• 대한간호학회지
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• 제27권3호
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• pp.503-509
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• 1997

This study was undertaken to identify optimal head elevation and position in the care of the neurosurgical patient with a cerebral aneurysm. The effects of 0°. 15° and 30° head elevation and three positions (supine, side tying position opposite to the operation site, and side tying position on the same side as the operation site) on ICP was studied in fourteen neurosurgical patients with cerebral aneurysms. The results are as follows : 1. The mean intracranial pressure was significantly lower when the patient's head was elevated at 30° as compared to 0° and 15°. 2. The mean intracranial pressure was significantly lower when the patient was positioned in the supine as compared to side tying position opposite to the operation site and side tying position on the same side as the operation site. The data indicate that head elevation to 30° and the supine position reduce ICP in neurosurgical patients with cerebral aneurysm.

• Journal of Oral Medicine and Pain
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• 제20권2호
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• pp.489-496
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• 1995

The purpose of this study was to evaluate an effect of change on head posture initial occlusal contacts with measuring the distances between initial occlusal contacts and maximum intercuspal position at different head posture in TMDs patient. For this study, 24 patients from age 13 to 36 were selected, they were examined health history taken, patients who have sign and symptoms of TMDs were examine before the study. For the normal group, 21 adults from age 23 to 25 were selected. They have normal or class I molar relationship, and have no other prosthetic restorations. Difference on distance between initial occlusal contact and maximum intercuspal position with mandibular kinesiograph$(MKG^R)$(K6 diagnostic system, Myo-tronic Inc, USA) in upright, supine, 45$^{\circ}$ extension, 30$^{\circ}$ flexion position of the head were measured. The Frankfort horizontal plane was used as a reference plane. The results were as follows : 1. There were significant differences between initial occlusal contacts of the normal and patient group on upright position and 30$^{\circ}$ flexion of the head(p<0.05, p<0.01) 2. The position of the initial occlusal contacts have a tendency to place anterior and inferior to maximal intercuspal position in upright position and 30( flexion of the head as well as posterior and inferior in supine position and 45$^{\circ}$ extension of the head in the normal and patient groups. 3. There were significant differences among the initial occlusal contacts between uptight and supine position; upright and 45$^{\circ}$ extension of the head(p<0.05); supine position and 30$^{\circ}$ flexion of the head, .and 30(flexion and 45$^{\circ}$ extension of the head in the patient group(p<0.01) The result have shown that after treatment on the supine position, it may be necessary to check occlusal contact on the upright position as well ass flexion of the head. It may need careful adjustment in occlusal condition on upright position of TMDs patient.

• 한국치위생학회지
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• 제15권4호
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• pp.743-750
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• 2015

Objectives: The purpose of the study is to examine the correlation and influencing factors among ethics position, self-esteem, and perception of patient medical information protection in the dental hygiene students. Methods: This is a cross sectional study using the structured questionnaire. A self-reported questionnaire was completed by 202 dental hygiene students using the stratified sampling method from September 1 to November 1, 2013. The questionnaire was modified and complemented from Ethics Position Questionnaire (EPQ). The questionnaire included EPQ, self-esteem, and perception of patient medical information protection. Data were analyzed by independent t-test, one way ANOVA, Duncan's multiple comparison analysis, Pearson's correlation analysis, and stepwise multiple regression analysis using IBM SPSS Statistics 21.0 program. Results: There was a positive correlation among all the variable including idealism position, self-esteem, and perception of patient medical information protection, The factors influencing on the perception of patient medical information protection were idealism position (${\beta}=0.271$, p<0.001) and self-esteem (${\beta}=0.248$, p<0.001). The corrected explanation power of the model was 15.1%. Conclusions: As the idealism position and self-esteem become higher, the perception of patient medical information protection gets higher. Therefore, this study suggests that it is needed to develop and vitalize implement the appropriate programs enhancing ethics consciousness, proper position, and self-esteem in the dental hygiene students receiving the education for their professionalism in the dental hygiene curricula.

• 대한물리의학회지
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• 제8권3호
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• pp.337-342
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• 2013

PURPOSE: The Unilateral neglect is characterized by difficulty shifting attention to the side of space opposite the brain lesion and frequently reducing use of contralesional extremities. This study was to identify whether the visual deprivation was responsible for head position on unilateral neglect patient after stroke. METHODS: A patient with left middle cerebral artery infarction participated in the study. We assessed neglect using line bisection and star cancellation test. Patient was instructed to maintain correct alignment of trunk and head in a sit position. We evaluated degree of head lateral tilting and rotation. Then, patient was blocked visual input. Also, we evaluated head position in the same way. RESULTS: He scored 3 points in the line bisection test and 9 points star cancellation test. In postural evaluation, he had deviated posture such as lateral head tilting and rotation. After visual cue deprivation, patient showed different head position which was decreased degree of head tilting and rotation. CONCLUSION: For vertical body orientation, it was used multiple sensory references including the vestibular, somatosensory, and visual system. This finding suggested that abnormal posture of neglect patient could be related to the visual input. It has important clinical implications in terms of understanding the neglect.

• 대한방사선기술학회지:방사선기술과학
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• 제38권1호
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• pp.1-6
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• 2015

Whole spine scanography(WSS)는 전신에 X선을 조사하는 검사로 치료기간 동안 빈번한 X선 조사가 이루어지는 검사이다. 일반촬영 분야에서는 많은 X선이 전신에 조사되는 검사이다. 따라서 논문에서는 Auto image pasta기법의 디지털 WSS 검사에서 환자의 검사방향에 따른 유효선량과 장기선량을 전산모사를 통하여 평가하였고, 영상에서 척추의 확대도와 각도의 변화를 평가하였다. 전후면 자세에서의 평균 유효선량은 0.069 mSv였고, 후전면 자세에서 평균 유효선량은 0.0361 mSv로 약 2배의 차이를 보였다. 전후면 자세에서 남성의 평균 유효선량은 0.089 mSv, 여성에 대한 평균 유효선량은 0.431 mSv로 나타났고, 후전면 자세에서 남성의 평균 유효선량은 0.050 mSv, 여성에서는 0.026 mSv로 나타났다. 확대율에서는 후전면 자세에서 전후면 자세에 비해 5%정도 확대 되었으나 각도에는 큰 변화를 보이지 않았다. 따라서 임상 환경에서 동일한 검사조건에서 환자의 자세를 변화시키는 것만으로도 환자의 피폭선량을 감소시킬 수 있음을 확인하였다. 특히 WSS와 같이 치료기간 동안 반복되는 검사에서 환자의 피폭선량 최적화를 위하여 검사 프로토콜의 재정립이 필요함을 확인하였다.

• 한국방사선학회논문지
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• 제9권7호
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• pp.467-471
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• 2015

본 연구에서는 L-tube insertion 환자의 흉부 AP 검사 시 tube tip이 환자의 자세나 방사선 조사각에 의해 왜곡되는 정도를 파악하고 정확한 임상정보를 제공하기 위해 검사 시 정확한 tube 각도를 유지하여 영상의 질을 높이고자 하는데 있다. 실험 장비로 SHIMADZU사의 ELMO-T6S를 사용하였으며, Chest phantom의 표면에 1 mm 간격의 눈금격자를 부착한 L-tube를 부착하여 실험을 하였다. 실험영상의 영상 획득 조건은 90 kVp, 4 mAs, SSD 120 cm로 하여 영상을 획득하였다. Phantom position은 table에서 supine, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$로 변화시키고 각 position마다 Head 방향과 Feet 방향으로 수직, ${\pm}5^{\circ}$, ${\pm}10^{\circ}$, ${\pm}15^{\circ}$ 촬영을 하여 영상을 획득하였다. 본 실험 결과로 L-tube tip의 위치는 환자의 자세와 방사선 입사각에 따라 달라지며 환자의 position이 30, 45, $60^{\circ}$일 때 보다 supine 일 때 tip의 위치변화가 적은 것으로 나타났다. 흉부 방사선 검사를 통해 L-tube tip의 정확한 위치를 보고자 할 때 잘못 된 입사각에 의한 영상의 왜곡이 발생하지 않도록 환자의 자세나 입사각을 조정해야 하며, 해당 시술을 확인하는데 정확한 평가 지표로 이용될 수 있도록 임상에서 업무를 수행하는 방사선사들의 세심한 노력이 필요할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.568-573
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• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• Journal of Oral Medicine and Pain
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• 제25권2호
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• pp.191-203
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• 2000

This study was performed to investigate the relationship between vertical dimension during swallowing and speech pattern in patients with temporomandibular disorders. For this study, 33 patients with temporomandibular disorders(TMDs), namely, 17 patients with disc displacement with reduction and 16 patients with disc displacement without reduction, and 30 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) was used for recording of electromyographic(EMG) activity(${\mu}V$) of the anterior temporalis, the superficial masseter, the sternocleidomastoideus and the trapezius insertion muscle during swallowing, and of mandibular positional change with function time(sec.) during swallowing and speech. A sentence of 'Sue is missing her house' was used for observing of speech pattern. Comparison between the two groups and relationship of the mandibular positional change and the function time between during swallowing and during speech were analysed by SPSS windows program. The results of this study were as follows : 1. Mean EMG activity of the trapezius insertion during swallowing was higher in the patient group, and the value was $3.4{\mu}V$ in patients and $2.1{\mu}V$ in normal subjects. 2. Vertica1 dimension(VD) at mandibular rest position before swallowing was slightly higher in the patient group, but VD at swallowing-late stage and at rest position after swallowing were not different between the two groups. 3. Swallowing time were 2.1 sec. in the patient group, and 1.5 sec. in the normal group, and the difference was significant. 4. VD during speech were generally higher in the normal group. In this case, speaking position showing the most difference between the two groups was 'her' position. The distance from habitual intercuspal position to 'her' position was 4.9mm in the patient group, and 6.6mm in the normal group. Speaking time was also longer in the patient group. 5. There were no difference in all observed items between the two categories of the patient group according to reduction of disc displacement. 6. Relationship between the positional changes during swallowing and speech were different between the patient group and the normal group. And in the normal group, VD at rest position before swallowing was negatively correlated with speaking time.

• 대한치과보철학회지
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• 제26권1호
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• pp.171-184
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• 1988

The establishment of an optimal and functional condylar position (centric relation) as the therapeutic and diagnostic reference position during occlusal treatment for patients with temporomandibular joint and muscle pain. dysfunction has long been an important subject in dentistry. The objective of this study was to compare the reproducibility md the changes of condylar position in normal group to those in patient group after use of the occlusal biteplane splint. For this study, 11 normal adults who had no symptoms of masticatory dysfunction and 18 patients who had visited at the department of occlusion in dental infirmary of Yonsei University were selected. For each subject three centric relation records were recorded before treatment, after 2 weeks and after symptoms were improved. And the condylar positions in centric relation were measured using articulators and a Vericheck. On the basis of this study, the following results were obtained. 1. In normal group, there was no significant difference of reproducibility in condylar position before and after the use of the occlusal biteplane splint for 2 weeks. 2. In patient group there was significant improvement in the reproducibility of condylar position after treatment (P<0.01). The reproducibility in patient group, however, was less than normal group. (P<0.01) 3. The mean distance of condylar movements was $0.38{\pm}0.22mm$ after 2 weeks in normal group. 4. In patient group, condylar movements were $1.36{\pm}0.70mm$ (P<0.01), significantly different from normal group. (P<0.01) 5. In patient group, the main direction of condylar movements after treatment was toward anterior and superior, preponderance being at superior direction.

• 기본간호학회지
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• 제19권1호
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• pp.35-45
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• 2012

Purpose: This study was done to explore the relationship between perceived patient safety culture and patient safety management activities among health personnel. Methods: This study was a cross-sectional survey. Participants were 342 health personnel working in two tertiary hospitals. Self-administered questionnaires were used to collect data from a convenience sample of 254 nurses and 88 doctors. Results: Scores on participants' perceived patient safety culture and patient safety management activities were just over the mean. There were significant differences in patient safety management activities by type of occupation, nurses' position, length of service, and work week. Doctors scored perceived patient safety culture and patient safety management activities significantly lower than nurses. In addition, perceived patient safety culture was significantly related to patient safety management activities. Factors which influence participants' patient safety management activities were communication, type of occupation, overall evaluation of patient safety, supervisor/manager, frequency with which events were reported, and nurse's position. Conclusion: Findings provide significant evidence that patient safety management activities are associated with perceived patient safety culture. Therefore, to build a positive safety culture, health personnel, especially doctors and general nurses need to visibly commit to patient safety management activities and be role models to ensure patient safety.