버스 및 트럭 안전도 개선방안 도출에 관한 연구

김형준(Kim, Hyung Jun),전교석(Jeon, Gyo Seok),장정아(Jang, Jeong Ah) 대한토목학회 2020 대한토목학회 학술대회 Vol.2020 No.10

리스프랑 관절 골절 및 탈구: 나사와 Kirschner 강선을 이용한 치료

하동준,김전교,곽희철,장의찬,Ha, Dong-Jun,Kim, Jeon-Gyo,Gwak, Heui-Chul,Jang, Yue-Chan 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.4

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

한국인 사체에서의 정상 거골의 실측

하동준,곽희철,김전교,김정한,이창락,김영준,이정한,하병호,김의철,Ha, Dong-Jun,Gwak, Heui-Chul,Kim, Jeon-Gyo,Kim, Jung-Han,Lee, Chang-Rak,Kim, Young-Jun,Lee, Jeong-Han,Ha, Byung-Ho,Kim, Ui-Cheol 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.4

Purpose: To investigate the measured values of the talus in Koreans. Materials and Methods: We measured 88 tali from 44 cadavers that have been donated between December 2012 and December 2015. Of the cadavers, 27 were male and 17 were female. Their mean age was 73 years. The length and width of the talus were measured using a digital goniometer and vernier caliper. Results: The values of cadaveric measurement, mean maximal width and length, width and length of the dome anterior, width and length of the posterior facet, height and length of the trochlear medial facet, and height and length of the trochlear lateral facet were $43.6{\pm}2.6mm$, $56.5{\pm}3.3mm$, $32.5{\pm}2.0mm$, $42.2{\pm}2.7mm$, $22.2{\pm}2.2mm$, $34.7{\pm}2.0mm$, $15.3{\pm}1.3mm$, $33.3{\pm}2.9mm$, $25.3{\pm}3.3mm$, and $30.8{\pm}2.4mm$ for men and $38.9{\pm}1.6mm$, $53.6{\pm}2.4mm$, $27.9{\pm}2.1mm$, $37.4{\pm}3.2mm$, $20.6{\pm}0.8mm$, $31.9{\pm}1.2mm$, $13.6{\pm}2.6mm$, $28.4{\pm}2.5mm$, $24.9{\pm}2.1mm$, and $28.9{\pm}1.4mm$ for women, respectively. The size of the talus showed an accuracy of 86% when anteroposterior diameter was greater than 59 mm. A difference in the size of the right and left talus was not observed. The mean inclination and declination angles were $24.4^{\circ}{\pm}4.2^{\circ}$ and $28.2^{\circ}{\pm}5.4^{\circ}$ for men, and $24.6^{\circ}{\pm}3.6^{\circ}$ and $24.7^{\circ}{\pm}6.7^{\circ}$ for women (p=0.980, p=0.018), respectively, at least $15^{\circ}$, which showed a big difference for every object up to $37^{\circ}$. Conclusion: This paper, to the best of our knowledge, is the first study to measure the talus in Koreans. There were differences by gender and ethnicity in the in measured talus values. The measurements were smaller than European-Americans and greater than Japanese.

족근골 유합의 발생 빈도: 단일 기관 자기공명영상 분석

김정한,곽희철,이창락,김영준,김전교,이선주,이정한,박준호,Kim, Jung-Han,Gwak, Heui-Chul,Lee, Chang-Rak,Kim, Young-Jun,Kim, Jeon-Gyo,Lee, Sun-Joo,Lee, Jeong-Han,Park, Jun-Ho 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.3

Purpose: Tarsal coalition results from defects during the developmental stage and produes ankle pain and limitations in the range of motions. Its incidence has been reported to be 1%, but there has not been any reports with respect to Koreans. Therefore, we evaluated the prevalence of tarsal coalition in Koreans. Materials and Methods: Between 2005 and 2014, we analyzed a total of 733 cases of foot and ankle magnetic resonance imaging (MRI) in our hospital. There were 391 men and 342 women. All MRI readings were read by a radiologist in our hospital. We classified the coalitions in accordance with the histological and anatomical characteristics, and calculated the prevalence in each group. Moreover, we tried to determine the prevalence of tarsal coalitions in accordance with sex, age, and proportion of the symptomatic tarsal coalitions. Results: There were a total of 11 MRIs of tarsal coalition - 9 talocalcaneal coalitions, 1 calcaneocuboidal coalition, and 1 calcaneonavicular coalition. Nine tarsal coalitions were observed in men and 2 in women. Conclusion: Through this study, we found that the prevalence of tarsal coalition, including the asymptomatic patients, is similar to the previously known prevalence (1%). By getting more MRIs of the foot and ankle, we could better represent the prevalence of tarsal coalitions in Koreans.

딜레마 토론을 활용한 의과대학 윤리교육 프로그램의 개발 및 적용

김지영(Ji-Young Kim),최승헌(Seung Heon Choi),한상환(Sang-Hwan Han),전교(Gyo Jun),김대성(Dae-Sung Kim),Mark C. Love,김미연(Mi-Yeon Kim),이언(Uhn Lee),고창순(Chang-Soon Koh) 한국의학교육학회 2000 Korean journal of medical education Vol.12 No.1

가천의과대학교에서는 의대생들의 도덕판단력 증진을 위해 의료윤리와 관련된 주제들에 대한 딜레마 토론을 활용한 의과대학 윤리교육 프로그램인‘생명과 사회 Ⅱ’를 개발하여 적용하였다.‘생명과 사회 Ⅱ’는 1998년부터 1999년에 거쳐 임상 및 기초의학 교원 20명이 참여하여 학습목표의 설정, 학습주제의 선정, 수업설계, 학습지도안의 작성 등 4단계를 거쳐 개발되었고, 1999학년도 3월부터 6월까지 의예과 2학년에 재학 중인 41명을 대상으로 적용되었으며, 효과성 평가를 위해 학생대상 설문조사가 실시되었다.‘생명과 사회 Ⅱ’의 학습목표는 문헌조사에 기초하여 설정되었으며, 학습주제는 기초 및 임상교원30명을 대상으로 한 ‘의학입문 교과목 개설을 위한 설문지’ 결과를 기초로 선정되었다. 수업설계는 구체적 수업목표의 설정, 수업방법의 선정, 주제별 수업의 배열, 강사 및 tutor의 선정의 단계를 거쳤으며, 학습지도안 작성은 주제별 학습목표의 설정, 학습내용의 선정, 딜레마 시나리오의 구성, 토론을 위한 질문의 구성의 단계를 거쳤다. 교육 프로그램은 토론의 준비, 토론의 진행, 토론의 평가의 단계로 운영되었으며, 평가는 학생 대상의 설문지를 통해 주제별 수업만족도, 전반적인 수업형태에 대한 만족도, 자유의견 등의 항목에 대해 실시되었다. 응답에 대한 분석 결과 개설목적 달성 여부 및 수업형태에 대한 만족여부에 관련된 문항에서 ‘매우 그렇다’ 또는 ‘그렇다’는 반응이 ‘그렇지않다’ 또는 ‘매우 그렇지 않다’라는 반응보다 높은 비율로 나타났으며, 딜레마 토론을 활용한 수업이 기타 교육방법을 활용한 수업에 비해 만족도가 높은 것으로 나타났다. Gachon Medical School has developed and implemented a medical ethics course entitled, Life and Society II . The course uses dilemma discussion based on medical case studies to allow students to develop their moral reasoning ability in both clinical and hospital settings. The course was developed by the faculty of medicine during the 1998-1999 academic years. The program was designed in a four-stage process: 1) learning objectives were identified, 2) contemporary controversies and relevant ethical issues were chosen based on relevance to modern medical practice, 3) a syllabus was drafted based on the aforementioned ethical issues and teaching methods appropriate for each issue were integrated into the syllabus, and 4) tutorial manuals were produced. The course was taught to 41 second-year premedical students and evaluated by student surveys. The learning goals were identified through both a literature survey of contemporary issues in medical ethics and an in-house survey of important content to teach in a medical ethics course. The curriculum was designed based on the identification of specific learning objectives per ethical issue, selection of appropriate materials and content, organization of dilemma scenarios and formulation of questions for discussion. The course was taught using a variety of teaching formats: dilemma discussions, seminars, tutorials, lectures, assigned readings and student presentations. Positive results were obtained from the student surveys: it was discovered that most students thought that the course s learning objectives were achieved. Furthermore, of all the teaching methods employed, most of our students felt that discussing dilemmas was the most effective method for developing moral reasoning ability.

아킬레스건 파열의 수술적 치료 결과 비교

김정한(Jung-Han Kim),곽희철(Heui-Chul Gwak),이창락(Chang-Rack Lee),김전교(Jeon-Gyo Kim),정준우(Jun-Woo Jeong) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.3

목적: 아킬레스건 파열에 대한 수술적 치료 중 최소 절개 경피적 봉합술과 관혈적 봉합술의 임상적 결과를 비교 분석하고자 하였다. 대상 및 방법: 2006년 1월에서 2014년 6월까지 최소 절개 경피적 봉합술을 시행 받은 25명의 환자들(1군)과 관혈적 봉합술을 시행 받은 30명의 환자들(2군)의 임상적 결과를 후향적으로 분석하였다. 술 후 임상적 평가는 Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) hind foot score, 환자의 만족도 및 흉터에 대한 미용적인 만족도로 하였다. 결과: 두 군 간의 AOFAS ankle-hindfoot score, 중간 장딴지 둘레 차이, 환자의 만족도 및 반흔에 대한 만족도 면에서는 통계적으로 유의한 차이를 보였으며 1군이 2군보다 우수한 결과를 나타냈다. 그 외의 임상적 결과에서는 통계적으로 유의한 차이를 보이지 않았다. 1군에서 비복신경손상이 2예 있었으며, 2군에서는 심부감염, 재파열, 심부정맥 혈전증의 3예의 합병증이 있었다. 결론: 아킬레스건 파열에 대한 수술적 치료에 있어 최소 절개 경피적 봉합술이 효과적인 치료법 중의 하나로 고려될 수 있을 것이다. Purpose: To compare and analyse the clinical outcomes between minimal-incision percutaneous repair and open repair among the surgical treatments for Achilles tendon ruptures. Materials and Methods: We retrospectively analyzed and compared the outcomes between 25 patients with minimal incision percutaneous repair (group 1) and 30 patients with open repair (group 2), from January 2006 to June 2014. The postoperative clinical evaluations were done by Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, overall patient"s satisfaction, and cosmetic satisfaction of scar. Results: There were statistically significant differences between the two groups with respect to AOFAS hind foot score, mid-calf circumference differences, overall patient’s satisfaction, and satisfaction of scar; the group 1 showed better achievement. There was no statistical difference between two groups in regards to other clinical outcomes. In group 1, there were 2 cases of sural nerve hypoesthesia, which fully recovered spontaneously at about 6 months after the surgery. In group 2, there were 3 cases of deep vein thrombosis, re-rupture, and deep infection. Conclusion: We recommend minimal incision percutaneous repair as one of the effective surgical treatment options for Achilles tendon ruptures.

정상 한국인에서 Catechol O-methyltransferase 유전형의 분포

윤경식,임동석,전교,정형화,김문희,장인진,전범석,신상구 大韓臨床藥理學會 2000 臨床藥理學會誌 Vol.8 No.2