• 임상간호연구
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• 제24권2호
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• pp.147-158
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• 2018

Purpose: This study was conducted to identify the effects of educational video program delivered using Tablet PC on physical discomfort, uncertainty, state anxiety, and nursing education satisfaction among early gastric cancer patients undergoing endoscopic submucosal dissection. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 60 patients who were hospitalized to undergo endoscopic submucosal dissection. The experimental group watched educational video using Tablet PC (n=30) and the control group received only the usual education (n=30). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of physical discomfort (t=3.05, p=.003) and nursing education satisfaction (t=-2.20, p=.032) in the experimental group were significantly different from that of the control group. However, the level of uncertainty (t=-0.82, p=.418) and state anxiety (t=-1.69, p=.097) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that the educational video program delivered using Tablet PC as an effective intervention alleviating physical discomfort and improving satisfaction regarding nursing education among early gastric cancer patients undergoing endoscopic submucosal dissection. Based on the findings, we believe that the educational video program can be helpful in decreaseing physical discomfort, and it also can be utilized to improve nursing education satisfaction.

• 대한임상검사과학회지
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• 제49권4호
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• pp.489-494
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• 2017

해부학 교육은 보건의학계열 학생들에게 가장 기본이 되는 과목이며 중요하다. 해부학 교육의 질적 개선 및 다양성을 위해서 임상병리학과, 물리치료학과, 작업치료학과 학생 130명을 대상으로 설문을 통해 기존의 해부학 교육과 카데바실습(cadaver dissection)의 만족도, 이해도, 인식을 조사하였다. 분석 결과, 해부학 수업에 대한 수업의 만족도는 성별에 따른 차이가 없었다. 또한 전공에 따른 교과서 중심의 해부학 수업에 대한 인식 차이가 없었으며, 모두 과에서 보통 이상의 만족도를 보였다. 그리고 전공에 따른 해부학 수업의 이해도의 차이 역시 없었다. 다만, 전공에 대한 만족도은 임상병리학과에서 유의하게 높았다 (p<0.05). 카데바실습 전. 후의 카데바실습에 대한 인식 분석결과 대부분의 학생들은 성별이나 고등교육 교과과정과 관계없이 카데 실습이 해부학수업에 꼭 필요하다고 인식하였고, 실습 후 카데바실습이 꼭 필요하다고 생각했으며 조사결과 모든 학생이 카데 실습 후에도 실물실습이 필요하다고 인식하였고 3~4시간이 가장 적당하다고 생각했다. 이번 결과로 해부학 교육의 다양성을 위한 학생들의 요구도가 높았으며 카테바실습 및 실물을 이용한 실습을 이용한 해부학 교육이 학습 효과가 높을 것으로 기대 된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.47-51
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• 2013

Background: Postoperative complications after esophagectomy can lead to considerable patient discomfort and prolonged length of hospital stay. Lack of physical activity can be one of the independent risk factors for postoperative complications because physical activity is closely related to physical function. The objective of this study was to determine whether physical activity among esophageal cancer patients decreases their risk of postoperative complications after esophagectomy. Materials and Methods: We investigated 51 consecutive patients with newly diagnosed resectable esophageal cancer who were scheduled to receive esophagectomy between January 2009 and November 2011. Demographic, clinicopathologic, and treatment information were recorded and physical function was measured. The last 7-days short version of the International Physical Activity Questionnaire was used to assess physical activity before the operation. Stepwise multiple logistic regression analysis was used to determine whether preoperative physical activity is related to the risk of postoperative complications. Results: Male gender [OR 18.6, (95%CIs: 1.2-284.4); P=0.035], 3-field lymph node dissection (OR 9.6, [95%CIs: 1.4-66.6]; P=0.022), low-level physical activity (OR 28.3, [95%CIs: 3.5-227.7]; P=0.002), and preoperative comorbidities [OR 5.9, (95%CIs: 1.1-31.5); P=0.037] were found to be independently associated with postoperative complications. Conclusions: The present study shows that low-level physical activity, preoperative comorbidities, and 3-field lymph node dissection are independent and significant risk factors for postoperative complications after esophagectomy. Although further study is required, maintaining high-level physical activity preoperatively may decrease the risk of postoperative complications.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.464-470
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• 2022

Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.

• 공학교육연구
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• 제8권1호
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• pp.20-30
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• 2005

최근 들어 '학습자 중심의 자기주도 학습' 이라는 새로운 교육패러다임에 대한 관심이 집중되면서, 문제중심학습(Problem-Based Learning; PBL)이 학생의 과학적 사고능력 및 지식의 확장, 적용력, 비판적 지식창출 능력, 창의적 문제해결 능력을 향상시킬 수 있는 방법으로 주목받고 있다. 기계공학 분야에서도 이러한 PBL교육기법을 적용한 교과과정 개발에 대한 노력들이 활발히 전개되고 있으며, 본 논문에서 제시하는 '제품해체 설계추론'교과목도 그러한 교육방법을 적용한 한 예시라 할 수 있다. 제품해체 설계추론은 제품개발에 있어서 그 기여도가 가장 높은 기초물리학이 실제 제품에 어떻게 응용되고 있는가를 학생들이 직접 참여하여 체험할 수 있게 하는 제품해체 학습법 (product dissection)을 도입하여, 설계추론(design reasoning)에 있어서 기초물리학의 중요성을 인식시키는 한편, 다양한 기초과학에 대한 흥미를 유발할 수 있는 실습위주의 교과목이라 할 수 있다. 이러한 교과목을 통하여 창의적 설계 인력 양성에 큰 역할을 할 수 있을 것으로 기대한다.

• 해부∙생물인류학
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• 제31권4호
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• pp.159-165
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• 2018

본 연구는 해부용시신을 이용한 참관 해부실습 전과 후에 보건의료계열 학생들의 죽음에 대한 인식 변화를 파악하여 죽음에 대한 바른 인식과 이해를 고취하도록 하는 데 기초자료를 제공하고자 시도하였다. 연구대상은 보건의료계열 1학년 학생 472명이었으며, 죽음에 대한 인식은 36문항으로 구성된 설문 도구를 사용하여 5점 척도로 측정하였다. 자료 수집은 2017년 4월 5일부터 6월 18일까지 실시하였다. 자료 분석은 SPSS win 24.0을 이용하여 빈도분석, 독립 t 검정, ANOVA, 짝비교 t 검정을 시행하였다. 연구결과, 참관 해부실습 전에는 직계가족 중 환자가 있는 경우(p=.016), 사망자를 직접 본 경우(p=.021)에 죽음에 대한 인식이 유의하게 높았다. 참관 해부실습 후에는 본인의 건강상태가 좋은 경우(p=.036), 직계가족 중 환자가 있는 경우(p=.010), 사망자를 직접 본 경우(p=.011)에 죽음에 대한 인식이 유의하게 높았다. 죽음에 대한 인식은 전체적으로 참관 해부실습 전(3.06점)보다 후(3.19점)에 유의하게 죽음에 대한 인식 수준이 높아진 것으로 나타났다(p=.000). 특히 죽음에 대한 불안은 참관 해부실습 후 유의하게 증가하였고(p=.000), 죽음에 관한 관심 역시 참관 해부실습 후 유의하게 높아졌다(p=.000). 따라서 죽음에 대한 불안을 완화할 수 있는 중재프로그램이 동반된다면, 해부용시신을 이용한 참관 해부실습은 해부학적 지식을 향상하는 데 매우 도움이 될 뿐만 아니라 죽음에 대한 인식 수준을 높이는 데도 도움을 주는 경험이 될 수 있어 적극적으로 장려할 필요가 있을 것이다.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.430-435
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• 2022

Objective: This study was conducted to investigate the effect of active movement with skin mobilization on range of motion, pain, and rating of perceived exertion in patients diagnosed with axillary web syndrome after axillary lymph node dissection. Design: A Case report Methods: It was performed on 7 patients diagnosed with axillary web syndrome after lymph node dissection. The subjects experienced a decrease in the range of joint motion and pain in movement when raising their arms in their daily lives, and complained of discomfort. The active range of motion, numeric rating scale, and modified Borg scale of shoulder joint flexion were measured, and the differences after active movement with skin mobilization were compared. Results: All subjects increased by 24.9 degree on average in active range of motion after active movement with skin mobilization intervention. There was no pain in the maximum range of joint motion measured before intervention, and rating of perceived exertion was significantly reduced. Conclusions: Active movement with skin mobilization can be a very useful way to help improve and treat axillary web syndrome, and it is recommended for improving the function and quality of life of axillary web syndrome patients. and It is also believed that it can be used steadily at home through the education of patients and families.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• Journal of Digestive Cancer Research
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• 제4권2호
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• pp.113-121
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• 2016

Background: We evaluated technique of hepatic resections using suprahilar-extrafascial dissection of Glissonean pedicle with vascular stapling device for pedicle transection with intent to minimize operative time and blood loss. Methods: We analyzed the clinical records of 326 patients who underwent anatomic liver resection by suprahilar-extrafascial pedicle isolation with vascular stapling division technique. Results: The minor liver resections were associated with significantly shorter surgery duration (105.1±21.1 vs. 225.6±75.6) and transection time (40.1±14.5 vs. 96.3±55.2) than major hepatectomies (p<0.0001 for all). The mean blood loss was 350.8±100.5 mL in minor resection and 485.4±250.2 mL in major resection (p=0.001). The mean blood transfusion requirement was 400.8±109.5 mL for minor resections and 550.9±100.0 mL for major hepatectomy (p=0.072). There was no significant difference in morbidity and mortality between groups (p=0.980; p=0.945). Major as well as minor liver resection were oncology superior with no significant difference in the 5-year overall survival rates. Conclusion: Suprahilar-extrafascial dissection of Glissonean pedicle represents an effective and safe technique of liver resection. Presented approach allows early and easy ischemic delineation of appropriate liver territory to be removed with selective inflow vascular control. It is not time consuming and it is very useful in re-resection, as well as oncological reasonable.

• Journal of Yeungnam Medical Science
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• 제41권3호
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• pp.179-187
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• 2024

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.