• 구강회복응용과학지
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• 제36권4호
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• pp.262-271
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• 2020

변연골 하방으로까지 파절선이 연장된 치아를 수복하기 위해 파절선의 노출 및 생물학적 폭경의 재확립을 위한 삭제형 골수술을 동반한 외과적 치관 연장술을 고려해 볼 수 있다. 그러나 이 술식은 특히 전치부에서 심미성을 훼손시킬 수 있다. 따라서 지지골과 치은을 희생시키지 않으면서 파절선을 치조와 하방에서 상방으로 위치 시킬 수 있는 교정적 정출술이 권장된다. 이 술식은 생물학적 폭경의 재확립과 더불어 수복물을 건전한 치아 구조에 위치할 수 있도록 해 준다. 또 다른 대안으로, 교정적 정출술 보다 방법이 간단하며 시간이 적게 소요되고 한번의 술식만으로 정출이 완료되는 외과적 정출술도 고려해 볼 수 있다. 외과적 정출술을 이용할 경우 구강내 교정 장치를 위치시키고 조정하기 위해 환자가 치과에 여러번 방문할 필요가 없다. 본 연구에서는 상악 중절치에서 치관-치근 파절이 발생한 경우 교정적 정출술 또는 외과적 정출술을 통한 다각적 방법을 병용함으로써 성공적으로 수복한 증례를 보고하고자 한다.

• 구강회복응용과학지
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• 제32권1호
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• pp.70-79
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• 2016

치주 질환이나 치아 우식으로 인해 구치부 치아가 상실된 환자들은 대합치 정출 및 인접치 경사가 발생하여, 교합평면의 붕괴나 수직 고경의 상실로 하악골 위치 변화가 나타날 수 있다. 특히 악교정 수술 환자에서, 이런 증상이 나타날 경우 하악과두가 관절와 내에서 안정화된 위치에 존재하여 술 후 안정성을 높일 수 있도록, 술 전 수직 고경을 재설정하는 치료가 필요하다. 따라서 보철, 교정, 구강악안면외과 등 다분야에서 진단 및 치료 계획에서부터 원활한 의사소통을 통한 양호한 치료 결과를 얻을 수 있도록 협력하는 것이 중요하다.

• 디지털융복합연구
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• 제16권4호
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• pp.39-47
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• 2018

본 연구는 우리나라 제4차 산업혁명 대응에 있어 사회-기술시스템론적 공공관리의 적용 가능성을 살펴보는데 목적이 있다. 이를 위해 제4차 산업혁명의 주요 개념과 논의점 검토와 함께 해외 선도국가들의 대응 전략을 국내외 문헌 연구를 통해 분석하였다. 이를 통해 본 연구는 기술 중심에서 벗어나 사회적 난제 해결과 인간중심의 사회 혁신을 위해 제4차 산업혁명을 이끄는 정부 정책기조의 변화 필요성을 강조하였다. 즉 제4차 산업혁명의 변화에 대응하여 사회적 난제를 해결하기 위해서는 기존의 수직적, 계층적, 분화적, 기계적 정부시스템을 과감히 탈피하고, 사회-기술시스템론적 공공관리 방식을 강조해야 한다고 보았다. 향후 정부의 정책 방향은 혁신을 확산할 수 있는 창발적이며 내재적인 모습을 보여야 하며, 정부조직과 정부운영방식의 재설계, 정부 정책영역의 재설정과 이를 입법적으로 뒷받침하는 입법행정의 공조 전략이 필요하다. 본 연구는 공공부문의 제4차 산업혁명 대응성 강화를 위한 정책연구의 첫 논의라는 점에 의미가 있으며 후속연구가 이러지기를 바란다.

• 한방재활의학과학회지
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• 제19권2호
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• pp.157-185
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• 2009

Objectives : The aim of this study is to suggest approach of oriental medical management and necessity by research of eastern and western medical literatures for Complex Regional Pain Syndrome(CRPS). Methods : We reviewed the clinical and experimental literatures of eastern and western concerned with CRPS which is related causation, signs and symptoms, diagnosis, etiology and management. Results : 1. CRPS is divided into type I and II by nerve injury. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. These conditions can be charaterized clinically by the sensory abnormalities, vascular abnormalities, oedema, sweating abnormalities, motor or trophic changes. 2. CRPS are well known to patients and physicians relatively, but the pathophysiology, causation and treatments are still unclear. 3. CRPS is needed to take the early diagnosis and multidisciplinary approach for significant effect. 4. CRPS can be regarded for obstruction syndrome of Ki and blood(痺證), blood stasis(瘀血), Wei symptom(痿證), numbness(痲木) in the oriental medical management of CRPS. Conclusions : Above the results, it is suggested that further studies and active approach of management of CRPS will be conducted precisely in oriental medicine.

• 디지털융복합연구
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• 제13권5호
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• pp.51-59
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• 2015

한국에서 피알 커뮤니케이션 연구가 본격적으로 시작된 것은 1997년이다. 이 연구는 학술지 "홍보학연구"가 학술진흥재단 등재(후보)지가 된 2003년부터 2012년까지 10년간의 한국피알연구사 융복합적 정리라 할 수 있다. 총 166편의 논문을 분석하는 작업의 초점은 연구의 틀이라 할 수 있는 이론들이다. 한국피알연구의 모습을 진단하는 것이 이 논문의 목적이다. 분석기간 발표된 논문들에 대한 전수조사를 통해 수집된 이론들을 1. 각 이론이 개발된 분야 (피알분야, 인접분야, 타분야), 2. 분석대상(개인, 조직, 사회), 3. 접근수준(기능주의적, 수사학적, 비판이론적 접근)으로 분류했다. 피알연구의 "추운현실"로 표현된 결과에서는 이론적 틀의 부재가 뚜렷한 하나의 특징으로 제시된다. 가장 많이 쓰인 3개의 이론은 공중관계성이론, 위기이론, 상황이론이었다. 연구주제로서 조직중심접근의 기능주의적 경향, 다수의 개인심리분석 연구에서 보이는 심리학이론의 활발한 차용 등이 주목할만한 현상이었다. 피알연구의 활성화와 발전을 위한 학제적 접근 등이 결론으로 제시된다.

• Safety and Health at Work
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• 제2권2호
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• pp.105-121
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• 2011

Objectives: This paper presents the framework and protocol design for a construction industry risk management toolbox. The construction industry needs a comprehensive, systematic approach to assess and control occupational risks. These risks span several professional health and safety disciplines, emphasized by multiple international occupational research agenda projects including: falls, electrocution, noise, silica, welding fumes, and musculoskeletal disorders. Yet, the International Social Security Association says, "whereas progress has been made in safety and health, the construction industry is still a high risk sector." Methods: Small- and medium-sized enterprises (SMEs) employ about 80% of the world's construction workers. In recent years a strategy for qualitative occupational risk management, known as Control Banding (CB) has gained international attention as a simplified approach for reducing work-related risks. CB groups hazards into stratified risk 'bands', identifying commensurate controls to reduce the level of risk and promote worker health and safety. We review these qualitative solutions-based approaches and identify strengths and weaknesses toward designing a simplified CB 'toolbox' approach for use by SMEs in construction trades. Results: This toolbox design proposal includes international input on multidisciplinary approaches for performing a qualitative risk assessment determining a risk 'band' for a given project. Risk bands are used to identify the appropriate level of training to oversee construction work, leading to commensurate and appropriate control methods to perform the work safely. Conclusion: The Construction Toolbox presents a review-generated format to harness multiple solutions-based national programs and publications for controlling construction-related risks with simplified approaches across the occupational safety, health and hygiene professions.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.599-606
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• 2021

Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

• Clinical and Experimental Reproductive Medicine
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• 제44권4호
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• pp.171-174
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• 2017

While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

• 대한두개안면성형외과학회지
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• 제16권3호
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• pp.147-150
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• 2015

Impalement injury is the subset of penetrating trauma, defined as fixed, elongated objects penetrate and remain in the human body cavity or region by relatively low velocity. We report an unusual case of facial and neck impalement where two dirty rusted iron bars penetrated forehead bilaterally and exited neck and ear respectively without causing major organ injuries. After thorough radiologic and physical evaluation, the patient got medical and surgical treatment. The patient was discharged without complication after four day of delayed wound closure. There have been no complications and sequelaes related with trauma, wound infection and scar contracture at 3-year follow-up. According to affected organs and pattern of impalement, individualized and multidisciplinary surgical approach should be considered. Following these guidelines as in this case, it was possible to achieve excellent clinical outcome in impalement injury.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.411-422
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• 2020

With the increasing number of children with inflammatory bowel disease (IBD), very early-onset IBD (VEO-IBD), defined as IBD that is diagnosed or that develops before 6 years of age, has become a field of innovation among pediatric gastroenterologists. Advances in genetic testing have enabled the diagnosis of IBD caused by gene mutations, also known as monogenic or Mendelian disorder-associated IBD (MD-IBD), with approximately 60 causative genes reported to date. The diagnosis of VEO-IBD requires endoscopic and histological evaluations. However, satisfactory small bowel imaging studies may not be feasible in this small population. Both genetic and immunological approaches are necessary for the diagnosis of MD-IBD, which can differ among countries according to the available resources. As a result of the use of targeted gene panels covered by the national health insurance and the nationwide research project investigating inborn errors of immunity, an efficient approach for the diagnosis of MD-IBD has been developed in Japan. Proper management of VEO-IBD by pediatric gastroenterologists constitutes a challenge. Some MD-IBDs can be curable by allogenic hematopoietic stem cell transplantation. With an understanding of the affected gene functions, targeted therapies are being developed. Social and psychological support systems for both children and their families should also be provided to improve their quality of life. Multidisciplinary team care would contribute to early diagnosis, proper therapeutic interventions, and improved quality of life in patients and their families.