Background: Despite fall prevention strategies suggested by researchers, falls are still a major health concern in older adults. Understanding factors that differentiate successful versus unsuccessful balance recovery may help improve the prevention strategies. Objects: The purpose of this review was to identify biomechanical factors that differentiate successful versus unsuccessful balance recovery in the event of a fall. Methods: The literature was searched through Google Scholar and PubMed. The following keywords were used: ‘falls,‘ ‘protective response,‘ ‘protective strategy,’ ‘automated postural response,’ ‘slips,’ ‘trips,’ ‘stepping strategy,‘ ‘muscle activity,’ ‘balance recovery,‘ ‘successful balance recovery,‘ and ‘failed balance recovery.’ Results: A total of 64 articles were found and reviewed. Most of studies included in this review suggested that kinematics during a fall was important to recover balance successfully. To be successful, appropriate movements were required, which governed by several things depending on the direction and characteristics of the fall. Studies also suggested that lower limb muscle activity and joint moments were important for successful balance recovery. Other factors associated with successful balance recovery included fall direction, age, appropriate protective strategy, overall health, comorbidity, gait speed, sex and anticipation of the fall. Conclusion: This review discusses biomechanical factors related to successful versus unsuccessful balance recovery to help understand falls. Our review should help guide future research, or improve prevention strategies in the area of fall and injuries in older adults.

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients’ fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

본 논문에서는 충남지역 로컬푸드 정책의 새로운 방향성을 모색하기 위해 지 속가능성, 지역균형발전의 관점을 활용하여 분석하였다. 이를 위해 로컬푸드의 이론적 논의, 소비자와 생산자 관점에서 로컬푸드 정책의 필요성을 주장하였다. 그리고 지속가능성과 지역균형발전의 시각에서 분석하고 새로운 방향성을 제시 하였다. 구체적으로, 로컬푸드 정책을 추진하였을 때 나타난 지역경제 선순환 구 조 및 가계소비지출 변화의 효과에 근거하여 지속가능성에 대한 필요성을 제시 하였고, 지방자치단체의 로컬푸드 사업 활성화를 통한 양질의 일자리 창출 및 비정규직 감소를 통하여 지역균형발전의 필요성을 제안하였다. 이를 통해 충남지 역 로컬푸드 정책에 대한 새로운 방향성의 결론을 내렸고, 나아가 향후 과제로 서 로컬푸드 평가지표개발⸱기초자치단체 지원⸱우수사례 발굴과 홍보 등도 함께 제의하였다.

조르조 아감벤(Giorgio Agamben)은 『불과 글』에서 ‘영성의 글쓰기’가 가능한 잠재성을 모색한다. 그는 불을 상실하고 신비가 없는 서사만이 존재하는 현대 문학을 비판한다. 현대사회는 자본주의의 극단과 고도의 디지털 기술혁명이라는 두 가지 환경에 압도당해 왔다. 따라서 작가가 불의 상상력을 보존하여 작품을 창조하는 것은 어려운 도전이다. 그러나 아감벤은 이러한 환경이야말로 오히려 불이 되살아나는 소생의 문학 창조를 모색할 수 있는 잠재성의 영역임을 포착한다. 그는 인간의 궁극적인 행복이 신을 관조함에 있다고 밝히면서, 예술작품 창조를 통한 불과 글의 궁극적 통합을 주장한다. 그가 주장하는 ‘영성의 글쓰기’는 인간의 영적 성장과 재생을 담보하는 예술 행위이다. 『불과 글』은 현대인에게 불에 대한 기억을 소생시키고, ‘문학과 종교’가 지향해야 할 방향성을 제시한다.

췌석은 만성췌장염에서 흔히 동반되는 소견으로 반복되는 복통과 췌장염의 원인이 될 수 있다. 췌석은 췌관 협착과 자주 동반되고 췌관내 박혀 있는 경우가 많아 바스켓을 이용하여 제거하기 어렵다. 체외충격파쇄석술(ESWL)로 치료하기도 하나 반복 시술이 필요하고 성공률도 높지 않았다. 최근에 개발된 SpyGlass™ DS II (Boston Scientific, Marlborough, MA, USA)는 직경이 3.5 mm로 가늘어 췌관이 확장되어 있을 때 안으로 삽입이 가능하게 되었다. 그리고 직접 췌석을 보면서 전기수압쇄석술(EHL)이나 레이저 유도 쇄석술(laser lithotripsy)를 시행하며 췌석을 제거해 볼 수 있게 되었다. 본고에서는 SpyGlass™ DS II와 EHL을 이용하여 10 mm 이상의 다발성 췌석을 제거하는 방법을 소개하고자 한다.

EBV-positive mucocutaneous ulcer (EBVMCU) is an indolent, superficial lymphoproliferative disorder that occurs in either iatrogenic or age-associated immunocompromised patients with latent Epstein-Barr virus (EBV) infection. Although EBVMCU is histologically similar with other lymphoproliferative disorders, such as EBV-positive diffuse large B cell lymphoma, the diseases are classified as distinct entities by the World Health Organization with different clinical manifestations, prognosis, and genetic profiles. EBVMCU commonly shows spontaneous regression by conservative management, reduction or cessation of immunosuppressive treatment, but local progression is possible. Complete remission of disease can be achieved with combination of surgical resection, chemotherapy and local radiation therapy. Herein, we report 2 cases of oral superficial lymphoproliferative disorders arising adjacent to the gnathic bone with striking differences in prognosis and bone involvement. One of the cases induced extensive osteomyelitis in the underlying bone. Furthermore, we discussed the differential diagnosis of EBVMCU and reviewed the former literature.

Malignant melanoma is a highly malignant tumor derived from melanocyte. Malignant melanoma of the oral cavity occurs mainly in the palatine mucosa and the maxillary gingiva in men in their 50s. Malignant melanoma can be divided into pigmented and non-pigmented(amelanotic). Among them, non-pigmented malignant melanoma accounts for 2-8% of all malignant melanomas. Pigmented malignant melanoma is detected through changes in pigmentation, whereas non-pigmented malignant melanoma is characterized by no pattern of color change. In this study, at the initial visit, a malignant lesion was suspected and a biopsy was performed. According to the biopsy results, it was diagnosed as polymorphic sarcoma, but the histological examination performed during the operation revealed that it was amelanotic melanoma. As such, the differential diagnosis is important because there is no clinical change in non-pigmented malignant melanoma. Diseases to be differentially diagnosed when non-pigmented malignant melanoma occurs in the oral cavity include squamous cell carcinoma, lymphoma, sarcoma, inflammation, and osteomyelitis. In this study, we report a case that showed the histopathological characteristics of malignant melanoma without superficial pigmentation.

목적 : 성인 발달장애인을 대상으로 한 국내·외 스노즐렌(다감각환경) 중재를 체계적으로 분석하여 알아 보고자 하였다. 연구방법 : EBSCOhost, Embase, PubMED, KISS, RISS 데이터베이스에서 2021년 12월까지 게재된 모 든 문헌들을 대상으로 분석하였다. 최종 선정된 13편의 연구를 체계적으로 고찰하여 대상자의 인구학적 특성, 종속변수 및 중재효과, 사용된 평가도구, 스노즐렌 중재 제공의 형태 등을 제시하였다. 결과 : 선정된 모든 연구는 국외에서 진행된 실험연구였으며, 연구에 참여한 대상자의 평균연령은 약 35.8 세였다. 스노즐렌 중재 대상자는 지적장애인이 가장 많았으며, 다수의 연구에서 대상자의 도전행동과 관 련된 종속변인을 설정하였다. 최종 선정된 13개의 연구 중 한 가지 이상의 영역에서 스노즐렌 중재의 긍정적인 영향을 보고한 연구는 총 10개(76.2%)로 대부분의 연구에서 중재의 효과가 있음을 보고하였 으며, 효과는 주로 행동관찰법을 사용하여 평가했다. 스노즐렌 제공의 평균 시간은 약 30분으로 개별 중 재로 진행된 연구가 주를 이뤘다. 결론 : 본 연구에서 스노즐렌 중재가 성인 발달장애인에게 긍정적인 영향을 미치는 적절한 중재방법임을 확인하였다. 따라서 본 연구는 향후 성인 발달장애인을 대상으로 하여 임상적판단의 근거로 사용되거나 관련 분야의 기초자료로 활용 될 수 있을 것으로 사료된다.

대통령 배우자의 역할 논쟁은 사적이면서 동시에 공적인 정체성을 지 니는 대통령 배우자의 특성으로 인해 체계적인 연구는 물론 담론 형성에 서도 많은 난관에 봉착한다. 본 연구는 대통령 배우자 관련 기존 문헌연 구를 통해 대통령 배우자의 역할 논쟁이 그 정체성을 규정하는 접근으로 부터 시작된다고 설명한다. 대통령 배우자의 공적 정체성에 무게를 둔다 면 그 역할도 제도화되어야 하며, 선출되거나 위임된 공적 권력이 없는 대통령의 배우자로 인식한다면 그 역할은 최소화되어야 한다. 다른 한편 결혼 여부를 떠나 한 독립적 개인으로 인식한다면 공적인 역할 논쟁에서 벗어나되 고위 공직자의 가족이라는 범주에서 책임성을 확보하는 문제에 주목해야 한다. 본 연구는 대통령 배우자의 역할에 관한 학술적 논의를 진전하기 위해서, 대통령 “배우자”로서의 사적 존재, “대통령실의 일부” 인 공적 존재, 그리고 결혼이라는 요소를 배제한 한 개인으로서의 “독립 적 주체”로 보는 세 가지 시각을 제안하였다. 이를 토대로 독립적 주체 로 바라보되 사적, 공적 책무성을 통합적으로 담아내는 ‘독립적/통합적 (independent/integrative)’ 역할 구분을 구체적으로 담아내는 사회적 담론 형성과 제도적 보완에 대한 전문적인 논의가 필요하다.

Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders. Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: “Kinesio taping,” “Kinesio tape,” “swelling,” and “edema,” with different combinations and derivations. Only articles available in English were included in this study. Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint. Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

Plunging ranula is a mucous retention cyst with extension below to the mylohyoid muscle. It can occur by an extravasation of saliva from the salivary gland due to trauma or obstruction of the duct. Fluid from the obstructed gland penetrate through the defect of mylohyoid muscle or through the posterior edge of mylohyoid muscle, and spreading to the cervical area. The “tail sign” has been widely reported as pathognomonic for their diagnosis. It indicates the communication between the collapsed sublingual and submandibular space over the posterior edge of the mylohyoid muscle. In this case, in addition to simple ranula in the right floor of mouth, MRI findings showed homogeneous contrast enhancement in front of the right cervical carotid artery and in the deep part of sternocleidomastoid muscle, but tail sign was not observed. Therefore it was clinically diagnosed as a branchial cleft cyst and was removed through surgical procedure. As a result of the final pathologic biopsy, the lesion, which has been suggested to be simple ranula in the floor of mouth, was diagnosed as reactive pyogenic granuloma, and the cervical lesion was diagnosed as a plunging ranula. This is a case report in which these two lesions are decided to have been separated from one before surgery. This report indicate that plunging ranula can be observed without tail sign and how to make an accurate diagnosis of plunging ranula by reporting misdiagnosis case.

Telangiectatic osteosarcoma(TAEOS) is a rare subtype of osteosarcoma(OS) composed of blood-filled or empty cystic architecture simulating aneurysmal bone cyst. TAEOSs account for 2-12% of all OSs. TAEOSs mostly develop around knee and proximal humerus, but TAEOSs of the jaws are rare. To the best of my knowledge, this is the fourth case of primary TAEOS affecting the jaws. A 36-year-old female who had been previously diagnosed osteosarcoma by biopsy reported with a chief complaint of throbbing and swelling of the right mandible. The patient received neoadjuvant chemotherapy followed by hemi-mandibulectomy. After surgery, patient received adjuvant chemotherapy. The patient is free of disease for 6 months after surgery. TAEOSs are mimicking other benign entities, such as aneurysmal bone cyst and central giant cell granuloma. Thus, careful diagnosis through thorough radiographic and histopathologic evaluation is important to establish a treatment plan, prognosis, prediction and management strategy.

As modern society has emerged and developed, the subway has established itself as a representative means of transportation in the city due to its speed, accuracy, and accessibility. According to the Indoor Air Quality Management Act, underground stations have established and managed the maintenance and recommendation standards for PM10, PM2.5, CO2, CO, HCHO, NO2, Rn, VOCs However, th the standards for airborne mold has not been applied for subway stations even though management for the health effect of exposure to mold is necessay. In this study, the correlation with major contributing factors was analyzed by measuring the concentration of airborne molds in the indoor air of underground stations and through literature research. It was confirmed that there was a correlation between the concentration of airborne molds in subway stations and the major contributing factors. As a result of the analysis, it was found that the concentration of airborne molds became higher as the location of the platform became deeper underground, during periods of congestion, and especially in summer. There was no significant correlation with the year of construction. Our findings indicate that appropriate management measures should be devised in response to such contributing factors.

There is a growing interest in animal-assisted intervention (AAI) all over the world. AAI is an umbrella term describing various forms of human-animal teams in formal human service, such as animal-assisted activity (AAA), animal-assisted therapy (AAT), and animal-assisted education (AAE). Animals commonly used as partners in AAI are dogs, cats, horses, guinea pigs, farm animals, and dolphins. Research on various topics within the field of AAI has experienced rapid growth over the past decade, but AAI approaches are still struggling to establish credibility as a complementary therapy method for a range of medical and psychological conditions. The aim of this review is to scrutinize the research literature related to AAI. Most studies have shown that AAI can have multiple outcomes, including social, psychological, and physical ones, in a wide range of settings. However, studies have not yet examined whether these effects carry over into other contexts. Moreover, study samples have tended to be small, non-representative, heterogeneous, and conducted without control groups. Further research is, thus, necessary to explore the sustainability and long-term benefits of AAI in a variety of settings and for different populations. Also, there is a need for specific guidelines for the welfare of therapy animals, as well as possible directions for standardized professional competencies.

Mucosal malignant melanoma is an uncommon tumor of the head and neck, and patient cannot easily recognize the lesion. Most patients are diagnosed with advanced lesions, and the 5-year survival rate is very low. Therefore, intraoral pigmented lesions require an incisional biopsy for differential diagnosis from malignant melanoma. As the size of the tumor increases, lesion showing vertical growth and lymph node metastasis increases, and the prognosis becomes poor. In this study, we report a case of mucosal malignant melanoma in the oral cavity that shows radial growth and no lymph node metastasis despite its relatively large size.

High level nuclear waste (HLW) is surely disposed in repository in safe by being separated from human life zone. Deep geological disposal method is one of the most potent disposal method. Deep geological repository is exposed to high pressure and groundwater saturation due to its depth over 500 m. And it is also exposed to high temperature and radiation by spent fuels. Thus, HLW repository suffers extremely complex thermo-hydro-mechanical-radioactive condition. Long-term integrity of repository should be verified because the expected lifetime of the repository is over 10,000 years. However, the integrity of monitoring sensors are not reach the endurance lifetime of the repository with present technology. And the disposal condition, thermo-hydro-mechanical-radioactive, should shorten the estimated lifetime of the monitoring sensors. Therefore, it is necessary to improve the long-term integrity of the monitoring sensors. Although long-term tests are required to identify the prolonged durability of monitoring sensors, accelerated tests can help curtail test period. Accelerated tests is classified into accelerated stress test and accelerated degradation test and their methodology and theories are investigated. Their tests are design and proceed by following process: 1) identify failure modes, 2) select accelerated stress parameter, 3) Determine stress level, 4) Determine testing time and number of specimens, 5) Define measurement paremeter and failure criteria, 6) Suggest measurement method and measurement duration. Literature reviews were conducted to identify the influence of the disposal conditions such as thermo-hydro-mechnical-radioactive on integrity of material and monitoring sensors. The investigated data reported in this paper will be utilized to verify the improvement of integrity of monitoring sensors.

정부는 시장실패 방지, 정보의 비대칭성 완화, 자원의 효율적 배분 등 다양한 목적을 가지고 시장에 개입하여 민간기업의 기술혁신을 지원해 왔다. 2000년대 들어 국가 연 구개발 예산이 급격히 증가하면서 기업에게 지원되는 정부재원도 비례하여 증가해왔으나 정 부의 재정지원이 효과적이고 바람직한 정책목표를 달성했는지에 대해서는 분명하지 않다. 본 연구는 이러한 문제인식 하에 국내․외 관련 논문과 정책연구 보고서, 리뷰 페이퍼 등을 종합적․체계적으로 분석하여 다양한 정부 재정지원에 대한 문제점을 살펴보고자 하였다. 국․내외 총 168편의 연구를 체계적 문헌분석과 컨텐츠 분석을 활용하여 정책 부가성, 지원 방식, 기업규모, 분석단위(unit of analysis), 분석대상, 연구방법론과 데이터 등 다양한 관점 에서 입체적으로 분석하였다. 문헌 간 교차 비교를 통해 다수의 중복 수혜, 재정지원과 정책효과 간의 구조적 시차, 재정지원 효과의 비선형성, 정책간의 간섭과 교호작용, 폐쇄형 혁신 과 제조업에 최적화된 조세제도 등이 현재 정부 재정지원의 문제점으로 분석되었으며, 이를 해결하기 위한 정책개선 방향으로 행동 부가성을 고려한 재정지원사업 성과지표 개발, 정부 부처 간 정책협력과 조율 강화, 다양한 상황을 고려할 수 있는 정책혼합(policy mix) 도입, 디지털 혁신․서비스 연구개발 등 새로운 형태의 기술혁신에 맞는 기업 재정지원 방식, 데이 터에 기반 한 증거기반 정책강화 등을 제시하였다.

Pancreatic acinar cell carcinoma (ACC) is a rare neoplasm accounting less than 1% of malignant pancreatic tumors. A 47-year-old male patient visited the emergency room with epigastric pain. Computed tomography or magnetic resonance imaging revealed a 4.7-cm heterogeneously enhanced solid and cystic mass with internal necrosis located in the head of the pancreas. Radiological diagnosis was borderline malignancy such as neuroendocrine tumor or solid pseudopapillary neoplasm. Two months later, the necrotic mass in the pancreas head had grown up to 11 cm, compressing the duodenum, superior mesenteric vein, and proximal transverse colon. Pylorus preserving pancreatoduodenectomy with segmental resection of transverse colon was performed. Histopathological examination revealed that the tumor was pancreatic ACC. The patient recovered without any complication and was doing well without recurrence for 12 months after surgery.

Sarcomatous transformation of fibrous dysplasia (FD) is rare and can occur in patients with McCune-Albright syndrome (MAS). To date, there have been several cases of malignant transformation of FD in the craniofacial area of patients with MAS. Here, we report an additional case of secondary osteosarcoma arising from FD in the mandible of a 41-year-old woman with MAS. The patient complained of rapid swelling in the right facial area, which was initially misdiagnosed as soft tissue sarcoma at another hospital. After neoadjuvant concurrent chemoradiotherapy resulting in poor response, the lesion was surgically resected in our hospital, and the final diagnosis of secondary osteosarcoma was rendered. Currently, post-operative adjuvant chemotherapy is in progress. As a result of our review of 17 reported cases showing malignant transformation in FD/MAS, the M/F ratio was 1:1.1, and the median age at onset of malignancy was 28.6 years. The most commonly affected site was the craniofacial bones (n=13; 76%), and the most common histopathologic type of malignancy was osteosarcoma (n=14; 82%). More than half of the patients (8/15; 53.3%) died within 1 year, mainly due to lung metastasis (6/8; 75%). Taken together, since MAS patients with malignant transformation of FD have a relatively poor prognosis, accurate diagnosis based on histopathologic findings as well as clinical and radiographic information is important to select optimal treatment.