;Park, Hee-Ok;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.34 no.2
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    • pp.215-229
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    • 2013
  • Objectives : Basic life support (BLS) is considered one of the essential clinical skills medical students should master. Nevertheless, neither the current state of education nor the educative effect of and attitudes toward BLS in Korean medical students have yet been reported. The aim of this study was to examine the educative effect of BLS training for Korean medical students in terms of attitudes, knowledge, and skills. Methods : Surveys concerning attitudes toward BLS and its education, and tests for knowledge and scheme performance were conducted with 85 students in a college of Korean medicine under training for American Heart Association (AHA) BLS course for healthcare providers. Results : Before training, 70.6% of students answered they felt the necessity to be trained in the BLS course. The levels of confidence to perform and self-presumed knowledge on BLS were low at first. After training, however, the level of confidence and knowledge increased significantly. In the final test, the mean scores of written test and scheme performance significantly decreased, while the level of confidence didn't. Most of the participants answered they wanted to be re-trained under regular re-education system. Conclusions : To evaluate the current state of BLS education and its educative effect in Korean medical schools, it's required to expand the target of research to larger number of colleges and students over the country.

Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications (폐합병증을 동반한 심한 면역저하 환자에서 폐생검술의 유효성 및 위험성에 대한 분석)

  • 이호석;이성호;김관민;심영목;한정호
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.539-546
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    • 2001
  • Background: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. Material and Method: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS.

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Effectiveness of Education Program Using Video Recording and Feedback on Skill Competency for Students of Majors in Health Care: A Meta-Analysis (동영상 촬영과 피드백을 이용한 실습교육이 보건의료전공 대학생의 술기수행능력에 미치는 효과: 메타분석)

  • Shin, Yun Hee;Kim, Sun Kyung;Kim, Hyunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.25 no.2
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    • pp.120-133
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    • 2018
  • Purpose: A meta-analysis was conducted to evaluate effectiveness of education programs using video recording and feedback in the improvement of competency in clinical skills for health care majors. Methods: Six databases were searched and inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled trials (NRTs) reporting level of skill competency using numerical measurements. Data analysis and synthesis were performed using Comprehensive Meta-Analysis software and Revman program. Results: Of 1,568 records, 11 studies met inclusion criteria. Statistically significant effectiveness of education programs using video recording and feedback was identified. A low risk of bias was detected among both RCTs and NRTs. Meta-analysis showed that the intervention groups had more effective improvements in skill competency (standardized mean difference [SMD]: 0.74; 95% CI: 0.33~1.16). Results of subgroup analysis showed higher effects when interventions dealt with one skill, used self-reflection with expert feedback, and included instruction from instructor in the education programs. Conclusion: Findings suggest that schools for health care majors should actively adopt video and feedback based skill training allowing educators to design effective programs. Potential is higher for students to achieve higher competency when they train with one skill at a time, use of instruction and receive feedback from experts.

Cross-Pin and Interference Screw Femoral Fixation in Anterior Cruciate Ligament Reconstruction using Hamstring Tendon -Technical Note- (슬괵건을 이용한 전방십자인대 재건술시 횡고정 핀과 간섭나사를 이용한 대퇴터널 고정술 -수술 수기-)

  • In Yong;Bahk Won-Jong;Park Jong-Beom;Hong Seung-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.60-63
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    • 2002
  • Purpose : The purpose of this study was to introduce new femoral fixation technique using a cross-pin and a bioabsorbable interference screw in hamstring ACL reconstruction. Method : Semitendinosus and gracilis were harvested for quadrapled graft. After tibial tunnel had been made, femoral tunnel was made 35 mm in depth. Then the graft passed through the tunnels. Cross-pin was fixed through the drill hole which had been made through upper sleeve of the Rigidfix system. While pulling the graft, bioabsorbable interference screw was fixed through the anteromedial portal. Conclusion : We introduced the new femoral fixation technique using a cross-pin and a bioabsorbable interference screw as a good method with high fixation strength and tight graft-bone contact.

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Relationship of Learning Motivation, Self-Directed Learning Ability and Problem Solving Process of Nursing Students after Practice Evaluation of Fundamentals of Nursing Course using Role Play (역할극 활용 기본간호학 실습 교육평가방법에 대한 간호학생의 학습동기, 자기주도적 학습능력 및 문제해결과정과의 관계)

  • Kim, Young-Hee;Lee, Young-Mee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.147-155
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    • 2012
  • This study was to investigate the understand learning motivation, self-directed learning ability and problem solving process of fundamentals of nursing course using role play in evaluating the course. The subjects were 289 nursing students in year 1 in J college taking fundamental nursing practice course from Nov. 22 to Dec. 10. 2010. After setting hospital context and preparing scenario with patient and nurse roles, the evaluation of fundamentals of nursing practice was performed. For learning motivation and self-directed learning ability, there were significant differences by application motivation, a group intending further study and a group positive in role play evaluation. For problem solving process, there were significant differences in male group and a group positive in role play evaluation. Learning motivation had significant positive correlation between self-directed learning ability and between self-directed learning ability and problem solving process. This evaluation had correlation between learning motivation, self-directed learning ability and problem solving process.