• 사회복지연구
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• 제42권2호
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• pp.419-441
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• 2011

본 연구는 암환자의 심리사회적 고통에만 초점을 두는 기존의 병리적 관점에서 벗어나 생존을 위협하는 암이라는 외상적 경험 속에서 얻게 되는 긍정적 변화와 성장을 검토하고 이에 대한 예측 요인을 분석하여 그 결과를 바탕으로 암환자의 외상후성장을 도모할 수 있는 임상적 개입에 대한 기초 자료를 제공하는 것을 목적으로 하였다. 이를 위해 연구 참여에 동의한 암환자 206명을 연구대상으로 설문조사를 실시하였으며 암환자의 외상후성장에 대한 예측요인을 검토하기 위해 인구사회학적 변인, 질병관련 변인, 대처, 사회적 지지를 독립변인으로 하여 연구모형을 구성하고 위계적 회귀분석을 통해 자료를 분석하였다. 조사 결과 암환자들의 외상후성장에 대한 주 영향요인으로 대처, 사회적 지지가 도출되었다. 이중 대처의 하위요인인 긍정적 재구조화가 암환자의 외상후성장에 대한 가장 강력한 예측요인으로 밝혀졌으며 이러한 결과를 토대로 사회복지적 함의와 후속연구에 대한 제언을 제시하였다.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.362-368
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• 2023

Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5-18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3-23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3-48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.

• Tuberculosis and Respiratory Diseases
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• 제87권3호
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• pp.378-385
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• 2024

Background: Intrapleural fibrinolytic therapy (IPFT) has been used as an effective agent since 1949 for managing complicated pleural effusion and empyema. Several agents, such as streptokinase, urokinase (UK), and recombinant tissue plasminogen activator (rt-PA), have been found to be effective with variable effectiveness. However, a head-tohead controlled trial comparing the efficacy of the most frequently used agents, i.e., UK and rt-PA (alteplase) for managing complicated pleural effusion has rarely been reported. Methods: A total of 50 patients were randomized in two intervention groups, i.e., UK and rt-PA. The dose of rt-PA was 10 mg, and that of UK was 1.0 lac units. UK was given thrice daily for 2 days, followed by clamping to allow the retainment of drugs in the pleural space for 2 hours. rt-PA was instilled into the pleural space twice daily for 2 days, and intercostal drainage was clamped for 1 hour. Results: A total of 50 patients were enrolled into the study, of which 84% (n=42) were males and 16% (n=8) were females. Among them, 30 (60%) patients received UK, and 20 (40%) patients received alteplase as IPFT agents. The percentage of mean±standard deviation changes in pleural opacity was -33.0%±9.9% in the UK group and -41.0%±14.9% in the alteplase group, respectively (p=0.014). Pain was the most common adverse side effect, occurring in 60% (n=18) of the patients in the UK group and in 40% (n=8) of the patients in the alteplase group (p=0.24), while fever was the second most common side effect. Patients who reported early (within 6 weeks of onset of symptoms) showed a greater response than those who reported late for the intervention. Conclusion: IPFT is a safe and effective option for managing complicated pleural effusion or empyema, and newer agents, such as alteplase, have greater efficacy and a similar adverse effect profile when compared with conventional agents, such as UK.

• 한국산학기술학회논문지
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• 제13권10호
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• pp.4629-4635
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• 2012

본 연구의 목적은 중량물 들기 작업시 비대칭 무게중심과 상체 옆으로 기울임 여부가 어떻게 L5/S1 주변 허리 근육의 Peak EMG 진폭에 영향을 미치는지를 알아보는 것이다. 요통을 포함한 근골격계질환은 무겁지 않은 물체의 지속적인 반복 취급뿐만 아니라, 일회성의 커다란 부하도 신체 조직의 부담으로 작용하여 발생할 수 있다. 11명의 20대 대학생 남성은 15.8kg의 물체를 들어올리는 Task를 3회 실행하였다. 이 때 대칭 무게중심의 물체를 상체를 기울이지 않고 들어 올리는 경우, 비대칭 무게중심의 물체를 상체를 기울이지 않고 들어 올리는 조건, 그리고 비대칭 무게중심의 물체를 상체를 기울여서 들어 올리는 경우에 따라 6개의 L5/S1 주변의 근육들로부터 Peak EMG 진폭이 수집되어 분석되었다. 결과는 비대칭 무게중심을 지닌 물체 취급시 무게중심에서 먼 쪽의 허리 근육에서 Peak EMG 진폭이 발생하고, 그 진폭의 크기는 대칭 무게중심 물체를 취급하는 경우보다 크게 나타났다. 또한, 비대칭 무게중심의 물체를 취급할 경우 물체나 상체를 물체의 무게중심 방향으로 기울이는 것은 기울이지 않을 때보다 대측성 등근육에서 Peak EMG 진폭 증가시켰다. 이러한 연구 결과는 비대칭 무게중심의 중량물을 들어 올리는 작업에서 요통 발생을 예방하기 위한 행정적인 조치로써 가능하면 상체를 전두면 기준으로 기울이지 않는 작업자 자세 조언이 필요함을 말해준다.

• 한국보건간호학회지
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• 제15권1호
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• pp.157-171
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• 2001

The study was designed to provide the fundamental information for understanding discomfort of bone marrow donors and for promoting an individual comfort by comparing the difference on discomfort between unrelated donors and related donors. The subject of the study was fifty related donors and thirty unrelated donors who was in the C University Hospital. This survey had been carried out and collected from October, 1998 to March, 1999. The scale of discomfort of donors associated with bone marrow donation were assessed by the questionnaire deviced by Kim Sang Dol and amended by the researcher. Data was analyzed by $x^2-test$, t-test, two-way ANOVA, and Pearson Correlation Coefficients. The results were as follows. 1. Considering the general characteristics of bone marrow donors according to gender, male was consisted of $60\%$ and female was consisted of $40\%$. Of those related donors are consisted for $62.5\%$ and accounted for $37.5\%$ of those unrelated donors. Considering the classification to the job, employee of company were major donors which was $35\%$, and next order was student, individual businessman, and housewife. Considering the education level. college students were $48.7\%$ and students who have less than high school level were $42.5\%$. 2. According to the above the results regarding discomfort of bone marrow donation, it is especially shown that the major cause for discomfort of bone marrow donors is on physical factor. The concrete examples for physical factor are pain in the region of bone marrow harvest and pain in the injection part by fluid therapy and blood-sampling, an immovability of the body after bone marrow harvest, and difficulties on walking. Considering physiological factor, there are an uneasiness about leading to injure their health, vague fear about the hospital. and a tedium at hospital. Environmental factors for discomfort of bone marrow donors are insufficient explanation for needle gauge and procedure of bone marrow donation and difficulty on following medical schedule. Therefore. it is necessary to establish more effective and systematically organized program for nursing intervention based on the research results. An effective program is only useful in getting rid of discomfort of bone marrow donors.

• 대한소아치과학회지
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• 제36권1호
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• pp.114-118
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• 2009

타석증은 대, 소타액선의 도관내에 석회화 물질이 형성되는 것이다. 타액의 점도가 높고 도관이 길고 구부러진 악하선에서 가장 호발한다. 어떤 나이에서도 발생할 수 있지만, 중년에서 호발하며 어린이에서는 드물다. 타석증의 임상 증상은 다양하지만, 부종이 가장 흔하며, 그 다음이 동통이다. 임상 검사와 방사선 검사(파노라믹 방사선 사진, 하악 교합면 방사선 사진, 타액선 조영술, 구강 내 및 구강 외 초음파, CT, MRI, 타액선 내시경)가 타석증의 진단 및 타석의 위치를 확인하는 데 도움을 준다. 치료는 도관의 절개에 의한 타석의 제거나 타액선의 절개를 포함하는 수술적 치료가 많다. 그러나, 일부는 쇄석술과 $CO_2$ 레이저, 내시경 등의 비침습적인 기술을 사용할 수 있다. 5세 여환이 구강저의 노란색 물질을 주소로 개인 병원에서 의뢰되었다. 4개월 전 처음 발견했을 때보다 3배 더 커졌으며 때때로 동통이 있었다고 하였다. 임상 검사 상, 노란색의 단단한 물질이 악하선 도관의 입구에서 관찰되었다. 와튼스 도관의 전방부에 발생한 악하선 타석증으로 진단내렸다. 국소마취하에 타석을 적출하였다.

• Radiation Oncology Journal
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• 제24권2호
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• pp.88-95
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• 2006

목적: 삼차신경통 환자에서 사이버나이프 방사선수술이 효과적이며 안전한 치료방법인지 알아보고자 하였다. 대상 및 방법: 2004년 3월부터 2005년 5월까지 수술 후 실패하였거나 수술이 부적합한 삼차신경통 환자 26명을 대상으로 사이버나이프 방사선수술을 시행하여 후향적 분석을 하였다. 치료 표적은 삼차신경근 진입구역으로부터 3 mm 떨어진 지점의 삼차신경 최고 근위부를 제외한 6 mm 길이의 삼차신경 부위를 설정하고, 그 부위에 80% 등선량 곡선에 단일 조사로 총방사선량은 $60{\sim}64Gy$를 조사하였다(중앙선량: 64 Gy). 결과: 추적관찰기간은 $3{\sim}15$개월이었다(중앙추적관찰기간 : 9개월). 대상환자 26명에서 사이버나이프 방사선수술 후 24시간 이내에 50% (13/26)에서 통증 완화를 관찰하였으며. 7일 이내에 조기 통증 완화를 보였던 환자는 96.2% (25/26)이었다. 치료 실패는 7.7% (2/26)에서 나타났으며 통증 개선 실패와 통증 재발이 각각 1명에서 관찰되었다. 치료 부작용으로 안면감각 감퇴가 11.5% (3/26)에서 관찰되었다. 결론: 삼차신경통 환자를 대상으로 사이버나이프 방사선수술을 시행한 예비 결과로 비교적 안전하며, 효과적인 치료임을 확인하였다.

• Journal of Korean Neurosurgical Society
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• 제46권5호
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• pp.468-471
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• 2009

Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

• 한국보건간호학회지
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• 제18권1호
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• pp.39-49
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• 2004

The purpose of this study was to investigate the effect of moxibustion heat therapy(Koryo hand acupuncture) on menstrual cramps. dysmenorrhea and ADL. The experiment was carried out during the period from March 24 to April 30, 2003. The subjects in the study were drawn from female students attending two colleges in Chungcheongbuk-do and Kyunggi-do. Of all those subjects. 19 and 14 subjects were assigned to the experimental and the control groups respectively. The moxibustion heat therapy were performed three times a week, subjects were treated twice a time. Data was analyzed using SPSS/WIN10.0 by $x^2$test. Wilcoxon sign rank. and Wilcoxon rank sum test. The result of this study were as follows : 1) After moxibustion heat therapy. the graphic rating score of menstrual cramps was decreased significantly from 7.79(SD=1.22) to 4.47(SD=2.25) in experimental group(z=-3.731. p=.000). And there was significant difference in the change of graphic rating score of menstrual cramps between both groups(z=-3.637. p=.000). 2) After moxibustion heat therapy. the score of face rating scale of menstrual cramps was decreased significantly from 3.95(SD=0.71) to 2.32(SD=1.00) in experimental group(z=-3.457. p=.000). And there was significant difference in the change of face rating score between both groups(z=-2.713. p=.007). 3) After moxibustion heat therapy. the score of adjective labor pain rating scale rank (ALPRS) of menstrual cramps was decreased significantly from 23.63(SD=4.19) to 17.27(SD=6.34) in experimental group(z=-2.941. p=.001). But there was no significant difference in the change of adjective labor pain rating score(ALPRS) of menstrual cramps between both groups(z=-1.918. p=.059). 4) After moxibustion heat therapy. the score of dysmenorrhea was decreased significantly from 7.0(SD=2.89) to 5.26(SD=3.54) in experimental group(z=-2.183. p=.029). But there was no significant difference in the change of the score of dysmenorrhea between both groups(z =-1.555. p=.125). 5) After moxibustion heat therapy, the score of ADL difficulty was decreased significantly from 33.26(SD=4.58) to 28.83(SD=9.44) in experimental group(z=-3.552. p=.000). And there was significant difference in the change of score of difficulty of ADL between both groups(z=-4.110. p=.000). The above finding indicated that the moxibustion heat therapy showed a practical effect on reducing menstrual cramps, dysmenorrhea and ADL difficulty in female. Accordingly. we can adopt the moxibustion heat therapy as a useful intervention in the community nursing.

• 한국사회복지학
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• 제56권2호
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• pp.93-119
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• 2004

본 연구에서는 국민기초생활보장 노인과 일반노인을 대상으로 노인학대의 실태 및 학대관련 요인에 대해 비교 연구하였다. 조사결과, 첫째로 학대경험에서는 전반적으로 국민기초생활보장 노인이 일반노인보다 높았으며, 두 집단 모두 심리적 학대와 방임의 비율이 높았다. 또한 학대발생은 두 집단 모두 "한 달에 한두 번"이라고 응답한 비율이 높았으며, 신체피해보다는 정신적 피해가 많았다. 둘째로 노인학대자들은 주로 40세 초반이었으며, 남성이 여성보다 약간 많았다. 학대의 주요 이유는 경제문제와 성격문제로 나타났다. 셋째로 노인학대에 영향을 미치는 요인을 보면, 국민기초생활보장 노인의 경우에는 자신이 우울하고, 평소에 음주를 하며, 주변의 지지를 받지 못하는 경우로 나타났다. 또한 학대자가 음주상태에서 공격했거나 아동기 폭력을 경험했고, 가정 내에서 정서적인 유대감이 낮으며, 가족 원수가 적은 경우에 학대가 발생하였다. 일반노인의 경우에는 노인이 아동기 학대를 경험했고, 주변의 지지를 받지 못하며, 학대자와 평소관계가 좋지 않고 정서적인 유대가 낮은 경우에 학대가 발생하는 것으로 나타났다. 이러한 결과를 기반으로, 결론에서는 두 집단의 특성을 고려한 다양한 개입방안을 제시하였다.