• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.157-163
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• 2019

Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.15-20
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• 2022

Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.48-59
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• 1999

Objectives. This study was conducted to evaluate the association between upper extremity musculoskeletal symptoms and Rapid Upper Limb Assessment(RULA) in vehicle assembly line workers. The goal of this study is to show the feasibility of RULA as a checklist for work related musculoskeletal symptoms (WMSDs) in Korean workers. Methods. The total number of 199 people from the department of assembly and 115 people from the department of Quality Control(QC) in automotive plant were subjects for this cross sectional study. A standard symptom questionnaire survey has been used for the individual characteristics, work history, musculosketal symptoms and non-occupational covariates. The data were obtained by applying one-on-one interview for the all subjects. RULA has been applied for ergonomic work posture analysis and the primary ergonomic risk sure was computed by RULA method. Association between upper extremity musculoskeletal symptoms and RULA were assessed by multiple logistic regression analysis. Results. A total of 314 workers was examined. The prevalence of musculoskeletal symptoms by NIOSH case definition was 62.4%. The distribution of musculoskeletal symptoms by the part of the body turned out to be following; back:41.4%, neck: 32.8%, shoulder: 26.4%, arm: 10.5% and hand:29.3%. The relationship of the individual RULA scores were statistically significant for the prevalence of musculoskeletal symptoms. As the result of the multiple logistic regressioin analysis, grand final score (OR=2.250 95% CI: 1.402-3.612) was associated with musculoskeletal symptoms in any part of the body.; upper arm score(OR=1.786 95% CI: 1.036-3.079) and posture score A(OR=1.634 95% CI: 1.016-2.626) in neck; muscel use score(OR=3.076 95% CI:1.782-5.310) and posture score A(OR=1.798 95% CI: 1.072-3.017) in shoulder; upper arm score(OR=1.715 95% CI: 1.083-2.715) and muscel use score(OR=2.057 95% CI:1.303-3.248) in neck & shoulder; muscle use score(OR=10.662 95% CI: 3.180-35.742) in arm; writst/wist score(OR=2.068 95% CI: 1.130-3.786) and muscle use score(OR=2.215 95% CI: 1.284-3.819) in hand & wrist.; muscle use score of trunk (OR=2.601 95% CI: 1.147-5.901) in back. Conclusions. Musculoskeletal symptoms of the extremities were strongly associated with individual RULA body score. These results show that RULA can be used as a useful assessment tool for the evaluation of musculoskeletal loading which is known to contribute to work-related musculoskeletal disorders. RULA also can be used as a screening tool or incorporated into a wider ergonomic assessment of epidemiological, physical, mental, environmental and organizational factors. As shown in this study, complement of the analysis system for the other risk factors and characterizing between the upper limb and back part will be needed for future work.

• Korean Security Journal
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• no.36
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• pp.93-109
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• 2013

This research is mainly based on the experimental result due to seek different outcomes whena certain security motion with a paticular gear is applied in a plausible confrontational situation. For the purpose of this research an Expandable Baton, which is one of the most commonsecurity equipments, was chosen to be applied in a situation of hitting a person's head. Alsothe results will be studied in the view of Kinematic theory. To demonstrate, 10 students who were majeored in Escort Crane studies at 'H' university werechosen as testees. The participants were grouped into two-one is practiced with the 'expanadable baton use program' and the other is pre-practiced. In this report two groups abovewill be reffered as 'group A' and 'group B' for conveniency. There were a number of differences and changes between two groups. Group B took more timethan the other group did. Group A spent about 0.428sec in section 'e2' and 0.230sec in section'e3' while Group B took 0.435sec, 0.232sec in each sections.To add on, more distinctive results were out when it was more focused on physical movements. Two gropus presented considerable changes- in an 'left-right' moving displacement-Group A;$2.16{\pm}0.9cm$ (left side), $3.78{\pm}1.42cm$ (right side), total $5.94{\pm}2.03cm$. Group B; $2.97{\pm}1.01cm$ (left side),$4.56{\pm}1.57cm$ (right side), total $7.53{\pm}2.13cm$.Continuously, different outcomeswere shown between two groups in a 'back and forth' moving displacement-Group A;$32.48{\pm}3.86cm$, $35.21{\pm}4.64cm$, total $69.36{\pm}5.72$. Group B; $34.50{\pm}6.12cm$, $37.04{\pm}3.70cm$, total $71.46{\pm}7.17cm$. Furthermore, changes in an 'up and down' moving displacement were - GroupA; $5.62{\pm}2.41cm$, $4.54{\pm}1.87cm$, total $10.11{\pm}1.57cm$. Group B; $6.33{\pm}1.78cm$, $4.86{\pm}1.85cm$,total $10.68{\pm}1.81cm$. To continue, there were few modifications of degree on participants' joints, espcially on 'Wristjoint', 'Elbow joint' and 'Shoulder joint', depend on different sections -Wrist joint;Group A; e1 $114.62{\pm}7.13$, e2 $68.27{\pm}6.37$, e3 $131.64{\pm}6.27$. Group B; e1 $112.62{\pm}6.13$, e2 $66.28{\pm}7.38$, e3$137.42{\pm}4.28$ and Elbow joint ; Group A e1 $132.31{\pm}6.55$, e2 $117.92{\pm}8.42$, e3 $144.41{\pm}6.32$. Group B; e1 $133.58{\pm}8.56$, e2 $114.45{\pm}8.21$, e3 $139.89{\pm}4.38$. Lastly, degree changes ofshoulder joint were; Group A; e1 $13.55{\pm}3.85$, e2 $131.42{\pm}11.24$, e3 $78.32{\pm}6.28$. Group B; e1$9.45{\pm}1.23$, e2 $136.74{\pm}13.21$, e3 $79.75{\pm}4.24$.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.10
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• pp.1594-1606
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• 2014

The purpose of this study was to examine safety accidents related to school foodservice, working and operating environments of school foodservice, status and awareness of safety education, educational needs, and information on qualitative improvement of school foodservice. The subjects in this study were 234 cooks in charge of cooking at elementary and secondary schools in Chungbuk. A survey was conducted from July 30 to August 8, 2012, and among 202 questionnaires gathered, 194 completed questionnaires were analyzed. Statistical analyses were performed on data utilizing the SPSS version 19.0. The main results of this study were as follows: 44.3% of workers experienced safety accidents. The most frequent safety accident was 'once' (60.5%), and most safety accidents took place between June and August (31.4%). The time at which most safety accidents happened was between 8 and 11 am. Most safety accidents happened during cooking (52.3%) and while using a soup pot or frying pot (52.4%). The most common accidents were 'burns', 'wrist and arm pain', and 'slips and falls'. Respondents who experienced safety accidents replied that 57.6% of employees dealt with injuries at their own expense, and only 35.3% utilized industrial accident insurance. In terms of the operating environment, the score for 'offering information and application' was highest (3.76 points), whereas that for 'security of budget' was lowest (1.77 points). As for accident education, employees received safety education approximately 3.45 times and 5.10 hours per year. Improving the working environment of school foodservice cooks requires administrative and financial support. Furthermore, educational materials and guidelines based on the working environment and safety accident status of school foodservice cooks are required in order to minimize potential risk factors and control safety accidents in school foodservice.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.84-89
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• 2013

Purpose: Patients' movement during long image acquisition time for the fusion image of PET-CT (Positron Emission Tomography-Computed Tomography) results in unconformity, and greatly affects the quality of the image and diagnosis. The arm support fixtures provided by medical device companies are not manufactured considering the convenience and safety of the patients; the arm and head movements (horizontal and vertical) during PET/CT scan cause defects in the brain fundus images and often require retaking. Therefore, this study aims to develop patient-compensation device that would minimize the head and arm movements during PET/CT scan, providing comfort and safety, and to reduce retaking. Materials and Methods: From June to July 2012, 20 patients who had no movement-related problems and another 20 patients who had difficulties in raising arms due to shoulder pain were recruited among the ones who visited nuclear medicine department for PET Torso scan. By using Patient Holding System (PHS), different range of motion (ROM) in the arm ($25^{\circ}$, $27^{\circ}$, $29^{\circ}$, $31^{\circ}$, $33^{\circ}$, $35^{\circ}$) was applied to find the most comfortable angle and posture. The manufacturing company was investigated for the permeability of the support material, and the comfort level of applying bands (velcro type) to fix the patient's head and arms was evaluated. To find out the retake frequency due to movements, the amount of retake cases pre/post patient-compensation were analyzed using the PET Torso scan data collected between January to December 2012. Results: Among the patients without movement disorder, 18 answered that PHS and $29^{\circ}$ arm ROM were the most comfortable, and 2 answered $27^{\circ}$ and $31^{\circ}$, respectively. Among the patients with shoulder pain, 15 picked $31^{\circ}$ as the most comfortable angle, 2 picked $33^{\circ}$, and 3 picked $35^{\circ}$. For this study, the handle was manufactured to be adjustable for vertical movements. The material permeability of the patient-compensation device has been verified, and PHS and the compensation device were band-fixed (velcro type) to prevent device movements. A furrow was cut for head fixation to minimize the head and neck movements, fixing bands were attached for the head, wrist, forearm, and upper arm to limit movements. The retake frequency of PET Torso scan due to patient movements was 11.06% (191 cases/1,808 patients) before using the movement control device, and 2.65% (48 cases/1,732 patients) after using the device; 8.41% of the frequency was reduced. Conclusion: Recent change and innovation in the medical environment are making expensive medical image scans, and providing differentiated services for the customers is essential. To secure patient comfort and safety during PET/CT scans, ergonomic patient-compensation devices need to be provided. Therefore, this study manufactured a patientcompensation device with vertically adjustable ergonomic ROM according to the patient's body shape and condition during PET Torso scan. The defects in the basal ganglia images due to arm movements were reduced, and retaking was decreased.

• The Journal of Dong Guk Oriental Medicine
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• v.2 no.1
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• pp.73-105
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• 1993

To say nothing of the orient and the west, the human beings discover the method of Jin Mac(診脈) by the way that observe disease. But oriental medicine devise special method of Jin Mac(診脈) in the study of Kyoung Mac(經脈). Although sip-ei Kyoung Mac Jin(十二經脈診), Sam Bu Gu Who Jin(三部九候診), In Young Mac Gu Jin(人迎脈口診), Chon Kwan Chuck Jin(寸關尺診) namely Yuk Bu Jung Wee Jin Mac (六部定位診脈) that is used today are devised, it has changed naturally by the changing treatment and the introduction of Yuin Yang(陰陽) and five element(五行). Many methods dg Jin Mac(診脈), it had not developped successing alternative, it had developped of declined by it's own way. 1. Results for the birth of Mac(脈) 1) Mac(脈), it means Kyoung Mac(經脈), at first entirelly Mac(脈), is seized a blood vessel that flows in the body. As presumed today, after finding many acupunture point, a general idea of Mac(脈) is not maked by the line that connect point and point, it connect between acupunture point and acupunture point. 2) Like blood flows in Hyul Mac(血脈), Gie(氣) flows in Kyoung Mac(經脈). The two things relate deeply each other. In a general idea or actrally Kyoung Rak(經洛), the two things sometimes accord, sometimes seperate, sometimes mix alternative. 3) Hyul Mac(血脈) and Kyoung Mac(經脈), we call it Mac(脈) entirely Kyoung Mac(經脈), is a way that manifest disease through Kyoung Mac(經脈) or a boundary that disease belongs to it method of Mac Jin(脈診) individual that disease of Kyoung Mac(經脈) is diagnosed by the jumping situation of Hyul Mac(血脈). 4) In method of Moxa, athough the pathology and the diagnostic of Mac(脈) are created by finding Mac(脈). Finding acupunture have opportunitty fot Mac Jin(脈診) and treatment. 2. Results of Kyoung Mac Mac Jin(經脈脈診) 1) In theory of kyoung Rak(經洛), disease are resumed for malfunction of Young Wee(榮衛) that flows in Kyung Rak(經洛). So to speak, in treatment of Kyoung Rak area, the purpose of diagnosis observe the situation of disease and cause. For fitting the purpose of diagnosis, the dead had esatablised four-diagnosis method mangMunMnnJeul(望聞問切), in four-diagnosis(四診法), the core is Mac Jin(脈診). 2) sip-ei Kyoung Mac Mac Jin(十二經脈診) had existed as Kyoung Mac Mac Jin(經脈脈診), it precedes Sam Bu Gu Who Jin(三部九候診). In Young Ki Gu Mac(人迎脈口診). 3) Although Bu Yang Mac(趺陽脈), So Um Mac(少陰脈) is a part of Sip-ei Kyoung Mac(十二經脈診), they developped especially because they located in the point of Won Hyul(原穴) and they are convenient for diagnose. 4) Sip-ei Kyoung Mac Mac Jin(十二經脈診), which belongs to Bu Yang Mac(趺陽脈) and So Urn Mac(少陰脈), is not important for the comming age medical books compared with Mac Kyoung(脈經). 3. Results gor Sam Bu Gu Who Jin(三部九候診) 1) Mac Jin(脈診) of Sam Bu Gu Who(三部九候), which is noted in the theory of Sam Bu Gu Who(三部九候診) of So Mun(素問), belongs to Kyoung Mac Mac Jin's(經脈脈診) geneology, Sip-ei Kyoung Mac Mac Jin(十二經脈診) is arranged, simplicated by the idealogy three talents(三才思想) in the heaven and the earth. 2) What Sam Bu Gu Jin(三部九候診) is regardded as very important in So Mun(素問), the editor of So Mun(素問) recognize the meaning that one discover disease early in this method of diagnosis. 3) After Young chu(靈樞), Nan Kyoung(難經) it is lacked the method of Sam Bu Gu Who Jin(三部九候診) in the books that treatment has changed. Sam Bu Gu Who Jin(三部九候診) based on actually clinic appropriate. 4. results for In Young Mac Gu Jin(人迎脈口診) 1) In Young Mac Gu Jin(人迎脈口診) is the method of comparative Mac Jin(脈診) according to the theory of Yin Yang(陰陽), it is presumed after Sam Bu Gu Who Jin(三部九候診), it had perished in parallel with the development of the theory of five elelment(五行). The development of the acupunture, the perishment of the treatment of negative(刺絡). 2) In Young Mac Gu Jin(人迎脈口診), Wang Suk Wha(王叔和) recreated that the left is In Young(人迎), the right is Kie Gu(氣口). In future generations by Jin Mu Taek(陳無擇) who is the writer of Sam In Bang(三因方). In Young Mac Gu Jin(人迎脈口診) is a measure for disease which classify it's inside and outside cause. 5. Results for Chon Gu Mac Jin(寸口脈診) 1) What we say Mac Jin(脈診) of Chon Gu(寸口) two means are used in commn. First case, we simply say the area of Chon Gu(寸口), second case, we say Chon Kwan Chuk Jin(寸口尺診) reducingly. Chon Gu(寸口) is the area which is the radial artery of wrist joint. What we attemp diagnose by only Chon Gu Mac(寸口脈), it is clearly shoued in the method of Nan Kyoung, five Nan(難經五難). 2) Because Jin Mac(診脈) is made in only Chon Gu(寸口), that is the area in which is concentated Kyoung Kee(經氣). That is the birth of Jin Kee(眞氣) and Jin Kee(眞氣) is related with disease. We can diagnose disease by taking Chon Gu(寸口). 3) Chuk Jin(尺診) in Nae Kyoung(難經) have two things. One is Il Chuk(一尺), the other is Chon Kwan Chu(寸關尺). 4) Chuk Chon Jin(尺寸診) is the method which diagnose the difference of point and the condition of Mac(脈) by dividing a part of Chuk(尺) in the area of Chon Gu(寸口). In Chon Gu Jin(寸口診), by introducing the theory of Yin Yang(陰陽), the method of Chon Gu Jin(寸口診) is developed by chon Gu Jin(寸口診). 5) What Chuk Kwan Chon Jin(寸關尺診) is that area of the Chon Gu(寸口) are divided fot three point, we can diagnose. By consulting Sam Bu Gu Who Jin(三部九候診), developping of the method of acupunture, utilzing the theory of five element(五行) it is devised by concentrating way of thinking of the method mac Jin(脈診) exiting. 6) Chon Kwan Chuk Jin MaC(寸關尺診脈) begin from Nae Kyoung(內徑) exiting. After Nan Kyoung(內徑), spread out widely from Mac Kyoung(脈診) of Wang Suk wha(王叔和), the future medicins followed it. Yang Hyun Jo(楊玄操) and established Chon Kwan Chuk Jin(寸關尺診) which is used widely today. This right and left Chon Kwan Chuk Jin(寸關尺診), we call it method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 7) We can think the base which presume the arrangement of the viscera for Chon Kwan Chuk(寸關尺) of the right and the left. 8) The origin, which seperate the right and the left of Mac(脈), is showed at the treory of Ji Jin Yo Dae(至眞要大論) in So Mun(素問) which Chon Chuk(寸尺) seperate the right and the left. But the method of diagnosis in Nan Kyoung(難經) have no seperation the fight and the left. Otherwise this. there is clearly writtened the seperation for the right origin of the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈) seek for Cang Gong(倉公). 9) Yang Hyun Jo(楊玄操) notice that the Chuk(尺) is mentioned for Sam Cho(三焦) in the method of Mac Kyuong(脈經), Sim Po Kyung(心包經) which put together with Sam Cho(三焦) allot on this, he had established the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 10) On the method of Paen Jak Yin Yang Mac(扁鵲陰陽脈) in Mac Kyoung(脈經), equal article exist with the theory of Pyung In Kee Sang(平人氣象論) in So Mun(素問). When Wang Suk Wha(王叔和) write Mac Kyung(脈經), we can presume that the book of Mac(脈) which Paen Jak(扁鵲) had experienced the origin have exited besides So Mun(素問), Young Chu(靈樞). If so he must be make Chon Kwan Chuk Jin(寸關尺診) very fairly standard. So Nae Kyoung(內經), which must be fllowed the method of Paen Jak Mac(扁鵲脈), do the method diagnosis of Chon Kwan Chuk(寸關尺), diagnise of disease and treat.