• 제목/요약/키워드: Trauma type

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치조골 골절을 동반한 유치열기 외상에 의한 영구절치의 치근 형성 이상 (ROOT MALFORMATION OF PERMANENT INCISORS BY ALVEOLAR BONE FRACTURE)

  • 지은혜;최형준;최병재;손흥규;김승혜;송제선
    • 대한소아치과학회지
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    • 제38권3호
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    • pp.290-295
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    • 2011
  • 치아형성 과정 중 치배 주위의 물리적 작용이나 대사 환경의 변화로 치아 발생은 영향을 받을 수 있다. 유치열기에 가해진 외상은 계승 영구치의 발생에 장애를 초래시킬 수 있는 가장 대표적인 물리적 요인으로 이로 인한 합병증으로 계승 영구치의 법랑질 변색 및 저형성증이 가장 흔히 발생하고 드물게 매복, 이소 맹출, 치근 형성 정지 및 치근 만곡 등이 나타난다. 본 증례에서는 만 6세 5개월의 여자 어린이 환자가 안면부 외상을 주소로 내원하여 상악 좌우 유중절치의 정출성 탈구, 상악 우측 유측절치의 함입성 탈구, 상악 좌측 유측절치의 구개측 측방 탈구로 진단되었고, 상악 치은부의 열상과 상악 전치부의 치조골 골절이 관찰되었다. 내원 당일 치과 응급실에서 동요도가 심한 상악 좌우 유중절치의 발치 후 치은 봉합술을 시행하였다. 24개월 정기 검진 중 방사선 사진 상에서 상악 좌,우측 측절치의 백악 법랑 경계(Cemento enamel junction, CEJ) 근방에 치근 만곡이 관찰되었고 상악 중절치 치근의 치관부 1/3부위에서 치근 형성이 정지되고 있는 양상이 관찰되었다. 치조골 골절이 어린이에서 흔하게 나타나는 외상의 유형은 아니나 본 증례에서와 같이 치근 발육이상 등 여러 합병증을 일으킬 수 있으므로 외상을 입은 환아에서 치조골 골절 여부에 대한 면밀한 검사 및 주기적인 검진은 예후 예측 및 향후 치료에 있어서 중요할 것이다.

교통사고로 수상한 임산부의 특성 (Characteristics of Injured Pregnant Women by the Traffic Accidents)

  • 김덕환;조영덕;김정윤;윤영훈;이성우;문성우;최성혁
    • Journal of Trauma and Injury
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    • 제25권4호
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    • pp.132-138
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    • 2012
  • Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.

Idiopathic type-4 hiatal hernia in a middle-aged cat

  • Kim, Gi-Na;Jeong, Soon-Wuk;Yoon, Hun-Young;Han, Hyun-Jung
    • 대한수의학회지
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    • 제58권2호
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    • pp.111-114
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    • 2018
  • A 6-year-old female domestic short hair cat presented with acute onset of vomiting, anorexia, lethargy, and tachypnea. The cat was apparently healthy prior to presentation without history of trauma. On diagnostic imagings, the entire stomach and spleen were detected in the thoracic cavity. An emergent celiotomy was performed, and a type-4 hiatal hernia was confirmed; the stomach, spleen, pancreas, and duodenum were herniated through the esophageal hiatus. It was corrected using phrenicoplasty, esophagopexy, and left-sided gastropexy and there was no recurrence 16 months after surgery. This is the first case report of an idiopathic type-4 hiatal hernia in a cat.

제 2형 SLAP 병변의 외상 유무에 따른 손상 기전 및 치료 결과의 분석 (Evauation of Injury Mechanism and Clinical Outcome Between Non-Traumatic and Traumatic Type II Slap Lesions)

  • 김용주;정훈;하종경;이관희;최성현
    • Clinics in Shoulder and Elbow
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    • 제13권2호
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    • pp.244-249
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    • 2010
  • 목적: 본 연구는 제 2형 SLAP 병변에서 외상의 유무에 따른 손상기전의 차이 및 임상 결과의 차이를 비교하고자 한다. 대상 및 방법: 2007년 1월부터 2009년 5월까지 제 2형 SLAP 단독 병변으로 수술을 시행한 27예를 대상으로 하였다. 제 2형 SLAP 병변의 분류는 Burkhart에 의한 분류법을 이용하여 병변이 전상방부에 위치하면 제 1형, 후상방부는 제 2형, 전후방 복합 병변은 제 3형으로 분류하였다. 치료 결과는 술 전, 술 후의 UCLA 점수와 KSS 점수를 사용하여 측정하였다. 결과: 총 27예 중 외상군은 16예, 비외상군은 11예였다. 제 2형 SLAP 병변의 형태는 외상군에서 제 1형은 12예, 제 2형은 2예 그리고 제 3형은 2예였다(p=0.013). 비외상군에서는 제 1형 2예, 제 2형 6예, 제 3형 3예였다 (p=0.026). 즉 외상군에서는 전방 병변이 더 많이 발생하였고 (p<0.05), 비외상군에서는 후방 병변이 더 많이 발생한 것으로 추정할 수 있다 (p<0.05). 외상군에서 UCLA 점수 및 KSS 점수는 술 전 평균 18점 (14~23점), 48점 (32~76점)에서 술 후 32점 (28~33), 86점 (71~92점)이었다. 비외상군에서는 UCLA 점수 및 KSS 점수는 술 전 평균 21점 (18~25점), 58점 (41~68점)에서 술 후 29점 (26~31점), 81점 (68~89점)이었다. 임상결과에 있어서 두 군 사이의 통계학적으로 유의한 차이를 보이지 않았다 (p=0.317, 0.405). 결론: 본 연구에서 제 2형 SLAP 병변의 형태가 외상 기전에 따라 차이가 있음을 관절경 소견을 통해 확인할 수 있었다. 따라서 제 2형 SLAP 병변에 대한 수술적 치료를 고려할 때 외상 유무를 파악하여야 할 것이다.

Follow-up Comparison of Two Different Types of Anterior Thoracolumbar Instrumentations in Trauma Cases : Z-plate vs. Kaneda Device

  • Park, Jung-Keun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • 제41권2호
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    • pp.77-81
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    • 2007
  • Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

Effectiveness of Computed Tomography for Blow-out Fracture

  • Rhee, Seung-Hyun;Kim, Tae-Seup;Song, Jae-Min;Shin, Sang-Hoon;Lee, Jae-Yeol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권6호
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    • pp.273-279
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    • 2014
  • Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was $192.6mm^2$ and the mean volume was $673.2mm^3$. Group B area was $316.2mm^2$ and volume was $1,710.6mm^3$. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

  • Iravani, Shahrokh;Kashfi, Seyed Mohammad Hossein;Azimzadeh, Pedram;Lashkari, Mohammad Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9933-9937
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    • 2014
  • Background: Colorectal cancer is the third most common type of cancer in males and the second in females in Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor for colorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of this study was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients and to investigate the variation between our populations with other populations. Materials and Methods: A total of 167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013 and specimens were taken through polypectomy and transferred to pathology. All data in patient files including pathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of < 0.05 was considered significant. Results: Mean age of participants was $57{\pm}15$. Some 84 were females (50.3%) and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) were in females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%) with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followed by 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, data being missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent type of lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70 (31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screening plans to prevent further healthcare problems with colorectal cancer in the Iranian population.

소아 구강악안면 영역의 외상에 관한 임상적 연구 (Clinical study of maxillofacial trauma of children)

  • 김학렬;김여갑
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권1호
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    • pp.43-52
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    • 2010
  • Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

북한이탈주민의 외상후 스트레스장애의 임상적 특성 (Clinical Characteristics of Post-Traumatic Stress Disorder among North Korean Defectors)

  • 이경은;안지현;김다은;문승연;홍진표
    • 대한불안의학회지
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    • 제14권2호
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    • pp.80-87
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    • 2018
  • Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

  • Choi, Chang-Hyuk;Jun, Chung-Mu;Kim, Jun-Young
    • Clinics in Shoulder and Elbow
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    • 제22권2호
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    • pp.87-92
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    • 2019
  • Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types. Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft $f{\ddot{u}}r$ Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20-87 years), and mean follow-up period was 2.3 years (range, 1.0-6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed. Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (p<0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (p=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (p=0.352). Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.