• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.255-259
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• 2018

Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.

• 해양환경안전학회지
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• 제29권7호
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• pp.836-842
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• 2023

「장애인복지법」에 따라 국가 자격시험은 장애인과 비장애인이 동일한 시험에 응시할 수 있도록 하고 있으며, 청각장애는 동력수상레저기구 면허취득 결격사유에 해당하지 않아 청각장애인도 면허취득을 할 수 있다. 선박이나 동력수상레저기구에서는 해상에서 충돌위험이 있을 때 조종신호, 경고신호 등의 위험신호를 음향신호를 통해 상대에게 알려 주위의 위험 상황을 발견하지 못하여 발생할 수 있는 사고를 예방하도록 하고 있다. 하지만, 청각장애인의 레저활동 중 주위 선박이나 동력수상레저기구의 소리를 통한 위험신호를 청각장애로 인해 위험신호를 확인하지 못해 발생할 수 있는 해양사고를 방지할 수 있는 방안이 필요하다. 음향수신장치(Sound Reception System)는 선교가 완전히 폐위된 선박에 설치하여 외부 소리의 증폭과 소리의 수신 방향을 화면상에 표시하는 장치로서, 청각장애인의 동력수상레저기구에 선박 음향수신장치를 활용하여 청각장애로 인해 청취할 수 없는 위험신호와 같은 음향신호의 유무 및 방향을 동력수상레저기구의 화면상에 시각적 표시를 통해, 청각장애인의 레저활동 중 음향신호를 확인하지 못하여 발생할 수 있는 해양사고를 예방하기 위한 개선방안을 제시하였다.

• The Korean Journal of Pain
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• 제31권4호
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• pp.296-304
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• 2018

Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.

• Journal of Medicine and Life Science
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• 제19권1호
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• pp.1-7
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• 2022

Learning disabilities (LD), also known as learning disorders, refers to cases in which an individual experiences lower academic ability as compared to the normal range of intelligence, visual or hearing impairment, or an inability to peform learning. Children and adolescents with learning disabilities often have emotional or behavioral problems or co-existing conditions, including depression, anxiety disorders, difficulties with peer relationships, family conflicts, and low self-esteem. In most cases, attention deficit and hyperactivity disorder coexists. As learning disabilities have the characteristics of a difficult heterogeneous disease group that cannot be attributed to a single root cause, they are diagnosed based on an interdisciplinary approach through medicine and education, such as mental health medicine, education, psychology, special education, and neurology. In addition, for the accurate diagnosis and treatment of learning disabilities, the diagnosis, prescription, treatment, and educational intervention should be conducted in cooperation with doctors, teachers, and psychologists. The treatment of learning disabilities requires a multimodal approach, including medical and educational intervention. It is suggested that educational interventions such as the Individualized Education Plan (IEP) and the Response to Invention (RTI) should be implemented.

• 기본간호학회지
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• 제10권3호
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• pp.326-334
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• 2003

Purpose: The purpose of this study was to identify characteristics associated with fractures in elderly people in order to provide basic data for fracture preventive programs for the elderly people. Method: The participants were 84 patients over age of 65, who were admitted to the orthopedic department in a hospital in Chungnam province. Data were collected from Sep. 1, 2002 to Aug, 30, 2003 through personal interviews using a structured questionnaire. The data were analyzed using SPSSPC program. Result: Physical characteristics before the fracture included weakness or paralysis in the extremities (29.8%), need of assistance or appliances (13.1%), difficulty on balance (28.6%), visual disturbances (26.2%), hearing impairment (17.9%), speech disturbances (2.4%), urinary dysfunction (21.4%), and sleep disturbances (54.8%). The fractures occurred most frequently in winter (32.1%), between 1 pm and 6 pm (48.8%), on weekends (41.6%), in the road (58.3%) while wearing snickers (27.4%) or shoes (27.4%). The region of fractures occurred most frequently was lower extremities (57.1%), and the causes of fractures were loss of balance (31.0%) and car accident (25.0 %). A significance difference was found for type of accident, footwear at the time of the accident, place of the accident according to gender and age. Also a significance difference was found for type of accident and place of accident according to season(p<.05). Conclusion: Therefore, these results should be considered when a fracture preventive program for elderly people is designed.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.24-28
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• 2006

목 적 : 가정의 경제수준은 소아의 성장과 건강에 영향을 미칠 것으로 생각된다. 이에 저자들은 저소득층 소아들을 검진하여, 병을 발견하고 치료방향을 제시하며, 나아가 학교보건 정책 수립에 도움을 주고자 하였다. 방 법 : 2004년 6월부터 7월까지 서울의료원과 을지대학병원 소아과에서 서울, 경기 지역의 사회복지기관에서 운영하는 공부방을 이용하는 저소득층 가구의 초등학생 285명을 대상으로 하였다. 이들의 신체계측, 시력, 청력, 구강검사를 시행하고, 일반 혈액검사, 콜레스테롤, 간기능검사, B형간염항체, 소변검사 및 대변검사를 실시하였다. 결 과 : 신체계측상 동자초등학교 학생과 각 학년별로 비교해 보면 남학생의 경우 체중은 1, 2, 5학년에서 유의하게 적었으며, 신장은 1, 2, 4학년에서 유의하게 작았다. 여학생의 경우 체중은 4학년에서 유의하게 적었으며, 신장은 1, 4학년에서 유의하게 작았다. 2003년도 초 중등학생 신체검사 결과와 각 학년별로 비교해보면 체중의 평균치는 남아는 전 학년에서 0.1-5 kg, 여아는 5, 6학년을 제외하고 0.8-3.2 kg 적었다. 신장의 평균치는 남아는 1-4 cm, 여아는 0.4-4 cm 작았다. 비만의 빈도는 비만도 20% 이상을 기준으로 하였을 때 남아 16명(11.3%), 여아 15명(10.7%)이었고, BMI 95 백분위수 이상을 기준으로 하였을 때 남아가 15명(10.6%), 여아가 14명(10%)이었다. 시력검사상 0.7 미만인 경우는 20.22%로 2003년도 초 중등학생 신체검사 결과의 15.61% 보다 유의하게 높았고, 청력장애는 0.36%로 0.03%에 비해 유의하게 높았으며, 충치는 69.47%로 51.89%에 비해 유의하게 많았다. 이번 조사에서 새롭게 발견된 질환으로는 갑상선기능항진증, 백내장, 신경섬유종, 중증 아토피피부염, 심실중격 결손, 사시, 서혜부탈장 및 신경성난청이 있었다 결 론 : 저소득층 가구의 소아들의 신체계측상 신장은 국내 평균치보다 작았고, 체중은 저학년에서 국내 평균치보다 작았으며, 시력장애와 청력장애, 충치의 발생은 더 높게 나타났다. 또한 비교적 간단한 방법으로 치료될 수 있는 질환들이 새롭게 진단되기도 하였다. 이에 저자들은 저소득층 소아들에게 좀 더 체계적인 관심과 진료가 이루어져서 더 나은 건강상태를 유지하도록 도와야 할 것이라고 생각한다.

• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.194-200
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• 2022

Background: Injury is the leading cause of death or disability in children and adolescents. Rates of deaths from injuries have recently declined, but studies of the occurrence of nonfatal injuries are lacking. Purpose: This study aimed to investigate nonfatal injuries in children and adolescents younger than 20 years based on data from the Korean National Health and Nutrition Survey, 2007-2018. Methods: A questionnaire survey was conducted to determine whether children and adolescents had experienced an injury requiring a hospital visit in the previous year. We investigated each injury's risk factors and characteristics. Results: Of a total of 21,598 children and adolescents, 1,748 (weighted percentage, 8.1%) experienced one or more injuries in the previous year. There was no yearly difference in the proportion of injuries experienced. Among the male subjects, 10.0% had an injury experience; among the female participants, 6.1% had an injury experience (P<0.001). The highest rate was 9.0% in children aged 1-4 years. In multivariate logistic regression analysis, male sex; having an urban residence; having restricted activity due to visual, hearing, or developmental impairment; and attention deficit/hyperactivity disorder were significant risk factors for injury experience. The characteristics of up to 3 injuries per patient were investigated, and 1,951 injuries were analyzed. Falls and slips accounted for 34.9%, collisions for 34.1%, and motor vehicle accidents for 11.3% of the total injuries. Ninety-six percent of injuries were unintentional, 20% caused school absences, and 10% required hospitalization. Conclusion: Among Korean children and adolescents, 8.1% experienced injuries at least once a year with no significant differences in incidence over the past 12 years. Greater attention and effort to prevent injuries are needed.

• 생물정신의학
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• 제22권1호
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• pp.7-13
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• 2015

Objectives The purpose of this study was to examine the psychiatric characteristics of outpatients with tinnitus. Methods A total of 88 subjects were included in this study. According to Tinnitus Handicap Inventory (THI) scores, the subjects were classified into two group ; a mild tinnitus symptoms (mild-tinnitus) group and a severe tinnitus symptoms (severe-tinnitus) group. A questionnaire was used for an assessment of demographic characteristics, and the THI, the Visual Analogue Scale (VAS) about tinnitus, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) are applied for evaluation of other clinical psychiatric characteristics. Results Higher THI scores were positively correlated with tinnitus course, the number of accompanying symptoms, and the VAS. BDI total scores, BDI factors, and BAI total scores were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Also suicidal ideation, interpersonal problems, sleep problems, occupational impairment, and fatigue were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Conclusions Tinnitus is a common disorder of hearing which is associated frequently with psychiatric problems. This study suggests that psychiatric interventions should be taken into consideration in the treatment of patients suffering from tinnitus.

• 대한골관절종양학회지
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• 제11권1호
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• pp.105-109
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• 2005

제 2형 신경섬유종증(Neurofibromatosis)의 임상적 특징 없이 말초에 발생한 티넬징후를 보이는 다발성신경초종(Schwannomatosis) 3례를 경험하여 이를 보고하고자 한다. 주증상은 동통이었으며 3예에서 청장년에서 발생하였다. 발생부위는 상완신경총, 슬와부 그리고 수부였다. 상기 환자 모두에서 이명과 현훈 및 시력저하소견 관찰되지 않았으며 가족력은 없었다. 3예에서 모두에서 두부 자기공명영상 촬영상 전정신경초종(Vestibular schwannoma)이 관찰되지 않았다. 병리소견상 신경초종이 확인되었다. 앞으로 더 많은 증례의 수집과 연구로 다발성 신경초종의 임상양상, 임상경과 그리고 유전학적 특징에 대한 추가적인 연구가 필요할 것으로 사료된다.

• International Journal of Railway
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• 제1권4호
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• pp.143-148
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• 2008

This paper is the output of a collaborative European project concerning the barrier free accessibility for disabled persons to regional and long distance trains in Europe. Disabled people represent around 13% of the population in Europe. This is approximately 63 million people. The range of disabilities includes people with reduced mobility including wheel chair users, viewing and hearing impaired people and other forms of impairment. Improving accessibility aims at contributing to the provision of public transport services to all citizens in an equitable way. The purpose of the project was to analyse and to evaluate the existing solutions at selected European railways for all required modules at the entrance (doors, information and safety solutions), to derive a design concept, to develop a mock-up in meeting the needs of rail travellers with the above mentioned impairments and to test it with user groups. The project also aims at deriving components for the determination of standards. The EUPAX Design Mock-up test was performed to verify the advantages of the layout of the train segment including the different modules such as access area (including the access door, gaps between platform and train as well as boarding aid devices), entrance vestibule, information systems inside and outside the train, emergency facilities, toilet with all conveniences and the additional test arrangements regarding push buttons, steps and emergency equipment. For this purpose a questionnaire was developed for the assessment of the EUPAX segment and the additional test arrangements. With the help of this questionnaire it was possible to execute a quantitative and qualitative evaluation. During three test phases 67 experts and handicapped persons from 6 countries have evaluated the Industrial Design mock-up based on this questionnaire. The test group covered persons from North (Denmark) to the South (Italy) and from the West (Spain) to the Middle of Europe (Germany). This is especially important for the generalization (harmonisation) of the results for all European countries. According to COST 335 the information for people with reduced mobility should be clear, concise, accurate and timely. So that all information can be received from persons, they must be transferred on at least two of the three possible ways (acoustical, visual, tactile), a so called "2-sense-principle". Based on the results ergonomic specifications/ solutions for the ergonomic design of the access area, the acoustic, visual and tactile information and the emergency devices including the emergency communication system were developed, related to the benefiting passenger groups.