• 철학연구
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• 제143권
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• pp.119-140
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• 2017

동서냉전체제의 해체 이후, 한반도의 통일에 관한 논의에서는 두 가지 지점에서 인식의 전환이 이루어졌다. 첫째, 통일의 진짜 핵심 문제는 체제통합이 아니라 사람의 통합이라는 인식의 전환이다. 둘째, 한반도의 분단과 관련되어 있는 4대 열강에 다수의 코리언 디아스포라가 존재하고 있으며 이들의 이산이 한반도의 비극적 역사와 관련되어 있다는 인식의 전환이다. 하지만 아직까지도 이 두 가지를 종합적으로 다루면서 통일론의 새로운 전환을 모색하고 있는 논의는 거의 없다. 코리언의 역사적 트라우마는 한반도의 근대 역사가 낳은 아픔으로, 코리언의 집단적 리비도를 억압함으로써 발생했다. 식민과 이산, 분단은 한반도의 근대 역사가 낳은 아픔으로, 코리언의 역사적 트라우마는 식민과 이산, 분단의 트라우마로 구성되어 있다. 또한, 식민과 이산, 분단의 트라우마는 모두다 '민족${\neq}$국가'의 어긋남이라는 억압의 구조를 공유하고 있다. 따라서 '민족${\neq}$국가'의 어긋남을 극복하는 것을 목표로 삼고 있는 통일은 코리언의 역사적 트라우마를 치유하는 과정과 분리될 수 없다. 무엇보다도 먼저, 이 글은 한반도에서 통일을 만들어가기 위해서는 식민과 이산, 분단의 트라우마들을 치유하는 과정을 필요로 한다고 주장하고 있다. 둘째, 이 글은 통일이 남북 두 국가의 문제가 아니라 동북아 차원에서의 역사적 트라우마를 치유함으로써 평화를 만들어내는 것이기도 하다고 주장하고 있다. 셋째, 이 글은 코리언의 역사적 트라우마를 치유하는 것은 아픔에 대한 '공감'으로부터 시작되어야 하며 '차이의 소통'을 통해서 통일한반도를 만들어가는 '민족공통성'의 생산으로까지 나아가야 한다고 주장하고 있다.

• 해양환경안전학회지
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• 제26권4호
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• pp.327-335
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• 2020

본 연구의 목적은 해양경찰공무원과 경찰공무원의 외상 관련 국내 연구 동향을 분석하여 향후 연구에 대한 시사점을 제공하는 것이다. KCI 등재학술지에 실린 해양경찰, 경찰의 외상 관련 논문 57편을 수집하여 논문의 기초사항, 연구대상, 연구방법, 측정도구, 관련 변인 등을 분석하였다. 해양경찰공무원과 경찰공무원의 외상 관련 연구는 2010년부터 시작되어 산발적으로 이루어지고 있었으며 57편 중 해양경찰공무원의 외상 관련 연구는 6편에 불과하였다. 연구자의 전공영역은 경찰행정분야(59.6 %)가 가장 많았고, 심리학(19.3 %), 의학 및 간호학(10.5 %), 사회복지학(8.8 %), 교육학(1.8 %) 영역에서 연구가 이루어졌다. 해양경찰공무원 대상 연구는 6편 중 1편 외에는 모두 경찰행정분야에서 수행되었다. 연구방법은 양적 연구방법(78.9 %)이 대부분이었다. 질적 연구는 3편이었는데 모두 경찰공무원을 대상으로 하였다. PTSD 척도는 IES-R-K가 가장 많이 사용되었고, PDS, PCL-5가 뒤를 이었다. 외상 관련 변인으로는 외상성 사건 경험, 회복력, 스트레스 대처 방법, 사회적 지지 순으로 연구가 많이 이루어졌다. 이러한 결과를 바탕으로 학문적 시사점과 후속 연구에 대한 제언을 하였다.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.500-506
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• 2018

본 연구는 119 구급대 편성 인원에 따른 중증외상환자의 병원 전 응급처치 실태를 분석하고자 2015년 1월 1일부터 12월 31일까지 J도 소속 119 구급대원에 의해 이송된 중증외상환자 1,067명 중 438명을 대상으로 수행하였으며, 수집된 자료는 IBM SPSS Statistics 21.0으로 분석하였다. 연구기간 동안 발생한 중증외상환자는 성별로는 남성이 2인 및 3인 구급대에서 각각 242명(70.6%), 66명(69.5%)으로 더 많은 빈도를 보였으며, 이들 환자가 이송된 의료기관별로는 지역응급의료센터로 이송된 비율이 각각 44.0%(151명), 49.5%(47명)로 가장 높았다. 119 구급대 편성 인원에 따른 현장 체류시간은 2인 및 3인 구급대 두 군 간에 유의한 차이를 보이지 않았으며(p=0.071), 전문기도유지술 및 정맥로 확보 시행빈도, 정맥로 확보 성공률에서도 각각 유의한 차이를 보이지 않았다(p=0.253, p=0.362, p=1.000). 본 연구 결과 단순한 양적 충원만으로는 중증외상환자의 병원 전 처치에 대한 질 향상에 영향을 주지 못하는 것으로 판단되며, 전문 인력의 확보와 함께, 직접의료지도의 단순화 및 간접의료지도의 활성화, 법적 업무범위의 확대 등이 필요하다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.111-117
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• 2011

Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

• 동의신경정신과학회지
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• 제26권2호
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• pp.79-88
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• 2015

Objectives: The purpose of this study is to investigate the effects of the M&L Trauma Psychotherapy Program on: Impact of Event Scale - Revised (IES-R-K); Euro QOL-5 Dimension (EQ5D); Five-facet Mindfulness Questionnaire (FFMQ); and psychological tests. Methods: Eight middle-aged women subjected to domestic violence participated in the two-day M&L Trauma Psychotherapy Program. The Program was executed 5 times 2 days for about 3 hours. We evaluated IES-R-K, EQ5D, FFMQ, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression inventory (STAXI) and SUDS before the Program and for four weeks afterwards, to analyze the effects of the M&L Trauma Psychotherapy Program. Results: The scores of IES-R-K, BDI, STAI-S, STAI-T, Hwa ST and Hwa CT decreased significantly (p<0.05). EQ5D scores increased significantly (p<0.05) and overall physical condition scale (VAS) increased. In the FFMQ scores, all five facet scores increased slightly. Scores of SUDS decreased significantly right after the program, and remained decreased four weeks later, rather than before the Program (p<0.05). Conclusions: The results suggested that the M&L Trauma Psychotherapy Program improved post-traumatic stress, quality of life and mindfulness skills, and had positive responses to psychological problems - depression, anxiety, anger and distress.

• Korean Journal of Radiology
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• 제21권7호
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• pp.891-899
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• 2020

Objective: To assess the diagnostic performance of a deep learning-based algorithm for automated detection of acute and chronic rib fractures on whole-body trauma CT. Materials and Methods: We retrospectively identified all whole-body trauma CT scans referred from the emergency department of our hospital from January to December 2018 (n = 511). Scans were categorized as positive (n = 159) or negative (n = 352) for rib fractures according to the clinically approved written CT reports, which served as the index test. The bone kernel series (1.5-mm slice thickness) served as an input for a detection prototype algorithm trained to detect both acute and chronic rib fractures based on a deep convolutional neural network. It had previously been trained on an independent sample from eight other institutions (n = 11455). Results: All CTs except one were successfully processed (510/511). The algorithm achieved a sensitivity of 87.4% and specificity of 91.5% on a per-examination level [per CT scan: rib fracture(s): yes/no]. There were 0.16 false-positives per examination (= 81/510). On a per-finding level, there were 587 true-positive findings (sensitivity: 65.7%) and 307 false-negatives. Furthermore, 97 true rib fractures were detected that were not mentioned in the written CT reports. A major factor associated with correct detection was displacement. Conclusion: We found good performance of a deep learning-based prototype algorithm detecting rib fractures on trauma CT on a per-examination level at a low rate of false-positives per case. A potential area for clinical application is its use as a screening tool to avoid false-negative radiology reports.

• 대한치과보철학회지
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• 제33권1호
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• pp.156-163
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• 1995

A total of 2,510 police personnel aged 20-59 were examined to determine the prosthodontic demands. The results were as follows. 1. Prosthodontic demands increase with aging. 2. Periodontic problem is the major cause of the prosthodontic needs in old personnel. 3. Trauma is the more popular cause of the prosthodontic need than periodontal problem in policeman. 4. The major cause of the untreatment is the lacks of time. 5. The younger persons have more fear of dental treatment. 6. Prostodontic demands show declining trends.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.139-145
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• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.41-46
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• 2017

Purpose: To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury. Methods: We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care. Results: Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury. Conclusion: The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.

• Journal of Chest Surgery
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• 제26권8호
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• pp.661-663
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• 1993

We have experienced 6 cases of esophageal perforation from September, 1988 to June, 1993, in the department of Thoracic and Cardiovascular Surgery, Chungang Univesity Hospital and obtained the following results. The number of male patients was 5, and female 1.The causes of esophageal perforations were spontaneous, post-emetic in 2 cases, spur of cervical spine in 1 case, foreign body in 1 case, surgical trauma in 1 case and blunt trauma in 1 case. Perforation developed in cervical esophagus in I case,and others in distal third of the esophagus. One case needed only conservative treatment, and others needed surgical intervention minor or major. There were 2 mortality cases, and 2 cases healed satisfactorily without complication, 2 cases had complications that needed reoperations.