• Journal of Korean Neurosurgical Society
• /
• 제29권11호
• /
• pp.1461-1468
• /
• 2000

Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

• 한국산학기술학회논문지
• /
• 제10권12호
• /
• pp.3919-3924
• /
• 2009

본 연구는 망막박리에서 실리콘 기름주입술에 대한 임상적 결과를 분석한 것이다. 1999년부터 2002년까지 유리체절제술과 실리콘기름 주입술를 받은 44명 환자의 45안을 연구하였다. 결과는 다음과 같다. 1. 유리체절제술 후 시력이 두 줄 이상 호전된 경우는 45안 중 24안(53%)이었으며, 45안 중 18안(40%)에서는 시력의 변화가 없었다. 2. 실리콘기름 주입술 후 16안(6.3%)에서 실리콘기름을 제거하였으며 그 중 1안에서 망막박리가 재발되어 실리콘기름 재주입술을 시행하여 망막재유착을 이루었다. 3. 재수술을 포함하여 해부학적인 재유착은 45안 중 44안(97%)에서 이루었다. 4. 실리콘기름주입 후 발생한 합병증은 백내장(16안), 녹내장(10안), 실리콘기름의 유화(5안), 각막병증(2안), 재발성 망막박리 (1안)이었다. 결론적으로 망막박리 환자에게 일차수술로 유리체 절제술 후 유리체 대용물로 실리콘 기름을 사용하는 것은 여러 합병증의 발생에도 불구하고 높은 해부학적 성공률과 시력 개선효과를 보여주었다.

• Journal of Trauma and Injury
• /
• 제30권2호
• /
• pp.25-32
• /
• 2017

Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

• Archives of Plastic Surgery
• /
• 제32권4호
• /
• pp.467-473
• /
• 2005

Calvarial bone grafting in craniomaxillofacial trauma and facial reconstructive surgery is now widely recognized and accepted as a standard procedure. One of the commonly reported problems of calvarial bone graft is the contour defect caused by partial resorption of the graft. But, there are few reports that discuss the fate of the calvarial bone graft based on the quantitative data. In this article, the changes of grafted calvarial bone were evaluated using 3-dimensional computed tomography(CT). 9 patients were observed with the CT scans at 2mm thickness immediately after operation and at the time of last follow-up. The area of the bone defect was segmented on the 3-dimensional CT image and calculated by AnalyzeDirect 5.0 software. The immediate postoperative bone defect area of the recipient site and the donor site were $612.9mm^2$ and $441.5mm^2$, respectively, which became $1028.1mm^2$ and $268.8mm^2$, respectively at the last follow-up. In conclusion, the bone defect area was less increased on the donor site of calvarial bone graft than on the recipient site. And the CT scan is a valuable imaging method to assess and follow-up the clinical outcome of calvarial bone grafting.

• 한국콘텐츠학회논문지
• /
• 제18권8호
• /
• pp.210-226
• /
• 2018

본 연구는 생애 통상 여섯 번의 수감 생활과 삼청 교육대 입소 경험이 있는 한 여성 노인의 삶을 생애사적 관점으로 살펴보았다. 생애사 텍스트는 만델바움(Mandelbaum, 1973)이 제시한 삶의 영역, 전환점, 적응의 순으로 분석하였다. 연구 참여자의 삶의 영역은 보조 공원시절의 노동 착취, 미군 전용 클럽에서의 호스티스 생활, 교도소 수감생활, 삼청 교육대 경험, 장애인 남성과의 결혼 생활, 농업 노동자의 생활로 나타났다. 삶의 전환점은 보조 공원 겸 가사 도우미 취업, 교도소 입소, 생계를 위한 호스티스의 삶, 국가 폭력에 의한 삼청 교육대 입소, 장애인 남성과의 결혼과 이혼, 농업 노동자로서의 사회복지 서비스 거부로 나타났다. 적응 전략은 보조 공원 시절의 철저한 순응, 소년 교도소 시절의 과장된 위약적 행동, 호스티스 집창촌 성매매 여성으로서의 돈 버는 기계, 장애인 남성과의 결혼 후 현모양처로서의 적응, 자영업자와 농업 노동자의 저항적 적응으로 나타났다. 연구자들은 연구결과에 의해 사회적 낙인과 함께 여성 수용 경험자들의 트라우마에 대해 논의를 하였고 여성 출소자의 사회 재적응을 도울 수 있는 상담심리차원의 제언을 하였다.

• The Korean Journal of Pain
• /
• 제29권1호
• /
• pp.23-28
• /
• 2016

Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

• 대한정형외과스포츠의학회지
• /
• 제4권1호
• /
• pp.6-11
• /
• 2005

관절 연골 손상은 급성 손상과 만성 손상인 퇴행성 관절염으로 구분되며, 급성 손상은 연골 손상의 깊이에 따라서 미세 손상, 연골 골절, 골연골 골절의 세 종류로 구분할 수 있고 각 손상의 종류별로 서로 다른 양상의 치유 반응과 예후를 보인다. 만성 관절 연골 손상은 다양한 원인으로 인해서 발생하며 관절 연골의 전반적인 퇴행성 관절염의 형태를 보인다. 관절 연골 손상 시 초기 손상의 정도가 예후를 결정짓는데 가장 중요하고 이외에도 손상의 크기, 부위, 나이, 활동성, 비만 정도, 하지 정렬 상태등도 예후를 결정하는 중요한 요소들이다. 본 논문에서는 관절 연골 손상 시 발생하는 관절 연골 내의 병태 생리적 변화에 대하여 기술하고 비수술적인 치료 방법을 생역학적인 측면과 생물학적인 측면으로 구분하여 그 효과를 알아보고자 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제29권2호
• /
• pp.32-39
• /
• 2018

Objectives: This study aimed to investigate the 3-year mean periods aftermath of child sexual abuse and to compare the sexual violence victims regard to the treatment. Methods: 682 sexual violence victims were recruited by Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center for children age 13, from 2004 to 2008. Data from 49 victims among 116 consented a follow-up, were analyzed. The victims were assessed by psychological test. Data was analyzed by SPSS ver. 15.0 (SPSS Inc.). Results: The average time elapsed from the last presumed sexual abuse was 39.7 months [standard deviation (SD) 26.02]. Overall, Children's Depression Inventory (CDI) was significantly decreased from 15.8 (SD 9.33) to 10.4 (SD 9.98), and several subscales (depression, anxiety, anger, posttraumatic stress, and dissociation) of Trauma Symptom Checklist for Children (TSCC) were also significantly decreased. CDI and TSCC scores showed no statistical difference between treatment-given and not-given groups, but Revised Children's Manifest Anxiety Scale (RCMAS) was decreased in treatment-given group, whereas it was increased in treatment-not-given group. The difference of RCMAS scores between the two groups was statistically significant [F(1,28)=4.54, p<0.05]. Conclusion: Sexually abused children showed overall symptom decreases over time, but anxiety was not decreased in treatment not-given group.

• Archives of Reconstructive Microsurgery
• /
• 제1권1호
• /
• pp.9-16
• /
• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.

• Journal of Trauma and Injury
• /
• 제19권1호
• /
• pp.89-92
• /
• 2006

Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.