• 한국임상수의학회지
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• 제30권6호
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• pp.499-502
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• 2013

목 부위에 교상을 입은 8살의 중성화된 수컷 푸들이 내원하였다. 신체 검사에서, 보행이 불가능하였고 심부통증이 있는 사지의 불완전 마비로 UML 증상을 보였다. 방사선과 CT 검사에서 경추 1번의 횡돌기의 골절, 경추 2번의 가시돌기의 골절이 관찰 되었다. 보존적 처지를 1주일 실시 하였으나 증상이 완화 되지 않아 수술적 교정이 선택되었다. 수술적 안정은, 배쪽으로 접근하여 나사, K-wires 와 bone cement를 이용하여 내원 7일차에 실시 되었다. 수술 후 4주 이후 혼자 설 수 있었으며, 6주 이후 보행이 가능하였다. 본 증례에서는 등쪽과 배쪽 부위 중쇠뼈 골절을 교정하기 위하여 배쪽 복합 고정을 실시하였으며, 좋은 예후를 보였다.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.605-610
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• 2009

Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

• 동서간호학연구지
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• 제3권1호
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• pp.17-26
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• 1998

The purposes of this study were to identify the contents, frequency of use, and the rationales of folk remedies frequently used for first aid at home for stomachache, vomiting, strain, food poisoning, vaginal bleeding, or wounds of snake or dog bite, or bee sting. As the method of the study, data were collected by conducting a questionnaire of 185 persons, who filled it out or who were interviewed from May to August in 1998. The collected data was analyzed by using frequency and the rationales for the contents of the folk remedies were described base on literatures. The results were as follows,. 1. The folk remedies for stomachache in frequency order were 'warming the abdomen', 'rubbing the abdomen with a hand', or 'pricking a finger to bleed', which have the rationals. 2. The folk remedies for vomiting in frequency order are 'drinking water of watery radish' and 'pricking a finger to bleed', which have the rationales. 3. The folk remedies for strain in frequency order are 'soaking the affected area into cold water or applying an ice pack' and 'after soaking jasmine in water, making a dough with flour, and then attaching it on the affected area', which have the rationales, Additionally, although the frequencies are low, 'drinking brewed Achyranthis Radix' and 'applying brewed leaves and stalks of Sambuci Cortex' have the rationales. 4. The folk remedies for food poisoning in frequency order are 'drinking black beans and licorice brewed together' and 'eating mung beans', which have the scientific grounds. 5. The folk remedies for bloody discharge in frequency order are 'drinking brewed lotus root' and 'eating boiled chicken stuffed with root of bell-flower'. However, 'drinking brewed Thujae orientalis Folium' has the rationales. 6. The folk remedy for snake bite wounds that has the scientific grounds is 'sucking blood by a person without hurt in the mouth'. However, quite a lot of people apply alum or soy paste, which has no rationales. 7. The folk remedies for the bee sting in frequency order are 'after removing the sting, applying soy paste or sauce' and 'applying saliva'. No rationales for 'applying saliva' have been found. 8. The folk remedy for the dog bite wound that has the rationales is 'applying juice of leaves or stalks of Xanthii Fructus'. However, 85% of surveyed people use remedies that have no scientific grounds, such as 'applying burnt dog hair mixed with (sesame) oil' and 'applying soy paste or sauce'. Various materials are used in folk remedies for first aid treatment as shown above. Some of the folk remedies have the rationales since their medicinal actions have been found. However, the medicinal actions of the majority have not been found, but only known that they are effective, Especially for the materials except botanical drugs, they are used without knowing the effects since their components and pharmacognosies have not been described in any literature. The results of this research may be used for materials to educate the surveyed people or to consult them. Accordingly, the folk remedies that have the rationales are required to continue to study to find out the effects.

• 대한두경부종양학회지
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• 제16권1호
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• pp.20-25
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• 2000

The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

• 대한치과보철학회지
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• 제57권3호
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• pp.245-253
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• 2019

골격성 3급 부정교합의 악교정 수술로 구강기능과 안모를 개선할 수 있다. 악골부조화가 클수록 술전 교정치료에 의한 치아 이동량이 더욱 커지기 때문에 치주조직에도 큰 변화를 줄 수 있는데, 특히 하악 전치부 치주조직의 파괴가 주로 발생된다. 이 보고는 20년전 골격성 3급 부정교합과 하악전돌로 악교정수술을 받은 후 하악 전치부의 심한 동요 및 반대교합의 해결을 위해 내원한 49세 여성환자의 증례로, Face Hunter, Plane System 및 ARCUS digma II를 이용하여 Top-Down concept의 개인 맞춤형 분석으로 치료계획을 수립하였다. 하악 전치부 발치를 동반한 순측 치조골 성형술과 임플란트 식립 후 즉시임시치관에 의한 즉시부하를 시행하였다. 최종 보철물은 CAD/CAM에 의한 Zirconia 수복물로 제작 후 구강 내에서 나사유지형으로 장착하였다. 6개월이 경과한 현재까지 보철물의 파절과 동요 등은 관찰되지 않았으며, 기능 및 심미적으로 만족스러운 결과를 얻었기에 보고하고자 한다.

• 한국학교보건학회지
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• 제2권1호
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• pp.131-146
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• 1989

This study was conducted for the development of recording system of students' health problems, and for the application of International Classification of Health Problem in Primary Care(ICHPPC) as a tool of morbidity classification in school health care. The data were collected from 12th of September to 24th of September in 1988. The objects were composed of health problems written by 10 school nurses who take service in the elementary school. The results were as follows: 1. The features of students' health problmes. The health problems of students were 68 problems from the total numbers of 361 codes of ICHPPC. The 93.4% of health problems was contained in 20 descriptive diagnoses and 97.0% was contained in 30 descriptive diagnoses. According to frequency of main health problems, There were abrasion, scratch and blister(26.7%); disorder of stomach function, other disease of stomach and duodenum (20.4%); headache(10.6%); bruise and contusion (5.3%); acute URI (5.0%); laceration and open wound(4.6%); Insect bite and sting(4.0%); epistaxis(3.4%): abdominal pain(2.6%): superficial tissue(1.7%). Out of all health problems, Category 17(accident, injury and poisoning was 44.7%. and Category 9(digestive system Disease) was 22.2%. 2. Applicability of ICHPPC by the school nurses. School nurses used 68 codes, among the total number of 361 codes from ICHPPC. According to ICHPPC method, school nurses can classified more diverse health problems systematically and objectively than that in other studies on school nurses activities. ICHPPC was found as a useful and applicable tool of morbidity classification in the practice of school nurses.

• 한국임상수의학회지
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• 제26권4호
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• pp.391-394
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• 2009

왼쪽 앞다리에 교상을 입은 아시아 물왕도마뱀은 세균감염에 의해 피부 출혈, 농포, 수포, 복부팽만, 패혈증의 증상을 보인 후 폐사하였다. 신장에서 균을 분리, 생화학적 검사와 PCR 방법을 이용 모가넬라 모가니로 동정하였다. 25종의 항생제 감수성 검사를 실시하였고 분리된 균을 1.6 ${\times}$ $10^{11}$CFU/mouse 농도로 마우스 복강에 접종, 포유류에 대한 병원성을 검사하였다. 실험결과 마우스는 모두 폐사하였다.

• 한국임상수의학회지
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• 제33권5호
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• pp.300-303
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• 2016

An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. A physical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal joint was markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, and osteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided during surgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect ($1.5cm{\times}0.5cm{\times}0.5cm$) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneus bone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite was implanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plate to deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test results was administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing was confirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The use of rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronic osteomyelitis.

• 대한소아치과학회지
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• 제35권3호
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• pp.532-538
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• 2008

Lesch-Nyhan 증후군은 드물게 나타나는 X 염색체 열성 유전 질환으로 purine의 대사 장애를 보이는 질환이다. Purine의 대사 장애는 대사에 관여하는 효소인 hypoxanthine guanine phosphoribosyl transferase의 결손 또는 활성 감소로 인하여 나타나며, 요산의 과다 생산에 의한 요산과다혈증, 요산과다뇨증 등의 신장계 증상과 정신지체, 무도증 등의 신경학적 장애를 보이고, 구강이나 손가락에 대한 자해를 나타낸다. 이 중 자해 행위는 입술과 혀, 손가락을 깨무는 경우가 흔하고, 심하면 혀와 손가락이 완전히 절단될 수도 있다. 이 경우 자해로 인한 통증뿐 아니라, 연조직 결손으로 인한 심미적인 문제와 상처 부위로의 2차 감염이 발생할 수 있다. 이러한 Lesch-Nyhan 증후군 환자에서 자해를 막기 위해 여러 방법이 사용되고 있는데, 이 중 치과적으로 접근하는 방법으로는 마우스 가드나 lip bumper 등의 장치를 이용하는 방법과 해당 치아들을 모두 발거하는 방법, 악교정 수술을 통해 개방 교합을 형성해 주는 방법 등이 있다. 본 증례는 13세 9개월의 Lesch-Nyhan 증후군 환아로서 자해에 의해 혀에 심각한 외상을 가한 경우로 마우스 가드를 이용한 보존적인 방법을 사용하였으나 계속적으로 혀에 외상을 가해 하악 전치 뿐 아니라 구치까지 발거하여 치료하였다.

• 대한장애인치과학회지
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• 제14권2호
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• pp.97-101
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• 2018

저자는 입술 및 혀에 대해 자해증상을 보이는 2명의 Lesch-Nyhan 증후군 환아에서 구강조직에 대한 자해행동을 예방하기 위해 soft mouth guard를 이용한 보존적 치료법과 전악발거의 침습적 방법을 이용하여 치료한 증례를 보고하는 바이다. Lesch-Nyhan 증후군 환자의 자해행동을 예방하기 위한 치료법은 아직 정립된 기준이 존재하지 않아 각 환자의 자해양상 및 정도에 따라 치료방법은 달라질 수 있다. 가능하다면 치아를 보존할 수 있는 장치 또는 BTX-A 제재 등을 이용한 보존적 방법을 먼저 시도해 보는 것이 좋다. 이 때 치료의 성공률을 높이기 위해서는 치과적 접근 이외에도 소아정신과와의 협진을 통한 정신심리학적 접근, 필요시 약물치료를 고려하는 것 등 여러 방향으로 접근하는 것이 더욱 바람직한 결과를 가져올 것으로 사료된다. 보존적 접근이 실패할 경우 더 이상의 조직상실과 전신적 감염 예방을 위해 극단적 방법이지만 전악발거를 고려해야 할 것이다.