• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.846-854
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• 2023

Vascular injuries of the extremities are associated with a high mortality rate. Conventionally, open surgery is the treatment of choice for peripheral vascular injuries. However, rapid development of devices and techniques in recent years has significantly increased the utilization and clinical application of endovascular treatment. Endovascular options for peripheral vascular injuries include stent-graft placement and embolization. The surgical approach is difficult in cases of axillo-subclavian or iliac artery injuries, and stent-graft placement is a widely accepted alternative to open surgery. Embolization can be considered for arterial injuries associated with active bleeding, pseudoaneurysms, and arteriovenous fistula and in patients in whom embolization can be safely performed without a risk of ischemic complications in the extremities. Endovascular treatment is a minimally invasive procedure and is useful as a simultaneous diagnostic and therapeutic approach, which serve as advantages of this technique that is widely utilized for vascular injuries of the extremities.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.22-26
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• 2001

Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.731-736
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• 2005

Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of Korean Physical Therapy Science
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• v.1 no.1
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• pp.135-144
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• 1994

The authors studied therapeutic effects and related clinical data retrospectively on a series of 48 consecutive patients with head injury who were referred to physical therapy and occupational therapy, Kosin University Medical Center during 1 year, from March, 1993. through March, 1994. The conclusions were as follows : 1. Average age of the subject patients was 50.6 years, their age remped from 14 to 72 years, and the incidence between male and femele was 1:1.1. 2. In respect to the educational level high school graduates showed the highest incidence 18 (39.1 %) of 46 cases, and in respect to economy level, middle class revealed the highest incidence, 31(64.6 %) in 48 cases. 3. The HBP was the most common cause of spontaneity injury, disclosing 19 cases in 35 patients(54.3%), whereas the main cause of traumatic injury was a traffic accident, 7 cases ( 53.8 %) in 13 patients. 4. As for the region of injury in the cases of spontaneity ICH was 14 persons (40%). In the cases of trauma, hematoma was seen in 6 cases(42.2 %) in 48 total cases ICH was seen in 17 cases (35.4 %) to be the most common region. 5. Among 35 persons, spontaneity CBR was the highest region of injury, 13 cases(37.1 %) ; the side of paralysis in extremities the right side showed higher incidence, 18 cas (1.4 %) as compared to the left, 16 cases(45.7%). In the case of traumatic injury, CBR was the highest region of injury, 4(30.8% )in 13 cases and as for the paralysis side, right side showed higher incidence 7 cases(53.8%) as compared to the left side 5 cases(38.5%). 6. In respect to recurrence, HBP was seen in 5 cases to be the most common cause, and as for the region of injury, CBR was the highest. 7. A period of rehabilitation therapy in the cases of physical therapy the highest term was 1-2 month, 14 persons(29.2%). As for occupational therapy within 2 week-term was the highest, 24 persons(50%). 8. Physical strenth grade M.T in the cases of the upper extrimities before therapy, the low mark(grade 0) was 30 cases(62.5%), compared to the high mark(above grade 3)seen in 1 case(2.1%), And after therapy, the lowest mark(grade 0)was seen in 5 cases(10.4%) where as the high mark(above grade 3)was seen in 29 cases(60.4%). In the case of the lower extremities before therapy, the mark(below grade 1)was 37 cases(77.1 %), while the high mark(above grade 3)was seen n 4 cases(8.4%). And after therapy the low mark(below grade 1)was seen in 5 cases (10.4 %) and the high mark (above grade 3)was seen in 29 cases(60.4 %). 9. Before therapy conigtive function-level evaluation utilized R.L.A.L, the low mark(below level 3)was seen in 9 cases(18.8%), while the high mark(above level 7)was seen in 18 cases(37.5%). And after therapy the low mark (below level 3)was 4 cases(8.3%) and high mark(above level 7)was seen in 38 cases(79%). 10. After rehabilitation therapy, patients who were able to walk independently were 29 persons(60.4%), among which 16 cases(55.2%) depended on cane. The ratio between the cases who were able to walk and unable to walk was 1.5:1.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.397-407
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• 2009

The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.169-176
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• 2011

Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.414-427
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• 2022

This study aims to analyze the color distribution of maxillary permanent incisors in Korean pediatric patients and determine the effects of age and root developmental stage on tooth color. The L^*a^*b^* values of 404 sound and fully erupted maxillary incisors without dental caries, restorations, trauma history or discoloration from 101 Korean patients between ages 7 and 15, with a mean age 10.0 ± 1.5, were analyzed with a spectrophotometer. CIE L^*a^*b^* values were 84.01, 0.17, and 24.07 in maxillary central incisors, and 82.33, 0.31, and 25.99 in maxillary lateral incisors. L^* values of maxillary central incisors were higher, and b^* values of maxillary central incisors were lower than those of maxillary lateral incisors (p < 0.001). The color differences among the subregions exceeded the clinical perceptibility threshold in both of the maxillary central and lateral incisors. L^* value for children at age 10 and younger was 84.13 in maxillary central incisors and 84.04 in maxillary lateral incisors, and those of older patients were 80.62 and 80.56, respectively. L^* value of maxillary incisors of children at age 10 and younger was significantly higher than that of older patients. The root developmental stage did not affect tooth color. This study suggests that the color differences between maxillary central and lateral incisors and among the subregions of a tooth and the effects of age should be considered for aesthetic restorations of permanent incisors in pediatric patients.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.51-60
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• 2021

Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.