• 한국산학기술학회논문지
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• 제21권12호
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• pp.619-628
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• 2020

본 연구의 목적은 의료기관에서 간호사와 환자의 전자동의서 작성 경험을 파악하고자 하는 것이다. 본 연구는 포커스 그룹 인터뷰를 적용한 질적 내용 분석 연구이며, 연구 참여자는 간호사 30명과 환자 27명이었다. 포커스 그룹 인터뷰와 심층 면담을 통해 자료를 수집하였고 내용분석 하였다. 본 연구결과 전자동의서 사용 경험과 관련된 주요 주제는 '전자 동의서 사용에 대한 유용성', '전자동의서 태블릿 PC 사용과 관련된 불편함', '전자동의서 기능향상에 대한 바람'이었다. 참여자들은 전자동의서는 간편하고 편리하며, 자원과 공간이 절약되고, 향상된 전자시스템의 기능이 있어 만족하나, 예기치 못한 기계의 오작동이 생기거가 충전 펜과 고정형 모니터를 사용할 때 또는 사용법이 익숙하지 않은 경우에는 불편하다고 하였다. 참여자들은 추후 점차 사용이 확대되고, 친필과 유사한 필체, 화면 확대 조정 및 시청각 보조 기능이 지원되기를 원했다. 전자동의서 사용자들의 불편함을 최소화하고 만족도를 최대화하기 위한 노력이 필요하다.

• 치위생과학회지
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• 제21권1호
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• pp.28-37
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• 2021

Background: Career success is the psychological achievement associated with an individual's work. Protean career management behavior is the behavior of managing individual careers in order to achieve individual career goals. The purpose of this study was to clarify the career success of dental hygienists as perceived by clinical dental hygienists and to compare the relationship between career success and protean career management behavior. Methods: Nationwide convenience samples of clinical dental hygienists were obtained; 354 people were surveyed online, and the data of 350 people were finally analyzed. The perception of career success of dental hygienists was assessed using a multiple response method. T-test, ANOVA, and χ2 tests were performed to investigate the differences and relationships between protean career management behavior and career success according to the general characteristics. Results: Career success was recognized by clinical dental hygienists as "income", "work proficiency", "patient consultation", "self-satisfaction", and "recognition by superiors" in order. There were significant differences in protean career management behavior according to general characteristics (p<0.05). Higher career management behavior was common in those higher in age, in married participants, in those with higher educational background, and in those with a higher career, better position, and more job change experience (p<0.05). Among the variables of career success perceived by clinical dental hygienists, "work proficiency" had a significant effect on "career management behavior" (p<0.05). "Work proficiency" and "recognition by superiors" were significant in "protean technological development behavior," and they also influenced actual behavior (p<0.05). Conclusion: The relationship between dental hygienists' career success and protean career management behavior was clarified. Dental hygienists performed career management behaviors to develop work ability and skills. In addition, the relationship between career management behavior and long-term employment was confirmed.

• 대한족부족관절학회지
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• 제26권2호
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• pp.78-83
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• 2022

Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm². The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

• Archives of Plastic Surgery
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• 제48권4호
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• pp.347-352
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• 2021

Background Mastectomy leaves unsightly scarring, which can be distressing to patients. Laser therapy for scar prevention has been consistently emphasized in recent studies showing that several types of lasers, including fractional ablation lasers, are effective for reducing scar formation. Nonetheless, there are few studies evaluating the therapeutic efficacy of ablative CO₂ fractional lasers (ACFLs). Methods This study had a randomized, comparative, prospective, split-scar design with blinded evaluation of mastectomy scars. Fifteen patients with mastectomy scars were treated using an ACFL. Half of each scar was randomized to "A," while the other side was allocated to group "B." Laser treatment was conducted randomly. Scars were assessed using digital photographs of the scar and Vancouver scar scale (VSS) scores. Histological assessments were also done. Results The mean VSS scores were 2.20±1.28 for the treatment side and 2.96±1.40 for the control side. There was a significant difference in the VSS score between the treatment side and the control side (P=0.002). The mean visual analog scale (VAS) scores were 4.13±1.36 for the treatment side and 4.67±1.53 for the control side. There was a significant difference in VAS score between the treatment side and the control side (P=0.02). Conclusions This study demonstrated that early scar treatment using an ACFL significantly improved the clinical results of the treatment compared to the untreated scar, and this difference was associated with patient satisfaction.

• Journal of Chest Surgery
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• 제55권6호
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• pp.462-469
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• 2022

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p<0.01) shorter operative and clamp times than the conventional group. The HMI group also had significantly shorter incision lengths (5.3±0.9 cm) than the conventional group (11.5±2.8 cm). The rates of stroke, TIA, and death at 30 days were not significantly different between the 2 groups. There was no significant difference in the rate of cranial and cervical nerve injuries, and all injuries were transient. A high lesion level (odds ratio [OR], 9.56; 95% confidence interval [CI], 3.21-28.42; p<0.01) and the clamp time (OR, 1.07; 95% CI, 1.03-1.12; p<0.01) were found to be risk factors for nerve injuries. Conclusion: Use of the HMI in CEA for carotid stenosis was advantageous for its shorter operative time, shorter internal carotid artery clamp time, reduced neurologic complications, and improved esthetics.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.730-740
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• 2022

Objective : Although several commercialized bone cements are used during percutaneous vertebroplasty (PVP) for patients with osteoporotic vertebral compression fracture (OVCF), there are no reports using domestic products from South Korea. In this study, we investigated the safety and efficacy of Spinofill^® (Injecta Inc., Gunpo, Korea), a new polymethyl methacrylate product. Methods : A prospective, single-center, and single-arm clinical trial of 30 participants who underwent PVP using Spinofill^® for painful thoracolumbar OVCF was performed with 6-months follow-up. Clinical and surgical outcomes included the Visual analog scale (VAS), Korean-Oswestry disability index (K-ODI), and Odom's criteria, complication rate, and recurrence rate. Radiological outcomes were evaluated by measuring the findings of postoperative computed tomography and simple radiograph. Results : The pain of VAS (from 8.95±1.05 to 4.65±2.06, p<0.001) and the life quality based on K-ODI (from 33.95±5.84 to 25.65±4.79, p<0.001) improved significantly, and successful patient satisfaction were achieved in 20 patients (66.7%) 1 day after surgery. These immediate improvements were maintained or more improved during the follow-up. There was no surgery- or product-related complications, but OVCF recurred in two patients (6.7%). Favorable cement interdigitation was reported in 24 patients (80.0%), and extra-vertebral cement leakage was reported in 13 patients (43.0%). The mean vertebral height ratio (from 60.49%±21.97% to 80.07%±13.16%, p<0.001) and segmental kyphotic angle (from 11.46°±8.50° to 7.79°±6.08°, p=0.002) improved one day after surgery. However, these short-term radiological findings somewhat regressed at the end. Conclusion : The overall outcomes of PVP using Spinofill^® were as favorable as those of other conventionally used products.

• 대한예방한의학회지
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• 제26권2호
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• pp.87-112
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• 2022

Objectives : This study reviewed existing studies on clinical examination of Korean medicine to investigate the trends and gaps of existing research on clinical performance examination (CPX) or objective structured clinical examination (OSCE) in Korean medicine education. Methods : We conducted a scoping review according to the five steps suggested by Arksey and O'Malley. Six databases(RISS, OASIS, KMBASE, KISS, ScienceON, and DBpia) were searched and studies published from 2012 to July 15, 2022 were considered. The subjects of the study were limited to domestic studies about OSCE or CPX conducted in Korean medicine education. Results : Among the 25 selected papers, 17 studies implemented OSCE or CPX in practice. Those studies were conducted in 8 clinical departments and 9 of them used standardized patients. All 14 survey studies reported positive answers in satisfaction, efficacy, and self-assessment. OSCE, CPX scoring items were developed by modifying existing tools or developing through expert surveys or through literature review and significant cases. Conclusions : This study is expected to be used as basic data for following studies and promote clinical examination. From now on, the colleges of Korean medicine should proceed research on large-scale students about extended subjects through various research methods to obtain objective results that can be generalized and acquire validity and reliability. In order to promote such research, it is necessary to induce cooperation from institutions related to Korean Medicine and local universities to develop modules, implement, and conduct post-evaluation.

• 대한심미치과학회지
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• 제30권2호
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• pp.102-111
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• 2021

전치부 영역에서 임플란트는 경, 연조직 조화가 필요하며 다양한 단계를 필요로 한다. 이 중 순측의 함몰은 연조직 이식을 통해 좋은 결과를 얻을 수 있다. 치은퇴축을 위한 피개가 아닌 함몰을 위한 연조직 이식은 공여부의 선택에 있어서 구개측에 비해 상악결절부위에서의 채득으로 연조직의 볼륨을 보다 증가시킬 수 있으며 출혈이나 술후 통증을 줄이고, 공여부의 치유를 빠르게 하는 장점이 있어 좋은 치료 선택이 될 수 있을 것이다.

• Clinics in Shoulder and Elbow
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• 제25권1호
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• pp.57-64
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• 2022

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.172-177
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• 2021

Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.