• 제목/요약/키워드: university hospital

검색결과 51,746건 처리시간 0.079초

TELOS를 이용한 Knee Stress (Lachman)검사의 표준화에 대한 연구 (A Study on the Standardization of the Test Method Upon Testing the Anterior Cruciate Ligament Damage Using TELOS)

  • 임종천;한동균
    • 한국방사선학회논문지
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    • 제8권2호
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    • pp.57-63
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    • 2014
  • 전방 십자 인대는 슬관절에서 가장 중요한 구조물로써 경골의 전방 전위 시 전체 위력에 대한 저항의 약 86%를 차지하고 회전의 축을 이루고 있어서 슬관절의 안정성을 유지 하는 기능을 한다. 슬관절의 인대 검사 장비인 TELOS 장비로 Lachrman 검사 시 정상 측과 수술 측 모두 인가되는 힘에 비례 하여 선형적으로 무릎의 굴곡이 일어났으며, 검사 시 외부 힘에 따라 무릎 굴곡이 발생하여 무릎 권고 각도의 유지하기가 어려웠다. 대퇴 고정 롤러의 위치를 슬개골 위 1cm미만과 3cm이상에 위치 시켜 동요를 측정하여 롤러 위치에 따른 대응t 검정을 실시하였으며, 그 결과 롤러의 위치 1cm 이었을 때 무릎 동요에 유의한 차이를 보였다(p<.05). 또한 무릎의 굴곡 각도와 동요의 상관분석을 통해 두 변수 사이에는 상관성이 없는 것으로 나타났으며 이는 Telos Device를 이용한 전방십자인대 검사는 무릎의 굴곡각도 보다는 대퇴 고정롤러의 위치에 영향을 받는 것으로 판단되며 따라서 대퇴 고정롤러의 위치를 슬개골 가까이 위치시키는 것이 대퇴골을 안정적으로 고정 시키고 경골의 움직임을 유발하여 정확한 무릎 관절의 동요를 진단 할수 있는 검사 방법이라 사료된다.

자기공명영상 검사 시 3D 프린팅 재료를 이용한 헤드셋 연구 (소음저감 효과) (Magnetic Resonance Imaging uses 3D Printed Material of Headset (Noise Reduction Effect))

  • 최우전;김동현
    • 한국방사선학회논문지
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    • 제12권3호
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    • pp.335-341
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    • 2018
  • 의료수준의 향상과 더불어 환자들의 첨단의료장비에 대한 기대수준이 증가하고 있으며 특히 자기공명영상(Magnetic Resonance Image : MRI)은 현재 모든 임상 분야에서 가장 핵심적인 영상진단 도구로서 사용되고 있다. 그러나 검사 중에 발생하는 심각한 소음으로 많은 환자가 심리적인 불안을 경험한다고 한다. 이에 본 연구에서는 자기공명영상검사실의 기존 헤드셋 흡음재에서 차음재를 추가한 헤드셋의 소음저감평가와 차음재별 영상 아티팩트(artifact) 유무를 알아보고자 하였다. 3D 프린팅한 헤드셋 내부에 흡음재(스펀지)와 차음재(아크릴판, 구리판, 3D copper plate)를 교차 배열하여 MRI 검사소음을 녹음하여 스피커로 같은 dB 값의 소음을 발생시키며 3D 프린팅 된 두부모형의 내부에 소음측정기로 dB 값을 측정하여 정량분석을 하며 자체 제작한 헤드셋을 물팬텀에 밀착시킨 후 MRI영상 아티팩트 유무를 검사한다. 드셋의 정량평가를 한 결과, 헤드셋 평균 dB 값은 81.8 dB로 나타났으며, 차음재를 추가한 헤드셋에서 가장 방음효과가 뛰어난 재료조합(구리, 아크릴판, 스펀지, 스펀지) 헤드셋의 평균 dB 값은 70.4 dB 값이 측정되었지만 MRI 시뮬레이션 결과 구리가 반자성체이기 때문에 아티팩트가 나타나 배제하였고 두 번째로 방음효과가 뛰어난 (스펀지, 아크릴판, e-copper plate, 스펀지) 헤드셋의 평균 dB 값은 70.6 dB 값이 측정되었고 MRI 시뮬레이션 결과 인공물 나타나지 않았다. 구리분말이 약 40%가 포함된 e-copper PLA로 출력한 재료를 동일하게 시뮬레이션을 한 결과 인공물 나타나지 않았으므로 3D 프린팅 재료의 사용이 적합하였고 구리보다 경제성이 우수하며 가공이 용이하므로 적합한 재료로 선정하였다. MRI관련 연구에 있어 3D 프린팅을 이용한 상호발전이 매우 기대된다.

동맥관 개존증의 임상적 고찰 (A retrospective clinical study of isolated patent ductus arteriosus)

  • 곽영태
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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수장부 다한증에서의 제3번 늑골 위 교감 신경(R3) 차단술의 중기 결과 (Intermediate Term Follow Up for R3 Sympathicotomy in Palmar Hyperhidrosis)

  • 손국희;김광호;백완기;김정택;김현태;김영삼;윤용한
    • Journal of Chest Surgery
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    • 제37권6호
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    • pp.530-535
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    • 2004
  • 배경: 수부 다한증을 치료하기 위해 시행하는 제3번 늑골 위 교감신경 차단술의 경우 다한증 치료 효과는 교감신경 절제술과 유사하면서 보상성 다한증의 발생이 교감신경절제술보다 적다는 연구결과들이 많이 있으나 대부분 단기 결과이며 중기 추적 결과가 발표되어 있지 않아 제3번 늑골 위 교감신경 차단술의 중기 추적을 시행하였다. 대상 및 방법: 인하대학병원 흉부외과에서 99년 4월부터 2001년 8월까지 제3번 늑골 위 교감신경 차단술을 시행한 환자 94명 중 설문조사가 가능했던 76명(남자 38명, 여자 38명)을 대상으로 전화 설문을 시행하여 평균 25$\pm$9.1개월 간(15∼50개월)의 중기 결과를 추적하였다. 교감신경은 3번째 늑골 상방에서 절단하였다. 환자들의 만족도를 알기 위하여 linear analogue scale을 사용하였다 (100: 가장 만족함). 결과: 수술 후 만족도에 관한 질문에서 100점 만점 기준일 때 수술 직후 만족도가 92.36$\pm$9.93 인데 비해 수술 후 15개월에는 7l.80$\pm$20.24로 만족도가 감소하였으며(p<0.001) 이러한 만족도 감소의 이유는 보상성 다한증과 증상 재발 때문이었다. 땀나는 정도도 수술 직후 중앙값 0에서 15개월 후 중앙값 1.5로 증가하였다. 보상성 다한증의 경우 수술 직후 중앙값 1에서 수술 15개월 후 5로 증가하였다. 결론: 이와 같은 결과로 제3번 늑골 위 교감 신경 차단술의 경우 수술 직후에는 훌륭한 치료 효과를 보이나 수술 15개월 후에는 치료효과가 점차 감소한다. 불만족의 가장 흔한 이유는 보상성 다한증과 다한증의 재발이다.

다한증의 흉강경을 이용한 교감신경절 절제술 (Videothoracoscopic Sympathectomy in Hyperhidrosis)

  • 이재영;김명천;조규석
    • Journal of Chest Surgery
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    • 제31권3호
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    • pp.279-285
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    • 1998
  • 손과 발에 정상 이상의 많은 땀이 나는 것은 정신적으로나 직업적으로 난처하고 때로는 무력한 상태를 만든다. 다한증은 자율신경계의 흔한 질병중 하나이다. 다한증은 특별한 치료법이 없었으며 따라서 액와 또는 경부 쪽에서 접근하는 절제술이 있었다. 최근에는 흉강경을 이용한 흉부수술(VATS)이 수장부와 액와부의 다한증에 가장 널리 사용되고 있다. 경희의료원에서는 1996년 3월부터 1997년 3월까지 양쪽 수장부에 다한증이 있는 15명의 환자를 양측 흉부 교감신경 절제술 (T2, T3, T4)을 시행하였고, 수술 전후로 컴퓨터 적외선 전신 체열 측정 (DITI)을 하였다. 이들 모두 개흉술로의 전환은 없었다. 3건의 술후 합병증으로 폐부종 1건, Horner씨 증후군 1건, 미각 다한증 1례가 있었다. 반 이상의 환\ulcorner에서 하복부, 둔부,배부, 대퇴부에 보상성 다한증이 나타났다. 결론적으로, 대부분의 환자는 수장부와 액와부에 땀이 나지 않고, 통증이 적고, 미용상 더 낫고, 족저부와 안면부에도 땀이 줄어 흉강경 수술 후의 결과에 대해 만족하였다. 또한 수술중에 수장부 온도를 측정함으로써 흉강경 교감신경 절제술의 성공 여부를 평가할 수 있었으며, 컴퓨터 적외선 체열 측정을 수술 전후로 시행함으로써 이 방법이 흉강경 교감신경 절제술의 성공적인 결과를 평가하는 객관적인 방법이 될 수 있었다고 사려된다.

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임파워먼트가 치과 의료종사자에게 미치는 영향 (Impact of the empowerment of dental personnels)

  • 이혜경
    • 한국치위생학회지
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    • 제10권2호
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    • pp.297-310
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    • 2010
  • Objectives : The purpose of this study was to verify the impact of the empowerment of dental personnels as one of variables affecting the performance of dental institutions and to seek ways of boosting their organizational productivity. Methods : The subjects in this study were dental personnels who worked in dental institutions. After three investigators were trained, a pilot survey was conducted from October 20 to November 20, 2009, and the questionnaire used in the pilot survey was finalized. The collected data were analyzed with a SPSS(Statistical Package for the Social Science) WIN 12.0 program. The findings of the study were as follows: Results: 1. The dental personnels investigated got 3.98 in meaningfulness, one of the empowerment factors. They found a meaning in their job when they performed it. 2. The dental personnels who were older were more excellent in self- determination and influence, and age made a significant difference to their empowerment. 3. The dental personnels who were better educated were more superior in terms of empowerment, and academic credential made a significant difference to their empowerment factors was statistically. 4. The dental personnels whose yearly salary was larger were more which were the factors of empowerment of each factor was statistically significant. 5. Dental health agency workers less than three years accounted for most of 152 people were working longer duration of empowerment as a whole was that each of the factor scores. Empowerment of each factor was statistically significant. 6. The dental hygienists made up the largest group among the dental institution employees, and the kind of occupation made a significant difference to meaningfulness, competency and influence, which were the factors of empowerment. 7. The greatest group of the dental personnels worked in dental clinics, and the dental hospital employees surpassed the dental clinic employees in competency, self-determination and influence. There was a significant difference in the influence factor according to the type of dental institutions. Conclusions : Thus, the dental personnels were more aware of the meaningfulness factor when their perception of the job-related empowerment was checked, and it indicated that most of them attached importance to meaningfulness during their job performance. But just employees who worked in dental institutions located in particular regions were examined, the findings might not be generalizable. In the future, more extensive research should be implemented, and the sorts of programs that could stir up empowerment among dental institution employees or bolster organizational empowerment should be developed.

노인장기요양보험제도에 관한 치과종사자의 인식도 연구 (A study on dental professionals' recognition on a system of long-term care insurance for the elderly)

  • 안권숙;지민경;민희홍
    • 한국치위생학회지
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    • 제9권1호
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    • pp.169-180
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    • 2009
  • This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

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일부 특수학교 장애인의 구강보건의식행태에 관한 조사연구 (Study on the oral health awareness and behavior in the special school for students of disability)

  • 송윤신;장우성
    • 한국치위생학회지
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    • 제11권1호
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    • pp.103-111
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    • 2011
  • Objectives : This study of oral health problems was conducted to 311 students in Special Schools in order to inquire into the state of their oral health behaviors, to find out the main obstacles against dental services, to secure dental reasonable basis for oral health promotion. Methods : A questionnaire survey was conducted in the Special School of the 311 students in the area of the metropolitan Seoul. By means of Chi-squared test and Fisher's exact test, oral hygiene habits for each type of the subjects, the contents of dental care services, the prerequisites to improve oral health, were inquired. To evaluate the effects to the current oral health status of types of disability, 2-way ANOVA was practiced. Results : The handicapped with Visual impairment, mental retardation, multiplicity with disabilities, answered negatively in their own oral health status. 47.4% of the deaf can do brush for theirselves without the inconvenience, but in other types of disability they showed that they were helped by others. Subjects did not use the secondary oral hygiene necessaries because, except brain damage, almost of types of disability impeded the convenient use. 60 to 88.2 percent of the total respondents were the recent visitors to dental clinique within 1 year, and the most common motives of the visiting dentist, is a routine medical examination, their movements to the dentist in all types of disabilities, needed helps of others. Most of them received medical treatment at a private dentist, the handicapped preferred the private care and place(49.8%). Only in the case of the brain disorders, extremely much of the disabled answered that they were needed the preventive treatment, and the another cases of disability were largely needed the treatment of the decayed teeth. To improve the oral health of the people with disabilities, at the opening of the clinics and hospitals over a certain size, the mandatory medical facilities for the care of the disabled should be preceded and followed by the improvement of dental insurance system so as to reduce the burdens of the cost of dental care. Conclusions : The improvement of oral health policy for the disabled are needed inevitably: Development of secondary oral hygienic easy to use for the disabled, the building systems of medical dental hospital with the disabled facilities, by the improvement of the insurance system, the reduction of the burden of payments.

방사선사의 병원감염관리에 대한 인지도, 수행도 및 임파워먼트와의 관련성 (The Relationship between the Awareness, Performance and Empowerment about Nosocomial Infection Control in Radiological Technologists)

  • 김미정;문일봉;손석준
    • 한국콘텐츠학회논문지
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    • 제13권12호
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    • pp.328-336
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    • 2013
  • 방사선사들의 병원감염 예방지침의 인식정도와 그 수행 능력 정도를 알아보고 병원감염관리의 개선 및 방사선사의 감염관리 교육을 위한 기초 자료를 얻고자 하였다. C대학병원에 근무하고 있는 방사선사 84명(평균연령 41세, 남 61명, 여 23명)을 대상으로 일반적 특성 10문항, 병원감염관련 문항 10문항, 병원감염관리 인지도 측정도구 24문항, 병원감염관리 수행도 측정도구 24문항, 임파워먼트는 12문항으로 방사선사에 맞게 수정 보완하였다. 연구대상자의 연령, 근무경력이 높을수록 병원감염에 대한 인지도와 수행도는 통계적으로 유의하게 높았다(p<0.05). 연구대상자의 병원감염 특성에서 감염관리 수행을 실천하지 못한 이유는 업무과다 (42.9%), 지식부족 (17.8%), 시간부족 (16.7%) 순이었다. 연구 대상자의 병원감염관리에 대한 인지도, 수행도, 임파워먼트간의 상관관계를 분석한 결과, 인지도와 수행도(r=0.476), 인지도와 임파워먼트(r=0.276), 수행도와 임파워먼트(r=0.459)가 유의한 양의 상관관계를 보였다(p<0.05). 연구대상자의 병원감염관리에 대한 수행도에 영향을 주는 요인은 임파워먼트가 높을수록 통계적으로 유의하게 높게 나타났다(p<0.05).

21-68세 남녀 100명의 슬관절 굴근과 신근의 근력에 대한 등속성 평가 (Isikinetic evaluation of the knee flexors and extensors on muscle strength in 100 men and women aged 21 - 68yr)

  • 남형천
    • 대한물리치료과학회지
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    • 제8권2호
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    • pp.967-976
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    • 2001
  • The purpose of the present study was to the investigate the effect of aging in men and women on muscle strength of knee extensor and flexors by using the cybex 6000 isokinetic dynamometer. A total of 100 volunteers participated in this study and were divided into five groups according to their chronological age as follows: 20s, 30s, 40s, 50s, 60s, 10 men and 10 women in each decade respectively. Isokinetic ($60^{\circ}{\cdot}s-l$) knee extensor and flexor peak torque, peak torque to body weight ratio, opposing muscles(flexor/extensor) peak torque ratio, deficit of peak torque between dominant and non-dominant were measured. The results obtained were as follows: 1) In men, While the aged increased. the peak torque of the knee flexor and extensor statistically sig nificant decreased in the dominant and non-dominant side. 2) In women, Statistically significant difference of knee extensor peak torque was found as the aged increased in the dominant and non-dominant side, but significant difference of knee flexor peak torque did not that. 3) In men, No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side, but statistically significant difference in the peak torque of knee flexor to body weight weight ratio was found as the aged increased in the dominant side. 4) In women. No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the dominant side, but statistically significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side. 5) In men and women, While the aged increased, statistically significant difference was found the dominant and non-dominant side in the peak torque of knee extensor to body weight ratio. 6) Peak torque of hamstring to quadriceps ratio of dominant and non-dominant side in men and women were not significantly different as the age increases. 7) Mean deficit of peak torque between dominant and non-dominant side in men and women were not significantly different as the age increases. From these results we conclude a proper exercise program is need before 50s decade to preserve in muscle strength of knee flexors and extensors.

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