• 제목/요약/키워드: Healing Experience

검색결과 234건 처리시간 0.037초

역혈행 후골간 도상피판을 이용한 전기아크손상으로 인한 손목부 결손의 재건 (The Reverse Posterior Interosseous Island Flap for the Reconstruction of Soft Tissue Defects in the Wrist Injured by Electrical Arc)

  • 서정석;이종욱;고장휴;서동국;최재구;정철훈;오석준;장영철
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.580-586
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    • 2007
  • Purpose: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. Methods: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. Results: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from $3.5{\times}8cm$ to $10{\times}12cm$(mean size $6.4{\times}8.9m$). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. Conclusion: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.

노인이 경험한 대체요법의 양상에 관한 연구 1 (A Study on the Patterns of Alternative Therapy Experienced by the Aged)

  • 이강이;김순이
    • 대한간호학회지
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    • 제29권2호
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    • pp.336-345
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    • 1999
  • This study looks at the various alternative therapy methods used in day to day life by elderly, over 60 years of age. The elderly have come to know and practice these methods for the following reasons it is good for the health ; it is the method used in the of fen days when there wesn't modern medicine ; it has been passed down from generations ; it can be done at home without having the need to go to the hospital ; acupuncture or poulticing can be used ; it can be done at home, which was an important factor in rural areas where hospitals are few and far between ; and 〔herbal〕 medicine could be prepared at home at no cost ; it derives from experience ; it is impossible to ignore tradition passed down through the generations. Diet control and plants (herbs) are methods most often used. as they are easy to find and can be readily used in critical situations. Other methods include oriental medicine practices of moxibustion with moxa cone, negative therapy, hand and finger acupunture, finger press method. ordinary acupunture, manual healing methods of massage. diaphoretic therapy and meditation to reach a state of calm, and qigong dirigation. The reasons for its use are as follows ; it has been used before ; it is effective ; there is some improvement after the treatment ; it is not harmful to the body ; medicine cannot be obtained and it is the only thing available ; it is not good for an old person to go to the hospital everyday. the symptoms are not serious enough to go to a hospital : and acupuncture is for these things. The means that the elderly have come to practice these methods are : it has been used since the past ; it has been told by the elders ; they have been told by friends ; it was part of their knowledge ; and they have come to know by watching their mother. Further, to regain vitality lost through old age, the elderly have relied on hot soup. a hearty meal. brewed honey water, pumpkin, or ginseng. Humans, by instinct. would rub or massage the areas that caused pain. These actions, combined with a breathing technique have been recognized in Tong-Eui-Bo-Gam(the essential of eastern medicine), the complete work of early modern medicine, are a useful means to revive chi(기). This knowledge is thought to have greatly affected our heathy lifestyle. Furthermore, though the demand for medical services would increase with age, the elderly have not always been able to tend to their needs at the hospital for reasons economic or other. Hence, these alternative therapy methods seem to have been practiced as a temporary means of relief. The excellence of our traditional therapeutic custom has not received full recognition due to the argument relating to its scientific merits. As a result, it has become vital to prove their effectiveness through scientific and other experimental means. The potency of moxibustion with moxa cone and hand and finger acupunture have been proven scientifically. but diet and herbal methods appear to be practiced as a result of customs passed down from generations. In addition, it is submitted that the effectiveness of the traditional methods of disease control and our heathy lifestyle that are easily found in the nursing field must be verified.

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유아기형 골화석증 환자의 치과적 관리 : 7년간의 경과 관찰 (Dental Management in a Patient with Infantile Osteopetrosis : A Case Report with a 7-Year follow-up)

  • 천민경;양선미;김재환;최남기;김선미
    • 대한소아치과학회지
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    • 제45권2호
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    • pp.257-264
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    • 2018
  • 골화석증은 파골세포의 기능 장애 및 증가된 골 밀도를 보이는 질환으로 그 중 유아기형 골화석증은 심각한 유형이다. 전신의 골경화와 범혈구감소증, 두개 신경 협착, 높은 감염위험성, 두부와 안모의 변형 등 다양한 증상을 유발한다. 대부분의 유아기 골화석증 환자는 발달 지연과 왜소증을 보이며, 조기에 사망에 이를 수 있다. 14개월의 여성 환아가 유전치부위에 초기 우식병소를 주소로 전남대학교 치과병원 소아치과에 내원하였다. 환아는 4세에 재 내원 하였으며 interferon-gamma, erythropoietin 치료를 받고 있었다. 성장 지연, 골격 변형, 좁은 상악궁, 총생, 선천적 영구치 결손, 우식증을 보였다. 소아과 의사와 협진하여 예방적 항생제 투여와 진정요법 후 치과 치료를 진행하였다. 이후 감염이 발생한 다수 유구치를 발치 후 상악에 가철성 연성 의치를 이용하여 구강 재건(rehabilitation)을 시행하였다. 골화석증 환자의 경우, 저하된 면역기능으로 인해 감염에 매우 취약하며, 출혈이나 발치와 연관된 골수염이나 패혈증이 유발될 수 있으므로 소아과 의료진의 협조와 예방적 항생제의 사용에 관한 고려가 간단한 치과시술 시에도 필수적이다. 또한, 당분섭취 제한 및 구강위생관리를 위한 의료진의 적극적인 개입이 필요하다.

구강악안면 결손부 재건에 사용한 유리피판 재건술 164증례의 임상성적 및 합병증 분석 (Analysis of Outcome and Complications in 164 Cases of Free Flap Reconstructions: Experience of a National Cancer Center)

  • 전재호;박성원;조세형;박주용;이종호;최성원
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권6호
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    • pp.478-482
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    • 2011
  • Purpose: Free flap reconstruction is performed on defects including benign and malignant tumors as well as trauma in the department of oral and maxillofacial surgery, but there are few reports of free flap reconstruction cases for oral cancer in patients in Korea. Methods: This study was designed to retrospectively analyze surgical outcomes and complications of 164 free-flap reconstructions performed at the Oral Oncology Clinic, National Cancer Center, during 2002~2011. A total of 164 free flaps were performed for reconstruction of oral and maxillofacial defects which were caused by oral cancer and osteoradionecrosis in 155 patients. Results: The present study had 162 successful cases and 2 failed cases for a total of 164 cases. The study had a success rate of 98.8% for free-flap reconstructions. Flap donor sites included radial forearm free flap (n=93), fibula osteocutaneous free flap (n=25), anterolateral thigh flap (n=18), latissimus dorsi myocutaneous flap (n=16) and other locations (n=12). Postoperative medical complications were generally pneumonia and delirium. Postoperative local complications occurred including partial flap necrosis, delayed wound healing of the donor site, infection of the recipient site and salivary fistula. The incidence of postoperative complications and patient-related characteristics including age, sex, smoking, history of radiotherapy, hypertension (HTN) and diabetes Mellitus (DM) were retrospectively analyzed. Patient age ($P$=0.003) and DM ($P$=0.000) and HTN ($P$=0.021) were significant risk factors for complications overall. Conclusion: The present study had no mortality and confirms that free-flap reconstructions are extremely reliable in achieving successful results.

한옥의 건강특성과 요소에 대한 언론보도 연구 : 1960년 이후 4대 일간지 기사 내용분석 (A research on the health characteristics and the elements of Han-Ok : Contents analysis of articles of the four daily newspapers since 1960)

  • 이민아
    • 가정과삶의질연구
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    • 제28권5호
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    • pp.25-38
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    • 2010
  • The purpose of this study was to investigate the trend changes of the health characteristics and the elements of Han-Ok appeared in the articles of the daily newspaper, and to provide basic information for applying to the healthy housing for the public living in modern society and furthermore the various facilities for healing. For the study, the relevant articles of 4 daily newspapers published from 1st of January in 1960 to 28th of February in 2010 were collected and analyzed. The results of the study were as follows: First, the articles about the health characteristics and the elements of Han-Ok have rapidly grown since the year of 2000. Especially, the residents' interviews, case reports and actual living condition of Han-Ok recently tend to increase. Second, the health characteristics of Han-Ok in the recent articles were focused more on the mental and social health than on the physical health. The physical health had the characteristics of the block of hazard environments, the offer of good quality environments, and the enhancements of residents' health. The mental health consisted of the psychological comfort, the sensory satisfaction and the emotional growth. There have been improvements of family relationships and the interactions with neighbors in the characteristics of social health since 2000. Third, the health elements of Han-Ok in terms of architecture and interior design were the structure, space, material, doors & windows, furniture & props, nature, and villages. The material elements were more stressed before 2000, but the spaces and the nature elements were highly focused after 2000 and the structure elements were steadily high regardless of years. Fourth, of the health elements, the structure and the material had the high effects on the physical health characteristics, on the other hand the spaces and the nature influenced more on the mental health. On-dol, Ma-dang, Dae-cheong, Ma-ru, soil, wood, Changhoji, natural environments, and doors & windows were the detail health elements which had high effects on the health characteristics of Han-Ok. For the future study, the experience based in-depth studies of the residents living in Han-Ok are suggested to grasp the actual effects of Han-Ok on the health. The professional consultations are also needed for the extracts of the health characteristics of Han-Ok and the functional elements which can be applied to the modern buildings.

종합병원 병동별 간호사실의 소음정도와 간호사실들의 소음인지도 및 소음관리노력 비교 (Comparision Between Noise Levels of Hospital Wards and the Nurses Efforts for Noise Management in Selected General Hospital)

  • 정현욱
    • 한국직업건강간호학회지
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    • 제10권2호
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    • pp.174-182
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    • 2001
  • This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.

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노인의 질병 관념에 관한 문화기술적 연구 (An Ethnography of the Concept of Illness by the Elderly)

  • 조명옥
    • 성인간호학회지
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    • 제12권4호
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    • pp.690-705
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    • 2000
  • This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential analysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and nonsupernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.

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장원소(張元素)의 생규(生涯)와 의학사상(醫學思想) (The life and medical idea of Jang Won-So)

  • 김용진;윤창열
    • 대한한의학원전학회지
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    • 제4권
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    • pp.127-157
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    • 1990
  • Geum-Won dynasty is the era which totalized the every medical attainments of before Song dynasty and appeared some medical practioners who found new medical theory based upon this, and is important time for various developments of the oriental medical theory. At this time of the era, the representative practioners are called the four noted physician of Geum-Won dynasty. Jang Won-So who influenced the formation of the theory of the four noted physcian of Geum-Won dynasty, originated new theory by joining the theory of "Nae-Gyung" with his own medical experience. The results can be summarized as follows after studying his life and idea of medicine. 1. Jang Won-So, courtesy name is Gyeol-Go, came from Yeog-Joo and it is unknown that when he was born and dead, but he lived in 11C. At 27, after failed in a Jin-Sa examination, he started medical study, and widely spreaded his medical art by healing the Yoo Wan-So's Sang-Han disease. 2. There are many Jang Won-So's writings, such as "Eui-Hag-Gye-Won" which is the condensation of his idea of medicine, "Jin-Joo-Nang" which is greatly contributed to development of Herbology, "Jang-Boo-Pyo-Bon-Han-Yeol-Heo-Sil-Yong-Yag-Sig" which is the sample of Jang-Boo-Byun-Jeung-Lon-Chi, and "Yag-Joo-Nan-Gyung" "Gyeol-Go-Ga-Jin" "Gyeol-Go-Joo-Sug-Hwa-Mag-Gyeol" "Gyeol-Go-Bon-Cho" "San-Yog-Bo-Sang-Bang" which are known do not existing. 3. Jang Won-So's study about Jang-Boo-Byun-Jeung was influenced by "Nae-Gyung" "Jung-Jang-Gyung" "So-A-Yag-Jeung-Jig-Gyeol" etc. and outline by Han-Yeol-Heo-Sil and the change and prognosis of the state of disease can be decided by Saeng-Sa-Yeog-Soon, so he contribute to development of lang-Boo-Byun-Jeung-Lon-Chi of posterity. 4. Jang Won-So succeeded and develope the theory of the herbs of Oh-Jang-Go-Yog-Bo-Sa and about Ki-Mi-Seung-Gang-Boo-Chim etc. appeared on "Nae-Gyung", especially invented such as Kwi-Gyung-Lon, In-Gyeung-Bo-Sa-Seol, Jang Boo-Pyo-Bon-Yag-Sig and he enriched the content of pharmacological theory, so he motivated various development of herbalogical theory. 5. Jang Won-So's idea of On-Yang-Bi-Wi directly influence Lee Go's assertion of Bi-Wi-Lon, idea of Go-Geum-I-Gue-Seol presented theological basis of posterior medical practioners formation of prescription, so the way of drug usage greatly developed. 6. Jang Won-So's theory of the lang-Boo-Byun-Jeung and herbology directly influenced to Lee Go, Wang Ho-Go, Na Chen-Ik, lang Byeok etc. so he became the father of Yeog-Soo class and indirectly influenced to Seol Gi, Jo Hen-Ga, lang Gae-Bin, Lee Jung-Jae etc. of Myeng dynasty, so the On-Bo class has been formed. Like this, because, his idea of medicine developed at various aspect and greatly influenced to posterity, Lee Si-Jin said "Since the emergency of "Nae-Gyung", Jang Won-So is the only man who greatly enhance medical principle.", so it is clear that this is not unfounded expression at all.

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$Br{\aa}nemark\;Novum^{(R)}$ 즉시 임플랜트 보철 수복 방법에 관한 삼차원 유한요소 분석적 연구 (THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF $BR{\AA}NEMARK\;NOVUM^{(R)}$ IMMEDIATE IMPLANT PROSTHODONTIC PROTOCOL)

  • 김우영;김영수;장경수;김창회
    • 대한치과보철학회지
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    • 제39권5호
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    • pp.463-476
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    • 2001
  • Since the treatment of edentulous patients with osseointegrated implant was first introduced more than 30 years ago, implant therapy has become one of the most important dental treatment modalities today. Based on the previous experience and knowledge, $Br{\aa}nemark\;Novum^{(R)}$ protocol was introduced with the concept of simplifying surgical and prosthetic technique and reducing healing time recently. This protocol recommends the installation of three 5mm wide diameter futures in anterior mandible and the prefabricated titanium bars for superstructure fabrication. This study was designed to analyze the stress distribution at fixture and superstructure area according to changes of fixture number, diameter and superstructure materials. Four 3-dimensional finite element models were fabricated. Model 1 - 5 standard fixtures (13mm long and 3.75mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 2- 3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 3-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and resin Model 4-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and porcelain A 150N occlusal force was applied on the 1st molar of each model in 3 directions - vertical($90^{\circ}$), horizontal($0^{\circ}$) and oblique($120^{\circ}$). After analyzing the stresses and displacements, following results were obtained. 1. There were no significant difference in stress distribution among experimental models. 2. Model 2, 3, 4 showed less amount of compressive stress than that of model 1. However, tensile stress was similar. 3. Veneer material with a high modulus of elasticity demonstrated less stress accumulation in the superstructure. Within the limites of this study, $Br{\aa}nemark\;Novum^{(R)}$ protocol demonstrated comparable biomechanical properties to conventional protocol.

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인공광을 이용한 접목표 활착촉진 시스템의 시작품 설계 - 활착촉진 시스템 내의 기온과 상대습도 분포에 미치는 기류속도의 효과 (Design of a Prototype System for Graft-Taking Enhancement of Grafted Seedlings Using Artificial Lighting - Effect of air current speed on the distribution of air temperature and relative humidity in a graft-taking enhancement system)

  • 김용현
    • Journal of Biosystems Engineering
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    • 제25권3호
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    • pp.213-220
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    • 2000
  • Grafting of fruit-bearing vegetables has been widely used to increase the resistance to soil-borne diseases, to increase the tolerance to low temperature or to soil salinity, to increase the plant vigor, and to extend the duration of economic harvest time. After grafting, it is important to control the environment around grafted seedlings for the robust joining of a scion and rootstock. Usually the shading materials and plastic films are used to keep the high relative humidity and low light intensity in greenhouse or tunnel. It is quite difficult to optimally control the environment for healing and acclimation of grafted seedlings under natural light. So the farmers or growers rely on their experience for the production of grafted seedling with high quality. If artificial light is used as a lighting source for graft-taking of grafted seedlings, the light intensity and photoperiod can be easily controlled. The purpose of this study was to develop a prototype system for the graft-taking enhancement of grafted seedlings using artificial lighting and to investigate the effect of air current speed on the distribution of air temperature and relative humidity in a graft-taking enhancement system. A prototype graft-taking system was consisted by polyurethane panels, air-conditioning unit, system controller and lighting unit. Three band fluorescent lamps (FL20SEX-D/18, Kumho Electric, Inc.) were used as a lighting source. Anemometer (Climomaster 6521, KANOMAX), T-type thermocouples and humidity sensors (CHS-UPS, TDK) were used to measure the air current speed, air temperature and relative humidity in a graft-taking system. In this system, air flow acted as a driving force for the diffusion of heat and water vapor. Air current speed, air temperature and relative humidity controlled by a programmable logic controller (UP750, Yokogawa Electric Co) and an inverter (MOSCON-G3, SAMSUNG) had an even distribution. Distribution of air temperature and relative humidity in a graft-taking enhancement system was fairly affected by air current speed. Air current speed higher than 0.1m/s was required to obtain the even distribution of environmental factors in this system. At low air current speed of 0.1m/s, the evapotranspiration rate of grafted seedlings would be suppressed and thus graft-taking would be enhanced. This system could be used to investigate the effects of air temperature, relative humidity, air current speed and light intensity on the evaportranspiration rate of grafted seedlings.

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