• Archives of Plastic Surgery
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• 제51권1호
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• pp.2-13
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• 2024

Background Although osteotomy is commonly performed in rhinoplasty, it is difficult for less experienced surgeon to understand mechanism of the procedure. The primary goal of this study is to improve understanding of nasal osteotomy in Asians by considering the surface aesthetics and anatomy of the nose as well as their relationships with the surgical procedure. Methods Surface aesthetics, anatomic considerations, kinetics of medial and lateral osteotomy, fracture levels of osteotomy were discussed in detail by reviewing the previous publications and 18 years of our experience. Moreover, the technical details of osteotomy were explained and personal tips for performing successful osteotomy were described. Results Dorsal and lateral aesthetic lines, dorsal and basal widths are main characteristics related to the surface aesthetics of nose to perform the osteotomy. In addition, these features are different in Asian population due to the anatomic difference with Caucasians, which makes the procedure difficult and requires more attention to perform osteotomy. Conclusion Because osteotomy is one of the most traumatic and invasive part of the rhinoplasty, it is crucial for the rhinoplasty surgeon to understand the relationship between surface aesthetics and osteotomy techniques to produce consistent and reproducible results.

• Korean Journal of Radiology
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• 제2권2호
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• pp.97-104
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• 2001

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.

• 한국콘텐츠학회논문지
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• 제19권3호
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• pp.100-113
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• 2019

본 연구는 출소자를 대상으로 아동기 외상과 가족기능성과의 관계를 분노표현방식이 매개하는지 알아보고자 하였다. 이를 위해 한국법무보호복지공단에서 주거지원을 받고 있는 출소자 500명을 대상으로 자료수집을 하여 최종 400명의 자료로 구조모형분석을 실시하였다. 분석 결과, 첫째, 아동기 외상은 가족기능과 부적상관을 나타냈고, 아동기 외상과 기능적 분노표현방식인 분노조절은 부적상관을 나타낸 반면, 역기능적 분노표현방식의 하위요인인 분노표출, 분노억제와는 정적상관을 나타냈다. 또한 기능적 분노표현방식인 분노조절은 가족기능성과 정적 상관을 나타낸 반면, 역기능적 분노표현방식인 분노표출, 분노억제는 가족기능성과 부적 상관을 나타냈다. 둘째, 아동기 외상경험과 가족기능과의 관계에서 기능적 분노표현방식인 분노조절과 역기능적 분노표현방식인 분노표출, 분노억제의 매개효과를 검증한 결과, 분노조절과 분노표출, 분노억제가 아동기 외상경험과 가족기능과의 관계를 부분매개하는 것으로 나타났다. 구체적으로는 아동기 외상경험과 가족기능과의 관계에서 분노조절은 가족기능에 긍정적인 영향을 미치는 반면, 분노표출 및 분노억제는 가족기능에 부정적인 영향을 미치는 것으로 확인되었다. 연구결과를 토대로 논의 및 시사점이 제시되었다.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.43-48
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• 2010

Purpose: Over the past few decades, the treatment of traumatic splenic injuries has shifted to nonoperative management from surgical intervention. Although some nonoperative management failure have been reported, in most trauma centers, nonoperative management is now believed to be the treatment of choice in hemodynamically stable patients. Then, in this study, we have retrospectively evaluated our experience with traumatic splenic injury. Methods: From January 2005 to July 2009, 150 patients with blunt splenic injuries were managed in our hospital. Patients' charts were retrospectively reviewed to analyze their treatment, the patients were grouped according to those who had been admitted before October 2006, defined as the "early group", and those who had been admitted after October 2006, defined as the "late group". After the patients had been divided into two group, physiologic parameters and differences between the treatments were compared. Results: 150 patients were admitted to our hospital with blunt splenic trauma. In late group, both the surgical management rate and the nonoperative management failure rate were lower than they were in the early group. Conclusion: We expect angioembolization to effectively replace surgery for the treatment of selected patients with blunt splenic injury and to result in fewer complications.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권3호
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• pp.164-172
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• 2016

Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

• 대한불안의학회지
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• 제14권1호
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• pp.44-52
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• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• 한국심리학회지 : 문화 및 사회문제
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• 제27권1호
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• pp.19-34
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• 2021

자신이 신뢰하는 대상에게 성폭력 피해 경험을 이야기했을 때 받게 되는 부정적인 반응은 상대방에 대한 믿음이 깨지는 배반외상 경험이 될 수 있으며, 이는 자신과 세상에 대한 부정적인 인지를 형성하고 우울로 이어질 수 있다. 기존의 연구들에서는 가족, 친구, 지인 등의 비공식적 주체가 보이는 사회적 반응에 대한 연구가 주로 이루어졌다. 그러나 개인은 생존, 안전, 생계, 교육 등의 다양한 이유로 자신이 속해있는 조직을 신뢰하고 의지하게 되며, 조직이 개인의 성폭력 피해에 대해 보이는 부정적인 반응인 조직배반(institutional betrayal) 역시 조직이 자신을 보호해줄 것이라는 믿음이 배반되는 외상 경험이 되어 외상 후 인지 및 우울과 연관될 수 있다. 그러나 조직배반이 우울로 이어지는 구체적인 기제를 밝히는 연구는 아직 이루어지지 않았다. 이에 본 연구에서는 외상 후 증상을 이해하고 치료하는 대표적인 접근 중 하나인 인지행동이론에 기반하여, 조직배반이 우울로 이어지는 경로를 외상 후 인지가 매개하는지를 살펴보고자 하였다. 이를 위해 성폭력 피해에 대해 조직배반을 경험한 여성 462명을 대상으로 설문조사를 실시하고 구조 모형을 검증하였다. 그 결과 조직배반은 우울에 직접적으로는 영향을 미치지 못하였으며, 자신에 대한 부정적 인지와 세상에 대한 부정적 인지를 통해서 간접적으로 우울에 간접적으로 영향을 미치는 것으로 확인되었다. 이는 성폭력 피해에 대해 조직배반을 경험한 사람들이 자신과 세상에 대해 가지고 있는 부정적인 인지를 확인하고 다루는 것이 이들의 우울을 예방하거나 치료하는 데 있어서 중요함을 시사한다. 본 연구의 결과를 바탕으로 연구의 의의와 제한점 그리고 후속 연구를 위한 제언을 논의하였다.

• Journal of Trauma and Injury
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• 제25권2호
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• pp.44-48
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• 2012

Purpose: The management of splenic injuries has shifted from a splenectomy to splenic preservation owing to immunity. The purpose of this study was to assess the kinds of management and outcomes through a review of our experience with splenic injuries. Methods: We retrospectively reviewed 47 patients with traumatic splenic injuries using by electronic medical records from Jan. 2007 and Dec. 2011. Splenic injuries were classified according to the American Association for the Surgery of Trauma (AAST) grading system. Results: There were 11 falls, 11 traffic accidents, 10 motorcylcle accidents, 10 pedestrian accidents and 5 abdominal blunt traumas. Low-grade injured patients (${\leq}$ Grade III) were 29 of 43(61.7%), and High-grade injured patients (${\geq}$ Grade IV) were 18 of 43(38.3%). In 34 patients, non-surgical treatment was performed, and 14 patients underwent a splenectomy. There were relatively more high-grade in older patients, and the high-grade-injury group showed need for a transfusion (p=0.002), more need for a splenectomy (p<0.001), a longer mean hospital stay (p=0.036), a longer ICU stay (p=0.045) and more combined organ injury (p=0.036). Conclusion: Conservative treatment should be considered in low-grade-injury patients (${\leq}$ Grade III). A Splenectomy was performed on 56% of the patients with Grade IV injuries, so a splenectomy should be considered carefully in such patients. In patients with a grade V injury, we think surgical treatment may be needed.