• Archives of Plastic Surgery
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• 제48권6호
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• pp.699-702
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• 2021

Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.189-195
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• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal & gastric aspiration and hypovolemic shock. Therefore, the rapid & correct bleeding control is very important for life-saving in the medical emergency room. In spite of the bleeding control methods of the wound suture & direct pressure, the postoperative bleeding can be occurred, because of the presence of various bleeding disorders & postoperative delayed wound infections. The proper care of bleeding disorders & wound infections are very important for the control of the delayed postoperative rebleeding. In spite of these methods, active oral bleeding can be presented by the other causes of head injury. A rare but particularly dangerous sort of bleeding that may have an especial importance to the patient with severe basal skull fracture that damage large vessels and even the cavernous sinus. The occurrence of profuse nasal or oropharyngeal bleeding may arise from damage to the anterior and posterior ethmoidal vessels, but when mixed with brain tissue it is evidence of mortal damage. In this condition, rapid entire oropharyngeal packing is essential for the control of active oral bleeding. This is a case report of rapid rational bleeding control method by much amount of wet gauze packings, in a 44-years-old male patient with active oropharyngeal bleeding by basal skull fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.431-436
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• 2009

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.86-90
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• 2014

Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

• 대한치과마취과학회지
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• 제2권2호
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• pp.107-113
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• 2002

Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• 대한치과마취과학회지
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• 제10권1호
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• pp.20-26
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• 2010

This type of neuropathic pain(atypical odontalgia) is seen most often in middle-aged women or men after dentoalveolar operation. Atypical odontalgia probably is caused by deafferentation leading to intraneural changes in the medullary dorsal horn. Treatment of this problem is difficult, but some success has been reported in uncontrolled, open-labeled studies using high doses of tricyclic antidepressants. This is the management report of a patient case, that had a neuropathic atypical odontalgia recognized with the right maxillary lateral incisor. The patient was consulted to the Department of Pain Clinics, ENT & Neurology and diagnosed the adenoid cystic carcinoma on left cerebellum and right paranasal sinus with extension to the cavernous sinus. In spite of the osteoplastic craniotomy, neurosurgical mass removal and radiation therapy were done with chemotherapy, atypical odontalgia was continued. In addition to the consultation to Psychology, stress management and antidepressant medication were done and improved slowly.

• 융합정보논문지
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• 제8권3호
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• pp.153-160
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• 2018

본 연구는 2018년 '대학기본역량진단'의 과정 중에 대학 평가정책에 따른 학과의 대응을 A 대학교 기독교교육과 사례를 중심으로 논의하고자 한다. 이를 위해 대학평가정책의 배경, 대학구조개혁평가, 대학기본역량진단을 살펴보고 학과의 대응으로 특성화, 교육과정, 수업의 질관리, 교육성과, 학생지원, 지역사회의 협력 및 기여를 논의한다. 학과의 특성화는 교육목적, 인재상, 교육목표 및 핵심역량과 관련 있고 교육과정은 학생들에게 진로 트랙을 제시하고 자신의 진로와 연계하여 강좌를 수강할 수 있도록 한다. 수업의 질 관리는 A대학교의 학사지원과, 교육품질관리센터, 교육역량강화센터와 연계한 강의관리시스템으로 연계되어 있고 학과의 교육성과를 향상시키기 위해서는 신입생 충원율과 재학생 충원율을 높이고 중도탈락율을 낮추도록 적극적인 학업지도 및 상담의 실시하고 있다. 학생지원은 A 대학교 학교 차원의 비교과 프로그램과 학과차원의 비교과프로그램, 학업 진로 취업지도 및 상담, 학생역량관리 등이 있다. 지역사회 협력 및 기여를 향상시키기 위해서는 안양시 및 기타 지역의 교육기관인 유치원, 초 중 고등학교에서 60시간 교육봉사, 지역학교 행사의 지원 봉사, 교사 초청 세미나 등을 진행하고 있다. 본 연구결과는 향후 대학교육에 기초자료로 활용될 수 있을 것이다.

• 기독교교육논총
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• 제68권
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• pp.245-277
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• 2021

본 연구는 기독교 그림책 관련 연구 동향을 알아보고자 하였다. 기독교 그림책과 관련된 연구의 연구시기, 연구내용, 연구방법 연구대상을 분석하여 기독교 그림책 분야의 다양하고 균형 있는 연구를 위한 기초자료를 제시하는데 목적이 있다. 본 연구를 위해 '기독교 그림책', '성경 그림책', '기독교 동화', '성경 동화'를 주제어로 국회도서관과 학술연구정보서비스(RISS)를 통해 검색된 국내 석·박사학위논문 45편을 추출하였다. 기독교 그림책 관련 연구를 연구시기, 연구내용, 연구방법, 연구대상의 네 가지 준거로 분석하여 빈도와 백분율을 산출하였다. 연구결과, 첫째, 기독교 그림책 연구논문의 연구시기별 동향은 1999년부터 2021년까지 석사학위 43편(95.6%), 박사학위 2편(4.4%)으로 석사학위 중심으로 기독교 그림책 관련 연구들이 이루어지고 있다. 둘째, 연구내용별 동향은 기초연구 12편(26.6%), 실천연구 33편(73.4%)로 나타났다. 기독교 그림책 관련 연구는 기초연구보다 실천연구 중심으로 활발히 이루어지고 있다. 셋째, 연구방법별 동향은 양적연구 33편(73.4%), 문헌연구 11편(24.4%), 질적연구 1편(2.2%) 순으로 나타났다. 기독교 그림책 관련 연구는 양적연구 중심으로 이루어지고 있고, 상대적으로 문헌연구와 질적연구가 낮은 비율을 차지하였다. 넷째, 연구대상별 동향은 인적대상 35편(77.8%), 물적대상 10편(22.2%)으로 인적대상으로 이루어진 연구가 많았다. 인적대상에서 단일대상 33편(73.4%), 혼합대상 2편(4.4%)로 나타났고, 단일대상 중 유아·아동을 대상으로 하는 연구가 30편(66.7%)으로 높게 나타났다. 즉, 기독교 그림책 관련 연구는 유아-유아, 유아-교사, 유아-부모 간의 혼합대상보다 단일대상인 유아로 이루어진 연구 비율이 높았다.

• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.181-184
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• 2014

Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its $2{\times}2{\times}3cm$ capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.346-352
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• 2009

There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.