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      • KCI등재

        Giant Wart as a Cutaneous Horn on the Dorsum of the Hand

        조홍만,이규정,민웅배,최용석 대한수부외과학회 2016 대한수부외과학회지 Vol.21 No.2

        A 81-year-old female presented with a giant cutaneous horn (1.5×2×4 cm sized) over the right hand, rapid growth recent 6 months. Cutaneous horn was excised and split thickness skin graft of the defect was done under regional anesthesia. Histopathology showed overlying a wart. In the current study, we report the case of a patient with giant wart as a giant cutaneous horn in a dorsal side of hand.

      • KCI우수등재
      • KCI등재

        Survival and Functional Outcomes after Hip Fracture among Nursing Home Residents

        조홍만,이규정,민웅배,최용석,이현석,문형진,심혜영,이대건,유미정 대한의학회 2016 Journal of Korean medical science Vol.31 No.1

        Following the implementation of a long-term care insurance system for the elderly in Korea, many nursing homes have been established and many more patients than ever before have been living at nursing homes. Despite the fact that this is a high-risk group vulnerable to hip fractures, no study has yet been conducted in Korea on hip fracture incidence rates and prognoses among patients residing at nursing homes. We recently studied 46 cases of hip fracture in nursing homes; more specifically, we investigated the most common conditions under which fractures occur, and examined the degree of recovery of ambulatory ability and the mortality within 1 yr. Among those who had survived after 1 yr, the number of non-functional ambulators increased from 8 hips before hip fracture to 19 hips at final post-fracture follow-up. These individuals showed poor recovery of ambulatory ability, and the number who died within one year was 11 (23.9%), a rate not significantly different from that among community-dwelling individuals. It was evident that hip-joint-fracture nursing home residents survived for similar periods of time as did those dwelling in the community, though under much more uncomfortable conditions. The main highlight of this report is that it is the first from Korea on nursing home residents’ ambulatory recovery and one-year mortality after hip fracture. The authors believe that, beginning with the present study, the government should collect and evaluate the number of hips fractured at nursing facilities in order to formulate criteria that will help to enable all patients to select safer and better-quality nursing facilities for themselves or their family members.

      • KCI등재

        Clinical and Functional Outcomes of Treatment for Type A1 Intertrochanteric Femoral Fracture in Elderly Patients: Comparison of Dynamic Hip Screw and Proximal Femoral Nail Antirotation

        조홍만,이규정 대한고관절학회 2016 Hip and Pelvis Vol.28 No.4

        Purpose: We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. Materials and Methods: We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index. Fracture union, sliding of hip screw, proximal femur shortening, and presence of complications were assessed radiologically at relevant follow-up intervals. Results: The mean operation time and blood loss were significantly lower for the PFNA group, but walking ability and Barthel index decreased to a similar extent for both groups. However, patients in the DHS group complained of significantly more pain (P=0.049). Although there were no significant differences between the two groups with respect to the time until fracture union was achieved, patients in the DHS group exhibited a higher extent of proximal femoral shortening and sliding of the hip screw. Differences about hip screw sliding and proximal femur shortening within each subgroup were not significant. Conclusion: Compared to DHS treatment, PFNA treatment of type A1 intertrochanteric fractures is associated with reduced blood loss, shorter operation time, and less severe pain after surgery. Additionally, sliding of the hip screw and proximal femur shortening are expected to occur more frequently after DHS.

      • KCI등재

        One-year Survival Rates and Functional Recovery in Veterans Who Suffer from Hip Fractures: Evaluation of Commissioned Hospitals’ System through Comparison between Veterans Hospitals and Commissioned Hospitals

        조홍만,서재웅,이현주 대한고관절학회 2018 Hip and Pelvis Vol.30 No.2

        Purpose: This study was performed to compare the: i) 1-year survival rate of patients with hip fractures, ii) factors affecting mortality in patients with hip fractures, and iii) results of functional recovery at commissioned hospitals (CH) and veterans hospitals (VH) to characterize the quality of care provided in the Korean commissioned hospital system. Materials and Methods: The study population consisted of 183 veteran patients (84 and 99 treated at a single VH and 39 CH, respectively) who underwent hip fracture surgery between January 2010 and February 2015. This study compared baseline characteristics (i.e., age, comorbidities, fracture types and surgical treatment approaches) of the two groups vs. clinical outcomes, and evaluated the waiting time, length of hospital stay, total medical expenses, mortality rate within one year, and functional recovery at last follow up. Results: There were no significant differences in age, fracture types, comorbidities, ambulatory status before fracture, waiting time, or length of hospital stay between the two groups, however, the total medical cost was higher in the CH group (P=0.009). There was no significant difference in mortality within one year after hip fracture (P=0.224) or functional recovery at last follow-up (P=0.463) between the two groups. Conclusion: The results of this study confirm that the Korean commissioned hospitals system is operating in accordance with its purpose. However, further studies are needed to better characterize the medical expenses of CHs vs. veterans hospitals.

      • KCI등재

        人才地域割當制

        曺洪錫(조홍석) 한국비교공법학회 2006 공법학연구 Vol.7 No.2

        한국사회의 수도권 집중도는 세계적으로 심각한 수준이다. 이러한 수도권 집중의 해소와 지역균형발전을 위하여 인재지역할당제가 제기되었다. 인재지역할당제는 지역별인구비례로 국가고시합격자를 할당하는 제도이다. 인재지역할당제는 전체응시자중 우수성적자가 몰려 있을 수도권지역대학출신자들을 절대적으로 불리한 지위에 놓여 있을 수밖에 없게 하여, 공무담임권의 보호영역에 속하는 공직의 기회균등과 직업의 자유의 침해를 가지고 온다. 또한 국민이라는 동일한 집단의 구성원을 거주요건에 따라 차별을 하여 평등권의 침해도 가져온다. 인재지역할당제는 합격자의 거주지를 제한하지 않고, 특정지역응시자에 대한 역차별의 가능성, 그리고 정원 내에서 합격자를 할당하며, 추상적 국가목적을 위한 구체적 기본권의 침해를 수반한다는 점에서 비례의 원칙에 합치되지 않는다. 직업공무원제도라는 관점에서 볼 때도, 인재지역할당제는 응시자의 지역성을 기준으로 한다는 점에서 직업공무원제도의 본질적 내용인 능력주의 원칙에 반한다. 따라서 인재지역할당제가 헌법적 한계 범위 내에서 실현되기 위해서는 법학전문대학원, BK21, 공공기관 및 기업의 이전 등과 같은 지역균형발전정책을 통하여 수도권집중의 근본원인을 해소해야 한다. 인재지역할당제가 지역균형발전을 위한 수단적 성격이라는 점을 부인할 수는 없다. 하지만 지역사회의 발전을 위한 여건이 마련되어 있지 않다면, 할당된 인재들은 지역을 외면하고 더욱더 수도권에 집중할 것이다. 바꾸어 말하면 인재의 지역할당만으로는 지역균형발전과 수도권인구집중 해소는 이루어 질 수 없는 것이다. 결론적으로 인재지역할당제가 합헌성을 갖추기 위해서는 공공기관의 이전과 기업의 이전, 지방대학의 육성을 통한 지역균형발전의 사회적?경제적 기반조성이 먼저 이루어 져야 한다. The problem of concentration on the seoul- and seoul near area in Korea is well known. The local quota system for a talented person is designed for the solving of the population concentration and the balancing development of the community. The local quota system for a talented person is the institution to assign the successful candidate of a state examinations by the proportional population of the regions. As the quota system is unfavorable to the participant in the seoul area universities in which the relatively excellent people among all the participant in the exam are concentrated, it results in the infringement on the liberty of occupation and principle of equal opportunity connected with a public office. Moreover, it causes to the infringement on equal rights by the discriminating against the constituent of identical group by the residence requisite. Because the local quota system does not restrict the resident of the candidate, it is possible that reverse discrimination against the candidate in near seoul area takes place, causes the infringement on the concrete civil rights because of abstract state interest, it could not pass the balancing test, which is used as a measure in case of the infringement of equal rights. In the sense of the occupational public servant institution, the local quota system violated the 'ability principle' which is the essential substance of the institution because it classifies a participant in an examination according to a regional factor. Accordingly, for the realization of the local quota system for the talented within the constitutional limits, the core-cause of population concentration on the seoul near area could be dilluted by the balancing development program for the community such as introducing the law school system, Brain Korea 21, distribution of the public organs and large enterprise into regions. Even if the local quota system for the talented can not be denied as a method-character for the balancing development of the community, if circumstances for development of the local society are not prepared, the assigned talented person will be concentrate in seoul area more and more. In other words, the solution of the population concentration problem and balancing development of the community cannot be realized only by the regional assignment of a talented person. In conclusion, the social ? economical footing should be conditioned for constitutional realization of the local quota system for the talented: the balancing development for community by the distribution of public organs and large enterprise into region, supporting of local university.

      • KCI등재

        전외측으로 만곡된 대퇴골에 삽입된 압박 금속판 주변 골절에 대한 랑데뷰 수술법 - 증례 보고 -

        조홍만,박지연 대한골절학회 2020 대한골절학회지 Vol.33 No.3

        An 84-year-old female visited with an intertrochanteric femoral fracture. The patient had undergone an open reduction and internal fixation with a compressive plate and elastic nail in an ipsilateral atypical diaphyseal femoral fracture in the past. Compressive plate and elastic nail remained, and anterolateral bowing was presented. To treat the periprosthetic trochanteric fracture, a proximal femoral nail was used without removing the previously inserted compressive plate. Under the “rendezvous” technique, using a combination of fixating intramedullary nail and compressive plate simultaneously, the distal screw was fixed, and a femoral head lag screw was inserted after reducing the fracture. Complete union of the fracture was achieved 16 months after the operation, and a decrease in mobility function was not found postoperatively. The authors report this case for the “rendezvous” technique as a treatment option for elderly patients with periprosthetic trochanteric fractures, who had previously undergone surgical treatment for ipsilateral atypical diaphyseal femoral fractures with anterolateral bowing. 84세 여자 환자가 대퇴골 전자간 골절이 발생하여 내원 하였다. 과거력상 동측 대퇴골 간부 비정형 골절로 압박 금속판과 유연성 골수정을 이용하여 수술적 치료를 받아 내고정물이 잔존하는 상태로, 대퇴골은 전외측으로 만곡된 소견을 보였다. 기존에 삽입된 압박 금속판을 제거하지 않은 상태에서근위 대퇴 골수정을 이용하여 수술적 치료를 시행하였는데, 골수정과 압박 금속판을 함께 고정하는 랑데뷰 방법으로 원위 나사를 고정하고, 골절을 견인한 후 대퇴 골두 나사를 삽입하였다. 수술 후 16주에 골절은 완전 유합되었고, 골절 전과 비교하여 보행 능력의 감소는 없었다. 전외측으로 만곡된대퇴골에 비정형 골절이 발생하여 수술적 치료를 시행 받은고령의 환자에게 랑데뷰 수술법은 고정된 압박 금속판 주변으로 전자간 골절이 발생한 경우 고려해 볼 수 있는 방법 중하나로 생각되어 보고하고자 한다.

      • KCI등재

        다문화 그림책을 활용한 과학활동이 유아의 과학적 탐구능력 및 언어능력에 미치는 영향

        조홍자 ( Hong Ja Cho ),안상화 ( Sang Hwa Ahn ),김여선 ( Yeo Sun Kim ) 한국어린이문학교육학회 2015 어린이문학교육연구 Vol.16 No.3

        본 연구는 다문화 그림책을 활용한 과학활동이 유아의 과학적 탐구능력과 언어능력에 어떠한 영향을 미치는지 알아보는데 목적이 있다. 연구대상은 G광역시에 위치한 S유치원의 만 5세 유아 50명으로 실험집단과 비교집단을 각각 25명씩 선정하였다. 실험집단에는 주 3회씩 5주간 총 15회의 다문화 그림책을 활용한 과학활동을, 비교집단에는 일반적인 과학활동을 실시하였다. 본 연구의 결과는 다음과 같다. 첫째, 다문화 그림책을 활용한 과학활동이 유아의 과학적 탐구능력 향상에 효과가 있는 것으로 나타났다. 둘째, 다문화 그림책을 활용한 과학활동이 유아의 언어능력 향상에 효과가 있는 것으로 나타났다. 이러한 결과는 다문화 그림책의 문학적 특성 및 다문화적 맥락을 활용한 과학활동이 유아의 과학적 탐구능력 및 언어능력에 긍정적인 영향을 가져왔음을 보여주었다. 이는 과학활동에 있어서 다문화 그림책을 활용하여 보다 효율적이고 다양한 접근이 가능한 교수·학습방법을 시사한다. This study examines the effects of science activities with multicultural picture books on young children``s scientific process skills and language ability. The subjects of this study were 50 five-year-old children from S kindergarten in G city. They were divided into an experimental group and a comparative group with 25 children in each group. The experiments were conducted a total of 15 times, three times a week for 5 weeks. Children of the experimental group took part in science activities with multicultural picture books; children of the comparative group took part in general science activities as usual during the same period. The results of this study can be summarized as follows. First, the post-test showed that the experimental group``s results were statistically significantly higher than the comparative group``s in young children``s scientific process skills and its sub-areas. Second, the post-test showed that the experimental group``s results were statistically significantly higher than the comparative group``s in young children``s language ability. These results mean that science activities with multicultural picture books had a positive effect on young children``s scientific process skills and language ability. The science activities with multicultural picture books used literary characteristics and multicultural contexts of multicultural picture books. Thus, this study suggests science activities with multicultural picture books provide opportunities for a variety of useful teaching and learning methods.

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