• Title/Summary/Keyword: Trauma center

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A Cephalometric Analysis of Lateral Morphologic Feature in Adult Cleft Lip and Palate Patients (구순 구개열 환자의 성장 후 안모에 관한 두부방사선학적 계측)

  • Choi Sang-Hee;Chun Sang-Deuk;Yoon Hong-Sik;Lee Hee-Kyung;Chin Byung-Rho
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.1-15
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    • 2003
  • Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of development of maxillofacial region in adult cleft lip and palate patients and to compare post-treat-ment craniofacial morphology between cleft lip and palate patients with secondary alveolar bone graft group and normal group. The material for this study consisted of 20 adult male patients with cleft lip and palate(mean 22.5, range 18-31) visited in Yeungnam University medical center. Cephalometric tracing and measurements were done by one investigator. Results were followed: The values of Na. perpendicular to point A, SNA angle and Pogonion to Na. perpendicualrwere -4.93±5.70, 76.45±4.69, and -6.38±6.73. The values of effective maxillary length, effective mandibular length, mandibular plane angle and facial axis angle were 85.6±4. 42, 123.88±7.10, 29.9±5.09 and 5.53±2.03. The value of upper incisors to point A was 3.95±2.74.

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A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy (경피경간 담도내시경술 이후에 발병한 담즙흉 1예)

  • Park, Chan Sung;Lee, Soon Jung;Do, Gi Won;Oh, Ssang Yong;Cho, Hyun;Kim, Min Su;Hong, Il Ki;Bang, Sung Jo;Jegal, Yang Jin;Ahn, Jong-Joon;Seo, Kwang Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.131-136
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    • 2008
  • Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

Clinical evaluation of Oriental Medicine treatment of Stable Compression Fracture by D.I.T.I. (D.I.T.I로 본 Stable Compression Fracture의 한의학적 치료효과)

  • Lee, Geon-Mok;Moon, Sung-Jae;Lee, Byung-Chul
    • Journal of Oriental Medical Thermology
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    • v.1 no.1
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    • pp.28-37
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    • 2002
  • Stable Compression Fractures(SCF hereafter) are most often caused by trauma such as traffic accidents. These SCFs usually occur in the thoracic and lumbar regions of the spinal cord. Human life spans have increased as a result of medical advances, which in turn has led to an increase in the elderly population. SCFs are divided into the categories of stable and unstable. The categories are determined through X-rays and P/Ex tests. The D.I.T.I. is then used to diagnose the severity and prognosis of the fracture injuries, and it allows an objective evaluation of the symptoms. This author researched 40 patients who were treated at Wonkwang University Oriental Medical Center from October 1995 to December 1996. The patients were diagnosed by X-ray as having SCFs and treated primarily with acupuncture. Both the changes in D.I.T.I. and patients' self-diagnoses of their conditions before and after treatment yielded the meaningful results which have been presented here. 1. 75% of those who suffer from Stable Compression Fractures are 60 years of older. Of those, the ratio of male to female is 1 to 4. This is due in part to the fact that many elderly women seek Oriental medicine treatment for conditions associated with advanced age. 2. 53.3% of these injuries occurred between T11 and L2. 3. 65% of patients were hospitalized for 10 to 29 days, and then able to be treated on an outpatiens basis. 4. The D.I.T.I. results showed 50% below $0.2^{\circ}C$, 30% between 0.3 and $0.5^{\circ}C$, 10% between 0.5 and $0.7^{\circ}C$, 10% between 0.7 and $0.9^{\circ}C$, and 0% over $0.9^{\circ}C$. 5. The results of treatment using Modified Evaluation System in Thoracolumbar Vertebral Fractures Method showed that 55% of patients achieved excellent recovery and 40% achived good recovery. After comparing the D.I.T.I. results before and after treatment, we found 50% of patients showed excellent recovery $({\Delta}T{\leq}0.2)$ and 40% showed good recovery$(0.2<{\Delta}T{\leq}0.5)$.

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Hill-Sachs Lesion on MR Arthrography of the Shoulder: Relationship with Bankart Lesion on Arthroscopy and Frequency of Shoulder Dislocations (견관절자기공명관절조영술에서의 Hill-Sachs병변과 관절경에서의 Bankart병변, 견관절탈구빈도와의 상관성)

  • Kim, Ji Na;Lee, Min Hee;Ahn, Joong Mo
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.26-32
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    • 2013
  • Purpose : This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations. Materials and Methods: 86 MRA of shoulder were evaluated in patients with arthroscopic Bankart repairs following anterior dislocations. The largest surface length of HS lesion on MRA and extent of Bankart lesions on arthroscopy were measured. Relationships between length of HS lesions and extent of Bankart lesions and frequency of dislocations were assessed. Results: HS lesions were identified on MRA in 78 patients. The largest surface length of HS lesion ranged from 9.3 mm to 29.6 mm (mean, 18.8 mm). The extent of Bankart lesion ranged from one to six o'clock extent (mean, 4.25 o'clock extent). Three patients had single dislocation and the other 75 patients had recurrent dislocations (mean 24.5 times). The largest surface length of HS lesions was positively correlated with extent of Bankart lesions (p = 0.001, r = 0.37), but not with frequency of dislocation. Conclusion: HS lesion was very common in patients with Bankart lesion. The severity of HS lesions was correlated with extent of Bankart lesions.

A Study on Narrative in Louise Bourgeois' "You Better Grow Up" (루이즈 부르주아의 작품 의 내러티브 분석)

  • Oh, Sang-Il
    • Journal of Science of Art and Design
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    • v.9
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    • pp.49-87
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    • 2006
  • Narrative has broad domains. So it is related to the everything man faces in his daily life and also performed in various modes. Narrative is revealed through all media including a character, which is also applied to plastic art. And narrative objects formed beyond the differences in media aid forms of expression are commonly based on a language. The study on such objects which created a new conceit of narratology can be said to be a spiritual trend by which to understand the world and man from the viewpoint of a 'story'. Plastic art took high interest in narrative in the same period as the rise of postmodernist art in the latter half of the 20th century, which was also applied to sculpture. The researcher, therefore, investigated through the history of sculpture in the 20th century the process in which narrative was denied under the value system of modernism and reappeared with the quickening of postmodernism. And as a result this period could be briefly characterized by 'return to figure' and 'reappearance of narrative'. The is, such flow means that late sculpture converted its center of interest from simple geometric abstract forms to irregular, figurative images. The researcher chose as the subject of his study the work of Louise Bourgeois, who was judged to have performed narrative positively and successfully among a great number of performed narrative positively and successfully among a great number of postmodernist sculptors who adopted it as their own strategy of expression. As the central artist of postmodrnist sculpture, She expressed human desire and condition as sexuality through the introspection of her own personal experience in contrast to the character of pop art sensitive to external world. The researcher borrowed narrative semiotics as a method of analyzing more elaborately the problem about the generation of narrative shown in her works. For it, he selected as the sample work for analysis Bourgeois's , which were judged to contain narrative most abundantly and as the metaphor of a gaze and recollection presented a new woman self that sublimed love, hatred, and loneliness. The narrative in her works are characterized by introspection questioning one's own trauma. It has independent domain and characteristics and clearly reveals narrative and content-centered characteristics, which are commonly discovered in postmodernist sculpture. The researcher could more concretely and definitely understand the characteristics of narrative through figurative images by analyzing the sample work. The researcher wanted to call your attention to the fact that the sculpture in the late 20th century contained narrative commonly and uniformly despite being characterized by various expressions and modes. And the focused on highlighting the fact that the narrative was more effectively revealed through figurative images of human body and simultaneously analyzing the formalizing process and structure for narrative. Besides he wanted to argue that the position of narrative defining the characteristics of sculpture should be valued more justly. Also, such acceptance of narrative, which is discovered in the sculpture, will have to be understood as the characteristics of the period reflecting the cultural aspect of the present time.

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Validation of Nursing Diagnose and Defining Characteristics for Patients with Cerebrovascular Accidents - Home Health Care Nursing (뇌혈관질환자와 관련된 간호진단 및 간호진단별 특성 규명과 타당성 조사연구 - 가정간호 대상자를 중심으로 -)

  • Kim, Hae-Young
    • Journal of Home Health Care Nursing
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    • v.2
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    • pp.35-51
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    • 1995
  • This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.

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A Survey on the Understanding of High School Teachers about Physical Therapist (고등학교 교사들의 물리치료사에 대한 인식도에 관한 조사)

  • Hong, Wan-Sung
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.39-58
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    • 1991
  • This study was carried out to recognize the understanding of high school teachers about physical therapist during September in 1988, The study population was comprised of 511 high school teachers who had lived in Seoul and Kyunggi Province. Mate teachers were $56\%$ and the rest of them were females. In age distribution $45.4\%$ of them belonged to the 3rd decade, in religion $36.2\%$ of them were Christians, and in their carrier $45.8\%$ of them were less then 5 years. The results obtained were as follows. 1. The high school teachers who knew about department of physical therapy is amounted to $62.6\%$ in male and $49.8\%$ in female. The high school teachers ($41.7\%$ in male and $38.6\%$ in female) considered that students aptitude was the most important thing to keep in mind in counselling those who wished to become physical therapists. There were difference in opinion between male and female teachers as to the counselling criteria (p<0.05). 2. The high school teachers who knew that the students would beemployed in sport center and health clubs after graduation amounted to $24.3\%$ in males and in general hospital to $27.1\%$ in female. There was significant difference in the knowledge for their field of employment between male and female teachers (p<0.05). 3. As to the effectiveness of the physical therapy, $41.3\%$ of male and $29.8\%$ of the female teachers responded to 'satisfactory', but indicating no statistical difference both sexes. 4. As for the attitude of physical therapiest, $43\%$ of them answered that kindness and service devotion were the prerequisite for them. There were statistical difference between male and female teachers in concepts about attitude (p<0.05). To the social level of physical therapist, majority of the teachers thought that physical therapist belong to moderate level in social class. 5. Those who considered that the physical therapy was necessary means for treatment of trauma amounted to $73\%$. The reason why teachers thought that physical therapy was not necessary was that it required too long period of time for the treatment. 6. Those who knew fully the job of physical therapist amounted to $55\%$ and the 55. $9\%$ knew that physical therapists work only at hospitals as the therapist and the rest of them misunderstood the job of physical therapist. 7. As for the academic background to be qualified as physical therapist, $76.2\%$ of them said that graduation of Junior College was required, $12.9\%$ graduation of Senior College and the rest of them had no ideas at all. There was no statistical difference between male and female teachers.

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The Meaning of Death and Caregiving in Old Age: Reading from the Novels of Kyung-ran Jo (문학 텍스트 속의 노년 죽음과 돌봄: 조경란 소설을 중심으로)

  • Park, Sun Ae;Kim, Cheong Seok
    • 한국노년학
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    • v.36 no.3
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    • pp.785-808
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    • 2016
  • This study portraits the way of self-preparation for death among the elderly and examines the meaning and values attached to the elderly-care by their family and friends through the analysis of Kyung-ran Jo's novels. First, the author describes the difficulties and inner conflict of women who provide care for the elderly, especially those facing death in the near future. She also describes how the acceptance of death and self-discovery among the caregivers can be developed from the experience of long term care. These are consistent with the arguments by Ecofemnist on positive sides of providing caregiving in an aging society. In her novels, caregiving from young women is not described as the consequences of internalized gender norms of traditional Confucian culture. Rather, it is depicted as attitude toward a life in a commune where the meaning of life and death of elderly is shared between generations. In addition, struggles of the elderly figures against diseases and the process of their death provide an opportunity for young caregivers to overcome the trauma of other's death witnessed in their childhood. They lead the young caregivers to reflect themselves by raising ontologistic questions on life and death. The author shows the communication between generations presenting the self-preparation of death from the old generation undergoing irreversible aging and caregiving activities of significant others from the young generation. In doing so, the author points out the ethical grounds for diseases and death in old age given the condition of personalization of death in the modern society.

The status of advanced cardiac life support performance by resident belonging to other department except for department of emergency medicine in in-hospital cardiac arrest (병원 내 심정지 상황에서 응급의학과 이외 전공의에 의해 시행된 전문 심장소생술의 현황)

  • Cho, Hyun-Woo;Woo, Jae-Hyug;Lim, Yong-Su;Jang, Jae-Ho;Cho, Jin-Seong;Choi, Jea-Yeon;Yang, Hyuk-Jun;Hyun, Sung-Youl
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.485-492
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    • 2018
  • Objective: This paper reports the status of the advanced cardiac life support (ACLS) according to the guidelines by residents belonging to other departments other than the department of emergency medicine. The differences in status between the junior group and senior group was also investigated according to grades of residents. Methods: The ACLS performance for in-hospital cardiac arrest cases of one academic hospital, except for the cases occurring in intensive care unit between November 2015 and October 2017, were analyzed retrospectively. Data included the characteristics of residents, patients' outcomes, ACLS performance, and conventional treatment having discordance with the ACLS guidelines. Leaders during cardiopulmonary resuscitation (CPR) were divided into a junior group and senior group. Results: A total of 152 cases were enrolled in this study. Of these, 131 cases (86.2%) showed at least one treatment with inconsistency from the guidelines and the incidence of discordant treatment was similar in the two groups (55 [85.9%] vs. 76 [88.4%], P=0.657). Implicit use of sodium bicarbonate was more frequent in the senior residents group (odds ratio [OR], 3.04; 95% confidence interval [CI], 1.36-6.81). On the other hand, no use of a defibrillator was less frequent in the senior residents group (OR, 0.14; 95% CI, 0.03-0.81). Conclusion: In both groups, the rate of discordance with the ACLS guidelines during CPR were high. The rate of implicit use of sodium bicarbonate and no use of defibrillator were significantly different in the two groups. A customized education strategy for ACLS is needed for each group.

A Phenomenological Study on Psychological Experiences and Resilience of Incest Sexual Victims in Adolescence (아동·청소년기 근친 성폭력 피해자의 심리경험과 적응에 관한 현상학 연구)

  • Chun, Hae-Lee;Shin, Dong-yeol
    • Industry Promotion Research
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    • v.6 no.2
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    • pp.37-46
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    • 2021
  • The purpose of this study is to examine the necessity of providing new perspectives by conveying the various psychological changes and realities experienced by victims of incest sexual violence after the incident, And it is meaningful to understand and record it through. The results of the analysis through the phenomenological methodology are as follows: First, participants were disturbed by the emotional neglect of their parents and forced violence, threats, and silence by their family members, resulting in disbelief in interpersonal relationships and low self-esteem and suffered constant difficulties in daily life. Second, the suffering and aftereffects of sexual violence experienced the conflict of roles by repeating the real maladjustment and social activity avoidance as the fear of being informed about the event, the negative thought about oneself, and the difficulty of interpersonal relationship. Third, the aftereffects of incest sexual violence in childhood·adolescence were found to be extreme with regard to PTSD. The PTSD experience has become a factor that forces participants to rely on substances, such as psychiatric medications and alcohol, and further avoids external activities with hallucinations and delusions. Fourth, the change through the adaptation process is a new perspective on life, facing and separating the events. During the adaptation program, they tried to express their words and feelings that they could not express because of the past hurts, to set goals for living their life, and to move forward. The experience of overcoming reality has enhanced participants' confidence in self-esteem, self-efficacy, and healthy self-control ability. In this study, it is meaningful to suggest a model in which the incest sexual violence trauma is reexperienced through the new daily crisis and the new adaptation process is repeated for each process.