• Title/Summary/Keyword: Physical Trauma

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Characteristics and Treatment of Temporomandibular Disorder in Children and Adolescents: An Analytic Review

  • Park, Hyung-Seok;Ahn, Yong-Woo;Jeong, Sung-Hee;Jeon, Hye-Mi;Ok, Soo-Min
    • Journal of Oral Medicine and Pain
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    • v.42 no.4
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    • pp.89-101
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    • 2017
  • Purpose: The purpose of this study is to investigate the prevalence of temporomandibular disorders (TMDs) in children and adolescents, their characteristic contributing factors, the characteristic features of symptoms and symptoms, and the response to treatment. Methods: We studied the researches, that were the results of the searches for words such as temporomandibular disorder, TMD, children, adolescents, and juvenile through PubMed and DBpia. Results: According to a study conducted in Busan, the ratio of adolescents increased from 18.3% to 21% in 2008 compared to 2000, and the proportion of boys increased from 38.58% to 45.38%. One of the characteristic contributing factors for adolescents is the macrotrauma such as jaw trauma, vehicle accidents, sports, physical abuse, forceful intubation, and third molar extraction. The second is a microtrauma from parafunctional habit such as bruxism, clenching, hyperextension, wind instrument, and fingernail biting that can cause joint overload, cartilage breakdown, synovial fluid alterations, and other changes within the joint. The diagnosis of TMDs in juvenile adolescents is not significantly different from that of adults. Medical history, clinical examination and radiological examinations are required. Conclusions: In the temporomandibular joint history and assessment, all comprehensive dental history examination is required, including head and neck pain, mandibular dysfunction, previous orofacial trauma, history of present illness with an account of current symptoms. For the treatment and management of temporomandibular arthritis in juvenile adolescents, understanding the characteristics of TMDs in juvenile adolescents and thoroughly analyzing appropriate diagnosis and possible contributing factors through comprehensive history taking & examination, conservative treatment, including fast and active cautions education, will be essential.

A Study on the Aesthetic Thought and Expression Tendency of Contemporary Architecture from the Concept of the Uncanny (언캐니 개념으로 바라 본 현대건축의 미적사유와 표현경향 연구)

  • Park, Kyoung-Ah
    • Korean Institute of Interior Design Journal
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    • v.22 no.1
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    • pp.164-173
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    • 2013
  • This study aims to analyze the aesthetic thought and expression tendency appeared in contemporary architecture by looking at today's architectural art based on the concept of the uncanny that Sigmund Freud contended as an aesthetic principle, of the aesthetic concepts tossed around to define the contemporary times in the aesthetics field and discuss the architectural analysis possibility of the concept of the uncanny. The generation structure of the uncanny that generates experiences of fear and surprise is classified into dual structure, trauma, threatening structure, and repetition compulsion. This is the principle that evokes a sense of experiencing subject, incorporates sensibility, and vitalizes internal process. This is also the methodology to organize and structure the concept of the uncanny. When seen from the four factors drawn from the concept of the uncanny and aesthetic expressions, the uncanny expression characteristics of contemporary architecture includes isolation, subversion, trace, absence, oblique line, flotation, concealment, and disturbance. Isolation and subversion refers to producing the space of the pressure of tension and relaxation caused by repression and relief from repression and eliciting the maximum expansion of the sense of space through spatial change. Trace and absence indicates being able to elicit more intense emotions from the experiencing subject by applying the images of alienation and absence in the way to reproduce historical trauma. This happens by implementing the potential value of physical activity. Oblique line and flotation means visual impulse. This happens in the way to visualize uneasy points. This causes uncanny by threatening the survival. Finally, concealment and disturbance refers to creating unpredictable space. The concept of masquerade and maze space composition are applied in the way to activate spatial perception, including space exploration and unintended subject's forced selection. As stated above, the uncanny expression characteristics shown in contemporary architecture can be presented as indicators that are available to analyze the undecided and diversified contemporary architecture aesthetically. In this respect, this study has great significance.

Conversion to Internal Fixation after Temporary External Fixation for Femoral Shaft Fractures in Polytrauma Patients (다발성 외상 환자의 대퇴골 간부 골절에서 임시 외고정술 후 내고정술로의 전환)

  • Choo, Suk-Kyu;Kang, Kyung-Woon;Kim, Young-Woo;Oh, Hyoung-Keun
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.151-157
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    • 2014
  • Purpose: We report the surgical outcomes for femoral shaft fractures in polytrauma patients who were temporarily treated with external fixation and subsequently converted to internal fixation. Methods: From August 2008 to April 2012, we enrolled 13 patients with multiple traumas due to high-energy injuries and concurrent femoral shaft fractures in which temporary external fixation was carried out. The mean age was 39 years, with a range from 18 to 55 years. Ten were men and 3 were women. According to the AO/OTA classification of fractures, type A was found in 5 patients, type B in 6, and type C in 2, with open fractures being found in 6 patients and femoral artery rupture occurring in 2. For internal fixation, intramedullary nailing was performed in 7 patients, and minimally-invasive fixation of locking compression plates was used in 6. Results: Of the 7 patients converted to intramedullary nailing, 1 experienced delayed union. Of the 6 patients treated with minimally-invasive plate fixation, delayed union occurred in 5, and an auto-bone graft was performed within, on average, 8 months (range: 5~10 months), leading to bone union in all cases in the final follow-up. None of the patients experienced infections or complications involving other organs after having been converted to internal fixation. During the mean follow-up of 19 months, patients achieved satisfactory functional outcomes. Conclusion: In polytrauma patients with a femoral shaft fracture who have been treated with temporary external fixation and who may need internal fixation due to the occurrence of delayed union, an appropriate internal fixation method needs to be selected based on the patient's physical status, and the fracture type.

Computed Tomographic Features of Blunt Abdominal Trauma in a Dog (개에서 컴퓨터단층촬영을 이용한 복부 장기 열상 진단 1례)

  • Park, Hyun-young;Seo, Ji-won;Lee, Young-won;Choi, Ho-jung
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.39-42
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    • 2016
  • A 10 months old, male Poongsan dog was referred with a history of right forelimb lameness due to hit by a car a few hours before presentation. On the physical examination, the dog showed pale mucous membrane, respiration distress, and skin abrasions. The main laboratory finding was leukocytosis, while hematocrit was normal. Abdominal radiography revealed the loss of abdominal serosal detail, which was diagnosed as peritoneal hemorrhage on ultrasonography (US) and aspiration. On computed tomography (CT), hepatic and splenic injuries were seen characterized by the discontinuity of the capsule with irregular margin and lower density lesions than parenchyma. No contrast enhancing area were shown in the laceration lesion. The accessory spleen was incidentally found by US and CT. In this case, acute intra-abdominal hemorrhage from splenic and hepatic laceration was diagnosed using CT.

Improvement of Functional Recovery by Cell Transplantation after Spinal Cord Injury (척수손상 후 세포이식에 의한 운동기능의 회복증진)

  • 이배환;이경희;성제경;황세진;김계성
    • Science of Emotion and Sensibility
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    • v.7 no.2
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    • pp.179-186
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    • 2004
  • Acute spinal cord injury can produce neurologic injury with many physical, psychological and social ramifications. It has been shown that two separate components combine to produce neurologic damage in acute spinal cord injury : the primary and secondary injuries. The primary mediators of spinal cord injury include the actual mechanical tissue disruption which is a passive process that occurs immediately following the trauma. A secondary injury cascade follows which appears mediated by cellular and molecular processes working through complex mechanisms. Both the primary and secondary injury cascades produce cell death both in neuronal and supporting cell tissues. Recovery from central nervous system(CNS) disorders is hindered by the limited ability of the vertebrate CNS to regenerate injured cells, replace damaged myelin sheath, and re-establish functional neuronal connections. Of many CNS disorders including multiple sclerosis, stroke, and other trauma, spinal cord injury is one of the important diseases because of the direct association with the functional loss of the body. Previous studies suggest that substantial recovery of function might be achieved through regeneration of lost neuronal cells and remyelination of intact axon in spinal cord injury which is occurred frequently. As a therapeutic approach in spinal cord injury, recently, cell transplantation provides a potential solution for the treatment of spinal cord injury. This review describes the characteristics of spinal cord injury and presents some evidence supporting functional recovery after cell transplantation following spinal cord injury.

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Traumatic Pseudoaneurysm of the Superficial Temporal Artery: Two Cases Report (수상 후 천측두동맥에 발생한 가성동맥류의 치료 2례)

  • Kim, Youn Hwan;Hwang, Won Jung;Song, Soon-Young
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.115-118
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    • 2007
  • Purpose: It is even less common traumatic pseudoaneurysm of the superficial temporal artery and rare with fewer than 200 cases reported in the recent literature. Most common causes of traumatic pseudoaneurysm is sequelae of blunt, penetrating, or iatrogenic surgical trauma. The diagnosis is based on physical findings and can be confirmed by duplex ultrasonogram, computed tomography, and angiography. Surgical resection, percutaneous embolization and conservative treatment have all been used to treat pseudoaneurysm. However recently, non invasive technique like percutaneous thrombin injection under ultrasonographic guidance has been done rather than surgical ligation. In this report, we proposed the several treatment options such as conservative treatment, thrombin injection, and surgical ligation according to the multifarous conditions of pseudoaneurysm, patient, and causes. Methods: We describe two cases of traumatic pseudoaneurysm of superficial temporal artery in which CT angiography was effective in diagnosis and characterization. One is chronic pseudoaneurysm after traffic accident, which is fusiform shape and small size. Since the patient prefered it, we proposed percutaneous thrombin injection first. But we recognize that this method failed, we used surgical ligation according to information of CT angiographic findings. The other is acute pseudoaneurysm after blunt trauma, which is large size accompanying large hematoma. So we proposed compressive dressing and aspiration of hematoma. Results: Two cases were well treated with no recurrence or complication. Conclusion: In conclusion, when selecting a treatment options, followings should be considered: pseudoaneurysm in CT angiography, chronicity, cause, and patient's preference.

An Electrophysiologic Study on the Median Digital Nerves in Healthy Adults (정상 성인의 정중지단신경에 대한 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.329-338
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    • 2005
  • The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. To evaluate of digital nerve conduction velocity of median nerve for obtain clinically useful reference value and compare difference in each fingers. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected conduction velocity and amplitude of digital nerves in median nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, ANOVA was used to compare each fingers and independent t-test was used to compare between Rt and Lt side also compare between different in genders. Conduction velocity of the right thumb was 49.77m/sec, index finger was 56.80m/sec, middle finger was 56.15m/sec and ring finger was 53.38m/sec. The left thumb was 50.48m/sec, index finger was 56.76m/sec, middle finger was 55.99m/sec and ring finger was 53.23m/sec. Amplitude of the right thumb was $64.30{\mu}V$, index finger was $73.95{\mu}V$, middle finger was $77.97{\mu}V$ and ring finger was $43.92{\mu}V$. The left thumb was $74.21{\mu}V$, index finger was $85.72{\mu}V$, middle finger was $88.06{\mu}V$ and ring finger was $47.28{\mu}V$. There were significantly difference between thumb, index, middle and ring fingers(p<.01) but there were no statistically difference between conduction velocity and amplitude of index and middle fingers(p>.01). The conduction velocity of index finger are faster than other fingers and amplitude of middle finger are greater than other fingers. The present results revealed that electodiagnosis can easily perform in index and middle finger for digital nerve of median nerve study.

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A Prediction on the Conservative Treatment Outcome of TMD Patients by Prognostic Factors (측두하악장애 환자의 보존적 치료결과의 예측에 관한 연구)

  • Lee, Hye-Jin;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.133-146
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    • 2001
  • This study was performed to predict the conservative treatment outcome of TMD patients by investigating the prognostic factors ; symptom duration, history of previous treatment, history of previous medication, history of trauma, disability of daily activity, severity of pain, noise, limitation of mouth opening(LOM) and maximum comfortable opening(MCO). Two hundreds and fifty-four subjects were selected for this study among the TMD patients who had visited the Dept. of Oral Medicine BNUH and been treated conservatively with medication, physical therapy, behavioral treatment, and splint therapy from 1991 to 2000. The subjects were divided into two groups improved or unimproved according to the treatment response following six months of conservative treatment. Those who showed less than 1 on NAS for pain, TMJ noise, and opening limitation belonged to the improved group and those who showed more than 2 on NAS belonged to the unimproved group. The two groups were compared with respect to symptom severity, number of diagnosis, history of trauma, previous treatment, previous medication, and disability of daily activity. A prognostic equation with the factors revealed to be significantly related to the prognosis of conservative treatment was obtained. The obtained results were as follows ; 1. In improved group, mean duration of history was 12 months, mean treatment duration of a patient was 4 months an mean number of treatment was about 10 times. In other words, in unimproved group, mean duration of history was 27.4 months, mean treatment duration of patient was 10.5 months and mean number of treatment was 19 times. 2. In unimproved group, multiple diagnosis, chronicity, disability of daily activity were significantly greater than that of the improved group. 3. Patients in unimproved group revealed severe noise at first visit and smaller maximum comfortable opening comparatively. 4. Prognostic factors such as duration of treatment, number of treatment, multiplicity, and chronicity and disability of daily activity showed a significant relation in prediction of improvement. 5. Prognostic equation with significant variables is as follows ; Y = 1.984 - 0.251Noise + 0.068MCO - 0.673Multiplicity. - 0.958Chronicity - 0.065Disability. Classification accuracy of 70.3 %, sensitivity of 71.4% and specificity of 66.7% were shown. 6. Prognostic equation with all factors is as follows : Y = 1.599 - 0.038Pain - 0.256Noise - 0.006Limitation + 0.068MCO - 0.580Multiplicity - 1.025Chronicity - 0.720Disability - 0.329Medication - 0.087Treatment + 0.740Trauma. Classification accuracy of 70.3 %, sensitivity of 73% and specificity of 64.3% were shown. 7. Prognostic value of the improved group with significant factors was $1.0446{\pm}1.0726$ and prognostic value of the unimproved group with significant factors was $-0.013{\pm}1.0146$. Prognostic value of the improved group with all factors was $1.0465{\pm}1.0849$ and prognostic value of the unimproved group with all factors was $-0.057{\pm}1.0611$.

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The Importance of Septoplasty in The Treatment of Nasal Bone and Grade I Septal Fracture: Estimation with Acoustic Rhinometry (비중격 골절을 동반한 단순 비골 골절의 치료에 있어 비중격 교정술의 중요성: 비강 통기도 검사를 이용한 평가)

  • Kim, Jun-Hyung;Shin, Dong-Woo;Choi, Tae-Hyun;Son, Dae-Gu;Han, Ki-Hwan
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.626-632
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    • 2010
  • Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

Utility of Brain Computed Tomography in Detecting Fractures of the Temporal Bones Correlated with Patterns of Fracture on High-Resolution Computed Tomography (고해상도 전산화 단층촬영에서 확인된 골절 유형에 따른 측두골 골절의 진단에서 뇌전산화 단층촬영의 유용성)

  • Kwon, Bong-Seok;Shin, Dong-Hyuk;Choi, Pil-Cho;Han, Sang-Kuk;Lee, Jeong-Hun;Song, Hyoung-Gon
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.38-42
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    • 2010
  • Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.