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응급실 내원 환자의 만족도 평가 및 관련 요인에 대한 연구
서강석,감신,박정배,이정헌,김종근,윤영국,곽경숙,이원기,우석정 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4
Background: To examine the influencing factors on patients' satisfaction in the emergency department(ED) for quality assurance. Methods: Patients who visited to the ED were prospectively investigated from November 1 to December 31, 1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction. A Chi-square test and LISREL 7.0 were applied for statistical analysis. Results: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfation, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. Conclusions: The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust for doctors. Willingness for revisit and willingness for recommendation are influenced by patients' satisfation. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfactoin in the ED.
縱斷的 資料에서 본 다운症兒와 精神遲滯兒의 身體發育樣相에 관한 硏究
李相于,朴俊東,辛尙根,安起英,姜信範 東亞大學校 附設 스포츠科學硏究所 1994 스포츠科學硏究論文集 Vol.12 No.-
The purpose of this study was to clarify physical growth pattern from longitudinal data of the down's syndrome and the mentally retarded children, through comparing our results with those of the normal children. Measurements of body height, body weight, chest girth and sitting height on 16 down's syndrome boys(16girls), 21 mentally retarded boys(14girls) and 90 normal boys(97girls) from 1982 to 1992 were taken every year during 11 years. The results were as follows : 1. In body height growth pattern for down's syndrome and mentally retarded children, down's syndrome and mentally retarded children showed lower then normal children, and then, group difference was significantly started 12 and 13-years-old of age over(P<0.05∼P<0.01) 2. Down's syndrome boys were significantly higher then normal boys except 17 years-old of age in body weight(P<0.01). 3. Down's syndrome and mentally retarded girls were significantly higher then normal girls except 13~15 years-old of age in body weight(P<0.05∼P<0.01) 4. Down's syndrome boys were significantly higher then normal boys between all age intervals in chest girth (P<0.01) 5. Down's syndrome and mentally retarded girls were significantly higher then normal girls in chest girth(P<0.01) 6. Down's syndrome and mentally retarded children were significantly lower then normal children except 7 through 11 years-old of age in sitting height(P<0.05∼P<0.01)
李相魯,姜信珠,安泰潤,奇宇恒 慶北大學校 師範大學 1985 敎育硏究誌 Vol.27 No.-
It is said that Korean teacher education is facing some critical Problems. We think that we can get some imformations from the reexaminations on the recent reforms in Japaness teacher education system. 1) As the basic orientation of teacher education, we need to distinguish open system and closed system; teacher education in all college level and teachers college level. Institutional improvements should be directed to democratization and specialization; abuses in massproductive teacher education are required to correct. 2) In principle, teacher education should be enforced solely in regular college level; through strengthening teaching method course, teaching subject courses, and student teaching practices, professionally of teacher education must be elivated. 3) As teacher education heavily depends upon teacher employment directly or indirectly, the plan of the teacher demand and supply is needed to be reasonable. And incentive systems for teachers are demanded. 4) In-service education should be qualified to enhance the autonomy of teaching profession. 5) The Co-research between colleges, educatibnal institutes, and schools is expected to strengthen and enlarge action research.
Kang, Joon-Ki,Yoon, Kang-Jun,Ha, Sang-Su,Lee, II-Woo,Jeun, Sin-Soo,Kang, Seok-Gu The Korean Neurosurgical Society 2009 Journal of Korean neurosurgical society Vol.46 No.5
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.
Tethered Cord Syndrome; Surgical Indication, Technique and Outcome
Kang, Joon-Ki,Lee, Kwan-Sung,Jeun, Sin-Soo,Kang, Seok-Gu,Lee, Il-Woo,Yoon, Kang-Jun,Ha, Sang-Soo The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.42 No.2
Objective : The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. Methods : Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. Results : During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. Conclusion : Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.