• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.276-282
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• 2020

Background: Orbital fractures are the most common pediatric facial fractures. Treatment is conservative due to the anatomical differences that make children more resilient to severe displacement or orbital volume change than adults. Although rarely, extensive fractures may result in enophthalmos, causing cosmetic problems. We aimed to establish criteria for extensive fractures that may result in enophthalmos. Methods: We retrospectively reviewed the charts of patients aged 0-15 years diagnosed with orbital fractures in our hospital from January 2010 to February 2019. Computed tomography images were used to classify the fractures into linear, trapdoor, and open-door types, and to estimate the defect size. Data on enophthalmos severity (Hertel exophthalmometry results) and fracture pattern and size at the time of injury were obtained from patients who did not undergo surgery during the follow-up and were used to identify the surgical indications for pediatric orbital fractures. Results: A total of 305 pediatric patients with pure orbital fractures were included-257 males (84.3%), 48 females (15.7%); mean age, 12.01±2.99 years. The defect size (p=0.002) and fracture type (p=0.017) were identified as the variables affecting the enophthalmometric difference between the eyes of non-operated patients. In the linear regression analysis, the variable affecting the fracture size was open-door type fracture (p<0.001). Pearson's correlation analysis demonstrated a positive correlation between the enophthalmometric difference and the bony defect size (p=0.003). Using receiver operating characteristic curve analysis, a cutoff value of 1.81 ㎠ was obtained (sensitivity, 0.543; specificity, 0.724; p=0.002). Conclusion: The incidence of enophthalmos in pediatric pure orbital fractures was found to increase with fracture size, with an even higher incidence when open-door type fracture was a cofactor. In clinical settings, pediatric orbital fractures larger than 1.81 ㎠ may be considered as extensive fractures that can result in enophthalmos and consequent cosmetic problems.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.738-746
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• 2020

Objectives : The purpose of this study was to evaluate surgical outcomes and complications of spinal deformity associated with neurofibromatosis type-1 (NF-1). Methods : From 2012 to 2018, patients suffering from spinal deformity associated with NF-1 who underwent surgical correction were identified. Demographic data and radiographic measures were retrospectively reviewed. Pre- and postoperative whole spine radiograph images were used to determine both coronal and sagittal Cobb angles. All of patients underwent 3-dimentional computed tomographic scan and magnetic resonance imaging scan to confirm dystrophic features. For evaluation of clinical outcomes, we surveyed the pre- and postoperative scoliosis research society-22r (SRS-22r) score. Results : Seven patients with spinal deformity associated with NF-1 were enrolled in this study. The mean age of patients was 29.5±1.2 years old. The mean follow-up period was 2.8±1.4 years. The apex of the deformity was located in cervicothoracic (n=1), thoracic (n=4), and lumbar region (n=2). Most patients have poor bone quality and decreased bone mineral density with average T-score of -3.5±1.0. All patients underwent surgical correction via posterior approach. The pre- and postoperative mean coronal and sagittal Cobb angle was 61.6±22.6° and 34.6±38.1°, 56.8±18.5° and 40.2±9.1°, respectively. Mean correction rate of coronal and sagittal angle was 44.7% and 23.1%. Ultimate follow-up SRS-22r score (average score, 3.9±0.4) improved comparing to preoperative score (average score, 3.3±0.9). Only one patient received revision surgery due to rod fracture. No serious complication occurred, such as neurological deficit, and viscerovascular injury. Conclusion : The surgical correction of patients having spinal deformity associated with NF-1 is challenging, however the radiographic and clinical outcomes are satisfactory. The all posterior approach can be a safe and effective surgical option for patients having dystrophic curves associated with NF-1.

• 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.

• 한국산학기술학회논문지
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• 제12권10호
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• pp.4459-4466
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• 2011

본 연구는 세로발활 높이와 트레드밀 경사도 차이에 따른 하지의 근활성도를 비교하여 효율적인 보행 운동에 관련 기초자료를 제시하고자 하였다. 하지에 정형외과적 및 관절가동범위에 제한이 없는 학생 17명을 대상으로 세로발활 높이를 정상발과 편평발로 나누어 경사도 $0^{\circ}$, 오르막 $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, 내리막 $5^{\circ}$, $10^{\circ}$, $15^{\circ}$에서 넙다리 곧은근, 넙다리 두갈래근, 앞정강이근, 장딴지근 가쪽과 안쪽 5개 근육의 근활성도를 측정하였다. 경사도 비교 결과 통계학적으로 유의하였고(p<.05), $0^{\circ}$과 내림 $15^{\circ}$에서 유의한 차이가 있었다(p<.05). 경사도와 세로발활높이 차이에 대한 상호작용 효과는 없었다. 근활성도 비교결과 통계학적으로 유의하였고, 근육과 세로발활 높이 차이에 대한 상호작용 효과가 있었다(p<.05). 개체 내 대비검정 결과 넙다리 곧은근과 장딴지근 안쪽근, 넙다리 두갈래근과 장딴지근 안쪽근에서 유의한 차이가 있었고, 장딴지근 가쪽과 안쪽근에서 상호작용 효과가 있음을 알 수 있었다. 세로발활 높이 차이 간에는 통계학적으로 유의하지 않았다(p>.05). 이러한 결과로 미루어 볼 때 정상발과 편평발은 하지 근활성도에서 차이를 나타냄을 알 수 있었다. 따라서 앞으로는 본 연구의 제한점을 보완하여 좀 더 많은 연구가 이루어져야 할 것이다.

• 대한한의학방제학회지
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• 제19권2호
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• pp.179-189
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• 2011

Objectives : Aconiti Lateralis Preparata Radix(fuzi, 附子) and its class herbs(chaunwu, caowu etc.) are necessary for some clinical conditions, such as cold pain, chilling etc,. But, they has some poison component. And, they have been known to cause liver and kidney injury, and dangerous in the patients who has abnormal range of LFT and RFT. This study shows the consequences for aspartate aminotransferase(AST), alanine aminotransferase(ALT), blood urea nitrate(BUN), and Creatinine were analyzed using samples from patients who took the decoction containing fuzi. Methods : Blood samples for Experiment Group(E) were collected from 63 patients, who took the decoction containing fuzi, admitted into the 6th internal medicine department of Dong Eui Oriental Medical Hospital between from January 2007 to March 2011. In compared to those of experiment group, blood samples as Control Group(C) were collected from 64 patients, who took the decoction not containing fuzi, admitted into the same hospital from January 2009 to April 2011. Results and Conclusions : 1. AST No changed : E 4.17%, C 2.63%, Increased : E 12.5%, C 28.95%, Decreased : E 80.33%, C 68.42% 2. ALT No changed : E2.94%, C5.13%, Increased : E 8.82%, C 20.51%, Decreased : E 88.24%, C 74.36% 3. BUN No changed : E 0%, CG 7.14%, Increased : E 32.25%, CG 14.29% Decreased : EG 67.65%, CG 78.57% 4. Creatinine No changed : EG 5.00%, CG 0%, Increased : EG 35.00%, CG 54.55% Decreased : EG 60.00%, CG 45.45% 5. The results suggest that the decoction containing fuzi isn't harmful AST, ALT, BUN, Cr of the patients who has high range of them.

• 한국대기환경학회지
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• 제30권2호
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• pp.175-187
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• 2014

The subways play an important part in serious traffic problems. Almost seven million citizens a day are using subways as a means of traffic communication in the Seoul metropolitan city in 2012. However, the subway system is a semi-closed environment, so many serious problems occurred in subway stations and injured passengers' health. Platform screen doors (PSD) are expected to prevent negligent accident such as injury or death from falling and improve the air quality of the subway station. Installation of PSD at stations in Seoul metropolitan subway had been completed in December 2009. Consequently, the underground transportation system became a closed environment, so the air quality has improved the platforms, but it has deteriorated in the tunnels. Especially, the subway cabin has many doors, and the doors are frequently opened and closed. For this reason, the effect of door opening on subway cabin, dust flow inside the subway cabin. In this process, the maintenance work may influence the health of people who work underground, as well as that of subway users (passengers). In this study, we measured air quality inside and outside of the subway cabin line 2 in Seoul, Korea. This study focused on the investigation of Indoor Air Quality (IAQ) and measurement target pollutants are PM10, CO, $CO_2$, $NO_2$, $O_3$. It was found that levels of PM10, $CO_2$, and $NO_2$ inside subway cabin line 2 exceeded the Korea IAQ standard. Concentrations of PM10, $CO_2$, and $NO_2$ inside of the cabin are higher than outside of the cabin (Indoor Outdoor ratio is higher than 1.). Concentrations of CO, $O_3$ inside of the cabin are lower than outside of the cabin (Indoor Outdoor ratio is lower than 1.). There is a high correlation between $CO_2$ and passengers inside of the cabin and PM10 is only the weakest correlation with passengers. Therefore, it is important to find out the emission source of $NO_2$. The results of this study will be useful as fundamental data to study indoor air quality of a subway cabin.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.140-145
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• 2011

목적: 금속 요골두 치환술은 주관절 불안정성을 동반한 고정할 수 없는 분쇄된 요골두 골절의 치료로 최근 다양한 임플란트의 개발로 널리 사용되고 있다. 저자는 금속성 요골두 치환술의 적응증과 국내에 사용중인 임플란트의 종류와 수술 술기를 문헌 고찰과 함께 기술하고자 한다. 대상 및 방법: 요골두 치환술의 주 적응증은 동반된 연부조직 손상으로 인한 주관절의 불안정성이 있고, 요골두의 분쇄 골절로 안정적인 내고정이 불가능한 골절이다. 이러한 경우 과거 시행되었던 요골두 절제술은 많은 합병증의 발생으로 금기시되고 있다. 현재 국내에서는 양극성, 압박 고정 단극성 및 이완 고정 단극성 임플란트의 3종류가 수입되어 사용되고 있다. 요골두 치환술은 궁극적으로 원래의 요골두의 크기와 길이로 복원하는 것이 중요하다. 과도하게 긴 요골두의 삽입은 흔한 합병증으로 수술 시 주의가 필요하다. 결과 및 결론: 요골두 치환술은 적절한 적응증과 정확한 수술 술기로 만족할 만한 임상적 결과를 얻을 수 있다. 향후 장기추시 연구와 다양한 치환물들의 임상적인 비교 연구가 필요하다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.178-187
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• 2012

Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.254-260
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• 2012

Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.

• Korean Journal of Acupuncture
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• 제21권2호
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• pp.47-67
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• 2004

Objectives : In the present study, the effect of Scolopendrid Water-Alcohol Extract (SWAE) applied to acupuncture point BL23 (Shinsu) on the neuropathic pain was examined. A common source of persistent pain in humans is the neuropathic pain. Anti-convulsant drugs are used to treat the neuropathic pain. In the oriental medicine, Scolopendrid was used for long time to treat convulsant syndrome and back pain, etc. Methods : On the bases of the Scolopendrid clinical application, the effect of SWAE applied to the acupuncture point was tested in the rat model of neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, One hundred microliter of SWAE was applied into the ipsilateral BL23 point at a dose of 10 mg/ml under enflurane anesthesia. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : SWAE injection increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 4h, suggesting a partial alleviation of pain. SWAE applied to BL23 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 4h. However, neither contralateral BL23 point, ST25 (Chonchu) point, nor LR3 (Taechung) point produce as much increase of mechanical sensitivity as ipsilateral BL23 point. And, this increase of mechanical sensitivity was dose-dependent. The improvement of mechanical threshold was interpreted as an analgesic effect. In addition, the analgesic effect of Scolopendrid 4 mg/kg injection is equivalent to that of gabapentin 50 mg/kg injection. The relations between SWAE-induced analgesia and endogenous nitric oxide(NO), inducible NO synthase (iNOS)/neuronal NO synthase (nNOS) were also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which are increased by nerve injury were suppressed by SWAE injection applied to BL23 point. Conclusions : The data suggest 1) that SWAE produces a potent analgesic effect on the neuropathic pain model in the rat and 2) that SWAE-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.