• Title/Summary/Keyword: Post-traumatic

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Osteoplastic Reconstruction of Post-enucleatic Microorbitalism

  • Yun, Ji Young;Kang, Seok Ju;Kim, Jin Woo;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.333-337
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    • 2012
  • Background Patients who have undergone enucleation during infancy due to retinoblastoma can develop microorbitalism due to the decreased growth stimulation from the eyeball and the surrounding soft tissues. Anatomically, the orbit consist of parts of the frontal bone superiorly, the maxilla inferiorly, the ethmoid bone medially, and the zygoma laterally. Considering the possibility of surgically expanding the orbit using tripod osteotomy, in this study we conducted tripod osteotomy on adult patients with microorbitalism of retinoblastoma. Methods Tripod osteotomy was conducted to expand the orbital volume in adult patients with microorbitalism due to enucleation in infancy for retinoblastoma. The orbital volume was measured using the Aquarius Workstation ver. 4.3.6 and the orbit width was measured with preoperative and postoperative 3-dimensional facial bone computed tomography (CT) imaging. Preoperative and postoperative photographs were used to visualize the difference produced by the surgery. Results The orbital volume of the affected side was 10.3 $cm^3$ before and 12.5 $cm^3$ after the surgery, showing an average increase in volume of 2.2 $cm^3$ (21.4%). The increase in the obital width was confirmed by the preoperative and postoperative 3-dimensional facial CT images and aesthetic improvement was observed by the preoperative and postoperative photographs. Conclusions Tripod osteotomy, which realigns the orbital bone, zygoma, and maxilla, is used to correct posttraumatic malunion as well as non-traumatic congenital abnormalities such as that seen in facial cleft. We applied this procedure in microorbitalism secondary to enucleation for retinoblastoma to allow orbital expansion and correct asymmetry.

Reconstruction of Medial Orbital Wall Fractures without Subperiosteal Dissection: The "Push-Out" Technique

  • Kim, Yong-Ha;Lee, Jin Ho;Park, Youngsoo;Kim, Sung-Eun;Chung, Kyu-Jin;Lee, Jun-Ho;Kim, Tae Gon
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.496-501
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    • 2017
  • Background Various surgical methods for repairing medial orbital wall fractures have been introduced. The conventional technique requires total separation of the displaced orbital bones from the orbital soft tissues. However, subperiosteal dissection around the fracture can cause additional damage. The aim of the present study is to introduce a method of reconstructing medial orbital wall fractures without subperiosteal dissection named the "push-out" technique. Methods Six patients with post-traumatic enophthalmos resulting from an old medial orbital wall fracture and 10 patients with an acute medial orbital wall fracture were included. All were treated with the push-out technique. Postoperative computed tomography (CT) was performed to assess the correct positioning of the implants. The Hertel scale and a comparison between preoperative and postoperative orbital volume were used to assess the surgical results. Results Restoration of the normal orbital cavity shape was confirmed by examining the postoperative CT scans. In the old fracture group, the median orbital volume of the fractured side was $29.22cm^3$ preoperatively, and significantly improved postoperatively to a value of $25.13cm^3$. In the acute fracture group, the median orbital volume of the fractured side was $28.73cm^3$ preoperatively, and significantly improved postoperatively to a value of $24.90cm^3$. Differences on the Hertel scale also improved, from 2.13 mm preoperatively to 0.25 mm postoperatively in the old fracture group and from 1.67 mm preoperatively to 0.33 mm postoperatively in the acute fracture group. Conclusions The push-out technique can be considered a good alternative choice for old medial orbital wall fractures with posttraumatic enophthalmos, acute medial orbital wall fractures including large fractured bone segments, and single-hinged greenstick fractures.

A Study on The Compensation about Diseases Related Military of United States of America (미국의 군복무 관련 질환의 보상에 관한 연구)

  • Kim, Tae-Yeol
    • Proceedings of the KAIS Fall Conference
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    • 2009.05a
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    • pp.18-23
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    • 2009
  • 지난 50여년간 국가유공자 및 제대군인의 보상은 전쟁 및 군복무중 발생한 상이처로 인해 장애를 입은 자를 중심으로 보상해 왔으며, 군 복무 중 발생한 질병의 보상에 대해서는 아직까지 심도 있게 논의된바 없다. 우선 한국의 군복무와 관련한 질병 보상과 관련한 본격적인 논의에 앞서 중요하게 고려되야 할 부분은 우리보다 100여년 이상 앞서 연구해 왔고 지금까지도 활발히 진행중인 미국의 질병 보상 제도와 질병 인정범위에 대해 분석해볼 필요성이 제기된다. 미국의 군복무와 관련한 질병에 관한 최초 보상의 역사는 1800년대로 군복무와 관련한 질병에 관한 대표적인 최초의 보상 질환은 PTSD(Post Traumatic Stress Disorder)의 초기 형태인 향수병(nostalgia)으로 이 질환이 군복무와 연관된 질환으로 인정받은 최초 질병이었다. 미국의 경우 미국의 군복무와 관련된 질환은 직접질환과 추정 질환으로 분류되는데 먼저 군복무 직접 질환의 경우 질병 보상이 되는 대표적 질환은 고혈압, 당뇨, 빈혈, 동맥경화증, 관절염, 심장염, 간질, 신장염, 정신병, 활동성 결핵, 위궤양 등 거의 모든 질환이 포함되어 있다. 특히, 정신병 흡연과 음주에 의한 질환 자살도 남에게 피해를 주지 않은 경우는 대부분 보상이 된다. 이상 살펴본 바와 같이 선진국에 비해 한국의 군복무와 관련한 질병보상 범위와 너무도 상이한데 국가유공자예우에 관한 법률 시행령 제 14조에 의거 1급부터 7급까지 등급판정을 부여하는데 이는 대부분 외상에 의한 절단, 관통상, 신체 기능상실자를 위주로 보상을 하고 있어 외상과의 합병증이 없는 질병에 대한 보상은 실질적으로 거의 인정을 받지 못하고 있는 실정이다. 끝으로 군복무와 관련한 질병 보상과 의료, 복지증진을 위한 종합적인 발전 방안을 몇가지 제언코자 한다. 첫째, 제대군인 질병연구센타 설립. 둘째, 정신질환, 외상후 스트레스장애군(PTSD), 진행성 질환 무상의료 지원 및 연금지급 셋째, 고엽제 2세환자의 역학조사가 필요하다.

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Effects of Herbal Medicine (Gan Mai Da Zao Decoction) on Several Types of Neuropsychiatric Disorders in an Animal Model: A Systematic Review - Herbal medicine for animal studies of neuropsychiatric diseases -

  • Kim, Su Ran;Lee, Hye Won;Jun, Ji Hee;Ko, Byoung-Seob
    • Journal of Pharmacopuncture
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    • v.20 no.1
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    • pp.5-9
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    • 2017
  • Objectives: Gan Mai Da Zao (GMDZ) decoction is widely used for the treatment of various diseases of the internal organ and of the central nervous system. The aim of this study is to investigate the effects of GMDZ decoction on neuropsychiatric disorders in an animal model. Methods: We searched seven databases for randomized animal studies published until April 2015: Pubmed, four Korean databases (DBpia, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, and Research Information Sharing Service), and one Chinese database (China National Knowledge Infrastructure). The randomized animal studies were included if the effects of GMDZ decoction were tested on neuropsychiatric disorders. All articles were read in full and extracted predefined criteria by two independent reviewers. Results: From a total of 258 hits, six randomized controlled animal studies were included. Five studies used a Sprague Dawley rat model for acute psychological stress, post-traumatic stress disorders, and unpredictable mild stress depression whereas one study used a Kunming mouse model for prenatal depression. The results of the studies showed that GMDZ decoction improved the related outcomes. Conclusion: Regardless of the dose and concentration used, GMDZ decoction significantly improved neuropsychiatric disease-related outcomes in animal models. However, additional systematic and extensive studies should be conducted to establish a strong conclusion.

MIDFACIAL DEGLOVING APPROACH IN MIDFACIAL BONE FRACTURE : THE REPORT OF CASES (Midfacial degloving approach를 이용한 중안면 골절 환자의 치험례)

  • Kim, Hyeon-Min;Jeong, Jong-Cheol;Song, Min-Seok;Jang, Jung-Hui;Kim, Nam-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.74-81
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    • 2005
  • In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

OSTEOMYELITIS OCCURING IN THE ZYGOMA CAUSED BY ODONTOGENIC MAXILLARY SINUSITIS - CASE REPORT (치성감염으로 발생한 상악동염을 동반한 관골의 골수염 - 증례보고-)

  • Kang, Hee-Jea;Lee, Jung-Hun;Kim, Yong-Deok;Byun, June-Ho;Shi, Sang-Hun;Kim, Uk-Kyu;Jung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.251-254
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    • 2004
  • Osteomyelitis is the inflammatory disease occured in the bone, involving a bone marrow, a Harversian system and the underlying cortical bone. Osteomyelitis is divided into acute and chronic osteomyelitis. Chronic osteomyelitis. is presented as a pain, swelling, pus discharge and radiographic change. The pathogenesis of osteomyelitis occcuring in the facial bone is predominately due to odontogenic microorgarnisms, Staphylococcus, resulted in odontogenic infection or post-traumatic infection. The mandible is the most commonly involved facial bone and the bones in the middle of third of the face is rare because of a abundant blood supply. Moreover, Osteomyelitis occuring in the zygoma is extremely rare. In our department, we report the case that osteomyelitis occuring in the zygoma with diabetes is resulted by odontogenic maxillary sinusitis.

Improvement of Pain according to Magnetic Resonance Imaging Classification in Bone Contusion around Foot and Ankle (족부 족관절 골좌상에서 자기공명영상 분류에 따른 통증의 호전)

  • Kim, Hyeong-Jik;Lee, Kwang-Bok
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.183-188
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    • 2019
  • Purpose: Bone contusion is usually treated with conservative therapy for 3 months. Bone contusion around knee and hip joints has been extensively reported on, but there are scant reports on this condition in foot and ankle joints. This study evaluated the nature, characteristics and location of bone contusion around foot and ankle joints to enlighten clinicians on how to better treat this disease entity. Materials and Methods: We classified bone contusion of the 76 patients into three types (102 sites; 47 ankle sprains, 18 traffic accidents, 11 falls) according to the Costa-Paz system with employing magnetic resonance imaging (MRI), and the study then analyzed the common sites and areas of occurrence according to the mechanism of injury and duration of pain after first conducting conservative therapy. Results: Of the 76 patients (102 sites) on the MRI, 43 case (42.2%) for talus, 19 cases for distal tibia, and 12 cases for calcaneus were involved. The classification, according to the Costa-Paz system, was Type I, 51 cases; Type II, 32 cases; and Type III, 19 cases. The duration of pain after conservative treatment was 12.15±2.17 weeks for Type I, 14.5±2.15 weeks for Type II, and 21.0±3.8 weeks for Type III. Conclusion: The most common location of post-traumatic bone contusion around both the foot and ankle is the talus, distal tibia, and calcaneus. The most common type of injury noted on MRI is a diffuse signal with change of the medullary component (Type I), In cases of bone contusion extending to a subjacent articular surface or disruption or depression of the normal contour of the cortical surface (Types II, III), the patients' pain appears to last longer. Thus, it is necessary to consider a longer period of conservative treatment in cases of Types II and III bone contusion because the patients' pain may last longer than 3 months.

Factors Influencing Posttraumatic Growth in Survivors of Breast Cancer (유방암생존자의 외상 후 성장에 영향을 미치는 요인)

  • Park, Jin-Hee;Jung, Yong-Sik;Jung, Youngmi
    • Journal of Korean Academy of Nursing
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    • v.46 no.3
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    • pp.454-462
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    • 2016
  • Purpose: Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The purpose of this study was to identify the level of PTG and its correlates in Korean patients with breast cancer. Methods: A sample of 120 participants was recruited from outpatients, who had successfully completed primary treatment of breast cancer at a university hospital., Data were collected from June to December, 2014 using Posttraumatic Growth Inventory, Illness Intrusiveness Rating Scale, Cancer Coping Questionnaire, Revised Life Orientation Test and The Multidimensional Scale of Perceived Social Support. Results: Total score for the PTG was $79.18{\pm}17.54$ in patients surviving breast cancer. Bivariate analyses indicated that PTG was positively associated with having a religion, perceived social support, greater optimism, cancer coping, and illness intrusiveness. Results of the regression analysis showed that cancer coping (${\beta}=.29$, p=.001), optimism (${\beta}=0.28$, p=.001) and illness intrusiveness (${\beta}=0.17$, p=.037) were statistically significant in patients' PTG. Conclusion: The research findings show that the variables of cancer coping, optimism and illness intrusiveness significantly explain PTG and these psychological variables can be used to provide improvement in PTG for patients with breast cancer.

XENOTRANSPLANT OF HUMAN BONE MARROW STROMAL CELLS; EFFECT ON THE REGENERATION OF AXOTOMIZED INFRAORBITAL NERVE IN RATS (인간 골수 기질세포 이종이식이 백서의 축삭절단 안와하 신경 재생에 미치는 효과)

  • Park, Eun-Jin;Kim, Eun-Seok;Kim, Jin-Man;Kim, Hyun-Ok;Yum, Kwang-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.3
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    • pp.239-247
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    • 2005
  • This study demonstrated that xenogenic human marrow mesenchymal stem cells (hMSCs) could elicit the regeneration of the sensory nerve after axotomy in the adult rats infraorbital nerves without immunosuppression. For this, we evaluated the behavioral testing for functional recovery of the nerve and histological findings at weeks 3 and 5 compared to controls. Xenogenic hMSCs did not evoke any significant inflammatory or immunologic reaction after systemic and local administrations. HMSCs-treated rats exhibited significant improvement on sensory recovery tested with von Frey monofilaments. At 5 postoperative weeks, in the hMSCs treated nerve, expression of myelin basic protein (MBP), neurofilament (NF) at the site of axotomy was higher than control. And mRNA expression of neurotropin receptor Trk precursor (TrkPre), nerve growth factor receptor (NGFR) and neuropeptide (NPY) in trigeminal ganglion were also higher. The number of myelinated nerve at distal stump and cells in trigeminal ganglion were higher in hMSC treated rats. So it was supposed that transplanted MSCs contributed to reducing post-traumatic degeneration and production of neurotrophic factors. Immunofluorescence labeling showed small portion of hMSCs (<10%) expressed a phenotypic marker of Schwann cell (S-100). Xenogenic or allogenic mesenchymal stem cells might have immune privileged characteristics and useful tool for cell based nerve repair.

The Relationship between Symptoms of Posttraumatic Stress Disorder and Addictive Use of Mobile Phone in Bullies of School Violence (학교폭력 가해자에서 외상후 스트레스 증후군의 증상과 휴대폰 중독적 사용과의 관계)

  • Seo, Ji-Yeong;Park, Chul-Soo;Kim, Bong-Jo;Cha, Bo-Seok;Lee, Cheol-Soon;Lee, So-Jin
    • Anxiety and mood
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    • v.8 no.2
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    • pp.127-132
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    • 2012
  • Objective : This study aims to investigate the relationship between addictive mobile phone use and post-traumatic stress disorder (PTSD) symptoms in bullies who experienced school violence. Methods : The study subjects consisted of 97 adolescents in The Foundation for Preventing Youth Violence after school violence. The participants conducted self-report questionnaire for addictive mobile phone use and Impacted Event Scale-revised-Korean version (IES-R-K). Partial correlation and multiple logistic regressions were performed. Results : The scores related to addictive mobile phone use were correlated with total score (r=0.21, p=0.04), avoidance score (r=0.21, p=0.04) and intrusive score (r=0.26, p=0.01) related to PTSD symptoms on the IES-R-K. Intrusive score related to PTSD symptoms on the IES-R-K were significant risk factor for addictive mobile phone use (O.R=1.25, 95% CI=1.12-1.39). Conclusion : This data supports that PTSD intrusive symptoms could be predictable factor of addictive mobile phone use. An appropriate intervention about PTSD symptoms might play a useful role in preventing addictive mobile phone use in bullies of school violence.