• Journal of Trauma and Injury
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• 제26권3호
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• pp.243-247
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• 2013

Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

• 구강회복응용과학지
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• 제28권1호
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• pp.87-101
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• 2012

이갈이는 이를 갈거나 악무는 것을 포함하는 부기능적인 행위를 말하며 광범위하게는 주간 및 야간에 나타나는 것을 모두 포함한다. 이갈이의 원인으로는 기본적으로 말초성 요인과 중추성 요인으로 나누어 살펴볼 수 있는데 현재까지의 연구 결과를 종합하여 볼 때 중추성 요인이 주로 작용하는 것으로 알려져 있다. 이러한 이갈이는 교모, 치경부 미세파절, 교근 비대, 교근 및 측두근의 통증, 턱관절의 통증 및 움직임의 제한, 치아 및 수복물 파절, 치수염, 외상성 교합 등을 유발 할 수 있고 특히 이악물기의 경우 협점막 압흔이나 협점막 백선 또는, 혀의 측면에 압흔 등을 유발한다. 이갈이의 정확한 진단을 위해 구강내 장치, 근전도, 수면다원검사 등을 이용하며 미국수면장애학회의 경우 이갈이의 임상 진단 기준을 제시하고 있다. 그러나 아직까지 이갈이의 명확한 원인이 밝혀져 있지 않기 때문에 치료법의 선택은 신중하여야 한다. 이갈이가 중등도 이상이고 임상 증상이나 징후를 유발하는 경우에 이갈이를 관리하기 위한 방법으로는 위험 요인의 조절, 구강내 장치, 보툴리눔 독소 주사, 약물 치료, 바이오피드백 등이 있으며 구강내 장치 요법이 현재로서 가장 합리적인 방법이다. 이갈이 치료와 교근비대에 대한 심미적인 개선을 같이 원하는 환자에서는 보툴리눔 독소 주사 요법이 이용될 수 있다.

• 대한치과보철학회지
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• 제37권2호
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• pp.143-166
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• 1999

The success of porcelain laminate veneer depends on the bond strength between tooth structure and ceramic restoration and the design of tooth preparation. In particular, incisal coverage and incisal finish line are the two most important factors in long-term fracture resistance. Although the majority of clinicians are practicing incisal coverage and there are various opinions on the geo-metrical ratio between the clinical crown length of the remaining tooth structure and the length of incisal extension in porcelain laminate veneer and the optimal incisal finish lines. scientific evidence still loaves much to be desired. The purpose of this study was to determine the effects of the amounts of incisal coverage and the types of incisal finish line on the stress distribution in maxillary anterior porcelain laminate veneers under two different loading conditions. Three-dimensional finite element models of a maxillary anterior porcelain veneer with differ-ent amounts of incisal coverage ; 0, 1, 2, and 3mm and different incisal finish lines feathered edge, incisal bevel, reverse bevel and lingual chamfer with various amounts of lingual extension were developed. 300N force was applied at the point 0.5mm cervical of the linguoincisal edge in two loading conditions ; A) 125 degrees, B) 132 degrees. Tensile and compressive stress in ceramic and shear stress in the resin cement layer were analyzed using three-dimensional finite element method. The results were as follows : 1. The types of incisal finish line had more influence on the stress distribution in porcelain laminate veneer than the amounts of incisal coverage. 2. In case of no incisal coverage, incisal beveled laminate exhibited more evenly distributed tensile stress than feathered edged laminate. And in case of incisal coverage, reverse beveled laminate and lingual chamfered laminate with 1mm lingual extension exhibited more evenly distributed tensile stress than lingual chamfered laminates with 2mm and 3mm lingual extension. 3. As long as the lingual chamfer goes, less tensile stress was found at the incisal edge, while much more tensile stress was found at the lingual margin area in proportion to the length of lingual extension. 4. Under 125 degree load, tensile stress in porcelain laminate veneer had increased compared with that under 132 degree load and the difference exhibited by the change of the amount of tooth support was larger. 5. The types of incisal finish line and the distance from the incisal finish line to the loading point had more influence on the shear stress distribution in the resin cement layer than the amounts of incisal coverage. In contrast loading condition had little influence.

• 대한소아치과학회지
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• 제28권4호
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• pp.654-660
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• 2001

상아질형성부전증은 유전적인 상아질의 결함으로 치아 발육과정 중 조직분화기에 발생되며 유치와 영구치 모두에서 나타난다. Shields등은 상아질형성부전증을 type I, II, III로 분류하였으며, Witkop에 따르면 1/8000명의 빈도로 이러한 유전적 소인을 갖게 되며, 남녀간의 차이는 뚜렷하지 않다고 한다. 이환받은 치아는 적갈색의 변색과 함께 심한 마모현상으로 인해 구치부 교합면과 전치의 절단면의 법랑질이 파괴되고 그후 급속도로 상아질의 파괴가 뒤따른다. 방사선학적으로 가느다란 치근과 구근상치관, 치경부 협착, 작거나 결손된 치수강이 관찰되고, 유치열에서 치근단병소나 다발성 치근파절이 관찰되기도 한다. 본 증례의 4세 남자환아는 치아색이 이상하다는 것을 주소로 연세대학교 치과병원 소아치과에 내원하였다. 치아는 전반적으로 황갈색의 변색과 중등도의 마모도를 보였으며, 방사선 검사 소견에서 치아의 치수강 폐쇄, 구근상치관, 짧은 치근들이 관찰되었다. 가족력상 각 세대마다 환아와 같은 치아변색과 마모의 유전양상이 관찰되었으며, 10세된 환아의누나는 영구치열에 전체적으로 회갈색의 변색과 경도의 마모도를 보였다. 임상 및, 방사선학적 검사소견상 상아질형성부전증으로 판단되어 환아의 손상된 치아에 대해 구치부는 기성금관 수복을, open-faced stainless steel crown으로 치근파절로 인해 발거된 상악 좌측 유중절치를 포함한 손상된 전치부를 수복해 기능적, 심미적으로 만족할 만한 결과를 얻어 이에 보고를 하는 바이다.

• 대한치과보철학회지
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• 제32권4호
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• pp.484-514
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• 1994

Cantilever bridge is widely used by mny clinicians, but its worst mechanical character, so called Class I lever system, makes dentists hesitate to restore the missing tooth with it. Therefore it is important to study stress of the cantilever bridge. In this study, two models of cantilever bridges that restores the missing mandibular second molar with two abutment teeth were constructed. One model was a type of cantilever bridge supported by a normal alveolar bone, the other one was supported by an alveolar bone resorbed to its 1/3 of root length. Maximum bite force(550N) and funtional maximum bite force(300N) were vertically applied to the distal end of the pontic, distal 1/3, and distal half of the pontic. And each force was also applied to centric occlusal contacts as a distributed force. Total 16 loading cases were compared and analyzed with 3-dimensional finite element method. The results were as follows: 1. The stress was concentrated on the joint of the pontic and the retainer, grooves, and distal cervical margin of the posterior retainer. 2. In case of maximum bite force(550N) at the end of the pontic, the risk of fracture at the joint of the pontic and the retainer was high. 3. In case of distributed force in centric occlusion and functional maximum bite force(300N), the stresses were less than the yield strength of the type VI gold for any loading cases. 4. In case of alveolar bone resorption, the occlusal force to the cantilever pontic caused more stress on the root apex and less stress on the alveolar crest region of the distal surface of the posterior abutment. 5. In case of alveolar bone resorption, the displacement was larger than that of normal alveolar bone in all loading cases.

• 여성건강간호학회지
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• 제6권1호
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• pp.67-81
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• 2000

The purpose of this study was to analyze women's health problems using Green & Kreuter's(1991) PRECEDE model and to develop health education program for women's health. The subjects were recruited women from Wonju city 18 years or older. 1. The results showed that about 50% of the women were satisfied with their lives as women, 23% of the sample felt there was a need for a women's health care center. The mean number of health problems was 3.1 and the prevalence rate, 44.4%. 2. We developed on educational program according to group differences related to health problems, diagnosis of disease, variables influencing health promotion behavior, and programs which each group wanted. Also we stressed self-efficacy and self-help group for the management of individual health to all groups. 3. The diagnoses of diseases that were experienced premarital over the past year were gastritis, bronchitis, spinal disk, and fracture, for the childbearing/rearing group, gastritis, vaginitis and cervicitis, cervical cancer and cystitis and nephritis and arthritis and for the middle-aged/elderly group arthritis, gastritis, vaginitis and cervicitis, and spinal disk. Of the sample 30.5% did not have a health exam in the past year, and only 10% of the premarital group, 12.5% of the childbearing/child-rearing group, and 18.3% of the middle aged-elderly group were concerned about their health and did something for their health. 4. The average score on the HPLP was 2.41. the HPLP was scores according to group were found to have significant differences. self-efficacy, family functions, health attention and were considered important variables in the premarital group, in the childbearing/child-rearing group self-efficacy, family functions, internal locus of control, health attention, and health perception and power others locus of control and then for the middle aged-elderly group self-efficacy, health attention, internal locus of control, family functions and health perception. 5. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. The premarital group requested the educational programs on diet, health exercise, family health and stress management. Also the childbearing/child-rearing group wanted programs on diet, family health, stress management, and health exercise, and the middle-aged/elderly group wanted that of family health, diet, climacteric changes stress management and health exercise. The program suggested that this program should be applied to women in the community to insure adequate management of women's health. Follow-up research with PROCEED is needed to analyze health outcomes, also, a women's health nursing specialist system is required to develop health promotion, and improve the quality of life for women.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제60권8호
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• pp.390-395
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• 2017

Background and Objectives With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. Subjects and Method In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. Results Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. Conclusion An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
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• pp.53-55
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• 2004

본 연구에서는 병원에서 멀리 떨어진 교통사고, 낙상에 의한 두개골이나 경추, 척추등의 골절을 동반한 심각한 외상이 있거나 기흉등의 육안으로 진단하기 힘든 응급환자에 있어서는, 구급차를 이용하여 후송중이라 하더라도 방사선검사를 하여 전문의로부터 적절한 진단을 받고 응급조치를 할 필요가 있다. 본 연구의 목적은 응급상황에 사용할 수 있도록 CDMA 1X EVDO 방식의 통신망을 기반으로 하는 이동형 의료영상 전송장치의 프로토타입을 구현하고 성능을 평가하는 것이다. 설계된 시스템은 영상을 전송하기 위한 DICOM 영상전송 클라이언트로 노트북 컴퓨터에 CDMA 1X EVDO 방식을 지원하는 셀룰러폰을 연결하였으며, 병원에는 영상을 받기 위한 DICOM 영상수신 서버를 설치하였다. DR영상을 영상전송 클라이언트의 저장소에 저장한 후, JPEG2000형식으로 압축하여 수신서버로 전송하였다. 모든 영상은 progressive하게 전송되어지고 디스플레이에 표시되었다. 영상의 질을 평가하기 위하여 PSNR을 계산하였으며, 전송품질을 측정하기 위하여 차량의 속도에 따른 CDMA2000 1X-EVDO의 전송률 및 영상의 전송속도를 측정하였다.