• Journal of Acupuncture Research
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• 제25권3호
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• pp.127-138
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• 2008

Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

• 한국산학기술학회논문지
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• 제21권10호
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• pp.115-126
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• 2020

최근 의료계에서 환자안전에 대한 관심이 지속적으로 높아지고 있고, 환자안전사고가 증가함에 따라 환자안전사고의 발생에 효율적인 대처를 위한 의료인들의 의사소통 능력의 필요성을 강조하고 있다. 따라서 본 연구는 환자안전사고 대처를 위한 시뮬레이션 기반 의사소통 교육 프로그램을 개발하고, 공공의료기관으로 지정된 병원의 간호사 에게 적용하여 교육 전, 후에 따른 의사소통능력, 자기효능감, 비판적 사고성향, 문제해결능력에 미치는 효과를 파악하고자 시도되었다. 또한 프로그램 적용 후 교육에 대한 만족도를 파악하였다. 연구대상자는 공공의료기관으로 지정된 병원의 간호사 32명이다. 2019년 8월 19일부터 8월 20일까지 자료수집 하였으며 자료 분석은 SPSS 23.0 프로그램을 이용하여 빈도, 백분율, paired t-test 로 분석 하였다. 연구결과 환자안전사고 대처를 위한 교육프로그램이 간호사의 의사소통능력, 자기효능감, 문제해결능력 향상에 유의하게 나타났으며, 비판적 사고성향은 교육 후 상승되었으나 통계적으로 유의한 차이는 없었다. 본 연구의 교육 프로그램이 간호사의 의사소통능력, 자기효능감, 문제해결능력 향상에 효과적인 교육 방법임을 확인하였다. 따라서 본 연구는 공공의료기관 간호사들의 환자안전사고 대처를 위한 의사소통 역량 향상에 도움을 주며, 임상에서 간호사를 대상으로 환자안전을 위한 교육 프로그램의 기초로 활용 될 수 있을 것이라 기대된다.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.56-59
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• 2011

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

• Journal of Chest Surgery
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• 제49권6호
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• pp.435-442
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• 2016

Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p=0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.

• 디지털융복합연구
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• 제17권1호
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• pp.219-227
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• 2019

본 연구는 보건계열 학생을 대상으로 환자안전 지식과 환자안전 수행자신감을 파악하기 위해 수행되었다. 보건계열학생 349명이 참여하였고, 자료분석은 SPSS 21.0을 이용하여 분석하였다. 연구결과 환자안전지식 정답률은 평균 65.7%였다. 환자안전 수행자신감은 평균 $7.11{\pm}1.74$점이었으며 문항별로 살펴보면 환자확인이 높았으며 효과적 의사소통이 낮게 나타났다. 환자안전지식과 환자안전 수행자신감의 하부영역인 환자확인, 의사소통, 수술시술, 낙상, 환자안전사고보고는 양의 상관관계였고, 환자안전지식과 감염관리, 시설환경은 음의 상관관계였다. 보건계열학생들에게 임상실습 전 환자안전에 대한 중요성을 높이고 안전한 임상실습이 수행될 수 있도록 환자안전교육프로그램을 개발하는 것이 필요하다.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.288-293
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• 2021

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.21-31
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• 1989

This is a series of continuing research on facial bone fractures of Koreans worked by Dept. of Oral and Maxillofacial surgery, Dental College of Yonsei University, Seoul, Korea, since 1972. The study was based on a series of 630 patients with facial bone fractures treated as in-patient at Yonsei Medical Center, Yonsei University, during the period of Jan., 1982 through Dec., 1987. The results obtained are as follows: 1. The ratio of Men to Women was 4.3 : 1, and admissions for facial bone fractures have been increased year after 1984. 2. The age frequency was highest in the third decade(38.3%), and fourth, second, fifth decade in orders. 3. The traffic accident was the most frequent cause of facial bone fractures (51.3%). 4. The most common location of facial bone fractures was the Mandible(35.3%), and Zygoma complex(29.8%), Nasal bone(15.0%), Maxilla(11.0%) were next in order of frequency. 5. In 291 patients of Mandible fractures, 226(77.7%) had fractures only in Mandible and 65(22.3%) had another facial bone fractures. The most frequent fracture site of Mandible was the Symphysis(43.0%) and Angle(22.4%), and Simple fracture was the most frequent in type of fracture(66.9%). Intermaxillary fixatin & Open reduction was major method of treatment(36.9%). 6. In 394 patients of Midface fractures 323)82.0%) had fractures only in Midface and 71(18.0%) had another facial bone fractures. The most frequent site of Midface fractures was zygoma complex & zygomatic arch(42.7%), and Simple fracture was the most common type of fractures. Observation(Maxilla :44.2%, Zygoma :51.0%) and Open Reduction(Maxilla :20.0%. Zygoma :23.5%) were the major method of treatment. 7. The frequency of Nasal bone fracture was about 1/5 of Midface fractures, and Closed Reduction(45.2%) was the major method of treatment. 8. The complication was reported in only 16 patients, and Malunion was the major complication. 9. Head(44.4%), Lower extrimities(14.5%) and Eye(12.3%) were injured commonly with facial bone fractures. 10. The elapsed time from injury to hospital was within 24 hours in 73.8% of patients, however 15.5% of patients arrived the hospital 72 hours after injury.

• Journal of Chest Surgery
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• 제6권2호
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• pp.225-230
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• 1973

Five cases of esophageal cancer developed at the site of esophageal lye stricture were reported. Duration of lye stricture was between 13 and 40years, and all 5 cases had taken normal diet without appreciable troubles after recovery from the acute stage of burn till the suspected onset of esophageal malignaney. Outstanding symptoms of this grave condition were rather acute progressive dysphagia and frequent episodes of esophageal foreign bodies, Diagnosis could be confirmed easily by endoscopic biopsy in suspected eases, and all were epidermoid carcinoma histopathologically. Curative resection of this condition was made in neither of the cases, and their prognoses were more grave than other esophageal malignancies in our experience. The development of esophageal carcinoma at the site of corrosive esophagitis with resulting benign stricture has now been suspected as a cause and effect relationship between these two conditions, and Kiviranta: stated that the incidence of esophageal cancer in patients with lye stricture of longer duration is a thousand times higher than normal population. During last one decade the authors experienced 5 cases of esophageal carcinoma developed at the site of lye stricture of the esophagus among about 350 cases of lye burned esophagus at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul, Korea. In Korea they still use lye as a detergent in rural area, and there are still many persons ingesting lye for suicidal attempt or on accident. Lye stricture of the esophagus is, therefore, the most common esophageal disease needing surgical procedures, and the authors believe that there will be much more eases of lye stricture complicated by esophageal eareinoma repoted in near future in this Country.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.87-96
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• 2009

Purpose: Injuries are the most important cause of morbidity and mortality in the childhood population worldwide. Thus, this study was down to investigate the type and the severity of injuries according to the age group in childhood. Methods: A survey of injury information and a chart review were done on 378 children (257 boys, 121 girls) who visited the Emergency Departments of Asan Medical Center from March 1, 2009, to March 31, 2009. To determine differences in injury mechanism, accident place, injury site, New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS), we divided the 378 patients into 4 group: under 1 year, 1 to 4 years, 5 to 9 years, and 10 to 15 years. Results: The mean (${\pm}SD$) age of the study group was 5.1 (${\pm}4.4$) years. Two year olds formed the largest group of injured children, with 77 cases (20.4% of the total). The most common cause of injury in childhood was being hit by an object (26.2%). Falls were frequent in the under-1-year group (22.2%) and slip downs (30.1%) were more frequent in 1-to-4-year group. More than half (53.4%) of the injuries occurred in the home, and the most common places of home-related injuries were the living room (41.1%) and the bedroom (31.2%). The mean (${\pm}SD$) NISS was 1.5 (${\pm}1.8$), and traffic accidents had the highest NISS ($2.8{\pm}5.1$). Injuries occurred most frequently during the evening. The peak period was 4:00 PM to 8:00 PM (33.7%). Conclusion: Patterns of childhood injury by age group were considerably different, and less severe and nonhospitalized injuries were common. Thus, need to improve surveillance of a variety of injuries, promote intersectional collaboration, build institutional capacities and mobilize community support and policy as an investment in prevention.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.550-556
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• 2023

Blunt breast trauma occurs in 2% of blunt chest injuries. This study aimed to evaluate the evidence on breast reconstruction after blunt trauma associated with the use of a seat belt. Also, we describe the first case of breast reconstruction using the Ribeiro technique. In November 2022, a systematic search of MEDLINE, EMBASE, and Google Scholar databases was conducted. The literature was screened independently by two reviewers, and the data was extracted. Our search terms included breast, mammoplasty, blunt injury, and seat belts. In addition, we present the case of a woman with a left breast deformity and her reconstruction using the inferior Ribeiro flap technique. Six articles were included. All included studies were published between 2010 and 2021. The studies recruited seven patients. According to the Teo and Song classification, seven class 2b cases were reported. In five cases a breast reduction was performed in the deformed breast with different types of pedicles (three superomedial flaps, one lower flap, one superior flap). Only one case presented complications. The case here presented was a type 2b breast deformity in which the lower Ribeiro pedicle was used successfully without complications during follow-up. Until now there has been no consensus on reconstructive treatment due to the rarity of this entity. However, we must consider surgical treatment individually for each patient. We believe that the Ribeiro technique is a feasible and safe alternative in the treatment of posttraumatic breast deformities, offering very good long-term results.