• Composites Research
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• v.36 no.4
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• pp.253-258
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• 2023

Although the development of transportation means has realized the right to mobility for the disabled who have difficulty in moving, it can be said that the improvement of the safety of passengers with disabilities that can occur in a car accident is lower than that of ordinary passenger seats. In particular, in the case of a rear-end collision that can occur suddenly, it is a reality that disabled passengers are vulnerable to head and neck injuries. Therefore, in this study, a multi-layer headrest foam that divides the headrest into three parts in the coronal plane was proposed to improve the head and neck injury index of disabled passengers in the vehicle in the event of a rear-end collision of a wheelchair transport vehicle. A range of stress scale factors was selected to give various compressive characteristics of the foam through low-speed rear-end collision analysis through a simple model, and GA optimization was performed by specifying the range as a parameter. Through the optimization result, the phase relationship between HIC and NIC was analyzed according to the compression characteristics of the layers. HIC responded most sensitively to the compression characteristics of the front layer and NIC responded to the compression characteristics of the mid layer, and the compression characteristics of the rear layer showed the lowest. A normal headrest and an optimized multi-layer headrest were placed in the validation model to analyze the low-speed rear-end collision sled test, and HIC and NIC were derived lower in the multi-layer headrest than in the general headrest. The compression behavior of the multi-layer headrest was also clearly shown, and it was verified that the multi-layer headrest was effective in improving the injury index of the head and neck compared to the general headrest.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.62-67
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• 2010

The spreading pathways which is the cause of infection on head and neck area are submandibular space, masticatory space, parapharyngeal space, retropharyngeal space, carotid sheath and mediastinum, etc. If spread to parapharyngeal area involving airway, such infection can be life-threatening by airway obstruction, or can cause vascular injury followed by hemorrhage, nerve injuries. Also, if spread to superficially, necrotizing fasciitis and many complications may occur including gangrene of skin. The key to successful treatment of infection on head and neck area is recognition of spreading pathways, early diagnosis and following therapeutic management. Our department present two cases, one is infection progressed superficially to suprasternal space, another is spreading deep according to parapharyngeal space, subclavian space and carotid sheath followed by airway obstruction, and obtained significant results with surgical incision and drainage, administration of selected antibiotics, continuous post-operative treatment. We report these 2 cases with literatures review.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.710-716
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• 2017

Objective : Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods : We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery). Results : Among all the 2617 THI patients, total number of pediatric patients was 256. The average age of the subjects was 9.07 (standard deviation${\pm}6.3$) years old. The male-to female ratio was 1.87 to 1 and male dominance increases with age. The most common cause for trauma were falls and traffic accidents. Age (p=0.007), surgery (p<0.001), mechanism of trauma (p=0.016), subdural hemorrhage (SDH) (p<0.001), diffuse axonal injury (DAI) (p<0.001) were statistically significant associated with severe brain injury. Conclusion : Falls were the most common cause of trauma, and age, surgery, mechanism of trauma, SDH, DAI increased with injury severity. There is a critical need for effective fall and traffic accidents prevention strategies for children, and we should give attention to these predicting factors for more effective care.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.223-231
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• 2015

Purpose: Delayed, traumatic, intraparenchymal hemorrhage (DTIPH) is a well-known contributing factor to secondary brain damage that evokes severe brain edema and intracranial hypertension. Once it has occurred, it adversely affects the patient's outcome. The aim of this study was to evaluate the prognosis factors for DTIPH by comparing clinical, radiological and hematologic results between two groups of patients according to whether surgical treatment was given or not. Methods: The author investigated 26 patients who suffered DTIPH during the recent consecutive five-year period. The 26 patients were divided according to their having undergone either a decompressive craniectomy (n=20) or continuous conservative treatment (n=6). A retrospective investigation was done by reviewing their admission records and radiological findings. Results: This incidence of DTIPH was 6.6% among the total number of patients admitted with head injuries. The clinical outcome of DTIPH was favorable in 9 of the 26 patients (34.6%) whereas it was unfavorable in 17 patients (65.4%). The patients with coagulopathy had an unexceptionally high rate of mortality. Among the variables, whether the patient had undergone a decompressive craniectomy, the patient's preoperative clinical status, and the degree of midline shift had significant correlations with the ultimate outcome. Conclusion: In patients with DTIPH, proper evaluation of preoperative clinical grading and radiological findings can hamper deleterious secondary events because it can lead to a swift and proper decompressive craniectomy to reduce the intracranial pressure. Surgical decompression should be carefully selected, paying attention to the patient's accompanying injury and hematology results, especially thrombocytopenia, in order to improve the patient's neurologic outcomes.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.44-44
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• 2009

The purpose of this study was to investigate humeral translation relative to the glenoid invivo during loaded and unloaded shoulder abduction. CT scans of 9 healthy shoulders were acquired and 3D models were created. The subject was positioned in front of a fluoroscope and motions were recorded during active abduction. The subjects performed two trials of holding a 3kg weight and unload. 3D motions were determined using model-based 3D-to-2D registration to obtain 6 degrees of freedom kinematics. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the glenoid. Humeral translation was referenced to the glenoid center in the superior/inferior direction. The humerus moved an average of 2 mm, from inferior to central on the glenoid, during arm abduction for both conditions. The humeral head was centered within 1mm from the glenoid center above $70^{\circ}$. There were no statistically significant differences for both conditions. The standard deviation decreased gradually over the motion, with significantly lower variability at the end of abduction compared to the initial unloaded position. We assumed that the humeral translation to the center of the glenoid provides maximum joint congruency for optimal shoulder function and joint longevity. We believe this information will lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.154-160
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• 2009

Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.200-204
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• 1999

Objectives: Injuries of neurologic structures during parotid surgery are sometimes unavoidable even in benign tumors. Since the major postoperative neurologic complications such as facial nerve palsy and Frey's syndrome give a serious and heavy burden to both patients and surgeons, it is very important to know detailed information concerning risk factors, the incidence of complication, possibility of recovery, and the term before complete recovery. Materials and Methods: This report was based on 95 patients with parotid gland tumor who had been treated and followed up over 1 year at department of surgery and otolaryngology, chonnam university hospital. Results: 1) Among total 95 cases, the facial nerve palsy developed in 18 cases(l8.9%) and Frey's syndrome in 6 cases(6,3%). 2) The incidence of facial nerve palsy increased in cases with large tumor size, and in those operated with bipolar method. However, we didn't find out relationships between the incidence of facial palsy, localization, and histologic type. 3) The incidence of Frey's syndrome showed an increasing tendency in the cases with large tumor size, benign nature, and in those underwent superficial lobectomy with posterior approach, without a statistical significance. Conclusions: Risk of facial nerve palsy, especially a transient form, seems to be related to tumor size and bipolar coagulation method. Although Frey's syndrome tends to develop easily in the cases treated with superficial lobectomy under the diagnosis of benign tumor, a futhermore study is suggested to obtain a statistical significance.

• Journal of the Ergonomics Society of Korea
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• v.30 no.3
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• pp.427-435
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• 2011

Objective: The objective of this study was to evaluate a work of building cleaners using the ergonomic methods. Background: Previous studies about cleaning worker describe typical physical demands of this work. They found that the most significant risk factors associated with the physical work of cleaners are static loads and repetitive movements and high output of force. Method: A head of ergonomics estimation was work analysis(define of combined task, work tool, work time and frequency of combined task) and posture analysis of worker. Results: The results showed that combined task of building cleaners was classification sweeping, mopping(wet), mopping(oil), moving barrels/carts, dumping trash bags, scrubbing, arrangement of cleaning tool, arrangement of circumferential, moving of cleaning tool, and waiting. The work time of combined task such as mopping(wet) and scrubbing indicated high ratio. The posture analysis of building cleaners indicated high value in bending of the head, lower arm, and hands. Conclusion: The findings appear to indicate that building cleaner were related to high risk of work-related musculoskeletal disorders. So, building cleaner would be required an interventional strategy, improvement of cleaning tools and working environment. Application: If ergonomics rule can be integrated into existing cleaning tools and work environments, the risk of occupational injuries will be reduced.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.353-359
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• 2000

Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.