• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.743-747
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• 2008

Purpose: Malignant changes of Marjolin's ulcer arising from chronic burn scar are rare. The majority of them are squamous cell carcinoma and basal cell carcinoma. Malignant fibrous histiocytoma is a deep seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. Methods: We report a 58-year-old male patient who was admitted due to $3.5{\times}5cm$ chronic ulceration of anterior chest wall on the center of old burn scar. His scar had been occurred by boiling oil and treated with conservative treatment 45 years ago. Preoperative punch biopsy showed suspicious malignant changes and contrast enhanced chest CT showed well-defined, irregular shape enhancing lesion on anterior chest wall without intrathoracic metastasis. Results: The tumor was widely excised and defect was covered with skin graft without infection, necrosis and any other complication. The pathologic findings are compatible with malignant fibrous histiocytoma(storiform - pleomorphic type). The patient underwent 3 cycles of chemotheraphy. Although distant metastasis to the lung developed 6 months later and the patient died 9 month later, there was no local reoccurrence. Conclusion: Aggressive and early excision is needed because malignant fibrous histiocytoma has characteristics of high malignancy with a propensity for early and distant spread. Furthermore, the patient's education about disease entity and postoperative regular follow-up for local recurrence or metastasis is very important. To prevent malignancy from secondly healing burn scar, early skin graft is recommended for patients with deep second degree burn.

• 여성건강간호학회지
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• 제19권3호
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• pp.188-200
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• 2013

Purpose: The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. Methods: Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. Results: Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. Conclusion: These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.

• 가정과삶의질연구
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• 제20권5호
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• pp.113-124
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• 2002

This study has been performed to explore conveniences and inconveniences of daily lives in rural residential care facilities among the elderly residents. In this study, five males and seven females aged 68 to 78 were asked about socio-familial and physical aspects of their daily lives in the facilities such as meals, social activities, family visits, recreation, and health care. The answers of the qualitative interview were drawn as follow; first, the residents perceived well planned regular meals and snacks, free visits of friends, regularly supervised daily sanitary activities, periodic outdoor activities, education programs provided by religious experts, and pastoral farming lives as most convenient aspects of the retirement facilities. In addition, some felt that facility life made them free of familial conflicts, while others appealed fear of being forgotten because of distant location. On the other hand, they perceived the supervised group activities and meals as major inconveniences. They also felt persistently depressed when closely observing serious illness or deaths of their co-residents. Therefore in this study, suggestions were made as follows: first, combination of normal family life and retirement facility should be developed in the mixed form of community welfare center and shared home. Second, intensive medical care facilities should be in collaboration with the retirement facilities, so that the residents are relieved from stressful contacts with extremely ill patients in the residential area.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2819-2826
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• 2015

Combinations of multiple biomarkers representing distinct aspects of metastasis may have better prognostic value for breast cancer patients, especially those in late stages. In this study, we evaluated the protein levels of N-${\alpha}$-acetyltransferase 10 protein (Naa10p), synuclein-${\gamma}$ (SNCG), and phosphatase of regenerating liver-3 (PRL-3) in 365 patients with breast cancer by immunohistochemistry. Distinct prognostic subgroups of breast cancer were identified by combination of the three biomarkers. The Naa10p+SNCG-PRL-3-subgroup showed best prognosis with a median distant metastasis-free survival (DMFS) of 140 months, while the Naa10p-SNCG+PRL-3+subgroup had the worst prognosis with a median DMFS of 60.5 months. Multivariate analysis indicated Naa10p, SNCG, PRL-3, and the TNM classification were all independent prognostic factors for both DMFS and overall survival (OS). The three biomarker combination of Naa10p, SNCG and PRL-3 performed better in patients with lymph node metastasis, especially those with more advanced tumors than other subgroups. In conclusion, the combined expression profile of Naa10p, SNCG and PRL-3, alone or in combination with the TNM classification system, may provide a precise estimate of prognosis of breast cancer patients.

• 농촌의학ㆍ지역보건
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• 제30권3호
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• pp.255-262
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• 2005

도서 지역이라는 울릉도의 특성상 응급 환자의 이송 수단으로 헬리콥터는 필수적이다. 울릉도 지역의 인구 분포의 변화가 고령화가 심화됨에 따라 헬리콥터의 이송 빈도는 더욱 증가될 것으로 예상된다. 그러나, 응급 환자 이송용 헬리콥터가 없어 이송 시간동안의 응급처치 등에 장애가 있으므로, 동해안에 환자 이송의 역할을 가진 헬리콥터의 배치가 필요하다고 생각된다. 아울러 최근 감소세에 들어섰던 울릉군 지역의 인구가 증가하고 있고, 독도 열풍에 따른 관광객의 증가가 현저하므로 그에 따른 울릉군의 적절한 보건 정책이 필요하다고 생각된다

• Journal of Periodontal and Implant Science
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• 제49권5호
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• pp.319-329
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• 2019

Purpose: Direct application of atmospheric-pressure plasma jets (APPJs) has been established as an effective method of microbial decontamination. This study aimed to investigate the bactericidal effect of direct application of an APPJ using helium gas (He-APPJ) on Porphyromonas gingivalis biofilms on sandblasted and acid-etched (SLA) titanium discs. Methods: On the SLA discs covered by P. gingivalis biofilms, an APPJ with helium (He) as a discharge gas was applied at 3 different time intervals (0, 3, and 5 minutes). To evaluate the effect of the plasma itself, the He gas-only group was used as the control group. The bactericidal effect of the He-APPJ was determined by the number of colony-forming units. Bacterial viability was observed by confocal laser scanning microscopy (CLSM), and bacterial morphology was examined by scanning electron microscopy (SEM). Results: As the plasma treatment time increased, the amount of P. gingivalis decreased, and the difference was statistically significant. In the SEM images, compared to the control group, the bacterial biofilm structure on SLA discs treated by the He-APPJ for more than 3 minutes was destroyed. In addition, the CLSM images showed consistent results. Even in sites distant from the area of direct He-APPJ exposure, decontamination effects were observed in both SEM and CLSM images. Conclusions: He-APPJ application was effective in removing P. gingivalis biofilm on SLA titanium discs in an in vitro experiment.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7445-7449
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• 2013

Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.

• Journal of Hospice and Palliative Care
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• 제19권2호
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• pp.170-179
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• 2016

목적: 암환자의 자가간호행위, 자기효능감, 외상 후 성장, 그리고 삶의 질의 정도를 평가하고, 질병관련특성에 따른 차이를 파악하여 이들의 정도가 낮은 환자군의 질병관련특성을 발견하여, 이를 증진시킬 교육과 프로그램의 적용 등 심리사회적 개입이 필요한 환자군에 대한 자료를 제공하고자 한다. 방법: 암환자 총 107명을 대상으로 자가간호행위, 자기효능감, 외상 후 성장, 심리, 사회관계적 삶의 질에 관한 설문조사 하였고, 진단병기, 진단 후 경과기간, 치료현황의 질병관련특성에 따라 그룹으로 나누어 이에 대해 평가하였다. 결과: 자가간호행위는 총 65점 중 평균점수 49.96점, 자기효능감은 총 50점 중 평균점수 37.78점으로 나타났다. 자가간호행위는 하위요인 중 투약의 항목에서는 진단 후 기간이 1년 이상 2년 미만의 환자집단에 비해 1년 미만의 환자집단에서, 추적관찰중 집단 및 전이집단에 비해서 현재치료중 집단이 높은 점수를 나타냈다. 외상 후 성장은 총 80점 중 평균점수 56.17점이 나왔고, 진단 후 경과기간 1년 이상 2년 미만의 환자집단이 1년 미만의 환자집단에 비해서 점수가 유의하게 높았으며, 하위요인으로는 자기지각의 변화가 차이를 보였다. 추적관찰 중인 집단이 현재치료 중 집단보다 점수가 유의하게 높았으며, 하위요인으로 대인관계의 깊이증가와 영적, 종교적 관심증가에서 차이를 보였다. 삶의 질은 총 40점 중 평균점수 25.79점이였으며, 질병관련특성에 따라 차이를 보이지 않았다. 결론: 진단 후 경과기간이 짧을수록 자가간호행위 높은 점수를 나타냈고, 외상 후 성장은 암 진단 후 경과기간이 1년 이후 2년 미만이 가장 높은 것으로 나타났다. 이를 토대로, 진단 후 1년 이내에 자가간호행위와 자기효능감 증진을 도모하는 것이 이를 유지하는 데에 도움을 줄 수 있을 것이다. 또한 암 진단 후 2년 시점에서 외상 후 성장을 위한 외적 자원의 투입이 필요하다.