• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.21-21
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• 2009

There are some patients who have traumatic anterior shoulder instability due to minor injuries like overhead activities. The purpose of this study was to clarify characteristic features of traumatic anterior shoulder instability due to minor injuries. According to the mechanism of injury in an initial dislocation, 83 shoulders that underwent the stabilizing surgery for traumatic anterior shoulder instability were divided into two groups. Traumatic group included patients who suffered from a fall or a direct injury. Minor injury group included patients who suffered from the other injury like overhead activity. General joint laxity, range of motion and laxity under anesthesia, and intraarticular findings were compared between two groups. The morphology of superior and middle glenohumeral ligaments, Bankart lesion, Hill-Sachs lesion, and partial articular surface tendon avulsion lesion were observed in arthroscopy. Minor injury group consisted of 19 shoulders with 8 males, 11 females and the mean age of 22.5 years. Traumatic group consisted of 64 shoulders with 52 males, 7 females and the mean age of 24.3 years. Female in minor injury group was significantly more than that in traumatic group. There was no difference in general joint laxity and intraarticular findings between two groups. Range of external rotation in injured side in minor injury group was significantly more than that in traumatic group. Inferior laxity in both sides in minor injury group was more than that in traumatic group. In conclusion, the traumatic anterior shoulder instability due to minor injuries might incline to occur the shoulder in female and with inferior laxity of shoulder.

• 대한물리치료과학회지
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• 제10권2호
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• pp.246-257
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• 2003

Even though the automation of industrial machinery has dramatically increased, most industries still require human hands for the production of goods. Our hands are essential to our existence. For this reason, hand injuries caused by industrial accidents have become an important issue lately. Most hand injuries are external wounds and constitute 38.6% of disabling industrial accidents. This significant statistic cannot be ignored by rehabilitation programs. The rate of success in operations of finger and hand injuries has increased, but relatively less consideration has been given to physical therapy, rehabilitation, research, or systematic installment in terms of welfare, which would help the injured carry on the nominal life they lived before their injury. Therefore, it is necessary to study systematically all related aspects to provide patients with physical therapy, rehabilitation, and social welfare, in order to restore their social, professional, and economical capabilities. Physical considerations, functional usability, and cosmetic restoration, as well as the patients' mental state must be addressed. The results of the study shows several problems. Medical appliances, manpower, and the environment of the treatment rooms are very poor. The patients cannot receive treatment early enough nor enough treatment because of too many patients for too few physical therapists. Close cooperation between physical therapists and doctors, nurses, or related departments is lacking. Furthermore, it is irrational that industrial accident premiums for the exert; e treatment of hand injury patients are not itemized. Lack of recognition of the importance of specialty in hand injury therapists leads to the lack of professionalization of systematic hand injury treatment In order to solve these problems, the professonalism of physical therapy should be acknowledged and particular treatment courses should be available and/or required. Based on the understanding of the hand injury patients' needs, new theories of physical therapy should be developed and modem medical appliances and facilities should be available, in order to provide the patients with qualitative medical treatment, which then will facilitate the patients' recovery.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.510-513
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• 2006

Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

• 한국운동역학회지
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• 제26권4호
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• pp.369-375
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• 2016

Objective: The purpose of this study was to investigate the possibility of injuries and the types of movement related to damage by body parts, and to prepare for prevention of injuries and development of a training program. Method: For this study, the experiment was conducted according to levels of 60 percentages (ST) and 85 percentages (MA) and 10 subjects from the Korean elite national weightlifting team were included. Furthermore, we analyzed joint moment and muscle activation pattern with three-dimensional video analysis. Ground reaction force and EMG analyses were performed to measure the factors related to injuries and motion. Results: Knee reinjuries such as anterior cruciate ligament damage caused by deterioration of the control ability for the forward movement function of the tibia based on the movement of the biceps femoris when the rectus femoris is activated with the powerful last-pull movement. In particular, athletes with previous or current injuries should perceive a careful contiguity of the ratio of the biceps femoris to the rectus femoris. This shows that athletes can exert five times greater force than the injury threshold in contrast to the inversion moment of the ankle, which is actively performed for a powerful last pull motion and is positively considered in terms of intentional motion. It is activated by excessive adduction and internal rotation moment to avoid excessive abduction and external rotation of the knee at lockout motion. It is an injury risk to muscles and ligaments, causing large adduction moment and internal rotation moment at the knee. Adduction moment in the elbow joint increased to higher than the injury threshold at ST (60% level) in the lockout phase. Hence, all athletes are indicated to be at a high risk of injury of the elbow adductor muscle. Lockout motion is similar to the "high five" posture, and repetitive training in this motion increases the likelihood of injuries because of occurrence of strong internal rotation and adduction of the shoulder. Training volume of lockout motion has to be considered when developing a training program. Conclusion: The important factors related to injury at snatch include B/R rate, muscles to activate the adduction moment and internal rotation moment at the elbow joint in the lockout phase, and muscles to activate the internal rotation moment at the shoulder joint in the lockout phase.

• Journal of Chest Surgery
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• 제40권1호
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• pp.66-68
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• 2007

외상성 심장 손상은 매우 위중한 의학적인 상황이다. 흉벽의 외상이 없는 경우 심장의 손상은 간과될 수 있다. 저자들은 자동차 추돌사고를 입고 우심방 파열이 발생한 47세 여자 환자를 보고한다. 감속손상으로부터 발생하는 비틀림의 힘은 고정점에서 심장의 파열을 일으킬 수 있다. 심장의 심각한 손상을 의심할 수 있는 가장 흔한 증상은 활력증후의 변화이다. 그러므로 감속손상을 입은 환자에서 흉벽의 외상이 없더라도, 이유가 설명되지 않는 저혈압이 관찰될 때 심장의 손상을 의심하여야겠다.

• 한국직업건강간호학회지
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• 제20권3호
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• 대한정형외과학회지
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• 제55권5호
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• pp.383-396
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• 2020

목적: 중등도 이상의 손상 환자를 대상으로 손상의 중증도에 따른 정형외과적 손상의 손상기전, 부위, 유형, 치료적 접근 및 그 치료결과를 분석하고자 한다. 대상 및 방법: 2014년부터 2019년까지 응급실/외상센터가 운영되지 않은 기간을 제외한 57개월 동안 국립중앙의료원 외상센터로 입원한 손상 중증도 점수(Injury Severity Score, ISS) 9점 이상의 환자들 중 정형외과적 손상이 동반된 778명을 대상으로 후향적 연구를 시행하였다. ISS와 생리학적 지표를 기준으로 한 손상의 중증도에 따라 중등도 손상군(1군, 679명)과 중증 손상군(2군, 99명)으로 분류하고 손상기전, 비정형외과적 손상을 평가하였다. 정형외과적 손상은 침범된 해부학적 영역과 골격구조의 수와 유형을 평가하였고, 치료적 접근 방법을 세분화하여 비교하였다. 치료결과는 재원기간을 포함하여 재원기간 내 발현된 전신 합병증과 사망률을 평가하였고 사망률에 미치는 요인을 분석하였다. 결과: 2군이 보다 젊고, 남성의 빈도가 높았고 고에너지 손상기전 및 동반 손상의 빈도가 유의하게 증가되었다. 정형외과적 손상 중 침범된 골격계의 수는 2군에서 유의하게 많아지면서 하지를 주로 침범한 1군에 비해 2군에서는 골반, 척추, 상지 영역의 침범이 유의하게 증가하였다. 정형외과적 손상은 환자의 임상적 상태에 따라 확정적 또는 단계적 치료가 시행되었으며 다발성 중증 손상을 보이는 2군에서는 일시적 외고정술을 이용한 단계적 수술의 빈도가 유의하게 높았고 1군에서는 생리학적 안정화를 이룬 뒤 확정적 수술을 시행하는 빈도가 유의하게 높았다. 중증도가 높아질수록 재원기간 역시 길어졌으며 재원기간 내 총 전신 합병증은 약 4.9%, 총 사망률는 약 4.5%였다. 중증도가 높아질수록 사망률은 유의하게 높아졌다(1군 2.9%, 2군 15.2%; p<0.0001). 사망률에 미치는 요인 중 고령과 높은 ISS가 중요한 요인으로 확인되었다. 결론: 손상의 중등도가 높을수록 고에너지 손상기전에 의한 손상의 발생 빈도가 높아지며 보다 젊고, 남성의 빈도와 동반 손상의 빈도가 높아졌다. 정형외과적 손상 역시 다발성 손상의 빈도와 중증도가 유의하게 증가되면서 정형외과적 외고정장치를 이용한 내고정술 등이 단계적 치료의 일환으로 시행된 경우가 유의하게 높아지는 경향을 보였다. 또한 재원기간, 전신 합병증 및 사망률 역시 유의하게 증가되는 경향을 보이며, 사망률에는 높은 연령과 ISS가 중요한 영향을 미치는 것으로 확인되었다.

• 한국컴퓨터정보학회논문지
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• 제25권11호
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• pp.239-244
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• 2020

본 연구는 광주지역 권역응급의료센터에 내원한 환자의 의료정보를 기초로 외상의 중등도별 특성 분석을 통한 손상발생의 위험요소를 파악하여 손상예방대책을 위한 보건예방정책 제언 및 기초 자료를 마련하는데 목적이 있다. 2019년 9월 1일부터12월 31일까지 4개월간 응급의료센터에 내원한 2585명의 환자를 대상으로 손상외인 관련성을 연구의 통계학적 분석을 위하여 SPSS-Window(ver. 20.1)프로그램을 이용하였다. 연구 분석결과는 다음과 같다. 응급의료센터에 내원한 손상 환자 중 전체 2585명 환자에서 성별은 남성(61.3%)이 여성(38.7%)보다 더 많았으며, 20대에서 50대까지의 연령층에서 발생률이 높았으며 중증도를 감안하면 50대(16.8%)의 연령층이 가장 많았다(P<.001). 둘째, 중등도에 따른 손상외인의 발생장소로는 도로 및 교통지역(35.1%)이 가장 높았다(P<.001). 셋째, 중등도에 따른 손상발생의 시간은 12-18시(35.8%)로 높았다(P<.001). 넷째, 중등도에 따른 손상부위는 두부 및 안면부(55.4%)에서 가장 높았다(P<.001). 다섯째, 중등도에 따른 손상 유형은 열린상처(31.2%)에서 높았다(P<.001). 향후 손상에 대한 지속적인 관심과 연구로 외상환자 등 중증도별 특성에 따라 구체적인 보건예방정책 수립이 요구된다.

• 한국임상수의학회지
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• 제20권1호
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• pp.134-137
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• 2003

A 5-year-old, male mixed breed dog was presented to Gyeongsang National University Animal Hospital for bilateral mandibular open fracture by bite. The dog had loss of the teeth and injury of the oral mucosa. Radio-graphic and blood examinations were conducted. Fracture lines were observed between first premolar and second premolar, but temporomandibular luxation was not observed on radiographs. In serum analysis, elevated levels of CPK and LDH were found. The dog was anesthetized and prepared for aseptic surgery. Acrylic external skeletal fixator with Kirschiner wire was applied. Pin loosening and malalignment of the right fracture line was observed at 7 weeks after surgery. We applied Kirschner-Ehmer fixator and half pins during the second surgical procedure. At 4 weeks after a second surgical procedure, the fixator and pins were removed from mandible. The fractures were healed with no complications.

• Anatomy and Cell Biology
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• 제51권4호
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• pp.225-231
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• 2018

Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012-2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.