• 대한정형외과스포츠의학회지
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• 제3권2호
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• pp.93-97
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• 2004

회전근 개의 전층 파열은 운동, 고정, 약물 등의 치료로 재생되기 어렵다. 파열은 시간이 지나면서 격심한 통증은 없어질 수 있으나, 대부분의 환자에서 어깨나 머리 위로 다시 움직일 때 증상이 재발된다. 작은 파열은 진행할 수 있으며, 광범위한 파열 시 통증이 감소될 수 있으나 점진적인 근력 약화가 동반된다. 치료 받지 않은 회전근 개 파열 환자의 일부는 견관절 관절염이 속발될 수 있다. 보존적 방법으로 치료하여도 증상이 지속될 때, 증상을 호전 시키고 기능을 회복시키는 가장 좋은 방법은 수술적 봉합이다.

• 한국농촌간호학회지
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• 제16권1호
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• pp.18-28
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• 2021

Purpose: This study attempted to confirm whether the suicide prevention effect could be achieved by managing the frailty of the elderly in rural areas. Methods: This study is a single-group pre-post study design. The frailty management program was applied twice a week for 12 weeks for the vulnerable elderly in the rural area from 16th April to 31st May in 2020. The program consisted of physical exercise, health education on nutrition management and disease control, cognitive training, and protein drink provision. Results: The average age of the participants was 77.1 years, and they lived alone (88.6%). As a result of providing the program, there were positive results such as increase in body strength (pre 12.27: post 13.27) and weight (pre 58.51: post 59.13), and decrease in depression (pre 4.66: post 1.20), and there was no statistically significant change in quality of life, Time Up & Go, and BMI. Conclusion: Frailty should be managed to prevent suicide in the elderly. It is necessary to expand and apply various programs that combine physical functions and emotional interventions such as health education, and exercise to maintain muscle strength.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.18-21
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• 2023

The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient's condition.

• 디지털융복합연구
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• 제11권10호
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• pp.619-627
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• 2013

본 연구는 응급의료기관을 내원 한 행려환자들의 내원, 진료, 발생특성에 따라 체류시간을 살펴본 후 영향을 미치는 관련요인을 파악하여 향후 의료서비스 개선방안을 위한 기초자료를 제공하고자 하는데 그 의의가 있다. 조사대상은 2012년 1월 1일부터 동년 12월 31일까지 1년 동안 충남소재의 응급의료기관을 내원한 행려환자 691명으로 하였으며, 분석방법은 빈도분석, ANOVA, 상관관계분석 후 독립변수를 더 미화하여 다중회귀분석을 실시하였다. 결론을 보면 첫째, 의료기관은 행려환자에 대한 부정적인 인식에서 벗어날 필요가 있으며, 질 좋은 의료서비스 제공 및 응급진료지원체계를 갖추고 있어야 한다. 둘째, 행려환자의 대부분이 남자이고, 40,50대가 절반이상을 차지하고 있어, 이들이 사회적으로 아직까지는 생산성이 높은 연령층이라고 할 수 있으며, 향후 의료적지원 뿐만 아니라 사회복귀프로그램이 포함된 정부 정책의 관리구축 방안이 필요하다.

• 한국보건간호학회지
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• 제18권2호
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• pp.312-329
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• 2004

This study was examined 718 workers who had consistent blood pressure results in 2001 and 2002 general health examinations that were held at a work places managed by a health care agency in Seoul. Significant results are found as follows by analysing SPSS 11.0 on the result of self-recorded questionnaires investigated from Mar 1, 2003 to April 30, 2003. 1. A sampled healthy group and a sampled unhealthy group had significant differences in four variables out of possible nineteens that are sex, age, marriage and occupation. The unhealthy group had more males than females, more aged (over 50 years old) than youngers (under 50 years old), more married than singles, more manufacturing workers than non-manufacturing workers. In the case of systolic blood pressure, as the healthy group had 16.52mmHg while that of the other group had 149. 58mmHg, 33.06mmHg of difference between those groups were detected. In the case of diastolic blood pressure, 74.93mmHg of the healthy group and 96.53mmHg of the unhealthy group yielded 21.60mmHg of difference between them. This result implies that a guidance of health care is required to be aware of 20-30mmHg volatility in blood pressure rate or to understand and treat properly own blood pressure. as it is difficult to detect hypertension in early stage due to no initial symptom. According to the result. an establishment of management system of workers, companies and health care agencies is required for consist health care. 2. In terms of risky habits to health, the unhealthy group had more proportion of past smokers, over-twice-a-week drinkers, people with higher obesity rate. However, in terms of excercise, the proportion of regularly exercising people is higher in the unhealthy group while that of non-exercising people is higher in the healthy group. On the other hand. the average grade of health practicing behaviour in two groups are not significantly different as the health group had 3.00 out of possible 6.00 while the other had 3.10. This result means that as workers are not interested in health practicing behaviour. health promoting programmes must be developed in such a way of various method of motivations and incentives. Particularly this implies that distortional objectives of exercises should be readjusted through health guidance. 3. Systolic blood pressure in the healthy group can be explained by sex and the obesity rate while that in the unhealthy group can be explained by subjective health awareness and the obesity. Diastolic blood pressure in the healthy group can be explained by sex and the obesity rate like the former. The obesity rate was significant variable affecting the blood pressure of both groups, and particularly the effect to the unhealthy group was remarkably higher than that to the healthy group. Therefore, this research identified that the health care on the blood pressure of workers is not only limited to hypertension patients, but also extended to all workers. In order for consistent care, an establishment of management system of workers, companies and health care agencies is required.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.140-149
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• 2018

최근 국민소득 증가와 더불어 인구감소로 인한 고령화, 1인 가구 증가와 같은 사회 현상이 관찰된다. 고령화 가구 및 1인 가구증가에 비례해 반려동물을 사육하는 가구도 증가하고 있는데 이들의 경우 대부분 외로움 극복과 가정 내 활력을 위해 반려동물을 활용한다. 반려 동물을 가족처럼 생각하는 사람들이 늘어나면서 국내 반려동물 시장의 규모도 동반 성장하고 있다. 고령화 가구 및 1인가구의 반려동물이 늘어나면서 생기는 문제는 홀로 남겨진 반려동물의 먹이급식, 운동관리 등과 같은 케어(Care)가 제대로 수행 되지 못하고 있다. 외부에서 원격으로 반려동물을 관찰하고 일정량의 먹이를 주기적으로 공급하며 운동유발을 통해 반려동물의 건강상태를 관리해주는 로봇에 대한 연구와 개발이 필요한 실정이다. 반려동물 중 반려견의 선택이 가장 높게 나타난다. 따라서 본 연구는 구동 방식에 대한 로봇연구와 기존의 반려동물 케어 시스템의 사례를 파악하고 장애물 회피 알고리즘을 이용한 반려견 케어 로봇에 대한 연구를 하였다. 3륜 중 2개의 바퀴에 모터를 장착하고 반려견의 간식 급여동작과 장애물 회피 알고리즘을 이용하기 위해 전면에 초음파 센서를 사용하였다. 후면에는 적외선 센서 4개를 장착하여 이동시 바닥과 물체의 감지가 가능하도록 시스템 구성 하였다. 그 결과 반려견이 로봇바퀴에 수납된 간식의 냄새를 탐지하여 로봇을 따라다니고 접근을 감지한 로봇이 회피구동 하며 반려견의 운동능력 향상시켰다. 그러나 본 연구는 반려견 케어로봇에 관한 연구로 다른 반려동물들의 특성이 반영되지 않았고, 지속적인 관찰 및 테스트를 통한 실증이 필요하여 후속 연구가 필요하다.

• 한국직업건강간호학회지
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• 제4권호
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.159-163
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• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• 한국콘텐츠학회논문지
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• 제13권6호
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• pp.380-389
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• 2013

급성기 병원의 간호사 배치수준은 환자안전 및 성과에 영향을 미치며, 간호사 배치기준의 법제화는 환자안전에 필요한 최소 인원을 보장하는 중요한 수단이 될 수 있다. 우리나라는 의료법에 간호사 정원기준을 제시하고 있으나, 환자안전 보장 및 간호의 질 향상을 위해서 다음의 몇 가지 사항에 대한 개선이 필요하다. 첫째 1962년 제정된 현행 의료법의 간호사 정원기준은 보건의료환경 변화에 따라 적정성에 대한 재검토가 필요하다. 둘째 의료법의 간호사 정원은 의료기관이 준수하여야할 최소 인원으로 모든 의료기관이 준수하도록 관리되어야 한다. 셋째, 간호사 배치기준은 환자의 이해를 돕고, 관리가 용이하도록 근무조당 입원환자수 대 간호사 수를 기준으로 하도록 한다. 넷째, 병원 간호단위별 근무조별 간호인력 배치정보를 공개하여야 한다.

• 한국병원경영학회지
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• 제8권4호
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• pp.1-25
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• 2003

The wave of globalisation initiated by marketisation has increasingly penetrated into all sectors across the world, accordingly, the health & hospital service sector could not be made no escapes, and it currently faces the order of more marketised competition more than ever. Traditionally, the characteristic of the hospital services in the UK has considered as a model of social provision by government. However, contrary to our knowledge, the sphere of the hospital service in the UK has already been immersed in by the marketisation, in which the private actors have been embedded in order to tweak the activities of the hospital service with in the European Union. As the methodology of this research, the qualitative analysis, namely the interview with some doctors in Surgery, NHS Trusts staffs and relevant specialists in has been performed on April to May, 2003. And on the other hand, the various documents related to its service have been analysed. Thus, this paper will review the characteristics of the health service sector in the UK. In doing so, it will illuminate what would be the structural factors derived from its existing system, as a result, it will shed light on how the UK government makes an effort to resolve the problematic situation by reviewing the policy direction of Foundation Hospital proposed recently. In the next stage, it will analyse how all elements consist of the hospital management in the UK has been adjusted and be likely to be changed within Europe. More specifically focuses on how the private hospital service has been managed and related with the activities of its public hospital service-NHS Trusts. Also, under the circumstance, what private health insurance companies function will be studied. In conclusion, it will be concluded that what will be the implication of Korean hospital service market so as to correspond to globally open market by WTO. Now the UK health service system has faced a turning point of becoming more health care market internally and externally pressed by global and regional factors. Thus it is meaningful to scrutinize how a key part of social provision in the health care market system tends to adjust to globally marketised regulation.