• Title/Summary/Keyword: orthopedic

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Study on the Adolescent Patient′s Stress during Hospitalization (청년기환자의 입원생활에 따르는 긴장에 관한 연구)

  • 백영주
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.72-79
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    • 1976
  • Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

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A STUDY OF THE TEMPOROMANDIBULAR JOINT IN NORMAL OCCLUSION USING T.M.J TOMOGRAM AND CEPHALOGRAM (단층 및 두부 방사선 계측사진을 이용한 정상교합자의 악관절에 관한 연구)

  • Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.16 no.1
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    • pp.85-106
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    • 1986
  • The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

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Measurement of the Nursing Staff Needed for Two Specialized Nursing units in a University Hospital (간호업무량 측정 및 간호인력 수요산정)

  • 이윤신;박정호
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.589-603
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    • 1992
  • This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

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A Study of the Effects of Casting on Lower Limbs -Comparison of Casted and Noncasted Limb- (하지석고붕대 적용에 의한 활동저하가 석고붕대 적용하지와 비적용하지의 둘레, 피부두겹두께 및 근력에 미치는 효과)

  • 최명애;박미정;채영란
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.517-528
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    • 1994
  • The purpose of this study was to compare the circumference, skinfold thickness and strength of the normal and casted lower limb prior to casting and following removal of the cast. The subjects for the study were nine orthopedic patients who had had long and short leg casts due to a tibial, fibula, or calcaneus fracture, or to a lateral collateral ligament rupture. Circumference, skinfold thickness, and strength of the normal and casted lower limb following removal of the cast were compared with those prior to the application of the cast. Measurements were made before cast application and after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and strength was determined by measuring the length of time the leg was held elevated at 45$^{\circ}$. The results can be summarized as follows 1. There was no change in the normal limb in the circumference of the midthigh and midcalf after casting as compared to before cast application. 2. In the casted limb the circumference of the midthigh decreased by 3.23% and that of the midcalf decreased significantly by 7.49% during the period of casting. 3. In the normal limb skinfold thickness of the quadriceps decreased and that of gastrocnemius increased by 20.63% during the period of cast application. 4. In the casted limb skinfold thickness of the quadriceps decreased significantly by 12.37% and that of gastrocnemius decreased by 10% during the period of cast application. 5. Strength of the normal lower extremity decreased significantly by 48.37% and that of casted lower extremity decreased remarkably by 73.07% during the period of cast application. 6. Circumference of the midthigh and the midcalf decreased significantly by 7.6% and 9.4% respectively on the casted side as compared to the normal side. Skinfold thickness of the quadriceps and the gastrocnemius on the casted side decreased by 6.12% and 18.55% respectively as compared to the normal side and strength in the lower extremity on the casted side decreased significantly by 44.32% as compared to the nor-mal side. From these results, it may be concluded that muscle atrophy occurs in the casted lower limb and muscle strength of the normal lower limb are also reduced during the period of application of a leg cast.

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The Effect of Supportive Group Nursing Care on Body Image of the Patient With tower Limb Fracture (지지적 집단간호가 하지골절 환자의 신체상(Body Image)에 미치는 영향)

  • 정추자
    • Journal of Korean Academy of Nursing
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    • v.15 no.3
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    • pp.74-80
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    • 1985
  • This study was attempted to identify the difference between body image of the patients with lower limb fracture and that of normal persons, and to examine if supportive group care could offer an apportunity for positive change in body image of the patient with lower limb fracture under the Quasi-experimental design. The subjects for this study were obtained by ta-king convenient sample of soldiers; the experimental group were 44 lower limb fractured patients hospitalized on the orthopedic Surgery unit in S Army General Hospital, while the control group were 44 normal enlisted men serving in the B Army regiment. Supportive group nursing care was given to the lower limb fractured patients who belong to the experimental group. Pre-and post-tests were administered to the experimental and the control group. The instruments to measure body image of the subjects were body Cathexis Scale developed by Scord and Jourard (1953) and Body Meaning Scale dove-loped by the reseacher. The reliability coefficients by Cronhach's u-test were .95 in body Cathexis Scale and .89 in Body Meaning Scale in this study. Data for this study were collected over a period 12 days from the 12th to the 24th of October, 1984 by the questionnaire. Data were analyzed by computer. Frequency, Percentage and x²-test were used to examine general chacteristics of the subjects. t-test was used to analyze the hypotheses. Analysis of variance was used to test difference in body image between groups classified by the general characteristics. Pearson Correlation Coefficient was used to identify the correlation between Body Cathexis Scale and Body Cathexis Scale and Body Meaning Scale. The results of this study were as follows: 1. No significant difference was found between the experimental and the control group on general characteristics of the subjects (p> .05). 2. Hypothesis I:“There will be a difference in body image between patiens with lower limb fracture and normal persons,”was supported(Body Cathexis t=6.91, p<.001, Body Meaning t=5.66, p< .001). 3. Hypothesis Ⅱ;“The will be a difference in body image of patients with lower limb fracture bet-ween after and before, supportive group nursing care was provided,”was supported (Body Cathexis t=5.90, p<.001, Body Meaning t=4.45, p <.001). 4. There was no significant difference in body image between groups classified by the general characteristics (p> .05). 5. The correlation between Body Cathexis Scale and Body Meaning Scale: It was reported that Body Cathexis Scale correlated with Body Meaning Scale in total subjects of the experimental and control group (r=.744, p<.001). That is, there was relatively high correlation between two scales. body Cathexis Scale correlated with Body Meaning Scale in the experimental group(r=.738, p <.001) and in the control group (r=.352, p <.001). That is, there was more than moderate correlation between two scales. In conclusion, it was found that there was a difference in body image between patients with lower limb fracture and normal persons, and supportive group nursing care offered an opportunity for positive change in body image of the patient with lower limb fracture.

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VR, AR Simulation and 3D Printing for Shoulder and Elbow Practice (VR, AR 시뮬레이션 및 3D Printing을 활용한 어깨와 팔꿈치 수술실습)

  • Lim, Wonbong;Moon, Young Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.175-179
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    • 2016
  • Recent advances in technology of medical image have made surgical simulation that is helpful to diagnosis, operation plan, or education. Improving and enhancing the medical imaging have led to the availability of high definition images and three-dimensional (3D) visualization, it allows a better understanding in the surgical and educational field. The Real human field of view is stereoscopic. Therefore, with just 2D images, stereoscopic reconstruction process through the surgeon's head, is necessary. To reduce these process, 3D images have been used. 3D images enhanced 3D visualization, it provides significantly shorter time for surgeon for judgment in complex situations. Based on 3D image data set, virtual medical simulations, such as virtual endoscopy, surgical planning, and real-time interaction, have become possible. This article describes principles and recent applications of newer imaging techniques and special attention is directed towards medical 3D reconstruction techniques. Recent advances in technology of CT, MR and other imaging modalities has resulted in exciting new solutions and possibilities of shoulder imaging. Especially, three-dimensional (3D) images derived from medical devices provides advanced information. This presentation describes the principles and potential applications of 3D imaging techniques, simulation and printing in shoulder and elbow practice.

Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture (해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

Effect of occlusal balance on center of gravity in body (교합균형이 자세 중심(重心)에 미치는 영향에 관한 연구)

  • Lee, Yun;Choi, Dae-Kyun;Lee, Sung-Bok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.2
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    • pp.57-67
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    • 2003
  • Suppose that dental occlusion is related to body posture. We want to find out that improving occlusal balance may affect vibration and distribution of C.O.P. in which way, by measuring change of posture and center of gravity (center of pressure, C.O.P.) which plays important role in measuring balance sensation. Total 11 students at Kyung Hee dental college students, 4 females and 9 males (age: 23-30) participated in this test, who have normal occlusion (Angle's classification I), no TMJ problems. All of the participants have no tooth loss except 3rd molar, no prosthesis over single tooth restoration, no orthopedic problems which affect balance sensation, and no otorhinolaryngological problems. First, we registrated bite by centric relation, and then fabricated stabilization splint that is increased 3.5mm vertical dimension around premolar region. By F-scan (Tekscan Inc., Boston, Mass), we measured discrepancy of average contact pressure of left and right foot. And we also measured discrepancy of vibration of C.O.P(center of pressure). before setting stabilization splint and after wearing stabilization splint at intervals of 1 week, 2 weeks, 3 weeks after. In normal human beings, improved occlusal balance by stabilization splint leads to decrease of vibration of C.O.P. (P<0.05). One week after wearing stabilization splint, vibration of C.O.P. decreased reliably (P<0.05), two weeks after wearing stabilization splint, vibration of C.O.P. decreased similarly comparing to before wearing and one week after wearing. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. (P>0.05) Difference between average contact pressure of right and left foot also decreased. (P<0.05) We could find decrease after one week of wearing stabilization splint (P<0.05) and two weeks after, the decrease was more reliable than one week after. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. Improvement of occlusal balance leads to decrease of vibration of C.O.P. and decrease of difference between right and left average contact pressure.

LONGITUDINAL STUDY OF CRANIOFACIAL GROWTH BY LATERAL CEPHALOMETRIC ANALYSIS (정상교합 아동의 두개안면부 성장에 관한 종적 연구)

  • Yang, Kyu-Ho;Park, Chang-Hun;Son, Jung-Soo;Kim, Nak-Hyun;Choi, Nam-Ki;Kim, Seon-Mi;Kim, Ki-Baek;Shin, Hye-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.412-419
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    • 2009
  • The purpose of this study was to provide the reference data evaluating the treatment effect of orthopedic appliances. The skeletal and dental growth increments were measured in 24 normal mixed dentition children (boys: 14, girls: 10) by three serial lateral cephalograms: initial mean age: 9${\pm}$1.3 years, mean observation period: 13${\pm}$1.3 months. Cephalometric changes were analysed. The results were as follows: 1. In boys, the maxilla showed forward and downward growth pattern and the mandible showed forward growth pattern (p<0.05). In girls, the maxilla and mandible showed forward and downward growth pattern(p<0.05). 2. Horizontal growth of both maxilla and mandible in girls was superior to those in boys (A point; girls: 2.39mm, boys: 1.26mm, with p<0.05), whereas vertical growth of both maxilla and mandible in boys was similar to those in girls. 3. The change in tooth axis showed labioversion of upper incisor (p<0.01) and comparatively stable lower incisor position.

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Accuracy and Precision of Three-dimensional Imaging System of Children's Facial Soft Tissue (소아 얼굴 연조직의 3차원 입체영상의 정확성 및 재현성 평가)

  • Choi, Kyunghwa;Kim, Misun;Lee, Koeun;Nam, Okhyung;Lee, Hyo-seol;Choi, Sungchul;Kim, Kwangchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.17-24
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    • 2020
  • The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children's facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject's compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children's facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.