• 기본간호학회지
• /
• 제7권1호
• /
• pp.122-136
• /
• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

• Archives of Plastic Surgery
• /
• 제38권5호
• /
• pp.642-648
• /
• 2011

Purpose: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. Methods: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. Results: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. Conclusion: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.

• 농업생명과학연구
• /
• 제45권4호
• /
• pp.47-58
• /
• 2011

The forest of Korea had been severely degraded since early 1900s until 1950s. Korean Government has successfully accomplished the reforestation works since 1960s. However, some plantations showed poor survival and growth caused by ignoring site characteristics in selecting plantation species and lack of tending works such as thinning. The natural regeneration of indigenous species, such as Quercus species and Pinus densiflora Siebold & Zucc., were examined in the plantations of Pinus koraiensis Siebold & Zucc. and Larix kaempferi Fortune ex Gordon. Quercus species regenerated mainly by sprouting while P. densiflora regenerated naturally from a few mother trees that remained in the plantations. P. koraiensis showed poor survival ($IVI{\leq}25%$) and suppressed growth (height ${\leq}3m$ and $DBH{\leq}3cm$ at 20 year-old) by Quercus species or P. densiflora in the plantation areas, however had high survival ($IVI{\geq}70%$) and growth (8 m height and 14.1 cm DBH at 20 year-old) in areas where silvicultural practices were conducted. L. kaempferi showed good survival ($IVI{\geq}40%$) and growth (17.2 m height and 16.3 cm DBH at 30 year-old) mostly in valley areas, while it was nearly dead ($IVI{\leq}10%$) in ridge or ridge-slope areas and was replaced by indigenous species such as Quercus species ($IVI{\geq}25{\sim}55%$) or P. densiflora ($IVI{\geq}18{\sim}50%$).

• Steel and Composite Structures
• /
• 제33권4호
• /
• pp.569-581
• /
• 2019

Corrugated steel plate shear wall (CSPSW) as an innovative lateral load resisting system provides various advantages in comparison with the flat steel plate shear wall, including remarkable in-plane and out-of-plane stiffnesses and stability, greater elastic shear buckling stress, increasing the amount of cumulative dissipated energy and maintaining efficiency even in large story drifts. Employment of low yield point (LYP) steel web plate in steel shear walls can dramatically improve their structural performance and prevent early stage instability of the panels. This paper presents a comprehensive structural performance assessment of corrugated low yield point steel plate shear walls having circular openings located in different positions. Accordingly, following experimental verification of CSPSW finite element models, several trapezoidally horizontal CSPSW (H-CSPSW) models having LYP steel web plates as well as circular openings (for ducts) perforated in various locations have been developed to explore their hysteresis behavior, cumulative dissipated energy, lateral stiffness, and ultimate strength under cyclic loading. Obtained results reveal that the rehabilitation of damaged steel shear walls using corrugated LYP steel web plate can enhance their structural performance. Furthermore, choosing a suitable location for the circular opening regarding the design purpose paves the way for the achievement of the shear wall's optimal performance.

• 대한소아치과학회지
• /
• 제48권2호
• /
• pp.237-244
• /
• 2021

상아질형성부전증은 상아질 형성 이상이 초래되는 유전성 질환으로 상염색체 우성 형질을 따른다. 상아질형성부전증은 유치와 영구치 모두 이환되며, 다양한 치아 변색, 상아질 및 법랑질 파괴, 심한 치아마모 등의 임상소견을 보인다. 방사선학적으로 치아는 가느다란 치근과 둥그런 치과의 형태를 보이고 치수강은 적거나 폐쇄되었다. 상아질형성부전증의 치료는 추가적인 마모를 방지하고 수직고경 회복을 목표로 한다. 본 증례는 치아의 마모와 변색을 주소로 내원한 상아질형성부전증을 지닌 남매의 상이한 15년간의 장기 예후를 보고하고자 한다. 두 환자에서 치료개입 시기의 차이에 따라 상이한 치료과정을 볼 수 있다. 첫 번째 환아는 대부분의 본인 치아를 살렸으나, 두 번째 환아는 모든 치아를 발치하였다. 이는 상아질형성부전증의 조기 진단 및 치료방법 결정에 도움이 될 수 있다.

• 한국의류산업학회지
• /
• 제21권5호
• /
• pp.640-655
• /
• 2019

Technology status was investigated by analyzing patents and development cases of wearable robots. Development direction of wearable robot for wearability was also suggested by understanding the problems of wearability from development cases through the FGI technique. The number of patents per technical field was the most in the field of strength support, but AI in the technology field was different in each country; Korea was found to be poor in the category of daily living assistance. The number of patents by technology category was the most in the category of muscular strength assistance. However, the values of AI in the technology category were different in each country; Korea was found to be poor in the category of daily living assistance. Development cases were focused on rehabilitation, so development is not fulfilled uniformly by use purpose. By wearing body parts, robots with single function type were mainly developed. Rigid material robots were mainly developed. It was confirmed that wearable robot technology is not developed evenly in the category of application because it is in the early stage of the technical proposal and centered on main performance improvement. We derived twelve wearable conditions for wearable robots: Shape and Size Appropriateness, Movement Appropriateness, Composition Appropriateness, Physiological Appropriateness, Performance Satisfaction, Ease of Operation, Safety, Durability, Ease of Dressing, Ease of Cleaning, Portability and Ease of Storage and Appearance Satisfaction. Finally, the development direction of a wearable robot for each wearable condition was suggested.

• Archives of Plastic Surgery
• /
• 제46권3호
• /
• pp.228-234
• /
• 2019

Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

• Journal of Trauma and Injury
• /
• 제35권3호
• /
• pp.209-214
• /
• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제33권1호
• /
• pp.16-23
• /
• 2022

Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study's objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12-71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool's validity and cut-off. Methods: Multidisciplinary experts devised the "Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND)," an assessment method that comes in two versions depending on the age of the child: 12-36 months and 37-71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach's alpha was positive (0.533-0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5-0.7 and specificity 0.7-0.9. Conclusion: The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12-36 months and 37-71 months.

• The Korean Journal of Pain
• /
• 제35권4호
• /
• pp.468-474
• /
• 2022

Background: The new type of corona virus has a wide range of symptoms. Some people who have COVID-19 can experience long-term effects from their infection, known as post-COVID conditions. The authors aimed to investigate prolonged musculoskeletal pain as a symptom of the post-COVID-19 condition. Methods: This is a descriptive study on the patients who were diagnosed with COVID-19 in a university hospital, between March 2020 and March 2021. Patient records and an extensive questionnaire were used to obtain relevant demographic and clinical characteristics, including hospitalization history, comorbidities, smoking history, duration of the pain, the area of pain, and the presence of accompanying neuropathic symptoms. Results: Of the diagnosed patients, 501 agreed to participate in the study. Among the participants, 318 had musculoskeletal pain during COVID-19 infection, and 69 of them reported prolonged pain symptoms as part of their a post-COVID condition which could not be attributed to any other cause. The mean duration of pain was 4.38 ± 1.73 months, and the mean pain level was 7.2 ± 4.3. Neuropathic pain symptoms such as burning sensation (n = 16, 23.2%), numbness (n = 15, 21.7%), tingling (n = 10, 14.5%), stinging (n = 4, 5.8%), freezing (n = 1, 1.4%) were accompanied in patients with prolonged musculoskeletal pain. Conclusions: Patients with COVID-19 may develop prolonged musculoskeletal pain. In some patients, neuropathic pain accompanies it. Awareness of prolonged post-COVID-19 pain is crucial for its early detection and management.