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김한별,박경혜,김인병,양혁준,이기중,임태호,한승백,강구현,강영준,김주영,김 철,박유석,박주옥,박준범,박준석,박현경,손재돈,오세현,오영민,이동욱,이형민,정시영,정진우,조광현,조영순,조한진,최대해,2015 응급의학과 전문의 총조사 위원회 대한응급의학회 2016 대한응급의학회지 Vol.27 No.5
Purpose: Emergency physicians cannot help doing night shift, and consequentially their circadian rhythms are broken and sleep quality decrease. We investigate sleep quality and the factors related with it, and make a suggestion for improvement of sleep quality. Methods: A nationwide survey was conducted with a representative sample of 406 emergency medicine specialist doing medical practice in emergency department in 2015. Results: The mean time of all duties was 14, and night duties were 7 per four weeks. Over half respondents thought they have some sleep problem in recent two weeks and are worried about sleep. The most common symptoms they have after night shift were fatigue and tiredness, and the next one is impaired memory, concentration, and judgement. Average Epworth Sleepiness Scale (ESS) was 7.54 (min 0, max 24), and 19 respondents had serious sleepiness during day time and may need medical advice. There was no difference of sleep quality according to sex, and whether having uninterrupted nap during night shift. However, the respondents having regular schedule pattern had better sleep quality and less day time sleepiness. Higher ESS was correlated with less satisfaction on shift schedule, intenser duty work, physically and mentally unhealthiness. Conclusion: Over half respondents answered they have sleep-related problems, and complaint various symptoms after night shift. Emergency physicians having regular shift schedule had better sleep quality and less symptoms after night shift. This requires additional analysis for the practically possible pattern of shift schedule.
만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증
박재용,최기원,조재호,강찬,최경진,정진화,김학준,배서영,차승도,김기천,한승환,2015 대한족부족관절학회 보험장애판정위원회,Park, Jae Yong,Choi, Gi-Won,Cho, Jae-ho,Kang, Chan,Choi, Kyungjin,Chung, Jin-Wha,Kim, Hak Jun,Bae, Su-Young,Cha, Seung-Do,Kim, Ki Ch 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.1
Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.