• Title/Summary/Keyword: Trauma patients

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Resection of Ganglion Cyst of the Posterior Cruciate Ligament using Arthroscopic Posterior Trans-septal Approach (관절경하 후격막 통과 도달법을 이용한 후방십자인대 결절종의 치료)

  • Nam, Il-Hyun;Yoo, Yon-Sik;Yun, Ki-Pyo;Ahn, Gil-Yeong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.31-36
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    • 2004
  • Purpose: We reviewed the effectiveness and the result of arthroscopic resection for ganglion cyst of posterior cruciate ligament(PCL) through the posterior trans-septal approach. Material and Method: Seven patients with symptomatic ganglion cyst of the PCL were treated with arthroscopic resection using posterior trans-septal approach. We analyzed advantages of the posterior trans-septal approach and presence of intra articular problem. Knee function was assessed using the lysholm knee scale. Results: The overall result for the 7 knees were very satisfied in all. We found that four of seven patients had intra articular problems, and past history of trauma could be found in 3 cases. The Lysholm knee scale was increased from average 93.3 points preoperatively to average 97.8 points postoperatively. Conclusion: Arthroscopic posterior trans-septal approach shows an effective technique for complete resection of cyst and evaluation of the combined posterior compartment injury.

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Surgical Treatment and Analysis of Esophageal Diseases (식도 질환의 외과적 치료 및 분석)

  • Choe, Yeong-Ho;Jo, Seong-Jun;Jo, Won-Min;Kim, Gwang-Taek
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1123-1128
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    • 1996
  • A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.

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Analysis of Outcome and Complications in 164 Cases of Free Flap Reconstructions: Experience of a National Cancer Center (구강악안면 결손부 재건에 사용한 유리피판 재건술 164증례의 임상성적 및 합병증 분석)

  • Jeon, Jae-Ho;Park, Sung-Won;Jo, Sae-Hyung;Park, Joo-Yong;Lee, Jong-Ho;Choi, Sung-Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.478-482
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    • 2011
  • Purpose: Free flap reconstruction is performed on defects including benign and malignant tumors as well as trauma in the department of oral and maxillofacial surgery, but there are few reports of free flap reconstruction cases for oral cancer in patients in Korea. Methods: This study was designed to retrospectively analyze surgical outcomes and complications of 164 free-flap reconstructions performed at the Oral Oncology Clinic, National Cancer Center, during 2002~2011. A total of 164 free flaps were performed for reconstruction of oral and maxillofacial defects which were caused by oral cancer and osteoradionecrosis in 155 patients. Results: The present study had 162 successful cases and 2 failed cases for a total of 164 cases. The study had a success rate of 98.8% for free-flap reconstructions. Flap donor sites included radial forearm free flap (n=93), fibula osteocutaneous free flap (n=25), anterolateral thigh flap (n=18), latissimus dorsi myocutaneous flap (n=16) and other locations (n=12). Postoperative medical complications were generally pneumonia and delirium. Postoperative local complications occurred including partial flap necrosis, delayed wound healing of the donor site, infection of the recipient site and salivary fistula. The incidence of postoperative complications and patient-related characteristics including age, sex, smoking, history of radiotherapy, hypertension (HTN) and diabetes Mellitus (DM) were retrospectively analyzed. Patient age ($P$=0.003) and DM ($P$=0.000) and HTN ($P$=0.021) were significant risk factors for complications overall. Conclusion: The present study had no mortality and confirms that free-flap reconstructions are extremely reliable in achieving successful results.

Analysis of Exposure Dose According to Chest and Abdomen Combine CT Exam Method (CT 흉·복부 통합검사 시 선량분석)

  • Mo, KyeongHwan;Han, DongKyoon;Lim, HyunSoo;Jeon, WooJin
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.401-408
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    • 2014
  • The purpose of this study is confirmed to usefulness between division exam and combine exam of chest and abdomen according to comparing chest and abdomen radiation dose of division exam and combine exam in CT exam method. This study was conducted on patients who were admitted to the E hospital from July 2013 to March 2014 underwent CT studies for the diagnosis of chest and abdomen disease. In study result, male dose were more higher than female dose according to gender analysis of exposure dose that combine exam effective dose were male $33.10{\pm}2.75mSv$, female $31.66{\pm}3.12mSv$ and chest exam effective dose were male $9.07{\pm}2.62mSv$, female $8.30{\pm}2.18mSv$(p<0.05). And, division exam dose and combine exam dose were similar in gender comparison (p>0.05). And, combine exam effective dose, only chest exam effective dose, only abdomen exam effective dose were more higher than DRL(Diagnostic Reference Level) in comparison of patient exposure dose with DRL (p<0.05). In conclusion, chest-abdomen combine exam dose and division exam dose were similar. The chest-abdomen combine study can be used as follow-up and emergency trauma patients. That study will be reduce exam time and the occurrence risk of side effect of the contrast medium.

The Impingement of The Posterior Elbow in The Heavy Workers (중노동자에서 발생된 주관절 후방부의 충돌 병변)

  • Moon, Young-Lae;Lee, Chul-Gap;Kim, Dong-Hui;Lee, Young-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.60-64
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    • 2005
  • Purpose: To describe the impingement of the osteophyte between the olecranon process and olecranon fossa and to understand the effect of removing the lesion on the elbow extension in heavy workers. Materials and Methods: Arthroscopy was performed to elbow of heavy industrial workers who complained painful limitation of elbow extension.6 patients(Teases) with average age of 43 year were selected. The average ROM showed flexion contracture of $17^{\circ}$ and further flexion of $87^{\circ}$. Results: In all cases, after the operation two months follow up, mean flexion contracture improved from $17^{\circ}\;to\;2^{\circ}$ with further flexion from$87^{\circ}\;to\;122^{\circ}$. After the operation 1 year follow up, the mean flexion contracture was $3^{\circ}$ and further flexion was $113^{\circ}$. Pain relief within acquired range of motion was achieved in all cases and there was no complication in this series. Conclusion: Selective removal of the impingement bony spur for treatment of flexion contracture in the patient with chronic cumulative trauma disorder patients appear to be effective method to control pain, recover joint movement and at] ow early rehabilitation.

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A RECENT 5-YEAR RETROSPECTIVE STUDY ON NASAL BONE FRACTURE (비골 골절에 대한 최근 5년간의 후향적 연구)

  • Oh, Hee-Kyun;Park, Young-Jun;Kim, Hyun-Syeob;Ryu, Jae-Young;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.230-236
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    • 2008
  • Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

The Distribution and Patient Care in Radiography for Emergency Outpatients (응급환자의 방사선영상검사 분포 및 Patient Care)

  • Lee, Hwan-Hyung;Kang, Won-Han
    • Journal of radiological science and technology
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    • v.19 no.1
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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MTA APEXIFICATION OF TRAUMATIZED IMMATURE PERMANENT INCISORS: A RETROSPECTIVE STUDY (미성숙 영구 전치의 외상 후 MTA를 이용한 치근단 형성술 : 후향적 연구)

  • Jeong, Seo Young;Ahn, Byung-Duk;Hong, So-Yi;Kong, Eun-Kyoung;Mah, Yon-Joo;Jung, Young-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.1
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    • pp.17-24
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    • 2011
  • The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF ORAL MIDAZOLAM AND INTRAMUSCULAR MIDAZOLAM IN SEDATING YOUNG PEDIATRIC DENIAL PATIENTS (소아 환자에서 미다졸람의 경구 투여와 근육 투여에 의한 진정 효과의 비교 연구)

  • Min, Yu-Jin;Yu, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.53-61
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    • 2006
  • When routine behavior control is impossible, midazolam is often used for sedation, because it has wide margin of safety, relatively few side-effects and multiple route of administration. Although intramuscular administration of all administration route is frequently used, it is a major source of anxiety, discomfort, and trauma in children. To the contrary, oral administration of midazolam is easily administered and accepted by children. But, it's therapeutic drug concentration has not been established. The purpose of this study was to compare sedation effect and physiologic parameter of oral midazolam which palliate demerits of intramuscular administration in sedating young pediatric patients with intramuscular midazolam Twelve negative children, mean age 62.5 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study On every visit, one of the following 2 different sedative regimen was given : (1) 0.30mg/kg midazolam by intramuscular administration (2) 0.75mg/kg by oral administration. Physiologic parameter(oxygen saturation, heart rate) was recorded by ten procedure and behavior was videotaped and rated using Ohio State University Behavior Rating Scale and Automated Counting System by one investigator, blind to administration route The analyzed sedative effect of oral midazolam resulted in good sedative effect, comparing to intramuscular route, And there is no statistically difference between oral and intramuscular administration of midazolam (p>0.05).

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Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension - (자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례)

  • Lee, Seung-Kyu;Kwon, Kung-Rock;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.133-147
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    • 2000
  • A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

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