• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.35-41
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• 2006

It is well known that concentration of C-reactive protein(CRP) in the serum increase as nonspecific reaction of the various tissue injury. The CRP, synthesized in the hepatocyte, is one of 'acute phase proteins' in the serum. The main signal patterns of this protein are regulated by synthesis of interleukin-I secreted from macrophage in the area of tissue injury. Many studies were performed for quantitative analysis for CRP according to various surgical operation, but the study for fracture patients associated with trauma, especially in mandible, are rare. The mandible fracture have intrinsic danger for infection in oral bacteria associated with open wound in oral cavity, and, are difficult for detection of tissue reaction between surgical swelling and infection by facial swelling. In this study, quantitative analysis for CRP associated tissue injury in mandibular fracture and surgical intervention was done, the results were as follows: 1. After initial mandibular trauma, the value of serum CRP diminished sequentially, most high value was presented in post-traumatic 2 days. 2. The CRP was diminished significantly 2 days after surgical intervention, and maintained normal value in 5 days after surgery. 3. The change of CRP are higher value in surgical intervention than initial trauma, it suggested that tissue injury from surgery was severe than trauma. 4. The high value of CRP was obtained in mandibular fracture combined soft tissue injury than no associated soft tissue injury. 5. In measurement of CRP according to surgical approach, highest serum value in patients of combined intra-oral and extra-oral approach was showed, and intra-oral approach, extra-oral approach, in sequential orders. 6. The CRP value are more higher in patient of 2 fracture site than only one fracture site. From the results obtained in this study, CRP has showed different values in mandibular fracture associated with severity of tissue injury and surgical intervention, and quantitative analysis of CRP value in serum can be applied to the clinical management of mandibular fracture.

• 대한족부족관절학회지
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• 제3권1호
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• pp.40-48
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• 1999

The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.

• 생물정신의학
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• 제15권4호
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• pp.310-315
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• 2008

Objectives : The evaluation of disability after trauma in psychiatry is relatively subjective compared with other departments. A consensus among evaluators could improve reliability of evaluations. We compared disability rate of common psychiatric disorders without definite brain injury depending on their diagnosis from experienced evaluators in Korea. Methods : A written questionnaire was mailed to each evaluator and the reply was analyzed. The questions included disability rate ranges of postconcussional syndrome, PTSD and depression. Other questions related with admission for evaluation, expected duration of treatment, life expectancy and need of supporting person were also asked. Results : Range of disability rate were from $8.6{\pm}4.5%$ to $26.6{\pm}12.8%$ in postconcussional syndrome, from $10.4{\pm}6.8%$ to $36.4{\pm}13.8%$ in PTSD and from $10.0{\pm}4.6%$ to $30.6{\pm}10.3%$ in depressive disorder. There were lots of diversity in expected duration of treatment with psychiatric disability. Decline of life expectancy and need of supporting person were considered at least 50% of disability. Conclusion : There is much diversity in evaluation of psychiatric disabilities with disability rate and expected duration of treatments even among experienced evaluators. A common consensus among experts may increase reliability of psychiatric evaluations after trauma.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.43-47
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• 2011

Purpose: Sensory impairment in infraorbital nerve is common symptom following mid-facial fractures. The purpose of this study is to document the incidence of sensory impairment in infraorbital nerve following midfacial fractures and its recovery. Methods: Three hundreds fourteen patients with midfacial fracture were included involving emergence areas of infraorbital nerve. Fractures were classified into zygoma fracture, maxilla fracture, complex comminuted fracture and pure blow out fracture. Neurosensory function was assessed with clinical symptoms and light touch test in infraorbital nerve regions. Patients were followed and sensory function was evaluated immediately, 1, 3 and 6 months after trauma. Results: The total series consisted of 198 zygoma fractures, 19 maxilla fractures, 30 complex comminuted fractures and 67 pure blow out fractures. The incidence of sensory impairment was 60% (63% in zygoma fractures, 84% in maxilla fractures, 93% in complex comminuted fractures, 31% in pure blow out fractures). Persistent sensory impairments were remained in 32% (33% in zygoma fractures, 47% in maxilla fractures, 73% in complex comminuted fractures, 6% in pure blow out fractures) 6 months after trauma. Younger patients had better prognosis than older patients in recovery of infraorbital nerve function ($p$ <0.05, $x^2$-test). Mean recovery time was 11 weeks. Conclusion: The incidence of post-traumatic sensory impairment was different according to fracture types. Age of patients and fracture type were important factors that influence to recovery of sensory impairment. Complex comminuted fracture had poor prognosis, and pure blow out fractures had better prognosis than other fractures.

• 대한불안의학회지
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• 제5권1호
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• pp.14-20
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• 2009

Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

• Archives of Reconstructive Microsurgery
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• 제4권1호
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• pp.16-22
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• 1995

We analyzed 11 children who underwent epiphyseal transplantation to the forearm for manage growing deformity ranged from 2 years 6 months to years(average 5 years 10 months) follow-up period. Etiologies of the functional impairment of the eleven were five traumatic, three congenital and three tumorous conditions. Lesions of epiphysis were distal radius in eight patients and distal ulna in three patients. Operation was performed with removal of non-functioning or deformed epiphysis followed by transplantation of free vascularized proximal fibular epiphysis with microvascular anastomesis. Evaluation was performed radiologically and functionally. The 9(81.8%) patients showed growth of transplanted epiphysis by radiological examination during follow up. At the last follow up, average growth rate was 0.86cm per year excepts 2 cases of no growth. Active wrist motion near normal to contralateral joint was achieved in 7 patients. In other 2 patients, active joint motion was improved but weaker than contralateral joint. Complications on donor site were two transient peroneal nerve palsy which have been resolved after 2 and 5 months post operation and one valgus ankle deformity. The ankle deformity was corrected with $Langenski\"{o}ld$ operation of the dital tibiofibular fusion. At recipient site, there was one superficial infection and it was easily controlled by systemic antibiotics. Many subsequent reports have described successful nonvascularized epiphyseal transplante, but overall results have been inconsistent and unsatisfactory. Other experimental and clinical studies in the transfer of vascularized epiphyses has encourage its clinical application. We also could gel successful growth in several cases with free vascularized epiphyseal transplantation.

• Journal of Trauma and Injury
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• 제30권3호
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• pp.80-86
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• 2017

Purpose: To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province. Methods: We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015. Results: The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia. Conclusions: As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.145-157
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• 2017

Purpose: We accessed epidemioloy of 908 acute burns (7 years) in the military, of injuries and propose proper educational programs to suit community. Methods: We surveyed burn demographics, circumstances of injuries, size, result of treatment. Results: The mean age was 20.6 years. The flame burns (FB) (325, 35.8%) were most common, followed scald (SB) (305, 33.6%), contact (CB) (219, 24.1%), electric (EB) (45, 5.0%) and chemical burns (ChB) (14, 1.5%). The more occurred during winter (29.7%). SB had mean 3.9% total body surface area (TBSA). The 251 (82.3%) had superficial burns by spillage of hot water/food on lower limbs (45.6%), feet (33.8%) in summer (34.8%), treated with simple dressing (92.8%). Morbidity rate was 5.6%; post traumatic stress disease (PTSD) (0.7%). FB had large wound (9.3% TBSA). The 209 (64.3%) had superficial burns by ignition to flammable oils (31.7%) and bomb powders (29.2%) on head/neck (60.3%), hands (58.6%) in summer (31.7%), autumn (30.2%). They underwent simple dressing (83.4%) and skin graft (16.0%). Morbidity rate was 18.8%; PTSD (10.5%), inhalation injuries (4.0%), corneal injury (3.7%), amputations (0.9%), and mortality rate (1.2%). CB had small (1.1% TBSA), deep burns (78.5%) by hotpack (80.4%) on lower limbs (80.4%). The more (59.8%) underwent skin graft. EB had 6.8% TBSA. The 29 (64.4%) had superficial burns by touching to high tension cable (71.1%) on hand (71.1%), upper limbs (24.4%) in autumn (46.8%). They underwent simple dressing (71.1%) and skin graft (24.4%). They showed high morbidity rate (40.0%); loss of consciousness (13.3%), nerve injuries (11.1%), neuropathy (8.9%), amputations (2.2%), and mortality rate (2.2%). Conclusions: The cook should wear apron over the boots during work. The lighter or smoking should be strictly prohibited during work with flammable liquids or bomb powders. Don't directly apply hotpack to skin for a long time. Use insulating glove during electric work. Keep to the basic can prevent severe injury and proper education is important.

• 대한불안의학회지
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• 제5권2호
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• pp.125-132
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• 2009

Objective : This study examined psychiatric characteristics of wounded persons of Daegu subway fire accident occurring in February 2003 after six years. Methods : 103 wounded persons completed psychometric measures at 2 months and 6 years after the accident. Changes of psychiatric symptoms were compared and factors affecting post-traumatic stress disorder (PTSD) seriousness were examined. Results : In Minnesota Multiphasic Personality Inventory, the scores of Psychopathic Deviate (Pd), Masculinity/ Femininity (Mf), Social Introversion (Si) scales were significantly changed over time. The scores of Symptoms Checklist-90-Revision subscales were mostly decreased over time, however, paranoid ideation (PAR) subsclae scores were not significantly changed over time. In all of the State-Trait Anxiety Inventory (STAI)-State, Beck Depression Inventory, Impact of Event Scale, and PTSD Checklist-Civilian, mean scores at 6 years after the accident were significantly lower than those at 2 months after the accident. However, STAI-Trait score was not significantly changed over time. Total seriousness of PTSD was found to be affected by quality of sleep. Conclusions : Psychiatric symptoms of subjects were largely improved over time, but distrust and doubt of others were continued. In addition, the wounded persons suffered from sleep problems. Therefore, early and continuous interventions of public institutions and public health specialists are needed for the wounded persons with chronic psychiatric disorders.

• 셀메드
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• 제2권1호
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• pp.6.1-6.4
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• 2012

The traumatic removal of the mandibular third molar may promote post chirurgic consequences such as orofacial pain and limited mandibular movements. The aim of this case report is to describe the use of an anterior bite plane and complementary therapies (low level laser therapy and acupuncture) to treat the muscular dysfunction and the painful symptoms. A 33 year-old male patient who had a severe malocclusion and signs and symptoms of temporomandibular dysfunction was submitted to an initial clinical examination: electromyography of the masticatory muscles and IRM of the temporomandibular joint. After treatments, the results showed reduced pain symptoms and an increase of the mandibular movements and adequated electromiographic activities. The authors concluded that the combination therapies may be used as an alternative treatment because it satisfied the functional requirements of the patient and provided an asymptomatic clinical condition.