• Title/Summary/Keyword: Injury pattern

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Transosseous Tie Fixation Using Krackow Sutures and Bone Tunnels in a Comminuted Fracture of the Upper Pole of the Patella: A Case Report

  • Baik, Jong Seok
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.305-308
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    • 2021
  • Comminuted fractures of the patella mostly occur at the inferior pole and require appropriate reduction and fixation to restore the extensor mechanism. Conventional methods such as tension-band wiring are not enough to gain proper fixation strength. Numerous methods have been reported, including circumferential cerclage wiring, osteosynthesis, and suture anchors depending on the fracture pattern. Herein, the author reports a relatively rare case of a comminuted fracture of the upper pole of the patella, for which we used augmented Krackow sutures in the quadriceps and fixation with tying of the suture limbs through patellar bone tunnels. Satisfactory results were obtained in terms of reduction and extensor mechanism recovery.

The analysis of lower extremities injury on depth jump (Depth Jump 시 하지 관절 상해에 관한 운동역학적 분석)

  • So, Jae-Moo;Kim, Yoon-Ji;Lee, Jong-Hee;Seo, Jin-Hee;Chung, Yeon-Ok;Kim, Koang-Ki
    • Korean Journal of Applied Biomechanics
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    • v.15 no.1
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    • pp.127-142
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    • 2005
  • The purpose of this study was to analysis biomechanics of the lower extremities injury the heights(40cm, 60cm, 80cm) of jump box as performed depth jump motion by 6 females aerobic athletes and 6 non-experience females students. The event of depth jump were set to be drop, landing and jump. The depth jump motions on the force plate were filmed using a digital video cameras, and data were collected through the cinematography and force plate. On the basis of the results analyzed, the conclusions were drawn as follows: 1. The landing time of skill group was shorter than unskill group at 40cm, 60cm drop height during drop-landing-jump phase especially. The landing time of 60cm drop height was significant between two group(p<.05). 2. The peak GRF of sagittal and frontaI direction following drop height improve was variety pattern and the peak vertical force of 40cm drop height was significantly(p<.05). 3. The magnitude of peak passive force was not increase to change the drop height. 4. The peak passive forces was significant at 40cm drop height between two groups(p<.05)

Two Part Triplane Fracture with Extention through Medial Malleolus (Four Cases Report) (족관절 내과를 침범한 두 부분 삼면 골절(4예 보고))

  • Cha, Seung-Do;Kim, Hyung-Soo;Chung, Soo-Tae;Yoo, Jeong-Hyun;Park, Jai-Hyung;Kim, Joo-Hak;Kim, Yong-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.179-183
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    • 2009
  • The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias-Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.

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Transdermal Delivery of Triamcinolone acetonide Gel by Ultrasound (초음파 조사에 의한 트리암시놀론 아세토니드 겔의 피부투과)

  • Song, Kyung-Suk;Kim, Young-Il;Yang, Jae-Heon
    • Journal of Pharmaceutical Investigation
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    • v.32 no.2
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    • pp.87-93
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    • 2002
  • This study is to enhance drug penetration via skin and investigate anti-inflammation effect following adoption of ultrasound. For this goal gel containing triamcinolone was prepared and the skin penetration rate and the change effects of blood plasma ingredients and serum enzyme were investigated. Using Franz type diffusion cell and the skin of hairless mouse, the permeation enhancing effect of ultrasound was tested. After the injury by direct trauma, the blood test was performed by measuring WBC, lymphocyte, and neutrophyl, and by analyzing CPK and LDH. The ultrasound transducer whose technical specification is geometric area(GA) $1.4\;cm^2$, effective radiation area(ERA) $0.8\;cm^2$, and beam non-uniformity ratio(BNR) 6.0 max was used. The influence of frequency having an effect on skin permeation rate was higher in the case of using 1MHz and continuous treatment. The temperature of receptor phase was not influenced in skin permeation by phonophoresis. Skin permeation increase attended by intensity of ultrasound, the permeation of triamcinolone was accelerated at $2.5\;w/cm^2\;than\;1.0\;w/cm^2$. Following muscle injury phonophoretic group the number of WBC, neutrophil and lympholyte were decreased significantly as compared with both control group and ultrasound group. The result of variation of serum CPK and LDH activity conformed to the phonophoretic effect as same pattern with the variation of WBC, neutrophil and lymphocyte.

A Nuclear Medicine Study on the Effect of High Energy Gamma Irradiation on Rabbit Liver (고(高)에너지 방사선(放射線) 조사(照射)가 가토(家兎) 간장(肝臟)에 미치는 영향(影響)에 관(關)한 핵의학적(核醫學的) 연구(硏究))

  • Lee, Joon-Il;Min, Bong-Hee
    • Journal of radiological science and technology
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    • v.12 no.1
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    • pp.3-16
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    • 1989
  • In order to investigate the in vivo effect of $^{60}Co$ radiation on rabbit liver, the uptake ratio and regional excretory value in hepatocytes and Kupffer cells were estimated during acute and chronic hepatic injuries. The left lobe of liver was irradiated at 15 Gy or 30 Gy with a single dose and subsequent changes were analysed with a seial nuclear medicine imaging by using $^{99m}Tc-phytate,\;^{99m}Tc-DISIDA\;and\;^{99m}Tc-HSA$ and resulting data were computerized. The degree of hepatic damage, duration of the injury, and recovery pattern after the irradation were in agreement with the findings of other investigations. However, out values were more quantitative evacuation than those of other publications. Recovery of decreased uptake of $^{99m}Tc-phytate$ was delayed approximately $2{\sim}3$ days later than that of $^{99m}Tc-DISIDA$. In acute radiation induced injury, the results demonstrated that the recovery of Kupffer cells was delayed more than that of hepatocytes. This discrepancy was considered due to the differences in repair activities between these cell types. The decreased of regional excretory value in irradiated area was found to be dose-dependent but had no corelation with regional uptakes of DISIDA and phytate. The decreased of regional excretory value observed in non-irradiated region suggested that irradiated liver might induce an indirect effect.

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Dental Treatment in a Autistic Child under General Anesthesia (전신 마취를 이용한 자폐아동의 치험예 -증례보고-)

  • Kim, Yun-Hee;Kim, Sang-Won;Beak, Kwang-Woo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.5 no.1 s.8
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    • pp.15-21
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    • 2005
  • Autism is characterized with an abnormality of reciprocal social relatedness and of communication development. Also, autistic children show repetitive and stereotypical behavior pattern and deficiency of endurance against change. Dental problems related to autism are self-injury and trauma from accidents. Sometimes self-injury is due to discomfort resulting from restoration and local anesthesia. Also, gingivitis and multiple caries are common because of poor oral hygiene. Autistic children are anxious about visual and auditory stimuli because they don't understand the dental procedure. If the face of any changes in their daily life, their behavior becomes uncontrollable. In a setting such as the outpatient office, an autistic child's uncontrollable behavior makes it difficult to carry out proper treatment. If they need treatment under general anesthesia, it is very difficult to manage them in a ward as they are severly anxious about being admitted to a hospital. Therefore it is necessary to treat these children according to a specific management program under general anesthesia in an outpatient office. This case study reports of a 14 year old autistic teenager who although became uncontrollable because of the pain from multiple caries and from anxiety of the dental treatment eventually received treatment under general anesthesia and under conscious sedation in an outpatient office.

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Transfer Patterns of Multiple Trauma Patients in University Hospital after Acute Phase Management (대학병원에서 급성기 치료가 완료된 다발성 외상환자의 전원 패턴)

  • Lee, Jong Min;Jang, Ji Young;Lee, Seung Hwan;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.261-265
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    • 2013
  • Purpose: The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type. Methods: Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review. Results: The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038). Conclusion: An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.

Oral and maxillofacial injuries in children: a retrospective study

  • Mukhopadhyay, Santanu;Galui, Sauvik;Biswas, Raju;Saha, Subrata;Sarkar, Subir
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.183-190
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    • 2020
  • Objectives: The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population. Materials and Methods: Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%. Results: Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46). Conclusion: Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

Altered Peripheral Nerve Excitability Properties in Acute and Subacute Supratentorial Ischemic Stroke (급성 및 아급성 천막상 허혈성 뇌졸중에서 발생하는 말초신경 흥분성 변화)

  • Seo, Jung Hwa;Ji, Ki Whan;Chung, Eun Joo;Kim, Sang Gin;Kim, Oeung Kyu;Paeing, Sung Hwa;Bae, Jong Seok
    • Annals of Clinical Neurophysiology
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    • v.14 no.2
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    • pp.64-71
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    • 2012
  • Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

Essential Factors in Predicting the Need for Angio-Embolization in the Acute Treatment of Pelvic Fracture with Hemorrhage

  • Yang, Seok-Won;Park, Hee-Gon;Kim, Sung-Hyun;Yoon, Sung-Hyun;Park, Seung-Gwan
    • Journal of Trauma and Injury
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    • v.32 no.2
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    • pp.101-106
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    • 2019
  • Purpose: The purpose of this study was to determine the essential factors for prompt arrangement of angio-embolization in patients with pelvic ring fractures. Methods: A total of 62 patients with pelvic ring fractures who underwent angio-embolization in Dankook University Hospital from March 2013 to June 2018 were retrospectively reviewed. There were 38 men and 24 women with a mean age of 59.8 years. The types of pelvic ring fractures were categorized according to the Tile classification. Patient variables included sex, initial hemoglobin concentration, initial systolic blood pressure, transfused packed red blood cells within 24 hours, Injury Severity Score (ISS), mortality rate, length of hospital stay, and time to angio-embolization. Results: The most common pelvic fracture pattern was Tile type B (n=34, 54.8%). The mean ISS was $27.3{\pm}10.9$ with 50% having an $ISS{\geq}25$. The mean time to angio-embolization from arrival was $173.6{\pm}89minutes$. Type B ($180.1{\pm}72.3minutes$) and type C fractures ($174.7{\pm}91.3minutes$) required more time to angio-embolization than type A fractures ($156.6{\pm}123minutes$). True arterial bleeding was identified in types A (35.7%), B (64.7%), and C (71.4%). Conclusions: It is important to save time to reach the angio-embolization room in treating patients with pelvic bone fractures. Trauma surgeons need to consider prompt arrangement of angio-embolization when encountering Tile type B or C pelvic fractures due to the high risk of true arterial bleeding.