• Journal of Chest Surgery
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• 제50권2호
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• pp.86-93
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• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.95-100
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• 2014

Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.133-138
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• 1998

23세의 건강한 산모에게서 정상 분만되고, 출생시 체중 3.lkg의 여자 아이가 출생 직후 청색증, 호홉 곤란 등의 소견을 보이나, 육안적으로 관찰되는 불완전 양측성 구순열 이외에는 특별한 두개안면 이형증 등의 소견은 관찰되지 않아서, 소아과 담당의사가 전비공을 통하여 비인두강 내의 분비물 등의 이물질 홉인을 시도하려다 작은 고무 도관의 삽입이 이루어지지 않아서 후비공 폐쇄를 의심하였다. 경구 호홉관을 이용하여 기도 확보 후에 후비공 폐쇄 여부의 진단을 위해서, 비강내 방사선 비투과성 물질의 접적 주입한 후에 방사선 사진, 컴퓨터 단층 촬영 등을 통하여 완전 골성 양측성 후비공 폐쇄를 확진하였다. 양측성 후비공 폐쇄는 출생시 주기적인 호홉 곤란의 증상을 보이며, 특히 포유시에 호홉 곤란의 증상이 악화되어서 신생아의 생명을 위협하는 응급 상황으로 이에 대한 외과적인 처치를 시행하기로 결정하였다. 후비공 폐쇄에 대한 외과적인 처치는 비강을 통한 접큰법, 구개부를 통한 접근법, 비중격을 통한 접근법 등의 여러 가지 접근법이 있으나, 본 환자의 경우는 완전 골성 양측성 후비공 폐쇄로 확진이 되었고, 이에 대한 저자들의 경험이 전혀 없는 상태이었기에 보다 좋은 수술 시야를 용이하게 확보할 수 있으며, 새로이 형성해준 후비공을 따라 점막 피판을 보존해 줄 수 있고, 수술 후 후비공의 개통성을 보다 확실하게 얻을 수 있을 것으로 예상되는 구개부를 통한 접근법을 이용하여 외과적인 처치를 시행하였다. 수술 후 약 1 년이 경과하였으나 임상적으로 호홉 곤란 등의 특별한 문제점이 없이 만족할 만한 경과를 보였다. 일반적인 교과서에서 설명하듯이 기성품으로 제작된 자가보전 견인자의 설압자는 이와 같은 신생아의 증례에서는 크기가 상대적으로 너무 커서 사용이 곤란하였다는 점을 염두에 두어야 할 것으로 생각되며, 추후 유사한 증례의 수술시에 도움을 주고자 매우 희귀한 증례인 완전 골성 양측성 후비공 폐쇄 환자에 대한 치험례를 문헌 고찰과 함께 보고하는 바이다.

• 대한정형외과스포츠의학회지
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• 제4권1호
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• pp.36-42
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• 2005

목적: 야구 선수에서 발생한 견관절 내부 후방 충돌에 대해 관절경 소견 및 치료 결과를 알아보고자 하였다. 대상 및 방법: 내부 후방 충돌로 진단하였던 5예를 대상으로 평균 15개월 추시하였다. 전 예에서 후기 거상기에 견관절 후방에 동통을 호소하였고, 외전 $120^{\circ}$에서 과수평-외전을 추가한 재위 검사상 전 예에서 양성을 보였다. 관절경하에 파열된 후방 관절와 순이나 SLAP 병변은 봉합하였고 회전근 개는 변연 절제하였으며 전방 관절낭 인대는 3예에서 관절낭 중첩술, 2예에서 관절낭 열 수축술을 시행하였다. 결과는 동통, 운동 범위, 운동 복귀 수준 등을 조사하였다. 결과: 관절경 소견상 전 예에서 후상방 관절와 순의 fraying이 있었고 2예에서는 후상방 관절와 순의 flap 파열, 1예에서는 제2형 SLAP 병변이 동반되었다. 전 예에서 극상근 건에 fraying이 관찰되었고 1예에서는 부분 파열을 보였다. 또한 전 예에서 $90^{\circ}{\sim}120^{\circ}$ 외전 및 외회전 상태에서 관절와 순에 회전근 개가 충돌하는 현상을 관찰할 수 있었다. 결과는 투구 시 전 예에서 동통이나 불안감은 없었으며, 평균 활동력은 이환 전의 활동력에 비해 평균 88% ($80{\sim}100%$)로 회복되었다. 결론: 내부 후방 충돌의 확진은 관절경 검사를 통해 가능할 것으로 사료되었으며, 내부 충돌의 원인이 되는 전방 미세 불안정성과 후방 관절낭 구축에 대해 전방 관절낭 중첩술이나 수축술 및 후방 관절낭 신연 운동은 비교적 만족스러운 결과를 보였다.

• 한국학교ㆍ지역보건교육학회지
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• 제1권2호
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• pp.105-125
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• 2000

The purpose of this study was to examine the influence of school safety accident on teacher's normal educational activities and to seek some desirable ways to cope with it. The subjects in this study were 351 class teachers randomly selected from Seoul and Kyonggi Province and surveyed from April through July, 2000. The conclusions were as follows; 1. Actual Condition of School Safety Accident 1) Approximately many teachers investigated had had an experience to suffer safety accident. Safety accident occurred most during break or class, but there was a significant difference according to service area. 2) Safety accident took place most in playground, and the most common cause was student's own carelessness, and the most widely occurred accident type was an injury. But there was no significant difference caused by the general characteristics of the teachers. 2. Influence of Safety Accident On Teacher's Educational Activities. 1) The largest reason they offered safety education was to ensure student safety. The greatest number of them had an opinion they would consider changing or giving up a planned normal educational activity if they recognized any possibilities of safety accident. There was a significant difference in this point according to gender and career. 2) They worried about possible safety accident most during field study, but there was a significant difference according to gender or presence or absence of safety accident experience. 3) The general characteristics of teacher produced a significant difference to an experience of avoiding educational activity due to psychological withdrawal, but safety accident experience didn't make any difference. 3. Minimization of Teacher Damage or Loss from Safety Accident. 1) The dominant opinion about teacher's small mistake for any occurrence of safety accident was that the responsibility should be escaped to maintain teacher's authority. For severe mistake, however, there were two different opinions at the same percentage: one was being exempted and the other was taking civil liability. 2) Establishing teacher insurance was preferred as a way to minimize teacher's economic loss from safety accident, but there was a significant difference according to gender. 3) The dominant opinion about the payment of insurance premium for safety accident was that it should be paid from school operating expenses.

• 한국운동역학회지
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• 제31권2호
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• pp.133-139
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• 2021

Objective: This study aims to verify the conventional deadlift motions using by two different grips, thereby elucidating the grounds for effective training methods that can minimize the risk of injury. Method: Total of 18 healthy young adults were recruited for this study (age: 25.11±2.19 yrs., height: 175.67±5.22 cm, body mass: 78.5±8.09 kg, 1-RM: 125.75±19.48 kg). All participants were asked to perform conventional deadlift with two types of grips which are overhand grip (OG) and underhand grip (UG). In each grip, participant perform the deadlift with 50% and 80% of the pre-measured 1-RM. A 3-dimensional motion analysis with 8 infrared cameras and 3 channels of EMG was performed in this study. A two-way ANOVA (group × load) with repeated measure was used for statistical verification. The significant level was set at α=.05. Results: There were significant differences in grip type and weight on the right shoulder joint, and only significant difference in grip on the left shoulder joint (p<.05). The hip joint ROM was significantly increased as the weight increased in both types of grips on phase 1, while the ROM of hip joint was significantly decreased as the weight increased only in the case of OG on phase 2 (p<.05). In case of the OG, as the weight, increased significantly increased L1 ROM and L3 ROM were revealed on phase 1 and phase 2, respectively (p<.05). Moreover, as the weight increased, UG revealed significantly decreased L5 ROM on phase 1, while both grips showed significantly increased ROM on phase 2 (p<.05). In addition, the erector spinae and the biceps femoris, which are synergist for the motion, showed a significant difference in both types of grip according to the weight (p<.05). The muscle activity ratio of gluteus maximus/biceps femoris showed a significant difference only in the UG according to the weight (p<.05). Conclusion: In conclusion, beginners might be suggested to use the UG for maintaining the neutral state of the lumbar spine and focus on the gluteus maximus muscle, which is the main activation muscle. For the experts, it may recommend alternative use of the OG and UG according to the training purpose to minimize the compensation effect.

• 대한통합의학회지
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• 제9권4호
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• pp.291-298
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• 2021

Purpose: The Pedisole is a newly developed shoe-mounted wearable assessment system for analyzing balance and gait. This study aimed to determine the reliability and validity of the parameters provided by the system for static balance and gait analysis of healthy adults. Methods: This study included 38 healthy adults (22.4±1.9 years) with no history of injury in the lower limbs. All participants were asked to perform balance and gait tasks for undertaking measurements. For analysis of balance, both the smart Pedisole and Pedoscan systems were concurrently used to analyze the path length of the center of pressure (COP) and the weight ratio of the left and right for 10 s. Gait was measured using the smart Pedisole and GaitRite walkway systems simultaneously. The participants walked at a self-selected preferred gait speed. The cadence, stance time, swing time, and step time were used to analyze gait characteristics. Using the paired t-test, the intra-class coefficient correlation (ICC) was calculated for reliability. The Spearman correlation was used to assess the validity of the measurements. In total, data for balance from 36 participants and the gait profiles of 37 participants were evaluated. Results: There were significant differences between the COP path lengths (p<.050) derived from the two systems, and a significant correlation was found for COP path length (r=.382~.523) for static balance. The ICC for COP path length and weight ratio was found to be greater than .687, indicating moderate agreement in balance parameters. The ICC of gait parameters was found to be greater than .697 except for stance time, and there was significant correlation (r=.678~.922) with the GaitRite system. Conclusion: The newly developed smart insole-type Pedisole system and the related application are useful, reliable, and valid tools for balance and gait analysis compared to the gold standard Pedoscan and the GaitRite systems in healthy individuals.

• 한국ITS학회 논문지
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• 제22권5호
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• pp.19-29
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• 2023

우리나라 도로 사고원단위는 도로 종류와 차로 수에 따라 단순 구분하고 있으나, 국외는 사고에 영향을 미치는 다양한 요소를 적용하고 있다. 본 논문은 TAAS(Traffic Accident Analysis System)의 사고 자료를 이용하여 일반국도 사고원단위를 도시부, 지방부, Older, 및 Modern 도로로 세분하였으며, 사고절감비용 산정 모형을 제시하였다. 국도 1,416.2km의 표본을 토대로 분석된 사망원단위(인/억대·km)는 도시부-Older 4.21, 도시부-Modern 1.37, 지방부-Older 2.18 및 지방부-Modern 0.99로 Older가 Modern 도로보다 높고, 도시부가 지방부보다 높게 분석되었다. 부상원단위(인/억대·km)는 도시부-Older 182.63, 도시부-Modern 103.42, 지방부-Older 67.44 및 지방부-Modern 42.96으로 사망원단위와 유사한 패턴으로 분석되었다. Modern 도로의 경우 KDI 지침의 사고원단위보다 매우 낮은 수준이다. 본 연구의 사고원단위를 적용하여 편익을 산정한 결과 사고비용절감편익 비율이 0.6%에서 14.1%로 증가하였으며, B/C는 0.626에서 0.724로 개선되었다.

• 한국건축시공학회지
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• 제19권4호
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• pp.289-297
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• 2019

현재 건축물에 사용되는 접착제는 주로 유기질 재료인 에폭시 수지 접착제가 사용되고 있다. 유기질 재료인 에폭시 수지 접착제는 유기성 물질로 접착제 생산 시 유해물질이 발생하며, 시공 후에도 유해물질이 실내거주공간에서 높게 나타난다. 또한 건축물 화재 시 유기 재료에서 발생되는 다량의 일산화탄소가 인명피해로 이어진다. 본 연구는 순수무기계 재료인 산화마그네시아, 인산염, 붕사를 사용한 무기 접착재에 대해 기존 유기 접착제를 대체 할 무기 접착재로의 활용가능성을 평가한 연구이다. 적정 인산염 선정에 관한 실험과 지연제로서 활용한 붕사의 첨가율에 대한 특성을 실험한 결과 적정 인산염으로 제1인산칼륨이 도출되었으며, 붕사 첨가율에 따른 특성을 측정한 결과 KS F 4923의 품질기준과 비교하여 경화수축률과 가열변화율은 품질기준을 만족하였으며, 인장강도는 붕사 첨가율 4% 이상에서 만족하는 결과가 나왔지만 접착강도의 경우 품질 기준을 충족하지 못하였다. 향후 접착강도 증진을 위한 추가적인 연구가 필요할 것으로 판단된다.

• Journal of Chest Surgery
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• 제31권8호
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• pp.804-810
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• 1998

배경: 다발성 외상환자는 교통사고, 산업재해, 우발적사고, 폭력 등의 증가로 최근 증가 추세에 있다. 다발성 외상은 심장, 폐, 대혈관 등의 흉부외상을 포함하는 경우가 많으며 이때는 환자의 생명을 위협할 수 있으므로 적절한 진단과 치료가 필요하다. 대부분의 흉부외상은 보존적 치료와 흉관 삽관술과 같은 간단한 외과적 시술 만으로 만족할 만한 치료효과를 보이지만 적절한 시기에 개흉술을 시행함으로써 환자의 생명을 구할 수 있는 경우가 있어 그 적응증 이나 시기의 판단에 있어서 경험있는 흉부외과 의사의 역할이 필요하다. 대상 및 방법: 저자는 다발성 외상 후 흉부개흉술이 필요했던 70례에 대하여 분석하였다. 환자들의 평균 나이는 35.6세 남녀비는 3.4:1이었다. 손상의 기전은 주로 교통사고, 추락사고, 자상이었다. 결과: 흉부손상의 가장 일반적인 유형은 혈흉이며, 두 번째는 횡격막 파열이었다. 환자의 60%에서 골절을 동반 하고 42.9%에서 복부손상을 37.1%에서 두부손상을 동반하고 있었다. 개흉술을 시행한 이유로는 출혈교정 혹은 지혈이 48.6%, 횡격막손상의 복구가 35.7%였으며, 폐 열상 봉합이 25.7% 였으며, 흉부 손상으로 인한 수술외에도 비장적출술(14.3%), 간엽절제술(8.6%) 간 열상 복구(5.7%)를 시행하였다. 수술후 합병증으로는 무기폐(8.6%), 창상감염(8.6%), 폐렴(4.3%)이었다. 수술후 6명의 환자가 사망하였고 수술사망율은 8.6%였다. 사망의 원인으로는 호흡부전증(2례), 급성 신기능부전증(2례), 패혈증(1례), 저혈량성 쇽(1례)이었다.