• 한국전문물리치료학회지
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• 제26권4호
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• pp.70-76
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• 2019

Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

• The Korean Journal of Pain
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• 제32권3호
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• pp.168-177
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• 2019

Background: Brennan's rodent paw incision model has been extensively used for understanding mechanisms underlying postoperative pain in humans. However, alterations of physiological parameters like blood pressure and heart rate, or even feeding and drinking patterns after the incision have not been documented as yet. Moreover, though eicosanoids like prostaglandins and leukotrienes contribute to inflammation, tissue levels of these inflammatory mediators have never been studied. This work further investigates the antinociceptive effect of protein C after intra-wound administration. Methods: Separate groups of Sprague-Dawley rats were used for quantitation of cyclooxygenase (COX) activity and leukotriene B4 level by enzyme-linked immunosorbent assay, as well as estimation of cardiovascular parameters and feeding and drinking behavior after paw incision. In the next part, rats were subjected to incision and $10{\mu}g$ of protein C was locally administered by a micropipette. Both evoked and non-evoked pain parameters were then estimated. Results: COX, particularly COX-2 activity and leukotriene B4 levels increased after incision. Hemodynamic parameters were normal. Feeding and drinking were affected on days 1 and 3, and on day 1, respectively. Protein C attenuated non-evoked pain behavior alone up to day 2. Conclusions: Based upon current observations, Brennan's rodent paw incision model appears to exhibit a prolonged period of nociception similar to that after surgery, with minimal interference of physiological parameters. Protein C, which is likely converted to activated protein C in the wound, attenuated the guarding score, which probably represents pain at rest after surgery in humans.

• Physical Therapy Rehabilitation Science
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• 제7권4호
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• pp.147-153
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• 2018

Objective: This study investigated the effects of air stacking training (AST) on pulmonary function, respiratory strength, and peak cough flow (PCF) in persons with cervical spinal cord injury (CSCI). Design: Randomized controlled trial. Methods: A total of 24 persons with CSCI were randomly allocated to the AST group (n=12) or the incentive spirometry training (IST) group (n=12). Patients with CSCI received AST or IST for 15 minutes, with 3 sessions per week for 4 weeks, and all groups performed basic exercises for 15 minutes. In the AST group, after the subject inhaled the maximal amount of air as best as possible, the therapist insufflated additional air into the patient's lung using an oral nasal mask about 2-3 times. In the IST group, patients were allowed to hold for three seconds at the maximum inspiration and then to breathe. The pre and post-tests measured forced vital capacity (FVC), forced expiratory volume one at second (FEV1), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and PCF. Results: Both groups showed significant improvements in FVC, FEV1, MEP, MIP and PCF values after training (p<0.05). The FVC in the post-test and the mean change of FVC, FEV1, MIP were significantly higher in the AST group than the IST group (p<0.05). Conclusions: The findings of this study suggested that AST significantly improved pulmonary function, respiratory strength, and PCF in persons with CSCI. Therefore, AST should be included in respiratory rehabilitation programs to improve coughing ability, pulmonary function and respiratory muscle strength.

• 대한응급의학회지
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• 제29권6호
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• pp.603-615
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• 2018

Objective: We analyzed the association between regional weather and temporal changes on the daily occurrence of trauma emergencies and their severity. Methods: In this cross-sectional prospective study, we investigated daily atmospheric patterns in trauma episodes in 1,344 patients in Cheongju city, South Korea, from January 2016 to December 2016 and analyzed the association of trauma occurrence and Injury Severity Scores (ISS) with weather conditions on a daily scale. Results: The mean age of trauma patients was $53.0{\pm}23.8years$ and average ISS was $9.0{\pm}2.0$. Incidence of trauma was positively correlated with average temperature (r=0.512, P<0.001) and atmospheric pressure (r=0.332, P=0.010) and negatively correlated with air pollutants (particulate matter less than $2.5{\mu}m^3$ [PM2.5], r=-0.629, P<0.001; particulate matter less than $10{\mu}m^3$ [PM10], r=-0.679, P<0.001). ISS was not significantly correlated with climate parameters and air pollutants, and variability was observed in the frequency and severity of trauma by time of day (highest occurrence, 16-20 pm; highest ISS, 4-8 am), day of the week (highest occurrence and highest ISS, Saturday), month of the year (highest occurrence, July; highest ISS, November), and season (highest incidence, summer; highest ISS, autumn). Conclusion: The study shows a positive relationship between trauma occurrence and specific weather conditions, such as atmospheric temperature and pressure. There was a negative relationship between concentrations of PM2.5 or PM10, and trauma occurrence. However, no correlation was observed between weather conditions or the concentrations of air pollutants and ISS. In addition, seasonal, circaseptan, and circadian variations exist in trauma occurrence and severity. Thus, we suggest that evaluation of a larger, population-based data set is needed to further investigate and confirm these relationships.

• 대한간호학회지
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• 제53권3호
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• pp.275-294
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• 2023

Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

• 임상간호연구
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• 제30권2호
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• pp.114-124
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• 2024

Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care. It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses' knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion: To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.

• Journal of Trauma and Injury
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• 제27권2호
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• pp.33-37
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• 2014

Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

• Journal of Chest Surgery
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• 제40권4호
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• pp.309-312
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• 2007

흉부 압박상에 의한 경부 기관의 파열은 매우 드물게 발생하며, 여러 가지 기전에 의해 설명되고 있다. 기관 손상을 받은 많은 환자는 병원에 도착하기 전에 사망하기 때문에 빠른 진단에 의한 치료는 예후를 결정하는 데 매우 중요하다. 교통사고에 의한 흉부 압박상으로 호흡곤란을 주소로 내원한 8세의 남아에서 발생한 경부 기관의 완전파열 1예를 조기 진단하여 수술치험하였기에 문헌고찰과 함께 보고하는 바이다.

• 간호행정학회지
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• 제12권3호
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• pp.373-384
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• 2006

Purpose: This is a pilot study to identify patient safety risk factors and strategies for patient safety management perceived by nurses. Methods: Data were collected and analyzed with an open questionnaire from April to May 2005, targeted on 100 nurses working in two hospitals. The issues were 'what are risk factors for patients, nurses, and other medical practitioners? How do they prevent with the aftermath of risk factors, causes of incidents?' For data analysis, types and frequency of risk factors were worked out, using the Australian Incident Monitoring System Taxonomy. Results: The types of patient safety risk factor perceived by nurses were as follows ; therapeutic devices or equipment, infrastructure and services (29.5%), nosocomial infections (16.3%), clinical processes or procedures (15.4%), behavior, human performance, violence, aggression, security and safety (12.2%), therapeutic agents (9.7%), injuries and pressure ulcers (8.7%), logistics, organization, documentation, and infrastructure technology (5.6%). Strategies for patient safety included training of prevention of infection, education about safety management for patients and medical professionals, establishment of reporting system, culture of care, pre-elimination of risk factors, cooperative system among employees, and sharing information. Conclusion: These results will be used to provide evidences for patient safety management and educational program.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2002년도 추계학술대회 논문집
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• pp.1066-1069
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• 2002

Dynamic postural control varies with the environmental context, specific task and intentions of the subject. In this paper, dynamic postural control against forward-backward perturbations of a platform was estimated using tri-axial accelerometers and a force plate. Ten young healthy volunteers stood upright in comfortable condition on the perturbation system which was controlled by an AC servo motor. With anterior-posterior perturbations, movements of ankle, knee and hip Joints were obtained by tri-axial accelerometers. and ground reaction forces with corresponding displacements of the center of pressure(CoP) by the force plate. The result showed that the ankle moved first and the trunk forward, which implies that the mechanism of the dynamic postural control in forward-backward perturbations, occurred in the procedure of the ankle, the knee and the hip. Knee flexion and hip extension in the period of acceleration, constant velocity and deceleration phase is very important fur the balance recovery. These responses depends on the magnitude and timing of the perturbation. From the present study the accelerometry-system appears to be a promising tool for understanding kinematic accelerative In response to a transient platform perturbation. A more through understanding of balance recovery mechanism may aid in designing methods for reducing falls and the resulting injuries.