• Title/Summary/Keyword: Hospital design

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Clinical Cases Analysis of Forearm Free Fasciocutaneous Flaps on Oral Cavity Defect Area (구강 결손부에 적용된 요골 유리전완 피부피판 적용례 분석)

  • Kim, Uk-Kyu;Lee, Kwang-Ho;Song, Won-Wook;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Jong-Ryoul;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.324-331
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    • 2010
  • The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

The Effect of Mother-fetus Interaction Promotion Program of Talking and Tactual Stimulation on Mother-fetus Interaction and Mother-infant play Interaction (태담과 촉각 자극의 모-태아 상호작용 증진 프로그램이 모아 상호작용에 미치는 효과)

  • Kim, Jung-Soon
    • Korean Parent-Child Health Journal
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    • v.5 no.2
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    • pp.253-276
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    • 2002
  • Mother and infant relationship has a great influence on child's developments. Expecially, mother and infant relationship is affected by mother and infant interactions during one year after birth and an omen of mother-infant interaction after birth is mother-fetus interaction. This study was conducted to develop mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primiparas and to evaluate the effect of the nursing intervention program on mother-fetus interaction and mother-infant play interaction. Non-eguivalent control group posttest design was used, and Blumer's symbolic interaction theory and Barnard's mother-infant interaction model was used a conceptual framework of this study. Fifty primiparas and infant(26 mother-infant dyads for intervention group and 24 dyads for control group) were recruited from three general hospital and an OBGY clinic located in Kwang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother- fetus interaction was conducted at 36 to 38 weeks of gestational age. And mother-infant play interactions were assessed at 4 to 6 weeks after birth using videotapes. Play situations were videotaped and two trained observers analyzed the tapes. The data were analyzed using chi-square test and Fisher's Exact Test to test the equivalence of two groups, and the effect of intervention progrom was determined with t-test and Wilcoxon Rank Sum test. The results were as follows: 1. The significant difference was found in mother-fetus interaction between two groups(t=2.085, P=0.0425). It indicated that intervention progrom was effective in improving mother-fetus interaction. 2. The significant difference was found in mother-infant play interaction between two groups(W=347.5, P=0.0001). In subscale analysis, three subscales showed significant differences between the groups: interactional behavior of mother(t=5.921, P=0.0001), interactional behavior of infant(t=5.736, P= 0.0000), and synchronic interactional behavior of mother and infant(t=7.940, P= 0.0000). In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas promoted mother-fetus interaction and mother-infant play interaction. Therefore, this study suggests that this nursing interventions to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother - infant relationship, and for promotion the social, affective, and cognitive developments of their children.

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Efficacy of the Mentalization Improvement Program for Adolescent (MIPAdo) for Enhancement of Mental Health in School Children (청소년용 정신화 프로그램의 학생정신건강 증진효과 평가)

  • Moon, Su-Jin;Oh, So-Young;Lee, Won-Hye;Hong, Min-Ha;Min, Jung-Won;Kim, Bong-Seog;Hwang, Jun-Won;Woo, Iee-Hyok;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.109-116
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    • 2012
  • Objectives : Understanding the emotions, thoughts, feelings and behaviors of others, as well as oneself, is part of the mentalizing function. We developed a new school-based community model for mental health, called the Mentalization Improvement Program for Adolescent-Community Model (MIPAdo-CM), based on the concept of mentalization. Methods : The MIPAdo-CM was composed of 12 sessions and was applied to 403 students in the 2nd grade of a middle school. Every session was conducted after the regular school hours for 6 weeks. After 6 weeks, we compared the endpoint changes of Adolescent Mental Problem Questionnaire-Revised (AMPQ-R), Emotional Empathy Test (EET), Peer Aggression Scale (PAS), Peer Bullying Scale (PBS), School Adjustment Scale (SAS), Test Anxiety Inventory (TAI) and Visual Analogue Scale between the subject and the control group. Results : There was no significant difference between two groups in AMPQ-R, EET, PAS, PBS, SAS, and TAI. On the Visual Analoge Scale, however, students in the trial classes reported more increase in understanding and respect for both others and themselves. Conclusion : The efficacy of MIPAdo-CM was subjective improvement of understanding and respect for both others and themselves, erence between two groups in AMPQ-R, Empathy test, To prove objective usefulness of this program, further studies with more structured design will be needed.

Evaluation of the accuracy of three different intraoral scanners for endocrown digital impression: An in vitro study (엔도크라운 디지털 인상을 위한 구강스캐너 3종의 정확도 평가: 실험실 연구)

  • Ural, Cagri;Park, Ji-Man;Kaleli, Necati;Caglayan, Esma
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.4
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    • pp.282-289
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    • 2020
  • Purpose: The aim of this in vitro study was to evaluate the accuracy of three different intraoral scanners (IOSs) on digital impressions of different types of endocrown cavity preparations. Materials and methods: Two human mandibular molar teeth were prepared with different endocrown abutment designs: one with a buccal wall (Class 2) and the other without a buccal wall (Class 3). Both cavity designs were scanned using a reference desktop scanner (E3) and three different intraoral scanners: Trios3 (TRI group), Cerec Omnicam (CER group), and i500 (I5 group). The obtained Standard Tessellation Language (.stl) datasets were exported to metrology software. The precision was evaluated based on deviations among repeated scan models recorded by each IOS. The trueness was evaluated based on deviations between the reference data and repeated scans. For detecting interaction, data were statistically analyzed using a univariate analysis of variance (ANOVA) and for analyzing the comparison of the test groups data were analyzed by one-way ANOVA and post-hoc Tukey test at the significance level of .05. Results: The deviation values for both cavity designs in the I5 group were significantly lower than those in the other IOS groups in terms of trueness. For both cavity designs, the TRI group exhibited better precision than the other IOS groups. Conclusion: Different technologies of IOS device's and different endocrown prepration designs affected the accuracy of the digital scans.

The Evaluation of Biocompatigbility of Collagen/Chondroitin Sulfate Sponge as a Scaffold for Corneal Stromal Layer (각막 간질 대체물로 콘드로이틴 설페이트가 결합된 콜라젠 스폰지의 생체 적합성 평가)

  • Jang, In-Keun;Ahn, Jae-Il;Seo, Yeong-Gwon;Kim, Jae-Chan;Song, Kye-Yong;Park, Jung-Keug
    • KSBB Journal
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    • v.21 no.6 s.101
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    • pp.439-443
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    • 2006
  • Biocompatibility and tissue regenerating capacity are essential characteristics in the design of collagenous biomaterials for tissue engineering. Attachment of glycosaminoglycans to collagen may add to these characteristics by creating an appropriate micro-environment. In this study, porous type I collagen matrices were crosslinked using dehydrothermal treatment and 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide, in the presence and absence of chondroitin sulfate (CS). The scaffold like discs in 3 mm diameter were inserted into the intralamellar stromal pockets of rabbit cornea. In 8 weeks of follow up, clinical evaluation including corneal neovascularization, opacity and transparency of the graft scaffold was performed, and the inflammatory reaction and migration of corneal fibroblast were evaluated histologically. No inflammation, neovascularization and opacity in any of the implant were observed. CS increased the corneal fibroblast invasion and the transparency. It is concluded that the type I collagen sponge showed a biocompatibility in corneal stromal layer and addition of CS slightly improved the quality of the bioartificial corneal stromal layer. These results could be useful for the development of corneal substitutes.

Additional Improvement and Evaluation of Exhaust Ventilation Systems at Small and Medium Sized Enterprise (중.소규모 사업장의 국소배기장치 설치 실태와 문제점 및 개선방안)

  • Lim, Seong-Keun;Park, Doo-Yong;Kim, Won-Ki;Kim, Soo-Geun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.20 no.1
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    • pp.1-9
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    • 2010
  • Objectives : The purposes of this study were to evaluate exhaust ventilation systems(EVSs) and to suggest problems and improvements. Methods : For 50 small and medium-sized enterprises, we carried out evaluation of EVSs. We evaluated hoods with smoke tester and measurement of capture velocity. In addition, we used several indicators for performance evaluation designed in this study. Results : 1. Based on the smoke flow pattern and the criteria of occupational health and safety act, 67.8% of hoods were rated 'good' level at smoke test whereas 26.3% were rated 'good' level at measurement of capture velocity. 2. 29.3% of hoods, of which ratio of measured actual air flow at hood(Qah) to required ideal exhaust air flow at hood(Qih) was 1 or more, were rated 'good' level. 3. The % of EVS, of which ratio of measured actual air flow at stack(Qast) to total required ideal exhaust air flow at hood(Qith) was 1 or more, was 29.0%. 4. For the ratio of measured Qast to existing air flow at fan(Qfan), only 5% of EVSs were 1 or more and 26.0% were 0.8 or more but less than 1.0. 5. For the ratio of measured Qast to total measured actual exhaust air flow at hood(Qath), 74.0% were 0.8 or more but less than 1.0. 6. The percentage of EVS, of which ratio of total measured Qath to existing Qfan was 0.8 or more, was 19.0%. 7. The percentage of EVS, of which ratio of total measured Qath to total required ideal exhaust Qith was 1 or more, was 26.0%. 8. For the comprehensive evaluation indicators designed in this study, 29.0% were 0.8 or more. Conclusions : We found that few exhaust local ventilations at small and medium-sized enterprises were rated 'good' level and that most exhaust local ventilations had 'poor' design and installation. Therefore, relevant professional manpower and enterprises have to construct exhaust local ventilation where it is needed, and technical guidance and economic support are needed to improve 'poor' exhaust local ventilation after self-evaluation.

Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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Individualized Acupuncture versus Standardized Acupuncture in Symptomatic Treatment of Osteoarthritis of the Knee-a Randomized Controlled Trial (ISRCTN 40706107) (퇴행성 슬관절염에 대한 맞춤형 침 치료 효과 검증 무작위 대조군 임상연구(RCT) (ISRCTN 40706107))

  • Byun, Hyuk;Kim, Sun-Woong;Ahn, Ji-Hyun;Kim, Yong-Suk;Seo, Jung-Chul;Choi, Sun-Mi;Park, Ji-Eun;K., Kawakita;N., Takahashi;E., Sumiya;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.183-195
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    • 2007
  • Objectives : To determine whether individualized acupuncture (IA) provides greater pain relief and improved function compared with standardized acupuncture (SA) in patients with osteoarthritis of the knee. Methods: Design is a randomized single blind controlled trial with two intervention arms (IA vs SA) of 6 weeks' duration and 3 months follow up. An orthopedist diagnosed 50 patients' symptoms as knee osteoarthritis. Interventions were applied by 2 residents studying the acupuncture and moxibustion specially in Dongguk University International Hospital. Primary outcome measure is pain as measured by visual analogue scale (VAS). Secondary measures of pain and disability include WOMAC, SF-36, LFI and KHAQ. Results : The 50 participants were well matched for age, sex, bad side, VAS, WOMAC, SF-36, LFI and KHAQ scores at the baseline. 3 participants dropped out. There have not been any adverse events in both groups. Participants in both groups experienced great improvement in all measures except SF-36at 3 and 6 weeks. At 18 weeks, the IA group experienced significantly greater improvement than the SA group in VAS but not in WOMAC, SF-36, LFI and KHAQ. Conclusions : Manipulation of IA seems to provide pain relief longer for osteoarthritis of the knee when compared with SA.

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The Effect of Supportive Group Nursing Care on Body Image of the Patient With tower Limb Fracture (지지적 집단간호가 하지골절 환자의 신체상(Body Image)에 미치는 영향)

  • 정추자
    • Journal of Korean Academy of Nursing
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    • v.15 no.3
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    • pp.74-80
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    • 1985
  • This study was attempted to identify the difference between body image of the patients with lower limb fracture and that of normal persons, and to examine if supportive group care could offer an apportunity for positive change in body image of the patient with lower limb fracture under the Quasi-experimental design. The subjects for this study were obtained by ta-king convenient sample of soldiers; the experimental group were 44 lower limb fractured patients hospitalized on the orthopedic Surgery unit in S Army General Hospital, while the control group were 44 normal enlisted men serving in the B Army regiment. Supportive group nursing care was given to the lower limb fractured patients who belong to the experimental group. Pre-and post-tests were administered to the experimental and the control group. The instruments to measure body image of the subjects were body Cathexis Scale developed by Scord and Jourard (1953) and Body Meaning Scale dove-loped by the reseacher. The reliability coefficients by Cronhach's u-test were .95 in body Cathexis Scale and .89 in Body Meaning Scale in this study. Data for this study were collected over a period 12 days from the 12th to the 24th of October, 1984 by the questionnaire. Data were analyzed by computer. Frequency, Percentage and x²-test were used to examine general chacteristics of the subjects. t-test was used to analyze the hypotheses. Analysis of variance was used to test difference in body image between groups classified by the general characteristics. Pearson Correlation Coefficient was used to identify the correlation between Body Cathexis Scale and Body Cathexis Scale and Body Meaning Scale. The results of this study were as follows: 1. No significant difference was found between the experimental and the control group on general characteristics of the subjects (p> .05). 2. Hypothesis I:“There will be a difference in body image between patiens with lower limb fracture and normal persons,”was supported(Body Cathexis t=6.91, p<.001, Body Meaning t=5.66, p< .001). 3. Hypothesis Ⅱ;“The will be a difference in body image of patients with lower limb fracture bet-ween after and before, supportive group nursing care was provided,”was supported (Body Cathexis t=5.90, p<.001, Body Meaning t=4.45, p <.001). 4. There was no significant difference in body image between groups classified by the general characteristics (p> .05). 5. The correlation between Body Cathexis Scale and Body Meaning Scale: It was reported that Body Cathexis Scale correlated with Body Meaning Scale in total subjects of the experimental and control group (r=.744, p<.001). That is, there was relatively high correlation between two scales. body Cathexis Scale correlated with Body Meaning Scale in the experimental group(r=.738, p <.001) and in the control group (r=.352, p <.001). That is, there was more than moderate correlation between two scales. In conclusion, it was found that there was a difference in body image between patients with lower limb fracture and normal persons, and supportive group nursing care offered an opportunity for positive change in body image of the patient with lower limb fracture.

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Effects on Maternal Attachment, Parenting Stress, and Maternal Confidence of Systematic Information for Mothers of Premature Infants (미숙아 어머니를 위한 체계적인 정보제공이 모아애착, 양육스트레스, 양육자신감에 미치는 효과)

  • Choi, Hyo-Sin;Shin, Yeong-Hee
    • Child Health Nursing Research
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    • v.19 no.3
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    • pp.207-215
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    • 2013
  • Purpose: The aim of this study was to examine the effects of systematic information on maternal attachment, parenting stress and maternal confidence of mothers of premature infants. Methods: Using a non-equivalent control group pre-post quasi-experimental design, 42 participants were assigned to one of two groups, an experimental group (n=20), which received systematic information; and a control (n=22), which received the usual discharge education. Prior to the intervention, baseline data were collected (pretest) and then the systematic information was provided four times for the experimental group. Maternal attachment, parenting stress and maternal confidence were measured. Data were collected three times: Seven to 10 days prior to discharge, day of discharge, and two weeks after discharge. Results: Mothers in the experimental group had significantly higher scores in maternal attachment (F=6.16, p=.005), lower parenting stress scores (F=5.56, p=.004), and higher scores for maternal confidence (F=16.50, p<.001) than mothers in the control group. These tendencies were progressively enhanced even two weeks after discharge from the hospital. Conclusion: The results indicate that provision of systematic information to mothers with premature infants is an effective intervention to enhance mothers' maternal attachment, decrease parenting stress, and enhance maternal confidence.