• 대한족부족관절학회지
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• 제15권2호
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• pp.72-78
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• 2011

Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.

• 대한족부족관절학회지
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• 제14권1호
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• pp.90-96
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• 2010

Purpose: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. Materials and Methods: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. Results: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. Conclusion: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.365-371
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• 2009

Purpose: Good color match holds a key position in facial reconstruction for good aesthetic result. To correct the wide facial soft tissue defect were usually used the tissue expanded cheek flap, deltopectoral flap or radial forearm free flap. This study is aimed to analyse the color difference after flap surgery by using chromameter. Method: From August 1995 to December 2006, 30 patients underwent flap operations were chosen randomly and evaluated color differences between flap site and adjacent skin. Reconstructive procedures included tissue expanded cheek flap(n = 10), deltopectoral flap(n = 10), and radial forearm free flap(n = 10). The measured sites were flap center within a radius of 1 ㎝ and four points of adjacent skin along the flap margin. The color was quantified in a three dimensional coordinate system $L^*$ (brightness), $a^*$ (redness), $b^*$ (yellowness). Results: There was no significant color difference between the pedicled flaps(tissue expanded cheek flap and deltopectoral flap) and adjacent skin area. On the other hand, color values of the radial forearm free flap were statistically different from those of adjacent skin area. Total color difference(${\Delta}E$) of tissue expanded cheek flap and deltopectoral flap were $7.45{\pm}5.78$ versus $9.41{\pm}7.09$, and that of radial forearm free flap was $11.74{\pm}3.85$. They suggest that pedicled flaps have a potential of better color match than radial forearm free flap. Conclusion: Thus, better esthetic result and satisfaction is more likely to be expected in pedicled flaps as long as it could be applied comparing radial forearm free flap.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.19-23
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• 2005

Tissue adhesives have gained popularity for quicker and painless closure of lacerations. The use of tissue glue is currently popular for the closure of superficial lacerations, especially in children. Histoacryl $Blue^{(R)}$(2-N-butylcyanoacrylate) is a topical wound closure that precludes the need for foreign bodies to close wounds. The purpose of this study was to compare the applications of Histoacryl $Blue^{(R)}$(HAB) and conventional suture, regarding cosmetic outcome. To compare the short term and long term results of various repair methods, we designed the prospective, randomized, blind study. Patients with laceration undergoing repair were randomly allocated to conventional suture, subcutaneous suture plus HAB, and HAB only groups. The exclusion criterions were large wound that require large tension for repair or avulsion wound. An independent, blinded observer assessed cosmetic result at 7-10 days after repair and 3-9 months postoperatively. Physician's satisfaction with wound appearance was recorded on 100 mm Visual Analogue Scale(VAS)(0=worst, 100=best). The difference in VAS score between conventional suture method and subcutaneous suture plus HAB methods were not significant. Tissue glue being easy to use with no complications and still resulting in equivalent cosmetic outcomes has several benefits. Especially in the case of children, the wound closure with Histoacryl $Blue^{(R)}$ could be a good alternative for repair of laceration in emergency room.

• 대한핵의학회지
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• 제27권1호
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• pp.22-27
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• 1993

Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of the drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of $^{99m}Tc$-HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction infused by zipeprol abuse.

• 한국치위생학회지
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• 제7권3호
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• pp.231-245
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• 2007

This study aims to discuss plans to improve the satisfaction level of dental services by understanding characters of beliefs about dental manpower and analyzing its related factors. Data were collected by structured questionnaire whose subjects consist of 1607 persons from 13 years old to 69 years old, who have ever experienced dental institution. Both univariate and biovariate analyses were employed to analyze level of dentist and dental hygienist's beliefs and its related factors and the results gained from the surveys and search are as follows. 1. Among the questions to measure dentist's beliefs, 'Respect for patients' was evaluated as the best, and the lowest items were 'not-hopeful explanation about prognosis of dental treatment', 'satisfactory explanation' and 'whether treatments are stopped by pains or not'. In addition, among questions to measure dental hygienist's beliefs, 'kindly welcome' and 'detailed explanations about medical directions' are the items evaluated as the best and 'notice of waiting time' marked the lowest evaluation. 2. The factors related to beliefs about dentists were age, ache experiences, dental fear, self-reported dental health status, frequence and primary purposes of the visits dental institutions, elapsed time from recently visited, present of favorite dental clinic to visit regularly. 3. The factors related to beliefs about dental hygienists were age, education, occupation, ache experiences, frequence and primary purposes of the visits dental institutions, periodic check of teeth, present of favorite dental clinic to visit regularly. 4. Direct painful, painful treatment experience under insufficient local anesthetic, indirect painful experience and dental fear were positively correlated. And the relationships were positive between ache experiences, dental fear and self-reported dental health status, but relationships were negative between ache experiences, dental fear and dentist! dental hygienist's beliefs.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.119-124
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• 2007

Purpose: We reconstructed the skin defect of lower legs exposing muscles, tendons and bone with fasciocutaneous sural artery flap and report our cases. Materials and Methods: Between March 2005 and September 2006, 8 cases of skin defect were reconstructed with fasciocutaneous sural artery flap. Defect site were 4 case of ankle and foot and 4 cases of lower leg. The average defect size was $4{\times}4\;cm^2$. There were 5 men and 3 women and mean age was 52.2 years. We evaluated the viability of flap, postoperative complication, healing time, patient's satisfaction. Results: There was no flap failure in 8 cases. But recurrent discharge in 2 cases was healed through several times adequate debridement and delayed suture without complication. Flap edema may be due to venous congestion was healed through leg elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence in follow up period. Cosmetic results as judged by patients were that 5 cases are good and 3 cases are fair. Conclusion: Sural artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Sural artery flap is useful method for the skin defect of lower legs because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

• 보건행정학회지
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• 제26권4호
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• pp.325-332
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• 2016

Background: Workplace violence was recognized to be social problems that might impact the health status and the job satisfaction of employee in hospitals. This study investigated the current status of violence and job stress among hospital employees working at administration and discharging department. Methods: The study subjects were 213 administrative employees working at 20 general hospitals. Data were collected by self-administered questionnaire that included information such as demographics, job-related characteristics, experience of violence, and job stress. The violence was classified as verbal violence, physical threat, and physical violence occurred by patients and caregivers. Analysis of variance, t-tests, correlation analysis, and multiple linear regression analysis were performed to examine the associated factors with job stress. Results: The levels of verbal violence, physical threat, and physical violence were $1.64{\pm}1.08$, $0.54{\pm}0.67$, and $0.04{\pm}0.17$, respectively. The score of job stress was $2.74{\pm}0.50$ and it was associated with age, existence of spouse, drinking frequency, subjective health status, disease history, night-time treatment, and public health administration career in simple analysis. In multiple linear regression analysis, the level of verbal violence experience was significantly associated with job stress (B=0.09, p=0.001). Also physical threats (B=0.18, p<0.001) and physical violence (B=0.48, p=0.008) showed positive association with job stress. Conclusion: This study attempted to examine the association between experience of violence and job stress in administrative employees at medical institutions. Levels of violence showed positive correlation with the job stress. Environment improvement to protect employee from violence and management of employees who experienced workplace violence are needed to reduce the job stress.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.115-119
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• 2008

Purpose: We reconstructed the skin defect of hands exposing tendons and/or bone with distally based ulnar artery flap and report our cases. Materials and Methods: Between March 2005 and September 2007, 6 cases of skin defect were reconstructed with distally based ulnar artery flap. Defect site were 5 cases of hand dorsal side and 1 case of hand volar side. The average defect size was $3{\times}3\;cm^2$. There were 4 men and 2 women and mean age was 55.5 years. We evaluated the viability of flap, postoperaive complication, healing time, patient's satisfaction. Results: There was no flap failure in 6 cases. But 1 case with recurrent discharge was healed with several times adequate debridement and delayed suture. 1 case with flap edema which might be due to venous congestion was healed with hand elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence was found in follow up period. Cosmetic results as judged by patients were that 3 cases are good and 3 cases are fair. Conclusion: Distally based ulnar artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Distally based ulnar artery flap is useful method for the skin defect of hands because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

• 대한한방소아과학회지
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• 제15권1호
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• pp.15-37
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• 2001

Objectives : The aim of this study was to investigate the usefulness and the remedical effect of Aroma therapy and Jaungo as a tool for Atopic dermatitis. Methods : We investigated 20 patients suffering from Atopic dermatitis and on the ground of it analyzed the remedical effect of Aroma therapy and Jaungo Results : 1. In distribution of nursing method, 45% was breast milk and formula, 35% was formular, 20% was breast milk. 2. The proportion of Atopic dermatitis concurred of congenital fever was 53.3%, after a disappearance of congenital fever was 46.7%. 3. That the season of symptom aggravation is not defined is 40%, next is summer 25%. The time of symptom aggravation is at night, 65%. 4. In the causes of symptom worsening, common cold and food was the best at each 33.3%. 5. In distribution of the therapeutic method, 65% was treated with oriental after occidental medicine and 30% only oriental medical care. Additional therapy except medical therapy was 60%. 6. In satisfaction degree of Aroma oil and cream therapy, 60% was not changed, 33.4% was very satisfied and satisfied. In aroma cream therapy, 55% was very satisfied and satisfied 40% was not changed. After using Jaungo therapy, 55.6% was very satisfied and satisfied, 44.4% was not changed. 7. After finishing the healing procedure, 65% was very satisfied and satisfied, 35% was not changed. Conclusions : Considering the above results, we have concluded that Aroma therapy and Jaungo have the remedical effect for Atopic dermatitis.