Journal of Korean Academy of Nursing Administration
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v.2
no.2
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pp.5-16
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1996
The purpose of this study is to identify the handwashing knowledge and attitudes of resistered nurses on general wards. Subjects for this study include 182 nurses working in general wards of a hospital in Seoul area. Data were collected by a questionnaire from July 30 to August 10,1996. Statistical analyses were done by the SPSS/PC program. The techniques used in this sudy included frequencies, chi-square test. The results of this study are summarized as follows. 1. 34.6% of the respondents reported that they washed their hand an average of 5 to 7 times during the work day. 2. 38.5% of the respondents reported always washing after each patient contact. Only 9.9% always washed before contact with a patient. 3. 56.6% of the respondents reported a washing time of 10 to 20 seconds, whereas 29.1% washed 21 to 30 seconds. Chi-square tests were employed to determine any differences in handwashing frequency and duration by age, working years, work position. There were no satistically significant differences among the variables. 4. 95.6% of the subjects used water and plain soap during the washing process. The respondents washed the palms of the hands, the backs of their hands and between their fingers(33%). Only 17.6% removed rings before handwashing. Similarly, 11% removed their wristwatch. The majority(96.2%) reported that they used communal textile towel to dry their hands. When asked what method they used to turn off the water faucet after washing, 98.4% reported using direct hand-to-faucet contact. 5. Nursing activities that showed the highest handwashing rates was after wound dressing(22.9%), followed by suctioning(21.4%), injection(21.2%), inserting catheter(18%). 6. Reasons cited for reduced handwashing frequency included being too busy to wash more often(74.7%), no need to wash more often(11.0%) and dry skin caused by frequent handwashing(3.3%). 7. When asked where they obtained their current knowledge of handwashing techniques, they reported professors(73.6%), resisted nurses(14.8%) and supervisor(6.6%). 8. Nursing staff thought that proper handwashing was important factor in decreasing nosocomical infections(72.4%).
Purpose: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. Methods: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. Results: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. Conclusion: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.
Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.
Manrique, Oscar J.;Ciudad, Pedro;Doscher, Matthew;Torto, Federico Lo;Liebling, Ralph;Galan, Ricardo
Archives of Plastic Surgery
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v.44
no.2
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pp.150-156
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2017
Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.
The objectives of this study was to investiage the effects of sitting posture on carpal tunnel syndrome. Carpal tunnel syndrome (CTS) continues to be one of the most widely publicized maladies of the cumulative trauma disorder. Many studies have reported a positive association between CTS and highly repetitive work, high force, and poor posture. High force and repetitive work have especially been associated with CTS, but the evidence for work being a primary cause of CTS is strongest when these factors are combined. In addition to carpal tunnel syndrome, hand, wrist, and other disorders are attributed to these work-related movements. Such disorders are referred to as repetitive stress injuries, cumulative trauma disorder, overuse syndromes, and chronic upper limb pain syndrome. Incorrect posture also may play a role in the development of CTS in people who work at a computer and other types of keyboards. The tendency to roll the shoulders forward, round the lower back, and thrust the chin forward can shorten the neck and shoulder muscles, compressing nerves in the neck. This, in turn, can affect the wrist, fingers, and hand. The treatment and prevention of carpal tunnel syndrome continue to be approached with a segmental view of the human body. For example, the most common ergonomic solution for carpal tunnel syndrome associated with keyboard use is to keep the wrists in a neutral position by using a wrist rest in front of the keyboard and good sitting posture.
Min, Hyoung Ki;Han, Kyung Ream;Lee, Sang Eun;Kim, Kyoung Tae;Kim, Chan
The Korean Journal of Pain
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v.19
no.2
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pp.223-227
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2006
Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.15
no.3
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pp.250-260
/
2005
This study was designed to find the symptom prevalence rates of musculoskeletal disorders and the risk factors of musculoskeletal disorders among selected hair dressers. Methods; The survey were conducted from July 1 to 30, 2004 for 459 hair dressers working in Seoul and Gwangju using self-administration questionnaire. The risk factors on musculoskeletal disorders have analysed by multiple linear regression analysis. The results of this study are summarized as follows: The experience rate of musculoskeletal disorders symptom in the last one year was 56.4%. The experience rates of each body parts were 36.4% on the shoulders, 30.5% on the legs and the feet, 28.5% on the low back, 27.0% on the hand and the fingers, 23.3% on the neck and 17.0% on the arms and the elbows. The prevalence rate of musculoskeletal disorders symptom in the last one week was 40.5%, those of each body parts were 24.0% on the legs and the feet, 21.4% on the shoulders, 20.7% on the low back, 15.7% on the hand and the wrists, 15.0% on the neck, 9.4% on the arms. The risk factors on musculoskeletal disorders were working posture(${\beta}=0.32$), perceived stress(${\beta}=0.19$), working period(${\beta}=0.16$), standing working over 10 hour(${\beta}=0.16$), hard working(${\beta}=0.11$). The adjusted determinant coefficient($R^2$) of this regression model was 0.267. Based on the results, in order to prevent musculoskeletal disorders of hair dressers, working posture shall be improved and leisure opportunities to relieve stress, and health management program shall be provided.
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.11
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pp.5219-5226
/
2011
A specialized anthropomorphic robot manipulator which can be attached to the housemaid robot McBot II, is developed In this paper. This built-in type manipulator consists of both arms with 3 DOF (Degree of Freedom) each and both hands with 3 DOF each. The robotic arm is optimally designed to satisfy both the minimum mechanical size and the maximum workspace. Minimum mass and length are required for the built-in cooperated-arms system. But that makes the workspace so small. This paper proposes optimal design method to overcome the problem by using neck joint to move the arms horizontally forward/backward and waist joint to move them vertically up/down. The robotic hand, which has two fingers and a thumb, is also optimally designed in task-based concept. Finally, the good performance of the developed manipulator is confirmed through live test of tasks.
Kim, Sun Ae;Kim, Tae Yang;Lee, Yeol Eum;Lee, Soo Yeon;Jeong, Mok Kun;Kwon, Sung Jae
The Journal of the Acoustical Society of Korea
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v.38
no.4
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pp.467-475
/
2019
A high-intensity ultrasound wave generates acoustic streaming and acoustic radiation forces when propagating through a medium. An acoustic radiation force generated in a three-dimensional space can produce a solid tactile sensation, delivering spatial information directly to the human skin. We placed 154 ultrasound transmit elements with a frequency of 40 kHz on a concave circular dish, and generated an acoustic radiation force at the focal point by transmitting the ultrasound wave. To feel the tactile sensation better, the transmit elements were excited by sine waves whose amplitude was modulated by a 60 Hz square wave. As an application of ultrasonic tactile sensing, a region where tactile sense is formed in the air is used as an indicator for the position of the hand. We confirmed the utility of ultrasonic tactile feedback by implementing a system that provides the number of fingers to a machine by receiving the shape of the hand at the focal point where the tactile sense is detected.
Journal of The Korean Society of Integrative Medicine
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v.8
no.1
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pp.47-56
/
2020
Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.
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