• 근관절건강학회지
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• 제23권3호
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• pp.197-205
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• 2016

Purpose: The purpose of this study was to conduct a comparison analysis on requirements of online continuing education requirements according to practical experience of nurses at small and medium-sized hospitals. Methods: Data had been collected with 236 nurses from May to June, 2015. The data were analyzed with the use of SPSS. Results: Among them, 45.8% participated in online continuing education. Nurses in beginning level required musculoskeletal diseases (20.9%), care for injuries and stomas (5.8%), and surgical disease and operation care (4.7%). Competent nurses required musculoskeletal diseases (19.7%), cerebrovascular diseases (9.9%), emergency care and CPR (8.5%), and medical nursing (8.5%). Skillful nurses required cerebrovascular diseases (13.9%), care for internal diseases (8.9%), and rehabilitation care (8.9%). Among the educational contents of diseases, the items that were significantly different according to practical experience were operation management ($x^2$=23.92, p<.001) and drug care ($x^2$=7.85, p=.020). Among continuing education methods, the items that were significantly different were video ($x^2$=16.81, p<.001), webtoon ($x^2$=8.96, p=.011), and test ($x^2$=10.56, p=.005). Among continuing education evaluation methods, the items that were significantly different were multiple-choices ($x^2$=9.43, p=.009) and OX ($x^2$=6.47, p=.039) based quizzes. Conclusion: Based on the study results, it is necessary to develop a differentiated continuing education program according to practical experience of nurses.

• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.105-110
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• 2006

Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.

• 디지털융복합연구
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• 제12권11호
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• pp.607-615
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• 2014

야외교육은 학습자에게 기대하는 내적 성장부터 생태와 환경까지 다양한 체험을 강조한다. 더불어 야외교육의 공동체성, 생태적 관점 등의 중요성은 시대적 요구이기도 하다. 이러한 야외교육은 우리나라 국가수준의 교육과정에도 반영되어 문서로 제시하고 있다. 하지만 야외교육에 대한 교육목표가 뚜렷하지 않고, 철학적 고민이 부족한 실정이다. 이에 본 연구에서는 야외교육에 대한 교육목표를 명확히 하고, 전문성에 대한 담론을 분석해서 지향점을 제시하였다. 야외교육의 전문성에 대해 논의하기 위해 '교사' 전문성, '체육 교사'의 전문성을 분석했다. 야외교육의 지향점으로는 첫째, 총체적 체험과 문제해결능력, 둘째, 반성적 실천가로의 지향으로 구분했다. 이는 야외교육은 효율적 지도방법만을 추구하는 것이 아니라 지도자 자신의 삶과 행위를 통해 지속적으로 성찰하고 실천하는 전문인으로 거듭나야 한다는 것이다. 결론으로는 첫째, 야외교육 체험에서 안전에 대한 문제 해결을 위한 매뉴얼 개발이 필요하다. 둘째, 야외교육을 가르칠 수 있는 전문인 양성을 위한 교과정 개발이 필요하다. 셋째, 야외교육을 학교교육으로 한정하지 않고, 비제도권 교육에 포함시켜야 함을 제시했다.

• 혜화의학회지
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• 제9권1호
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• pp.711-724
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• 2000

I reached following conclusion through a bibliographic study about the drug dependence. 1. The drug dependence is the case that taking drugs continually in order to get around discomfort and get mental drug efficacy. that is also the state of poisoning that shows compulsions that using all means to get drugs. the drug dependence is coincident with alcolism in Oriental Medicine. 2 Medicinal matters that causes the drug dependence consist of two field. one is licit drugs, including a tranquilizer, a sleeping pill, anti-anxiety drug, alcohol, caffeine, tobacco, etc. the other is illict drugs, including opium products, psychostimulant, a hallucinogen, aromatic agent(adhesives, LSD, etc.) 3. Drugs that causes dependences has the habit which causing mental dependences and the medicinal poisining which causing physical dependences. 4. A syndrome of abstain from the drug which rides on all kinds of drugs is analogous to depressive psychosis, epilepsy, insanity, depressive syndromes, disorder of internal organs, histery, dizziness, etc. 5. The drug dependence causes visceral dysfunction, that is chiefly inflammatory lesion of brain, heart lung etc. (inflammatory lesions os mainly due to infect.) and injuries liver which removes toxic agents and kidney which is an excretory organ. 6. The treatment of the drug dependence, which needs at first check the medical record and the syndrome, is consist of the expectant treatment and isolating treatment as a rule and sometimes mental therapeutics is going on at the same time. 7. The oriental medical cure of the drug dependence needs more concrete study.

• 대한기계학회논문집A
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• 제34권11호
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• pp.1727-1732
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• 2010

고소작업차는 최근 건물이 초고층화됨에 따라 그 필요성이 더욱 커지고 있으나 그 이용에 따른 사고가 빈번하게 발생하고 있다. 고소작업차 붐대 및 유압기기를 구성하는 부품 손상은 탑승인원이 많은 경우 다수의 피해자가 추락으로 인해 사망에 이를 수 있다는 점에서 큰 문제를 안고 있으며 또한 유사 사고가 다시 발생할 수 있는 점이 내재되어 있어 그 심각성은 매우 크다고 할 수 있다. 이에 법공학적인 측면에서 좀 더 전문화되고 체계적인 사고조사와 원인 규명을 통해서 사전에 예방대책을 마련함으로써 유사 및 동종재해의 발생을 최소화해야 한다. 본 연구에서는 파단면 검사를 통한 부품 파손형태 검사 및 재료 물성평가 등을 통해 기계부품 파손에 의한 추락 사고에 관한 정확한 사고 원인을 규명함으로써 동일 형태의 안전사고 예방에 기여하고자 한다.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• 대한정형외과학회지
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• 제56권6호
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• pp.540-545
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• 2021

슬개골 횡골절은 수술이 필요한 전위된 슬개골 골절의 가장 흔한 형태이다. 이러한 슬개골 횡골절은 골절선을 지나 평행하게 삽입된 Kirschner-강선이나 나사못에 장력대 강선을 추가적으로 고정한 기법이 흔히 사용된다. 그러나 고식적인 고정 방법의 경우 삽입된 강선이나 핀의 돌출에 의한 합병증이 흔히 발생한다. 이러한 합병증은 내고정물의 제거를 위한 추가적인 수술을 필요로 하고, 의료비 상승 및 슬관절의 기능 제한을 일으킬 수 있다. 이에 슬개골 횡골절에 대해 안정적인 고정력을 제공하고 수술 시 연부조직 손상을 최소화하여 골절부 혈류를 보존하고 수술 후 통증을 감소시키며, 내고정물에 의한 자극과 그에 따른 통증을 감소시켜 관절 운동 제한 발생 위험을 감소 시키는 최소 침습 부하 분산 경피적 슬개건 봉합술을 이용하여 치료한 사례들을 수술 술기와 함께 보고하고자 한다.

• Safety and Health at Work
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• 제11권4호
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• pp.526-532
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• 2020

Background: The high incidence of work-related diseases and injuries among day-laborers and workers with no legal contracts (informal workers) has received the attention of the Thai authorities. Workers' low occupational health literacy (OHL) has been reasoned as one contributing factor. Absence of a valid tool has prevented assessment of informal workers' OHL. The aim of this study was to create a valid and reliable Occupational Health Literacy Scale within the context of Thai working culture (TOHLS-IF). Methods: This study used the mixed method approach to develop TOHLS-IF. Questions were generated using in-depth interviews and an extensive review of the literature. Experts' assessment confirmed the content validity of TOHLS-IF. The scales of its psychometric properties were assessed in a sample of 400 informal workers using cluster random sampling. Results: The final version of the TOHLS-IF comprises 38 items within 4 dimensions: Ability to Gain Access, Understanding, Evaluation, and Use of occupational health and safety information. Factor analysis identified items explaining 50.22% of the total variance. The final confirmatory analysis confirmed the model estimates were satisfactory for the construct. TOHLS-IF demonstrated a high internal consistency and satisfactory reliability (Cronbach's alpha = .98). Conclusion: The TOHLS-IF is a valid and reliable instrument to assess informal workers' OHL. The structural dimensions of this instrument are based on the concept of health literacy and Thai culture. Thai health professionals are encouraged to benefit from this instrument to assess their workers' OHL and apply findings as guidelines for effective occupational health and safety interventions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권6호
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• pp.332-338
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• 2023

Objectives: This study aimed to compare the effectiveness of a hybrid arch bar (hAB) with the conventional Erich arch bar (EAB) for the management of jaw fractures, focusing on their use for temporary fixation in patients undergoing open reduction and internal fixation (ORIF). Materials and Methods: Patients presenting with maxillary and mandibular fractures at our institution were included in this prospective, comparative study. Placement time and ease of occlusal reproducibility were recorded intraoperatively for Group A (hAB patients) and Group B (EAB patients). The primary outcome was comparison of the postoperative stability of the two arch bars. Postoperative measurements also included mucosal overgrowth, screw loosening or wire retightening, and replacement rates. The data were tabulated and computed with a P<0.05 considered statistically significant. Results: The study included 41 patients. A statistically significant difference was observed in postoperative stability scores (3) between Group A and Group B (85.0% vs 9.5%, P=0.001). The mean placement time in Group A (23.3 minutes) significantly differed from that in Group B (86.4 minutes) (P<0.001). The ease of intraoperative occlusion was not different between the two groups (P=0.413). Mucosal overgrowth was observed in 75.0% of patients (15 of 20) in Group A. Conclusion: The hAB was superior to EAB in clinical efficiency, maxillomandibular fixation time reduction, stability, versatility, and safety. Despite temporary mucosal overgrowth, the benefits of hAB outweigh the disadvantages. The choice between hAB and EAB should be based on specific clinical requirements.