• 대한치과마취과학회지
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• 제8권1호
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• pp.1-9
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• 2008

Common dental procedures (local anesthesia and dental treatment) are potentially stress-inducing in many patients, especially medically compromised patients. The body response to dental stress involves the cardiovascular system (an increase in cardiovascular workload), the respiratory organ and the endocrine system (change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given. This protocol is predicated on the belief that the prevention of or reduction of stress ought to begin before the start of an appointment, continue throughout treatment, and, if indicated, into the postoperative period. The authors used the stress reduction protocol in the care of local anesthesia infected teeth in medically compromised patients. The final prognosis was comfortable without any complications.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.63-68
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• 2019

Background Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea. Methods We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014. The distribution of sex, age, injured body part, type of injury, and mechanism of injury sustained by patients who received hand and upper extremity injuries from using an engine saw, electric saw, or hand grinder was evaluated. Results Among 594 subjects who were injured by power tools, 261 cases were hand and upper extremity injuries. The average age was 53.2 years. Tendon injury was the most common type of injury. An electric saw was the most common type of power tool used. More injuries occurred in non-occupational settings than in occupational settings. Conclusions In this study, power tool-induced hand and upper extremity injuries were mostly caused by direct contact with electric saw blades. More injuries occurred due to non-occupational use of these tools, but the ratios of amputations and structural injuries were similar in the non-occupational and occupational groups.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.233-234
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• 2002

• Journal of Trauma and Injury
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• 제33권2호
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• pp.81-87
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• 2020

Purpose: Chronic subdural hematoma (CSDH) is a common disease in elderly patients and is usually treated by burr-hole drainage. However, the optimal surgical technique for treating CSDH has not been determined. In this study, we analyzed outcomes and recurrence rates after burr-hole drainage with or without irrigation in patients with CSDH. Methods: Eighty-two CSDH patients treated with burr-hole drainage at Wonju Severance Christian Hospital from March 2015 to June 2016 were enrolled in this study. The subjects were divided into three groups based on the surgical technique performed as follows: single burr-hole drainage without irrigation (group A, n=47), single burr-hole drainage with irrigation (group B, n=14), or double burr-hole drainage with irrigation (group C, n=21). These three groups were compared with respect to clinical and radiological factors and the recurrence rate, and independent factors predicting recurrence were sought. Results: After burr-hole drainage, CSDH recurred in 15 (18.3%) of the 82 patients, and six patients (7.3%) required reoperation. More specifically, recurrence was observed in 12 patients (25.5%) in group A, one (7.1%) in group B, and two (9.5%) in group C. The number of burr-holes did not significantly affect recurrence (odds ratio [OR]=0.38; 95% confidence interval [CI]: 0.60-2.38), but irrigation had a significant effect (OR=0.20; 95% CI: 0.04-0.97). Conclusions: This study shows that irrigation during burr-hole surgery in CSDH patients significantly reduced the risk of recurrence, regardless of the number of burr-holes used. We therefore recommend the use of active irrigation during burr-hole drainage surgery in CSDH patients.

• The Journal of Advanced Prosthodontics
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• 제7권4호
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• pp.323-328
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• 2015

PURPOSE. This in-vitro study was designed to evaluate retention forces, microleakage and plastic deformation of a prefabricated 2-implant bar attachment system (SFI-Bar, Cendres+$M{\acute{e}}taux$, Switzerland). MATERIALS AND METHODS. Two SFI implant-adapters were torqued with 35 Ncm into two implant analogues. Before the tube bars were finally sealed, the inner cavity of the tube bar was filled with liquid red dye to evaluate microleakage. As tube bar sealing agents three different materials were used (AGC Cem (AGC, resin based), Cervitec Plus (CP; varnish) and Gapseal (GS; silicone based). Four groups with eight specimens each were tested (GS, GS+AGC, AGC, CP). For cyclic loading, the attachment system was assembled parallel to the female counterparts in a chewing simulator. The mean retention forces of the initial and final ten cycles were statistically evaluated (ANOVA, ${\alpha}{\leq}.05$). RESULTS. All groups showed a significant loss of retention forces. Their means differed between 30-39 N initially and 22-28 N after 50,000 loading cycles. No significant statistical differences could be found between the groups at the beginning (P=.224), at the end (P=.257) or between the loss of retention forces (P=.288). Microleakage occurred initially only in some groups but after 10,000 loading cycles all groups exhibited microleakage. CONCLUSION. Long-term retention forces of the SFI-Bar remained above 20 N which can be considered clinically sufficient. The sealing agents in this study are not suitable to prevent microleakage.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.69-74
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• 2019

Background Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings. Methods The medical records of patients who visited the trauma center of Wonju Severance Christian Hospital from January 2010 to December 2015 for the management of venomous snakebite were retrospectively reviewed. Starting in 2014, fasciotomy was performed in patients with an intracompartmental pressure of more than 40 mmHg in addition to the clinical symptoms of compartment syndrome. Results A total of 158 patients with snakebite came to the hospital within 48 hours for treatment. Most patients (110 patients) were bitten at the upper extremities (69.6%). Since 2014, 33 out of 59 patients were suspected to have compartment syndrome, and their intracompartmental pressures were measured. Seventeen of those patients had a high intracompartmental pressure (average, 49.6 mmHg; range, 37-88 mmHg), and fasciotomy was performed. Conclusions In this study, as many as 10.8% of all cases were in need of fasciotomy when compartment syndrome was diagnosed by measuring the intracompartmental pressure. Previously, it was reported that fasciotomy was not required in many cases of compartment syndrome originating from snakebite. However, some patients may develop very severe compartment syndrome, requiring fasciotomy.

• 대한족부족관절학회지
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• 제26권2호
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• pp.66-70
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• 2022

Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

• 기독교교육논총
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• 제66권
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• pp.147-178
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• 2021

본 연구의 목적은 탈북청소년이 한국 사회에 정착하는 과정에 있어 기독교 신앙이 기여하는 바를 밝히는 것에 있다. 연구 방법은 내러티브를 활용했다. 연구참여자들은 입국하여 1년 이상이 된 17세에서 24세로 교회에 소속되어 있는 9명의 후기청소년이다. 연구문제는 네 가지이다. 첫째, 탈북청소년들은 탈북동기와 여정을 통해 과거를 어떻게 회고하는가? 둘째, 탈북청소년들은 현재 남한 사회에 적응해가는 과정에서 어떠한 어려움을 경험하고 극복하면서 정체감을 확립하는가? 셋째, 탈북청소년들은 통일세대 주역으로 미래를 재구성해나갈 수 있는가? 넷째, 탈북청소년들은 기독교신앙의 의미를 어떻게 해석하고 있으며 신앙은 한국사회 적응에 어떤 영향을 미치고 있는가? 연구결과는 다음과 같다. 첫째, 탈북청소년들의 탈북 동기와 과정에서 이들의 불안과 우울, 외상 후 스트레스가 정체성 혼란을 가져오며 한국 사회 적응에 방해 요인이 된다는 사실을 발견하게 되었다. 둘째, 탈북청소년들의 불안정한 정착에는 가족 갈등, 세대 갈등, 죄책감과 딜레마라는 미해결 감정과 학업 경쟁, 진로 고민, 취직의 부담감, 높은 사회적 장벽에 대한 인식이 있었다. 셋째, 한국 사회에서 태어난 청소년에 비해 탈북청소년들은 통일에 대한 인식이 높아 이들의 남한 사회 유입은 통일에 미치는 영향이 매우 크다고 할 수 있다. 넷째, 탈북청소년들은 가치 혼란을 초래할 수 있는 한국 사회에서 예배의 경험과 신앙과 문화와의 만남은 한국 사회 정착에 큰 도움을 주었다. 이러한 결과는 탈북청소년중 기독교 신앙인을 대상으로 그들이 남한 사회에서 정체감 형성과 적응과정에 기독교 신앙이 어떻게 기여하였는지 규명하고 북한 선교와 통일을 앞두고 미래세대를 위해 일하는 모든 기독교 사역자들에게 시사하는 바가 크다.

• 기독교교육논총
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• 제71권
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• pp.155-179
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• 2022

본 연구의 목표는, 여성 정치사상가 한나 아렌트(Hannah Arendt)가 『책임과 판단』에서 소개한 개념 '집합적 책임'을 들여와 기후변화를 주제로 하는 기독교교육 분야에 응용하는 것이다. 먼저 본 연구는 '집합적 책임' 개념을 집합적 유죄 개념에 대비하면서 작금의 기후변화 문제가 개인윤리의 과제라기보다는 정치적 과제로 인식되어야 한다는 사실을 강조한다. 그리고 기후변화에 대한 '집합적 책임'의 교육활동이 그 자체로 교육자와 학습자가 공히 참여하는 공공의 정치행위로 전개되어야 마땅하다고 주장한다. 본 연구는 정치행위로서 기독교교육 활동의 전개방안에 관하여 다음의 네 가지를 제안한다. 첫째, 기후변화로 인한 인류존망 위기에 대한 불안 및 분노의 감정을 공적 수준에서 발표하며 공유하기. 둘째, 칸트가 말한 "확장된 심성(공통감각)"을 통하여 이기주의(이권 편향)를 초월하기. 셋째는 "시민참여로서 아렌트적 토론학습"으로 호명되는 대화와 토론의 학습공동체를 결성하는 일이다. 마지막으로 넷째는, 그 같은 학습공동체 안에서 "사랑으로 행동하는 믿음"을 이웃사랑의 지평에서 실천할 수 있도록 격려하는 기독교교육이 일어나야 한다는 점이다. 본 연구의 학술적 의의는 아렌트의 정치이론을 기후변화 및 기후활동, 그리고 기독교교육에 관계지어 구체적으로 다룬 국내 최초의 학제간 연구논문이라는 사실이다. 비록 정치이론을 기독교교육에 응용하는 이론적 조직신학적 연구를 표방하나, 실제 교육장면에서 활용가능한 실천적 제안을 동반하고 있음을 자부한다.

• 기독교교육논총
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• 제71권
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• pp.23-59
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• 2022

이 논문은 디지털 인식론이 기독교교육에 미치는 영향에 대해 탐구하였다. 한 시대의 매체는 그 시대 인식의 유형과 형태를 결정하고, 이것은 결국 그 시대의 기독교교육의 방향에도 결정적 영향을 미치기 때문이다. 따라서 이 논문은 세 부분으로 이루어지는데, 첫째 매체와 인식론과의 관계에 대한 탐구, 둘째 디지털 인식론에 대한 탐구, 그리고 셋째 디지털 인식론이 기독교교육에 미치는 영향에 대한 탐구이다. 이 논문은 먼저 맥루언의 매체이론의 관점에서 매체가 단순히 오감의 확장을 넘어서서 새로운 환경과 삶의 양식을 만드는 것을 통해 우리의 인식을 변화시킨다는 것을 발견하였다. 그리고 디지털 인식론을 인쇄매체 시대의 전통적 인식론과의 비교를 통해서 4가지로 정리하였는바, "언어적 인식에서 전감각적 인식에로", "인과관계에서 관계성에로", "역사적 사고에서 탈역사적 사고에로", 그리고 "해석적 인식에서 수행적 인식에로"의 인식에 있어서의 패러다임 변화를 살펴보았다. 아울러 이 논문은 디지털 인식론, 즉 전감각적인식, 관계적 인식, 탈역사적 인식 그리고 수행적 인식이 기독교교육에 미치는 영향을 고찰하였다. 고찰을 통해 본고는 디지털 매체가 기독교교육의 본질에 순기능적으로도, 역기능적으로도 작용할 수 있음을 발견하였고, 결국 디지털 시대가 기독교교육에 역기능이기보다는 순기능이 되고, 도전이기보다는 기회가 되도록 하는 것이야말로 디지털 시대의 기독교교육에게 주어진 과제라고 하는 것을 깨닫게 되었다.