• 한국가족복지학
• /
• 제55호
• /
• pp.59-90
• /
• 2017

본 연구는 소아암 환아와 가족을 위해 한국백혈병소아암협회에서 실시된 '가족희망파트너사업' 의 총체적인 효과를 규명하고 이들에 대한 지원의 실증적 기초자료를 마련하는데 그 목적이있다. 이를 위해 본 연구는 '가족희망파트너사업'을 통해 1년 이상 서비스를 이용 중인 보호자6명, 소아암 아동 5명을 2016년 6~7월까지 인터뷰하였으며, 수집된 자료는 질적분석 과정을거쳐 해석되었다. 본 연구의 결과는 다음과 같다. 소아암 환아와 가족은 '혹독한 아픔의 장벽' 과 '소용돌이치는 불안과 소진'에 직면해있었는데, '가족희망파트너사업'을 통해 연계된 '회복과 성장의 디딤돌이 되어준 참 스승'으로 말미암아 다차원적인 효과를 경험하게 되었다. 즉'환아의 전반적인 재활 지원', '가족관계의 향상', '사회적 관계에 대한 해갈(解渴)', '압박에서의 해방'이라는 긍정적인 효과들을 체험하게 되었다. 본 연구는 '가족희망파트너사업'의 다차원적인 효과를 심층적으로 확증하였으며, 한국백혈병소아암협회에 의해서 소아암 환아와 가족을 위해 국내외적으로 최초로 시도된 '가족희망파트너사업'의 방향성을 모색하였다는데 의의가있다.

• 대한족부족관절학회지
• /
• 제22권3호
• /
• pp.105-110
• /
• 2018

Purpose: This study examined the effects of beraprost sodium on digital infrared thermal images in patients with peripheral arterial disease caused by type 2 diabetes mellitus. Materials and Methods: Twenty-five diabetic patients with peripheral arterial disease were treated with beraprost sodium in a prospective, multicenter, cohort study from February 2013 to December 2014. Beraprost sodium ($40{\mu}g$) was administered orally 3 times daily ($120{\mu}g/day$) for 6 months. The visual analogue scale (VAS) and digital infrared thermal imaging (DITI) were performed to compare the blood flow improvement between before and after dosing. Results: Among the 25 patients included in the evaluation, 22 patients completed the study. A significant increase in body temperature was observed in the front and left side, particularly in the plantar side in DITI compared to that before and after administration. An increase in body temperature was observed at the frontal part from $28.1^{\circ}C{\pm}2.3^{\circ}C$ to $29.1^{\circ}C{\pm}2.1^{\circ}C$ (p=0.021), at the left side from $27.8^{\circ}C{\pm}2.4^{\circ}C$ to $28.6^{\circ}C{\pm}1.9^{\circ}C$ (p=0.028), at the plantar part at $24.0^{\circ}C{\pm}1.5^{\circ}C$, and at the plantar part at $27.1^{\circ}C{\pm}2.4^{\circ}C$ (p<0.01). The VAS decreased significantly from $5.4{\pm}1.3$ to $2.7{\pm}2.0$ after 6 months of treatment (p<0.01). Conclusion: Beraprost sodium is a safe and easy-to use oral medication for diabetes peripheral arterial disease. It can be expected to increase the blood flow and decrease the lower extremity pain statistically after being taken for 6 months.

• 동의신경정신과학회지
• /
• 제30권3호
• /
• pp.251-263
• /
• 2019

Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

• 한국표면공학회지
• /
• 제55권6호
• /
• pp.390-397
• /
• 2022

Parylene-C which was mainly used for industries such as electronics, machinery and semiconductors has recently been in the spotlight in the medical field due to its properties such as corrosion resistance and biocompatibility. In this study we intend to derive a plan to improve the bonding strength of Parylene-C coating with the SUS304 base material for medical use which can be applied to various medical fields such as needles, micro needles and in vitro diagnostic device sensors. Through plasma pretreatment the bonding strength between Parylene-C and metal materials was improved. It was confirmed that the coated surface was hydrophobic by measuring the contact angle and the improvement of the surface roughness of the sample manufactured through CNC machining was confirmed by measuring the surface roughness with SEM. Through the above results, it is thought that it will be effective in increasing usability and reducing pain in patients by minimizing friction when inserting medical devices and in contact with skin. In addition it can be applied to various application fields such as human implantable stents and catheters, and is expected to improve the performance and lifespan of medical parts.

• 한국컴퓨터정보학회논문지
• /
• 제26권3호
• /
• pp.119-126
• /
• 2021

근대5종 경기는 기구 없이 하는 운동과 기구를 사용하는 운동 그리고 동물과 함께하는 운동은 물론 사람과 사람이 경쟁하는 운동뿐만 아니라 정적운동과 동적운동을 포함하는 운동 종목이다. 근대5종 경기 선수들의 윤리적인 문제는 열악한 환경과 경제적 이유와도 관계가 있으며 운동선수의 윤리인식과 태도, 그리고 정신은 스포츠 선수의 심적 환경에 많은 영향을 주고 있다. 본 연구에서는 현대 스포츠에서 중요한 문제로 다르고 있는 윤리적인 문제들의 개선 방향을 검토하고자 질적 연구방법을 적용하여 근대5종 경기의 스포츠 정신과 윤리성을 탐색하고자 하였다. 스포츠에서 보상주의는 경기력 향상이나 기록 갱신의 원인이 되기도 하지만 때로는 왜곡된 선수상의 형성 원인이 되기도 한다. 에어도핑은 선수의 건강이나 공정성의 논란과 함께 스포츠선수의 정신적 육체적 손상과 폐해를 야기할 수 있는 윤리적 문제를 안고 있다. 금지약물을 복용하는 선수나 이를 방치하거나 종용하는 지도자나 감독자의 책임과 윤리문제는 매우 중요한 사안으로 다루어지고 취급되어야한다. 스포츠 현장에서 선수나 감독 지도자의 경기실적에 종속된 보수체계가 선수나 지도자의 생계와 연관이 있기 때문에 공정하고 정의로운 경기진행을 위해 성과에만 매달리는 선수육성에서 탈피하여 이념과 논리에서 합리적으로 인식되는 윤리성회복을 강조함으로써 비윤리성문제가 극복되어야 할 것이다.

• 한국노년학
• /
• 제40권4호
• /
• pp.659-689
• /
• 2020

본 연구는 연령차별을 경험한 노인들이 스스로 부정적 차별 인식을 내면화하는 일련의 과정에 집중하는 연구이다. 노인들이 일상생활에서 경험하는 연령차별의 모습을 규명하고 이같은 차별경험이 '자기연령주의(self-ageism)'를 통해서 어떤 결과로 이어지는지를 탐색하기 위해 근거이론방법을 활용하였다. 분석결과에 따르면 노인들은 명시적 차별 뿐 아니라 암묵적 차별에도 반응하는데 이 과정에서 노인의 고통(빈곤, 질병, 무위, 고독)의 강도가 높고 객관적인 차별상황에 속에서 차별대응에 실패한 기억이 강할수록 더욱 높은 수준의 자기연령주의를 갖게 되는 것으로 나타났다. '자기연령주의'는 나이에 의한 '차별'을 당한 노인들이 스스로에 대한 부정적 이미지를 내재화함으로써, 현실에서 다양한 거부/분리/멈춤 등의 행동을 통해 삶의 질적 측면에서의 불이익을 감수하는 현상이다. 건강, 제도적 지원, 보듬어주는 사람들과 같은 지지적 자원들이 존재하는 경우에 노인들은 보다 적극적인 방식으로 작용/상호작용을 통해 자기연령주의를 극복할 여지를 보이지만, 반면 이러한 자원들의 부족으로 스스로 동기부여하지 못하는 노인들의 경우 자기연령주의로 인한 부정적 환류에 갇혀버리게 됨으로서 침체되고 위축된 삶을 살아가게 된다. 이런 상태에서 스스로를 동기화(motivation)해서 신체, 인지, 정서, 사회적 반응을 해나가는 것은 매우 쉽지 않은 일이다. 그러므로 분석과정에서 특별히 두 가지 부분, 맥락적 조건과 중재적 조건에 주목하며 미시적으로는 노인의 동기화와 회복력(resilience) 향상을 위한 프로그램을 제안하였고, 거시적으로는 전 생애주기와 관련한 복지 및 건강서비스 체계 보완, 커뮤니티케어를 통한 접근성과 통합성 확대, 인식개선과 차별금지법과 같은 시스템 마련의 필요성을 주장하였다.

• Journal of Chest Surgery
• /
• 제55권2호
• /
• pp.118-125
• /
• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• Journal of Korean Neurosurgical Society
• /
• 제65권5호
• /
• pp.719-729
• /
• 2022

Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

• 동의생리병리학회지
• /
• 제36권4호
• /
• pp.138-142
• /
• 2022

This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.

• Pediatric Infection and Vaccine
• /
• 제28권3호
• /
• pp.173-180
• /
• 2021

2020년 4월에 유럽에서 처음으로 소아 다기관 염증 증후군(multisystem inflammatory syndrome in children; MIS-C)이 확인된 이후, MIS-C는 코로나바이러스감염증-19(COVID-19)의 병력이 있는 소아들에게서 발병하는 것으로 알려졌고 대부분의 환자들은 유럽과 미국에서 보고되었다. 이에 국내에서 진단된 MIS-C 사례로, 급성 심근염이 동반되고 정맥내 면역글로불린(intravenous immunoglobulin; IVIG), 스테로이드 및 anakinra로 효과적으로 치료한 증례를 보고하고자 한다. 내원 5주 전 COVID-19 진단받은 병력이 있는 14세 여아가 지속되는 고열, 전신 발진 및 부종, 복통, 그리고 저혈압을 주소로 내원하였다. 혈액검사에서 염증수치 및 심장효소수치 상승을 보였고 감염질환을 비롯하여 다른 질환이 배제되었다. 환자는 MIS-C 진단 하에 IVIG와 고용량 메틸프레드니솔론(methylprednisolone) 요법으로 치료하였으나 심기능이 점차 악화되고 관상동맥 확장증이 확인되었다. 이에 제6병일부터 인터루킨-1 수용체 길항제인 anakinra를 투여하였고 이후 점차 환자의 심기능이 호전되었다. 환자는 제19병일에 퇴원하였고 1개월 후 시행한 심초음파상 심기능 및 관상동맥이 정상화되었다.