• 대한방사선기술학회지:방사선기술과학
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• 제40권3호
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• pp.407-413
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• 2017

의료 방사선은 환자의 진단 및 치료를 함에 있어 중대한 이득을 제공하지만 주변인에게 불필요한 피폭을 발생시킨다. 이에 본 연구에서는 환자와 일반인이 같은 공간 내 상주하는 다인 병실에 대해 선원항의 종류에 따른 공간선량률을 분석하고자 하였다. 실험은 몬테카를로 모의모사(MCNPX)를 이용하였으며, 선원항은 전신 뼈검사 환자와 이동형 X선 발생장치를 모사하였다. 실험결과 전신 뼈검사 환자의 측면 병상 위치에서 약 $3.46{\mu}Sv/hr$의 선량이 나타났으며, 이동형 X선 발생장치를 이용한 실험 결과, 흉부검사 시 측면 병상 위치에서 $1.47{\times}10^{-8}{\mu}Sv/irradiation$, 복부검사 시 측면 병상 위치에서 $2.97{\times}10^{-8}{\mu}Sv/irradiation$ 값이 나타났다. 이처럼 다인병실에서는 주변 환자에게 불필요한 방사선을 발생시키며, 국내의 미흡한 다인 병실의 방사선에 대한 법적인 규제 및 체계적인 차폐 방안이 마련되어져야 할 것이다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.178-187
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• 2012

Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1019-1021
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• 2004

신경종은 후종격동 종양의 흔한 형태이며 주로 증상 없이 단순흉부촬영상 우연히 발견되거나 흉통이나 요통 등의 신경압박증상이나 기관지를 압박하여 나타나는 증상 등에 의해 발현되기 쉽다. 하지만 본 증례와 같이 자발성 혈흉을 일으키는 경우는 극히 드물다. 환자는 45세 남자로 갑자기 생긴 흉통 및 호흡곤란을 증상으로 타 병원 응급실 내원하여 시행한 단순흉부촬영상 우측 늑막삼출이 의심되어 폐쇄성 흉관삽입술 후 혈흉으로 진단되었고 흉부 전산화단층촬영상 후종격동 종양 소견 보여 본원으로 전원되었다. 전원 후 시행한 흉추 자기공명영상촬영상 아령모양의 신경종 의심되어 수술적 절제를 시행하였고 병리조직검사상 신경섬유초종으로 판명되었다.

• Journal of Chest Surgery
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• 제43권6호
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• pp.804-807
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• 2010

둔상에 의한 기관지 손상은 소아에서 드물게 발생하나 치명적일 수 있으며 성공적인 치료를 위해서는 호흡 유지가 중요하다. 외상에 의해 기관지가 절단된 소아 환자에게 기도 유지에 어려움이 었었으나 응급실에서 체외막형 산화기를 이용한 환기 보조 하에 성공적으로 수술적 치료를 시행하였기에 이를 보고하고자 한다. 체외막형 산화기 보조 기간 동안 전신적 헤파린 투여는 필요하지 않았으며, 혈전성 합병증도 발생하지 않았다. 결론적으로 헤파린 사용 여부와 상관없이 선택적인 둔상 환자에게서 환기 보조를 위한 체외막형 산화기는 유용하다 할 수 있겠다.

• 대한간호학회지
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• 제36권6호
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• pp.968-975
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• 2006

Purpose: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Method: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. Results: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. Conclusion: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.

• 대한족부족관절학회지
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• 제22권2호
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• pp.74-77
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• 2018

Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.

• 대한전기학회논문지:시스템및제어부문D
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• 제50권5호
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• pp.241-246
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• 2001

The conventional stethoscope can not store its stethoscopic sounds. Therefor a doctor diagnoses a patient with instantaneous stethoscopic sounds at that time, and he can not remember the state of the patient's stethoscopic sounds on the next. This prevent accurate and objective diagnosis. If the electronic stethoscope, which can store the stethoscopic sound, is developed, the auscultation will be greatly improved. This study describes an amplifier for electronic stethoscope system that can extract heart sounds of fetus as well as adult and alow us hear and record the sounds. Using the developed stethoscopic amplifier, clean heart sounds of fetus and adult can be heard in noisy environment, such as a consultation room of a university hospital, a laboratory of a university. Surprisingly, the heart sound of a 22-week fetus was heard through the developed electronic stethoscope. Pitch detection experiments using the detected heart sounds showed that the signal represents distinct periodicity. It can be expected that the developed electronic stethoscope can substitute for conventional stethoscopes and if proper analysis method for the stethoscopic signal is developed, a good electronic stethoscope system can be produced.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.134-137
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• 2014

To report the fracture of proximal humerus in the lateral anchor site after suture bridge repair. A 57-year-old female patient with shoulder pain on the right-side was admitted through the emergency room following a car accident. Seven weeks before the accident, the patient had undergone surgery at a different hospital for the repair of supraspinatus tendon rupture on the right-side via suture bridge technique. Humerus surgical neck fracture was confirmed by X-ray, and proximal humerus fracture at the anchor site was confirmed by magnetic resonance imaging. Following 7 months of conservative treatment resulted in satisfactory bone union and motion of the shoulder joint. We report the need of close observation during and after the arthroscopic repair of the rotator cuff in patients with osteoporosis.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.180-183
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• 2015

We report the case of a 14-year-old girl who visited the emergency room because of suprapubic discomfort and sudden acute urinary retention. She did not have any significant medical and surgical history, and her neurological examinations were all normal. Urinary catheterization led to the passage of 500 mL urine. Abdominal ultrasonography showed a hematocolpos that was compressing the urinary bladder. Gynecologic history taking revealed that the patient has not had menarche yet. Therefore, a cruciate incision was performed and her urination became normal. As the surgical outcome after adequate hymenotomy for imperforate hymen is usually good, the diagnosis of imperforate hymen is important. However, this condition is easily missed in the clinic because the first physician visited by the patient rarely takes a detailed gynecologic history or performs appropriate physical examinations. Although rare, imperforate hymen should be considered as a cause of acute urinary retention in the adolescence period. If an adolescent girl presents with abdominal pain and voiding dysfunction, a detailed gynecologic history and appropriate physical examinations of the genital introitus should be performed.

• 정신신체의학
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• 제3권1호
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• pp.98-106
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• 1995

This study presents the cases of two patients suffering from chest pain as the chief complaint and refers to related literatures to reveal the psychoanalytic meaning of chest pain. In the first case, the patient who was balked of the desire to be loved complained of her pain in the chest She had been bereaved of her husband and felt deserted by someone on whom she depended, and these experiences caused the chest pain. The drive related to this chest pain in a dependent and aggressive one. The second case, the chest pain of a 28-year-old unmarried woman, resulted from Oedipal conflict Her Oedipal conflict did not resolve successfully for the exessive sexual stimulation in her childhood such as her experiences of witnessing the primal scenes sleeping with her parents in the same room, even under a same blanket In addition, there were some other traumas which prevented her from that conflict: Her father bathed her until her puberty: She saw her father's back view as he urinated in a jerry: She heard her parents' frequent quarrels. This patient felt guilty about desire of Oedipal incest, and chest pain seemed to occur as a kind of self-inflicted punishment.