• Archives of Plastic Surgery
• /
• 제41권4호
• /
• pp.362-365
• /
• 2014

Background Many implants are being used for the reconstruction of orbital wall fractures. The effect of the choice of implant for the reconstruction of an orbital wall fracture on the surgical outcome is under debate. The purpose of this article is to compare the outcomes of orbital wall reconstruction of small orbital wall fractures on the basis of the implants used. Methods The authors conducted a retrospective study using electronic databases. Between March 2001 and December 2012, 461 patients with orbital wall fractures were included in this study. Among them, 431 patients in whom the fracture size was less than $300mm^2$ were analyzed. The fracture size was calculated using computed tomography scans of the orbit in the sagittal and coronal images. Cases in which the fracture size was less than $300mm^2$ were included in this study. Results One hundred and twenty-nine patients were treated with silastic sheets; 238 patients were treated with titanium meshes; and absorbable meshes were used in the case of 64 patients. Overall, 13 patients required revision, and the revision rate was 3.0%. The revision rate of the silastic sheet group was 5.4%. In the multivariable analysis, the revision rate of the group reconstructed with silastic sheets was highly statistically significant (P=0.043, odds ratio=3.65). However, other factors such as age, sex, fracture type, and fracture size were not significant. Conclusions Reconstruction of orbital wall fractures with silastic sheets may cause more complications than that with other materials such as titanium meshes and absorbable meshes.

• 대한수학교육학회지:수학교육학연구
• /
• 제22권3호
• /
• pp.353-370
• /
• 2012

중학교의 함수 개념 도입과 관련하여 7차 교육과정의 개정 시 종속적인 변화관계에 기반하여 도입하도록 큰 변화를 시도하였고 이러한 방향은 현재 2009 개정 교육과정에서도 유지되고 있다. 이에 본 연구에서는 이러한 교육과정의 변화가 학생들의 함수개념 이해에 어떤 변화를 가져왔는지 그리고 실제 교수 학습 장면에서 함수가 어떻게 지도되고 있는지를 탐색하였다. 이를 위해 학생들의 경우 과제기반 심층 면담을 통해 함수 개념화의 특성을 살펴보았고 또 다른 한편으로는 학생들의 지도교사들을 대상으로 면담을 실시하여 수업에서 함수를 도입하는 방식에 대해 질문하였다. 연구결과 학생들은 종속적 변화관계에 기반하여 함수를 인식하는 정도가 매우 미약하며 교사들 또한 종속적 변화관계에 기반하여 함수를 지도하는데 어려움을 겪고 있음을 확인할 수 있었다. 이러한 논의를 바탕으로 학교수학에서 함수 지도와 관련한 몇 가지 제언을 하였다.

• 대한공간정보학회지
• /
• 제8권1호
• /
• pp.85-95
• /
• 2000

최근 활발한 수치지도의 제작과 함께 수치지도 수정/갱신의 필요성도 증대되어가고 있다. 수치지도를 수정/갱신하는 방법에는 사진측량, 지상측량, 인공위성의 활용 등 많은 방법이 이용되고 있으나, 작업의 과정에 많은 시간이 소요되고, 소규모 지역적인 부분의 갱신에는 경제적, 시간적인 문제로 적용하는데에 제한적인 요소들이 존재한다. 따라서, 본 연구에서는 공사의 준공시에 작성되는 준공측량도면을 이용하여 수치지도를 수정/갱신하는 방법을 제시하고 이에 대한 정확도를 분석하여, 경제적인 수치지도의 수정/갱신방법을 제시 하였다. 본 연구의 결과, 1/1,000 수치지도를 수정/갱신하기 위하여 1/1,200 준공측량도면을 이용한 결과, 국가 수치지도 제작 정확도에 준하는 수치지도의 수정/갱신이 가능하였다. 또한, 수치지도의 갱신을 위하여서는 전산화된 파일의 제공이 필요하며, 보다 정확한 준공측량도면의 작성을 위하여 지역기준점 개념의 도시보조 기준점의 도입이 적극적으로 검토되어야 할 것으로 조사되었다. 이를 뒷받침하기 위하여 준공단계에서 측량을 실시하여 준공측량도면을 작성할 수 있는 법률적인 지원이 있어야 할 것이다.

• 의료법학
• /
• 제16권2호
• /
• pp.295-326
• /
• 2015

2012. 2. 1. 의료법이 개정되며 의료인은 2개 이상의 의료기관을 개설할 수 없을 뿐 아니라 운영에도 관여할 수 없게 되었다. 그러나 이러한 개정 법률의 입법목적이 무엇인지 불분명할 뿐 아니라 여러 제반사정을 기초로 입법목적을 확정하더라도 개정 법률이 그러한 목적을 달성하기에 적합한 수단이 되기 어렵다. 이 글에서는 의료법 개정 경과와 의료기관 1인 1개설주의의 연혁, 개정 의료법의 입법목적을 확정 검토하는 한편, 개정 의료법이 제한하는 기본권과 명확성의 원칙, 과잉금지원칙을 토대로 동 법률의 위헌성을 살펴보기로 한다.

• Clinics in Orthopedic Surgery
• /
• 제10권4호
• /
• pp.398-406
• /
• 2018

Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

• 대한지구과학교육학회지
• /
• 제11권3호
• /
• pp.237-243
• /
• 2018

이 연구는 '지구와 달' 주제와 관련된 초등학교 2009 개정 과학교과서와 2015 개정 과학교과서 내용을 분석하는데 목적이 있다. 연구를 위해 우리나라의 2009 개정 과학교과서와 2015 개정 과학교과서의 '지구와 달' 관련 단원의 내용을 선정하여 분석하였다. 연구결과, 첫째, 2009 개정 과학교과서에 2015 개정 과학교과서로 개정되면서 교육과정의 성취기준 상에서는 큰 변화는 없었다. 둘째, 두 교육과정의 구체적인 교과서 내용 진술이나 전개는 별다른 차이가 없었으나, 탐구활동면에서는 교육과정의 탐구활동 제시에서는 물론 교과서에 제시된 구체적인 탐구활동에서도 많은 변화를 보였다. 셋째, 2009 개정 과학교과서에 비해 2015 개정 과학교과서에서는 사진과 삽화를 많이 사용하고 있었다. 넷째, 실험관찰과 관련된 변화는 거의 없었으나, 단원을 정리하는 활동이 2015 개정에서는 2009 개정에 비해 강화되었다.

• 공학교육연구
• /
• 제25권1호
• /
• pp.3-11
• /
• 2022

The purpose of this study is to empirically analyze the learning experiences of high school mathematics and science subjects of new students in science and engineering, and to provide basic data and respond to strengthen basic knowledge of science and engineering students in the future. The subjects of the survey were 481 freshmen in science and engineering at S University. First, as a result of analyzing the learning experiences of freshmen, the geometric subjects were significantly lower, which is the result of students' sensitive responses to transitional changes in the curriculum and SAT system after revision. In science, general elective subjects were higher than career elective subjects, and there was a deviation between science subjects, which is a result of reflecting the diversity and hierarchy of science subjects. Next, as a result of analyzing the difference in learning experience after revision compared to before the revision of the curriculum, the learning experience of Mathematics II increased significantly and the geometry decreased significantly. Both Chemistry I and II increased significantly compared to before the revision, and Earth Science I decreased significantly. This can be seen as a result of strategic choices based on obtaining grades in the CSAT and disadvantages in college entrance exams. As a result of the study, students' sensitive reactions to changes in the high school education environment were confirmed, basic mathematics and science-related courses were opened to alleviate variations in the academic ability due to elective courses, and countermeasures tailored to each university's situation.

• 대한예방한의학회지
• /
• 제26권2호
• /
• pp.69-74
• /
• 2022

Objective : This study was aimed to review the Act on the Promotion of Korean Medicine and Pharmaceuticals. Method : We searched document about the Act on the Promotion of Korean Medicine and Pharmaceuticals. We used Korean Law Information Center(https://www.law.gov.kr) to find the revision of the act. Results : We looked at the current status of the revision of the Act on the Promotion of Korean Medicine and Pharmaceuticals, and the law was revised four times in total. Through the revision of the law, the definition of Korean medical practice was not only expanded, but also the establishment and role of National Institute of Korean Medicine Development were extended. Specific descriptions of Korean medicine technology will be needed in the future, and laws that are less effective should be revised and the role of National Institute of Korean Medicine Development should be further strengthened. Conclusion : For the future of Korean medicine, in-depth consideration is needed on how to foster oriental medicine.

• Clinics in Shoulder and Elbow
• /
• 제25권4호
• /
• pp.311-320
• /
• 2022

Background: The outcomes of patients 50-55 years old or younger undergoing prosthetic shoulder arthroplasty (PSA) may not generalize to younger patients. We report outcomes following PSA in a consecutive series of patients 40 years or younger. We hypothesize that total shoulder arthroplasty (TSA) provides better outcome and durability than resurfacing hemiarthroplasty (RHA). Methods: Patients were stratified by diagnosis and surgical procedure performed, RHA or TSA. Active range of motion and self-assessed outcome were evaluated preoperatively and at final follow-up. Results: Twenty-nine consecutive PSAs were identified in 26 patients, comprising 9 TSAs and 20 RHAs, with a minimum of 2-year follow-up. Twelve PSAs were performed for chondrolysis. Mean active forward elevation, abduction, external rotation, and internal rotation improved significantly (p<0.001 for all). Mean pain score improved from 6.3 to 2.1, Simple Shoulder Test from 4.0 to 9.0, and American Shoulder and Elbow Surgeons score from 38 to 75 (p<0.001 for all). Patients undergoing RHA and TSA had similar outcomes; but three RHAs required revision, two of these within 4 years of implantation. Four of five patients undergoing revision during the study period had an original diagnosis of chondrolysis. Conclusions: PSA in young patients provides substantial improvement in active range of motion and patient reported outcomes irrespective of diagnosis and glenoid management. However, patients undergoing RHA, especially for chondrolysis, frequently require subsequent revision surgery, so that RHA should be considered with caution in young patients and only after shared decision-making and counsel on the risk of early revision to TSA.

• Journal of Korean Neurosurgical Society
• /
• 제66권2호
• /
• pp.162-171
• /
• 2023

Objective : The goal of this study was to analyze the clinical outcomes of endoscopic third ventriculostomy (ETV) and endoscopic septostomy when shunt malfunction occurs in a patient who has previously undergone placement of a ventriculoperitoneal shunt. Methods : From 2001 to 2020 at Seoul National University Children's Hospital, patients who underwent ETV or endoscopic septostomy for shunt malfunction were retrospectively analyzed. Initial diagnosis (etiology of hydrocephalus), age at first shunt insertion, age at endoscopic procedure, magnetic resonance or computed tomography image, subsequent shunting data, and follow-up period were included. Results : Thirty-six patients were included in this retrospective study. Twenty-nine patients, 18 males and 11 females, with shunt malfunction underwent ETV. At the time of shunting, the age ranged from 1 day to 15.4 years (mean, 2.4 years). The mean age at the time of ETV was 13.1 years (range, 0.7 to 29.6 years). Nineteen patients remained shunt revision free. The 5-year shunt revision-free survival rate was 69% (95% confidence interval [CI], 0.54-0.88). Seven patients, three males and four females, with shunt malfunction underwent endoscopic septostomy. At the time of shunting, the age ranged from 0.2 to 12 years (mean, 3.9 years). The mean age at the time of endoscopic septostomy was 11.9 years (range, 0.5 to 29.5 years). Four patients remained free of shunt revision or addition. The 5-year shunt revision-free survival rate was 57% (95% CI, 0.3-1.0). There were no complications associated with the endoscopic procedures. Conclusion : The results of our study demonstrate that ETV or endoscopic septostomy can be effective and safe in patients with shunt malfunction.