• Archives of Plastic Surgery
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• 제34권3호
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• pp.358-364
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• 2007

Purpose: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. Methods: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. Results: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. Conclusion: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.149-158
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• 2015

Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.

• 근관절건강학회지
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• 제3권2호
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• pp.216-228
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• 1996

This study has purpose to perform leaving the hospital nursing plan during hospital treatment of patient with the knee ligament Injury on the basis of the concerns between the time of leaving the hospital after 2 weeks in hospital and the concerns through practical life after leaving the hospital systematically. This study is also tried to make exercise plan to prevent atrophy of Quardriceps muscle of the thigh caused by the limitation of activities. The subjects of study are 12 people who were in the hospital in affiliation to a university in Seoul, were operated on the knee ligament, and were discharged from the hospital within 2 weeks. Data collection time was for about 4 months from December, 94 to March, 95. Research method was performed 2 times by unorganized open questions. The collection of first data is through direct interview about the concerns before leaving the hospital, and secondary data is through direct interview about the concerns by practical life and experiences after leaving the hospital. The data was categorized by classifying several common elements among similar contents according to data by the situational analysis of Giorgi. The result of this study is as follows : 1) The concerns before leaving the hospital are like that the concerns of recovery possibility, the limitation of activities, the grim realities of life, the lack of confidence about self-nursing, the eyes of the surroundings, the burden to the others, and so on. 2) The concerns after leaving the hospital are like that the demands of the inconvenience by the limitation of self-nursing, the support about self-nursing by the difficulties of performing treatment order, the support of physical activities limitation by physical tiredness and the limitation of social activities, the support of information by the necessities of education in using crutches before leaving the hospital and continuing informational needs, psychological and mental support of normal physical recovery by the worries of physical recovery and physical change, and social support by thankfulness for his family and relatives. I suggest to make more systematic leaving the hospital nursing plan and exercise education plan for nursing plan after leaving the hospital of the patients with the knee ligament injury on the basis of this content.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.233-241
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• 2021

Purpose: The medical community has been heavily impacted by the coronavirus disease 2019 pandemic. The management of facial trauma patients has been affected by the patient capacity of emergency rooms. In this study, we share our experiences of facial trauma management during the social lockdown period and investigate the epidemiological changes in facial bone fractures. Methods: A total of 997 patients who presented to Ajou University Hospital Emergency Center and were evaluated by plastic or maxillofacial surgeons for facial trauma were included in this retrospective study. Our study design was a comparative study of two groups: the 2019 group (control) and the 2020 group (the experimental group that experienced social lockdown). Results: The total number of emergency room inpatients reflected the national pandemic trends with three peaks in patient numbers. According to these trends, facial bone fractures had two different low points in August 2020 and December 2020. A comparison of the 2019 and 2020 facial bone fractures did not show a statistically significant difference in the total number of patients. An analysis of the causes of trauma showed that domestic accidents increased in 2020 (30.92%; p<0.001). Among the anatomical sites of facial injury in surgical patients, the frontozygomatic complex fracture increased the most in 2020 (p=0.018). Facial injuries with two separate sites of injury or with three or more involved sites also showed a significant increase in 2020 (p<0.001). Conclusions: We demonstrated that the incidence of facial trauma patients correlated with the incidence of patients presenting to the emergency department and that facial trauma is inextricably related to multi-trauma cases. Domestic accidents and facial trauma with multiple anatomically involved sites are increasing trends that need more attention.

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.3-10
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• 2024

Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

• 치위생과학회지
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• 제7권1호
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• pp.1-7
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• 2007

이 연구는 치과 진료실에서 치과위생사의 감염예방 실태를 파악하여 치과위생사가 감염예방을 실천하는데 기초 자료로 제공하고자 한다. 연구 대상은 2005년 10월과 11월에 인천경기도회와 서울시회 보수교육에 참여한 치과위생사로 하였으며, 감염 예방에 관한 설문조사를 자기기입방식으로 시행하였다. 그 결과는 다음과 같다. 1. 감염예방 교육경험은 "있다"로 응답한 자가 72명(42.9%)이었고, "없다"고 응답한 자가 96명(57.1%)이었고 감염예방 교육경로를 보면 "근무병원 자체 교육을 통해서"가 42명(58%)으로 가장 많았다. 2. 손상 경험은 "있다"로 응답한 자가 147명(87.5%)이었고 "없다"로 응답한 자가 21명(12.5%)이었으며, 손상 경험이 있는 대상자 147명의 전체 연 평균 손상 횟수는 7.7회였다. 손상을 입힌 기구 명으로는 "explorer"가 125(75%)명으로 가장 많았다. 3. 감염성 질환에 감염된 경험은 "있다"로 응답한 자가 6명(3.6%)이었는데 질환으로는 "B형 간염"이 4명으로 가장 많았고, "풍진" 1명, "결핵" 1명이었다. 4. 실천 점수가 높은 문항은 "2. 나는 진료 후에 손을 씻는다(1.86점)", "7. 나는 국소 마취 후 마취주사바늘 뚜껑을 덮는다(1.86점)", "20. 나는 폐기물을 분리수거하여 적출물처리업자에게 위탁 한다(1.85점)"이었으며, 실천 점수가 낮은 문항은 "16. 나는 진료복을 하루에 한번 갈아입는다(0.24점)"와 "감염성 환자 진료 후에는 진료복을 매번 세탁 한다(0.52점)"이었다. 5. 지식도가 가장 높은 문항은 "1. 치과 진료를 하는 동안에 전염은 감염원, 전염방법, 전염경로, 감염되기 쉬운 숙주에 의해 좌우 된다(0.95점)" 이었으며 지식도가 가장 낮은 문항은 "5. HBV(B형간염)는 95oC에서 5분 이상 가열해야 파괴 된다(0.27점)"이였다. 6. 조직관련 요인 점수가 가장 높은 문항은 "나는 필요한 경우 마스크, 장갑 등의 보호 장구가 항상 이용 가능하다(0.89점)"이었으며 가장 점수가 낮은 문항은 으로 "내가 일하는 곳에는 감염과 관련된 위험한 상황에 노출되었을 때 참고할 수 있는 지침서가 있다(0.33점)" 이었다. 7. 진료환경에서 세면대와 진료실의 거리는 "1미터 미만"이 116명(69.0%), 소독실과 진료실의 거리는 "2미터 미만"이 77명(45.8%)으로 가장 많았으며 보호 장구 구비 현황은 마스크(일회용) 168명(100%), 일회용 장갑(라텍스) 167명(99.4%)으로 대부분 구비되어 있었다. 반면 안면 보호대는 응답자수가 108(64.3%)명으로 가장 적었다. 소독, 멸균기에서는 autoclave가 있다고 응답한 자가 165명(98.2%)이었다.

• 대한족부족관절학회지
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• 제26권2호
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• pp.95-102
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• 한국응용과학기술학회지
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• 제40권4호
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• pp.642-649
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• 2023

본 연구의 목적은 허벅다리걸기 시 유도 선수들의 무릎 관절 부상 경험이 운동학적 요인과 압력 중심 요인들에 미치는 영향을 분석하는데 있었다. 본 연구에는 허벅다리걸기를 특기로 하는 오른손잡이 남자 대학 유도 선수 중 최근 2년 이내 무릎 관절 부상 경험이 있었던 13명(연령, 20.69.1±0.75 세; 신장, 172.85±4.81 cm; 체중, 74.92±5.51 kg; 경력, 8.92±0.95 세)과 상해 경험이 없었던 13명(연령, 21.08.1±0.76 세; 신장, 172.54±6.32 cm; 체중, 76.62±9.09 kg; 경력, 9.46±0.94 세)이 두 그룹으로 나뉘어 피험자로 참여하였다. 두 그룹의 발목, 무릎, 힙 관절각도 변인과 압력 중심 가동범위와 속도 요인들의 차이를 분석하였다. 그 결과, 부상 경험 그룹은 부상 경험이 없었던 그룹에 비해 허벅다리걸기 기술 발휘 시 한발 지지 구간 중 E3에서의 무릎 관절 굴곡 각도와 E4에서의 힙 관절 신전 각도에서 작은 수치를 나타내었다. 더불어 부상 경험 그룹은 부상 경험이 없었던 그룹에 비해 한발 지지 구간에서 압력 중심 가동범위와 전방 이동 속도 요인에서도 낮은 수치를 나타내었다.

• 성인간호학회지
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• 제24권6호
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• pp.607-614
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• 2012

Purpose: This is a descriptive research that reports incidents of workplace violence among care helpers. Methods: The subjects were 181 care helpers from elderly care facilities and domiciliary elderly welfare centers in Daejeon. Data were collected through self-administered questionnaires from July to November 2011. Subjects were asked to report incidents of violence within the previous six months. Data analysis included one-way ANOVA, and logistic regression analysis. Results: Forty-seven percent of care helpers reported verbal violence, 16% reported being physically threatened, more than 21 % reported sustaining a physical injury with 2% reporting severe physical injuries. Further, 18.8% of the care givers reported being sexually harassed by client. There were differences in reported workplace violence based on service types, service hours and whether there were policies about workplace violence. Conclusion: To prevent workplace violence for carehelpers, it is necessary to make a policy for preventing violence and develop a violence prevention program to meet service characteristics of facility-based and domiciliary care helpers.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.417-420
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• 2009

The purpose of this report is to describe our surgical experiences in the treatment of cerebral decompression with in situ floating resin cranioplasty. We included in this retrospective study 7 patients who underwent in situ floating resin cranioplasty for cerebral decompression between December 2006 and March 2008. Of these patients, 3 patients had traumatic brain injury, 3 cerebral infarction, and one subarachnoid hemorrhage due to aneurysmal rupture. In situ floating resin cranioplasty for cerebral decompression can reduce complications related to the absence of a bone flap and allow reconstruction by secondary cranioplasty without difficulty. Furthermore, it provides cerebral protection and selectively eliminates the need for secondary cranioplasty in elderly patients or patients who have experienced unfavorable outcome.