• 제목/요약/키워드: Cervical spine injury

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Indications and findings of flexible bronchoscopy in trauma field in Korea: a case series

  • Dongsub Noh
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.206-209
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    • 2023
  • Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

교통사고로 한방병원에 내원한 근골격계 환자 2,048명에 대한 임상적 분석 (Clinical Analysis of 2,048 Musculoskeletal Patients Who Visited the Traffic Accident Clinic of a Korean Medicine Hospital)

  • 도호정;신예슬;김창은;송현섭;신재권;강병구;고원일;전세환;조용규;김은수
    • 척추신경추나의학회지
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    • 제11권1호
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    • pp.11-23
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    • 2016
  • Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

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사지마비로 장기 침상안정 환자에서 폐결핵 발생부위 변화 1예 (A Case of Atypical Distribution of Pulmonary Tuberculosis in Bedridden Patient with Quadriplegia)

  • 황헌규;정은정;임건일;양승부;임한혁
    • Tuberculosis and Respiratory Diseases
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    • 제69권1호
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    • pp.52-55
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    • 2010
  • Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

슬링운동치료를 이 용한 Neurac 기법의 이론적 근거와 적용방법 (Theoretical Basis and Application of the Neurac Technique Which Uses the Sling Exercise Therapy)

  • 김선엽;김택연
    • 대한정형도수물리치료학회지
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    • 제12권2호
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    • pp.52-65
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    • 2006
  • Sling exercises therapy can speak as appliable comprehensive exercises therapy technique efficiently in general exercise field for injured worker's rehabilitation process and health improvement patient or athlete, injury or disease that have pain or dysfunction to neuromuscular system using that shake. At 1990 an early stage, because physical therapist and doctors of medical treatment developed country norway of north europe cooperate sling exercises therapy's concept trend spreading worldwide establishing theory newly based on scientific basic be. Musculoskeletal system, old man and young child's nervous system injurer's treatment and exercise and industry worker's rehabilitation process, athlete's rehabilitation etc. several fields introduced in early 2000s to Korea apply. Sling exercises therapy neuromuscular system disease continuous abatement as general concept of active exercise and treatment that use sling exercises equipment by purpose know can. This review article wishes to introduce about neuromuscular activation, "Neurac" technique that can speak as step developed more concept based on application principle etc, of basic sling exercises effort's change by suspension point's change that is concept, stability exercises principle, open kinetic chain exercises and closed kinetic chain exercises. Arranged about Plateau potential's characteristic and working mechanism and Neurac technique's application method that can say as Neurac technique's neuro-physiologic base, and presented treatment method of lumbar part disease and cervical part, shoulder joint part disease to application example. Because plateau potential forward player that induce using Neurac technique in part muscles that act role that keep spine surrounding stability in this article keeps muscle's contraction continuously, between global and local muscles, presented several study findings that can cause affirmative change in insufficient muscle adjustment state such as imbalance of muscles' action order. Expect that case studies that use this Neurac technique here after consist continuously.

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자동차 사고를 재현한 시뮬레이션 교육 프로그램 개발을 위한 요구도 조사 (Survey of the Need for the Development of a Simulated Training Program that Reproduces Automobile Accidents)

  • 강민주
    • 한국화재소방학회논문지
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    • 제33권1호
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    • pp.179-187
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    • 2019
  • 본 연구는 119 구급대원 60명과 응급구조학과 교수 9명을 대상으로 조사한 자동차 사고 시뮬레이션 교육 프로그램에 대한 요구도 조사이다. 연구결과 응급처치 항목에서 경추보호대 착용에 대한 시뮬레이션 교육 요구도가 가장 높았고(76.8%), 시나리오 주제 항목에서 머리 손상에 대한 시뮬레이션 교육 요구도가 가장 높았다(75.4%). 구급대원의 근무경력 43개월을 기준으로 두 그룹별 요구도 차이를 확인한 결과 응급처치 항목은 항쇼크바지 사용법과 KED 사용 및 신속 구출에 대한 요구도가 두 그룹에서 유의한 차이를 보였고(p = 0.01, p = 0.05), 시나리오 주제는 얼굴, 복부, 기타 손상에 대한 요구도가 두 그룹에서 통계적으로 유의한 차이가 있는 것으로 나타났다(p = 0.05, p = 0.04, p = 0.03). 자동차 사고 시뮬레이션 교육 프로그램에 대한 119 구급대원과 응급구조학과 교수의 요구도도 높게 나타났으므로 이를 기반으로 추후 시뮬레이션 프로그램 개발이 필요하다고 평가되었다.

교통사고 환자 120례에 대한 임상적 고찰 (The Clinical Study on 120 Cases with Traffic Accident)

  • 이지은;정효근;류충열;조명래;위준;류미선;김자영
    • Journal of Acupuncture Research
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    • 제25권6호
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    • pp.135-143
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    • 2008
  • Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

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키아리 1형 기형을 동반한 고도 척추 측만증에서 수술 전 Halo-Pelvic 견인 후 발생한 6번 뇌신경(외전신경) 마비 (Sixth Cranial Nerve (Abducens Nerve) Palsy after Preoperative Halo-Pelvic Traction for Severe Scoliosis with Chiari I Malformation)

  • 황재광;이춘성;최신우;김정환
    • 대한정형외과학회지
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    • 제55권6호
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    • pp.534-539
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    • 2020
  • 고도 척추 측만증의 치료는 척추외과 의사에게 어려운 과제로 남아있다. 고도 척추 측만증의 수술 시 급격한 교정은 신경학적 손상이나 기구 실패 등의 수술 중 합병증의 위험을 증가시킬 수 있다. 이러한 합병증을 최소화하기 위해 최종 수술을 시행하기에 앞서 부분 교정을 얻기 위한 다양한 수술 전 견인법들이 사용되고 있다. 하지만 이전 연구에 의하면 halo 견인과 관련한 합병증의 하나로 뇌신경 마비가 발생할 수 있으며 대표적으로 6번 뇌신경(외전신경)의 마비가 가장 흔하게 나타난다. 이러한 합병증을 줄이기 위해 견인 무게의 점진적 증량이나 세심한 신경학적 검진이 필요하며 특히 이전에 뇌수술이나 경추부 수술을 시행한 경우에는 더욱 주의가 필요할 수 있다. 저자들은 이전에 키아리 1형 기형과 관련하여 감압술을 시행했던 고도 척추 측만증에서 수술 전 halo-pelvic 견인에 의한 6번 뇌신경 마비의 증례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

다분절 경추 유합 및 내고정 수술결과 (Multi-Level Anterior Interbody Fusion with Internal Fixation in Cervical Spine)

  • 전우열;배장호;정병우;김성호;김오룡;최병연;조수호
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.55-60
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    • 2001
  • Objective : The purpose of the present study was to examine neurologic changes, fusion rate and degree of kyphosis from the surgical results of those patients who underwent multi-level anterior interbody fusion and internal fixation. Methods : Among 63 cases of the patients who received multi-level anterior interbody fusion and internal fixation in 5 years between 1995 to 1999 at the neurosurgery department, we performed a retrospective study in 52 cases that could be followed up with dynamic view imaging ; the results were compared and analyzed. The analysis was based on the results of history taking, physical findings and radiologic findings, and Odom criteria were used to classify those cases with neurologic changes. Results : Among those 52 cases in whom the follow-up was possible for at least a year and dynamic view imaging was possible, bone fusion was seen in 93% of the trauma cases and 95% in the non-trauma cases and overall bone fusion was observed in 94% of the cases. Bone fusion was seen in 93% of the autobone cases, 95% of the allobone cases, and 94% of the Mesh cases. Radiologic changes were observed by comparing the lateral view after surgery ; kyphosis was seen in 53% of the autobone cases, in 70% of the allobone cases, and in 35% of Mesh cases ; in 45% and 60% of the non-trauma cases and trauma cases, respectively ; and in 55% of the 2 level fusion cases and 46% of the 3 level fusion cases. Neurologic changes classified according to Odom criteria showed excellent result in 48% of all the cases, good in 23%, fair in 4%, and poor in 25%. Conclusion : Even those cases with multi-level fusion, a high fusion rate could be obtained by performing anterior interbody fusion and internal fixation ; those cases with kyphosis were related more with the presence or absence of posterior compartment injury rather than the fusion level ; and those trauma cases showed not much difference in the fusion rate compared with non-trauma cases but had a high possibility of kyphosis.

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대전대 OO한방병원 침구의학과 환자들에 대한 통계적 분석 - 2019년 9월부터 2022년 9월까지 - (Statistical Study of the Patient of Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital in Daejeon - from September, 2019 to September, 2022 -)

  • 김소정;장현진;김민주;최현규;박필제;강연수;김홍경;정정교;전주현;김영일
    • 대한한의학회지
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    • 제44권2호
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    • pp.20-33
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    • 2023
  • Objectives: This study is designed to statistically analyze the features of patients who visited to Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital for 3 years. Methods: This study retrospectively analyzed the medical records of patients at Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital using IBM SPSS ver. 27.0 for Windows. Results: 1. In the analysis of the total number of patients, those in their 30s accounted for the highest percentage, male patients had a higher rate. 2. In the analysis of KCD-8 code, spinal stenosis and fractures in areas other than the spine were the most common in the 70s and older, and cervical sprains were the most common in other. 3. In the analysis of the number of hospitalizations, patients classified as illness or higher age had more re-hospitalization than patients classified as injury or lower age in first-time care. 4. In the analysis of hospitalization duration, patients classified as illness, female or higher age had longer hospitalization duration than patients classified as accident, male or lower age in first-time care. Conclusion: We expect that the results of this study would be used as reference materials for analyzing medical consumption condition of Department of Acupuncture and Moxibustion.