• Journal of Trauma and Injury
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• 제34권4호
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• pp.257-262
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• 2021

Purpose: Pediatric hand trauma is common and sometimes causes deformity or disability. The incidence and etiologies of hand trauma in children are different from those in adults. This study analyzed the characteristics of pediatric hand trauma cases and patients over a 15-year period. Methods: We conducted a retrospective medical record review of 3,432 children (2,265 boys, 1,167 girls, under 18 years of age) with hand injuries from January 2005 to December 2019. We evaluated the sex distribution and injury etiologies. Injuries were classified by type as burns, amputations, crushing injuries, lacerations, extensor and flexor tendon injuries, open and closed fractures, and nerve injuries. Results: Among the pediatric hand injury patients, males were predominant (1.94:1). Simple lacerations (58.4%) were the most common injury type, followed by fractures (22.8%). Lacerations and burns tended to be common in younger age groups, while tendon injuries, nerve injuries, and crushing injuries were more frequently encountered in older age groups. Conclusions: Hand trauma prevention strategies should be established considering the frequent trauma etiologies in specific age groups. An awareness of age-specific characteristics of pediatric hand trauma patients will be helpful to prevent hand trauma.

• 운동영양학회지
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• 제24권3호
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• pp.32-38
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• 2020

[Purpose] Sarcopenia is considered one of the major causes of disability in the elderly population and is highly associated with aging. Exercise is an essential strategy for improving muscle health while aging and involves multiple metabolic and transcriptional adaptations. Although the beneficial effects of exercise modalities on skeletal muscle structure and function in aging are well recognized, the exact cellular and molecular mechanisms underlying the influence of exercise have not been fully elucidated. [Methods] We summarize the biochemical pathways involved in the progression and pathogenesis of sarcopenia and describe the beneficial effects of exercise training on the relevant signaling pathways associated with sarcopenia. [Results] This study briefly introduces current knowledge on the signaling pathways involved in the development of sarcopenia, effects of aerobic exercise on mitochondria-related parameters and mitochondrial function, and role of resistance exercise in the regulation of muscle protein synthesis against sarcopenia. [Conclusion] This review suggested that the beneficial effects of exercise are still under-explored, and accelerated research will help develop better modalities for the prevention, management, and treatment of sarcopenia.

• 대한간호학회지
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• 제29권1호
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• pp.117-126
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• 1999

Accidents involving children are an important cause of death and disability. They also have enomorous financial implications. In order to prevent childhood accidents, research and education for safety should be strengthened. The purpose of this study was to determine how often young children have accidents and what factors affect the accident rate. The sample consisted of 771 children who were in the second, third and forth grades of two elementary schools located in Kyung-gi Province. One school had students from middle class families living in apartment complexes and the other, students from lower income families mainly living in single houses. The questionnaires included items on the occurance of accidents and the parents' attitudes regarding accidents during the academic year from March 1997 to February 1998. The Questionnaires were distributed to conventiently selected students to be compeleted by their parents and collected during the period of May 28, to June 6, 1998. The data were analyzed using SAS PC statistical package. The results of the study are as follows ; 1. Of 771 student subjects, 393 had 887 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were May, Sunday, and between 1 and 4 p. m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on around their homes followed by school and, then, inside the home 4. Most of the accidents were caused by carelessness on the part of the children and the most frequent type of injury was an abrasion. 5. Children most injured their legs 6. They were treated at home most often and usually emergency treatment was performed by family members with, disinfection being the main type of first aid. Cost of the treatment ranged from 8,000 to 20,000 won in most cases. 7. House type and parents' education level were statistically significant in chi-square analysis. 8. Parents educate their children about traffic safety most frequently followed by fire safety and, then, prevention of violence. 9. Parents think that prevention of violence should be the most important part of injury prevention education both at school and home. 10. To identify factors related to accident occurrence, multiple logistic regression was performed and the main factors were birth order and house type.

• 한국융합학회논문지
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• 제9권10호
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• pp.347-353
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• 2018

본 연구의 목적은 장애인에 대한 차별과 폭력경험이 자살생각에 어떠한 관련성이 있는지를 파악하고자 하였다. 연구 자료는 2014 장애인실태조사를 이용하였으며, 6,332명을 최종분석대상자로 하였다. 자살생각은 최근 1년 동안 실제로 자살시도를 해 본적이 있는지 여부로 정의되었다. 참조군은 자살생각 없음이며, 로지스틱회귀분석을 실시하였다. 연구결과 자살생각을 가진 장애인은 18.5%(n=1,171)였다. 장애인이라는 이유로 언어폭력과 정신적 폭력을 당한 경험이 있는 경우에서 자살생각 위험이 높게 나타났다. 성희롱, 성추행, 성폭력을 경험한 시기가 청소년기인 경우에서 자살생각 위험이 16.7배(CI=4.22-66.18), 가해자가 모르는 사람인 경우 5.85배(CI=2.34-14.6), 대처방법이 무시하거나 참는 경우 4.08배((CI=2.05-8.12) 자살생각 위험이 높았다. 결혼 시 차별경험을 받은 경우 1.60배(CI=1.24-2.08), 장애로 인한 차별을 항상 느끼는 경우 2.73배(CI=4.22-66.18) 자살생각 위험이 높았다. 차별경험과 폭력경험으로 인한 자살생각은 자살로 발전할 수 있으므로 정신적 안녕을 위해 가족 및 사회의 관심과 배려 및 지역사회 차원의 예방프로그램이 함께 지원되어야 할 것이다.

• 재활복지
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• 제18권4호
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• pp.221-235
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• 2014

최근 급속한 인구 고령화로 인해 뇌졸중의 발생빈도가 증대되고 있으며, 후천적 장애의 주요 발생요인이 되고 있다. 본 연구는 뇌졸중의 후유증으로 인한 장애를 극복하기 위한 재활 과정에서 사용되는 보조장비인 체위제어용 자세변환기에 관한 것이다. 본 논문에서는 국내와 일본의 자세변환기 용품을 조사하여 기능과 용도에 따라 분류와 비교를 수행하였고, 와상체위를 제어하기 위해 스마트 고기능 자세변환 시스템의 설계방식을 제안하였다. 이는 욕창방지 튜브와 체위 경사동작 튜브를 통합한 매트리스 동작을 갖도록 고안된 것이다. 또한 스마트 기능을 추가하여 현재 기기 상태의 모니터링과 기본자세변경, 교대부양 및 체위제어의 무선 기능의 수행이 가능하도록 설계하였다. 시스템제어 하드웨어는 3개의 주요부, 즉 센서 검출부, 모터구동 제어부, 블루투스(Bluetooth) 통신을 위한 시스템제어부로 구성되어 있다. 결과로서, 본 연구에 의해 설계된 시스템이 최근 인터넷 정보화 기술의 적용분야인 IoT(Internet of Things) 기술이 접목된 고기능 스마트 자세변환장치로 실용화 될 수 있음을 확인하였다.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.589-593
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• 2019

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.284-294
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• 2001

Objective : Stroke is leading cause of death and more importantly it is cause of serious disability. The effective treatment of acute ischemic stroke still remains a challenge to modern medicine. Recent clinical trials have shown that carotid endareterctomy(CEA) provide overwhelming benefits compared with medical therapy in preventing subsequent stroke for symptomatic carotid stenosis. For the asymptomatic ones, the data are less compelling, but highly suggestive that CEA do have benefits in properly selected patients. Materials and Methods : To investigate the clinical manifestations of carotid stenosis and results of CEAs, authors analyzed retrospectively 19 CEAs in 16 patients from June 1986 to June 1999. Age of patients ranged from 55 to 76 years(median, 66) and male to female ratio was 14 to 2. The duration of follow-up was 1 to 144 months (median, 26). All of CEAs were done on the side of stenosis more than 80% and bilateral CEAs were done in three. Six CEAs were performed in asymptomatic patients. Results : Seventeen of 19 CEAs showed excellent results and complication rate was low although ipsilateral ischemic stroke occurred in two. Conclusion : CEA may be a valuable surgical treatment for ischemic stroke caused by carotid stenosis and also for prevention of stroke of asymptomatic patients with carotid stenosis.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.710-716
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• 2017

Objective : Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods : We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery). Results : Among all the 2617 THI patients, total number of pediatric patients was 256. The average age of the subjects was 9.07 (standard deviation${\pm}6.3$) years old. The male-to female ratio was 1.87 to 1 and male dominance increases with age. The most common cause for trauma were falls and traffic accidents. Age (p=0.007), surgery (p<0.001), mechanism of trauma (p=0.016), subdural hemorrhage (SDH) (p<0.001), diffuse axonal injury (DAI) (p<0.001) were statistically significant associated with severe brain injury. Conclusion : Falls were the most common cause of trauma, and age, surgery, mechanism of trauma, SDH, DAI increased with injury severity. There is a critical need for effective fall and traffic accidents prevention strategies for children, and we should give attention to these predicting factors for more effective care.

• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.227-233
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• 2018

Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.235-243
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• 2017

Objectives: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. Methods: Forty-eight children (age 9-18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. Results: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. Conclusion: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.