• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.935-939
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• 2000

Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.130-136
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• 1992

본 영남대학교 의과대학 부속병원 정형외과에서는 1986년 12월에서 1991년 11월까지 경부 간부 골절 31례에 대하여 Ender nail을 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균연령은 37.3세였고, 남자에게서 3배가 많았으며, 교통사고가 가장 많은 원인이었다(67%). 2. 폐쇄성 골절이 20례, 개방성 골절이 11례였으며, 분쇄골절과 분절골절이 18례(57.7%)였고, 중간부 골절이 16례로 가장 많았다. 3. 동반손상이 19례에서 있었고, 수상후 수술까지의 기간은 평균 7.6일이었다. 4. 평균 골유합 기간은 18.9주였으며, 2례에서 지연유합을 보였다. 5. 합병증으로 하지 단축이 2례, 각형성 변형이 3례, 관절 운동 제한 2례, 감염이 연부조직에 1례 있었다. 이상 경골 간부골절 치료에 사용한 Ender nail은 시술의 간편성, 적절한 고정성과 운동성, 비교적 폭넓은 적용 범위등으로 좋은 치료 결과를 기대할 수 있는 방법으로 사료된다.

• 한국의료질향상학회지
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• 제10권2호
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• pp.190-203
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• 2003

Background: Dental hygienists are at risk of acquiring infections through exposure to infectious agents. This study explores the frequency of exposure to infectious agents and infection control practices among dental hygienists. Methods: We undertook a cross-sectional survey to examine the exposure to infectious agents and infection control practices among dental hygienists through questionnaire. Data were obtained from 124 dental hygienists attending educational conferences. A multiple logistic regression analysis was conducted to determine the factors that effect infection control practices in relation to age, completion of infection control education, recognition of their own serum hepatitis Ag/Ab status, the number of one day patients, location of clinics, type of clinics, and career years. Result: Of the 124 dental hygienists, 91.7% were exposed to at least one accident such as needle stick injuries during their practices periods. The health screening coverage rate in dental hygienists was 16.5%. The number of one day patients and career years were important in relation to infection control practices among dental hygienists. The adjusted odds ratio estimates for career years were 5.049 times greater(95% Cl 1.238-20.597) for groups with over 4 career years than under 2 career years. That for the number of one day patients were 0.261(95% Cl 0.071-0.955) lower for through 20 up to 30 patients, 0.531(95% Cl 0.102-2.78) lower for through 30 up to 40 patients and 0.498(95% Cl 0.123-2.017) lower for more than 40 patients than under 20 patients. Conclusion: From these results, prevalence of infection control practices among dental hygienists is related to the number of one day patients and career years. Prevention of cross infection and reduction of future transmission should be a priority to dental hygienists for promotion of infection control and further efforts to educate newcomers on infection prevention should be made.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.367-376
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• 1997

저자등은 1992년 1월 1일부터 1996년 12월 31일까지 최근 5년간 전남대학교병원 구강악안면외과에 입원하여 치료받은 환자중 추적이 가능한 중안면골 골절 환자 234례에 대해 임상통계학적 비교 분석하여 다음과 같은 결과를 얻었다. 남녀비는 5.3 : 1로 남자에서 호발하였고, 연령별로는 20대, 30대, 10대순으로, 월별로는 8월, 5월, 9월과 10월 순으로 발생하였다. 발생원인은 자동차사고, 추락사고, 오토바이 사고의 순이었고, 골절부위로는 관골-상악골 복합골절이 86례로 가장 많았다. 연관 손상으로는 안면열상이 가장 많았으며 신경외과적 손상, 하악골 골절순이었다. 수상후 수술시 까지 경과시간은 1주일이내가 55%였다. 사용된 금속판수는 관골 또는 상악골 단독골절시에는 2개, 관골-상악골 복합 골절시에는 3개, Le Fort I, Le Fort I, II ; II, III ; I, III ; Le Fort I,II,III 골절시에는 각각 4개, 5.5개, 7개였다. 술후 합병증으로는 감염 7례, 안면비대칭 6례, 안구함몰증 5례, 부정교합 2례로 모두 20례(8%)가 발생하였다. 이상의 결과는 중안면골 골절시에 골절 부위와 환자의 전신상태 및 연관 손상에 대한 신속한 진단과 치료가 필요하고 타과와의 협동 치료가 이루어져야 함을 시사하였다.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of Acupuncture Research
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• 제33권4호
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• pp.149-163
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• 2016

Objectives : The purpose of this study is to determine the effect of Functional Cerebrospinal Therapy(FCST) on patients from traffic accidents with Temporomandibular Joint Disorder. Methods : We reviewed the medical records of 33 patients who were treated for injuries stemming from traffic accidents at the Dong-Eui University Korean Medicine Hospital from December 29th, 2015 to August 29th, 2016. The patients were divided into 2 groups: Group A(n = 15) and Group B(n = 18). In Group A, patients received Korean medical treatments with FCST using an Accurate Balancing Appliance(ABA) - a standard intra-oral appliance. In Group B, patients received Korean medical treatments without FCST. To estimate the efficacy of the treatments in decreasing pain, we analyzed the Visual Analogue Scale(VAS), Neck Disability Index(NDI) and Oswestry Disability Index(ODI). Results : In Group A, VAS of headache(VAS H), VAS of neck & nuchal pain(VAS N), VAS of shoulder pain(VAS S), and VAS of low back pain(VAS L) were significantly improved during each period. In Group B, VAS H was significantly improved during each period, except the period from the first visit to two weeks later. VAS N, S, L were significantly improved during each period, except the period from the first visit to one week later. The total VAS improvement during each period in Group A was significantly higher than Group B. In both groups, NDI and ODI were improved significantly during each period. The improvement of NDI and ODI during each period in Group A was significantly higher than Group B. Conclusion : According to the results, FCST using ABA may be an effective treatment for patients from traffic accidents.

• Journal of Preventive Medicine and Public Health
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• 제1권1호
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• pp.1-8
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• 1968

This paper describes the incidence of transport accident for the period, 1955-1965. Transport accidents were classified into three categories, viz. railway(WHO Classification of Diseases, E-802), watercraft (E 550-E 858) and motor vehicle accidents(E810-E835, E840-E841, E844-E845). Crude data on the subject were collected from the various souces of Government Statistical Books including Statistical Year Books edited by the Central Office of Economic Planning Board, Annual Police Reports by the Ministry of Home Affairs, and the national and local associations for road traffic safety. From the data incidence and mortality rates by year, month and local province were computed and other variables relevant to the epidemiology of accidents were observed. The following summary could be drawn: 1. Death rates due to transport accidents per 100,000 population were 12.3 for 1955 and 9.7 for 1965. The incidence of injury due to the same cause were 34.0 for 1955 and 35.9 for 1965. 2. Death rates by transportation vehicle showed 9.0 due to motor vehicle accidents, 1.7 due to water-crafts, and 1.6 due to railway trains for 1955. In 1965 death rates were 6.0 due to motor vehicles, 1.2 to water-crafts and 2.4 to railway. 3. Seasonal distribution of transport accidents revealed that car accidents occur more frequently in spring and fall fall seasons while ship accidents do in winter and train accidents more in summer. 4. Both car and ship accidents slightly decreased during the past decade, 1955-1965, whereas the accidents of railway trains showed a tendency of increase. 5. Although the survey on railway accidents excluded the injuries of passengers or railway employees corresponding to WHO classification of diseases, E 801, due to inaccuracy of data, it is roughly estimated that the same number of casualities as the incidence among pedestrians or any other than passengers or employees assumed to be at work(E 802).

• Journal of Preventive Medicine and Public Health
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• 제1권1호
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• pp.43-49
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• 1968

Epidemiological and statistical observations were made of fire hazards that occurred during the past 18 years, 1948 to 1965. Injury and mortality rates for all ages were computed chronologically. For the years of 1955, 1961 and 1965, all fire accidents were epidemiologically analysed to draw characteristic patterns in relation to the seasonal and 24 hour distribution, causes and sites of accidents etc.. Fire hazards observed herein are the categorys E 916 of the International Classification of Causes of Death, 1955, and includes all accidents caused by fire and explosion of combustible materials. The following conclusion was made: 1. The average number of annual deaths due to fire was 183 and the number of the in jured due to the same cause was 335. The mortality rate per 100,000 population was 0.8 and the ratio of injuries per death was 1.83. 2. The casually rate including both the dead and injured was 5.0 per 100,000 in Seoul, the highest among the provinces and followed by 3.4 in Cheju -Do, 2.1 in Kangwon-Do, 1.7 in Kyunggi-Do accordingly. The other provinces had a range of 0.6 to 1.2. 3. The monthly distribution of fro accidents showed that the winter months, December through February, had more frequent accidents, while the summer season, June through August had less. The 24 hour distribution of accidents showed more cases from 12:00 to 18:00 and less from 4:00 to 10:00 hours. 4. The per cent distribution of causes of accidents showed; 90.0% for careless, 10.0% for arson. The cause of carelessness was further breakdown into; 15.0% for kitchen fire places, 13.8% for fire playing, 9,4% for electrical heating and wires, 8.3% for fuels, 6.3% for matches, 5.2% for ash dumps and the remaining for others. 5. The accidents as classified by place revealed that 56.8% of the total occurred at the common dwelling houses, 11.3 at various industrial workshops, 9.3% at the street shops and the remaining at the miscellaneous places.

• Journal of Chest Surgery
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• 제43권1호
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• pp.104-107
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• 2010

급성호흡부전증후군은 치료가 어렵고 치명율이 높다. 인공호흡기 치료에 반응하지 않는 중증의 경우 체외막 산화기(Extracorporeal membrane oxygenation, ECMO)가 적용되고 있다. 교통사고로 다발성 외상을 받은 21세 여자가 흉부 방사선상 양측폐에 심한 침윤 소견과 동맥혈가스 검사상 급성호흡부전증후군(Acute respiratory distress syndrome, ARDS)으로 판단되어 정맥동맥 체외산화기(Veno- arterial Extracorporeal Membrane Oxygenation, VA ECMO) 치료를 시작하였다. ECMO 적용 2일째 흉부 방사선상 폐 침윤 소견 악화되면서 동맥혈 산소 포화도(Systemic oxygen saturation, $SaO_2$)가 85% 미만으로 저하되었다. 이에 중추신경계와 폐의 산소화를 향상시키기 위해 ECMO의 유출로에 곁회로를 이용하여 우측 경정맥에 연결하여 정맥-정맥동맥 ECMO (Veno-venoarterial ECMO, V-VA ECMO)로 전환하였고 이후 동맥혈 산소 분압($PaO_2$) 65 mmHg, $SaO_2$ 94%로 향상되었다. V-VA ECMO로의 전환은 전신에 산소 공급을 늘리기 위해 고려해 볼 수 있는 방법으로 생각된다.

• 한국화재소방학회논문지
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• 제29권6호
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• pp.57-64
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• 2015

육상 및 해상에서 일어나는 화재를 진압하기 위한 가스계 소화설비 중 이산화탄소 소화설비는 우수한 성능 및 높은 경제성으로 인하여 널리 사용되고 있지만, 고농도 이산화탄소로 인한 질식사고가 빈번히 발생하여 안전문제가 항상 지적되어 왔다. 본 연구에서는 수치해석을 통하여 선박 내 압축기실의 이산화탄소 소화설비 화재 진압 특성을 예측하고, 이산화탄소 소화설비로 인한 질식사고를 방지하기 위한 2중 안전 제어기법을 제시하여, 이산화탄소 소화설비의 안전을 도모하였다. 수치해석 결과로는 4가지 시나리오를 선정하여, 화재발생 후 이산화탄소 소화설비 작동으로 인한 열발생률 변화, 온도변화, 이산화탄소 농도변화, 산소 농도변화 및 화재진압 특성을 고찰하였으며, 방호구역 내 환기팬 용량이 충분하지 않은 경우의 위험성 및 적절한 환기시스템의 필요성을 제시하였다.