• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.106-109
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• 2021

Displaced fracture of the distal third of the clavicle usually occurs after direct trauma to the shoulder and typically results in superior displacement of the proximal fragment. We report a previously undescribed case of downward displacement of the clavicle caused by a fall on an outstretched hand, and we suggest the mechanism of injury.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.500-506
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• 2018

본 연구는 119 구급대 편성 인원에 따른 중증외상환자의 병원 전 응급처치 실태를 분석하고자 2015년 1월 1일부터 12월 31일까지 J도 소속 119 구급대원에 의해 이송된 중증외상환자 1,067명 중 438명을 대상으로 수행하였으며, 수집된 자료는 IBM SPSS Statistics 21.0으로 분석하였다. 연구기간 동안 발생한 중증외상환자는 성별로는 남성이 2인 및 3인 구급대에서 각각 242명(70.6%), 66명(69.5%)으로 더 많은 빈도를 보였으며, 이들 환자가 이송된 의료기관별로는 지역응급의료센터로 이송된 비율이 각각 44.0%(151명), 49.5%(47명)로 가장 높았다. 119 구급대 편성 인원에 따른 현장 체류시간은 2인 및 3인 구급대 두 군 간에 유의한 차이를 보이지 않았으며(p=0.071), 전문기도유지술 및 정맥로 확보 시행빈도, 정맥로 확보 성공률에서도 각각 유의한 차이를 보이지 않았다(p=0.253, p=0.362, p=1.000). 본 연구 결과 단순한 양적 충원만으로는 중증외상환자의 병원 전 처치에 대한 질 향상에 영향을 주지 못하는 것으로 판단되며, 전문 인력의 확보와 함께, 직접의료지도의 단순화 및 간접의료지도의 활성화, 법적 업무범위의 확대 등이 필요하다.

• 한국심리학회지 : 문화 및 사회문제
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• 제26권2호
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• pp.99-119
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• 2020

본 연구에서는 관계중독에 영향을 미치는 요인을 규명하여 개입 방안 마련에 기초자료를 제공하고자, 아동기 외상과 내면화된 수치심 및 거절민감성을 관계중독에 영향을 미치는 요인으로 간주하고 이들 간의 관계를 살펴보았다. 이를 위해 만 18세 이상 성인 남녀 465명을 대상으로 아동기 외상 척도, 내면화된 수치심 척도, 거절민감성 척도, 관계중독 척도를 사용하여 자료를 수집하고, 구조방정식을 통한 매개모형 검증을 실시하였다. 분석 결과, 첫째, 아동기 외상은 내면화된 수치심에 영향을 미치고 내면화된 수치심은 거절민감성에 영향을 미치는 것으로 나타났으며, 내면화된 수치심은 관계중독에, 거절민감성은 관계중독에 영향을 미치는 것으로 나타났다. 둘째, 아동기 외상과 관계중독 간의 관계에서 내면화된 수치심은 매개효과를 나타냈으나, 아동기 외상과 관계중독 간의 관계에서 거절민감성의 매개효과는 유의하지 않았다. 반면, 내면화된 수치심과 관계중독 간의 관계에서 거절민감성이 매개효과를 나타냄으로써, 아동기 외상이 관계중독에 미치는 효과는 내면화된 수치심과 거절민감성에 의해 연속적으로 다중매개되는 것으로 나타났다. 셋째, 다집단 동등성 검증 결과, 성별에 따른 차이는 나타나지 않았다. 본 연구결과는 아동기에 경험하는 외상이 관계중독에 주요한 원인이 될 수 있으며, 아동기 외상은 수치심을 내면화시키고 이는 거절민감성을 야기함으로써 관계중독으로 이어질 수 있음을 의미한다. 연구결과를 토대로 시사점과 제언이 제시되었다.

• 대한치과의사협회지
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• 제51권11호
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• pp.604-609
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• 2013

Crown fractures are relatively common trauma to anterior teeth, and should be restored immediately in most cases. For those who suffer from unfortunate traumatic episode, the best treatment option should be minimally invasive approach. In the presence of fractured tooth fragment, reattachment procedure creates positive emotional response in the patient and simplifies the procedure and maintenance of the patient's original tooth anatomy and occlusion. Without fractured tooth fragment, next conservative option could be direct composite restoration which is based on minimal invasion concept. This article proposes simple and very conservative techniques that anyone can do in daily practice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.327-334
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• 2021

A transparotid approach, with a retromandibular or preauricular incision, is an alternative surgical approach for treating a subcondylar fracture and reducing the potential for complications such as injury to the facial nerves. However, retromandibular and preauricular incisions are both created far away from the parotid gland-dissection area. Thus, it is necessary to undermine the skin and retract it anteriorly to access the surgical field. Here, we introduce a modified approach wherein the incision allows for direct access to the fracture site. This approach may be adopted to shorten the incision length, reduce the retraction trauma at the surgical site, and help prevent injury to the facial nerve.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1508-1515
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• 1992

Between 1975 and 1992, forty five patients with trachea stenosis received tracheoplasty for relief of obstruction. The causes of airway problem are brain contusion[19 cases, 40%], cerebrovascular disease[3 cases, 7%], drug intoxication[8 cases, 18%], psychotic problem[2 cases, 4%], trachea tumor[3 cases, 7%], adult respiratory distress syndrome[9 cases, 20%] and direct trauma[1 case, 2%]. Direct causes of trachea stenosis were complications of tracheostomy[36 cases, 80%], complications of nasotracheal intubation[5 cases, 11%], tumor[3 cases, 6%] and trauma[1 case, 2%]. Thirty one patients underwent the sleeve resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Forteen patients received the Montgomery T-tube for relief of airway obstruction. Four patients have done simple excision of granulation tissue. Two, subglottic stenosis patients were received Rethi procedure[anterior division of cricoid cartilage, wedge partial resection of lower thyroid cartilage and Montgomery T-tube molding] and the other subglottic stenosis patient underwent permanent trachea fenestration. Including cervical flexion in all patients postoperatively, additional surgical techniques for obtain tension-free anastomosis were hyoid bone release technique in two cases, and hilar mobilization, division of inferior pulmonary ligament and mobilization of pulmonary vessel at the pericardium were performed in one case. Cervical approach was used in 39 cases, cervicomediastinal in 12 cases and transthoracic in one case. Complications of tracheoplasty were formation of granulation tissue at the anastomosis site[3 cases], restenosis[9 cases], trachea-innominate artery fistula[2 cases], wound infection[2 cases], separation of anastomosis[2 cases], air leakage[3 cases], injury to a recurrent laryngeal nerve[temporary 8 cases, permanent 2 cases] and hypoxemia[1 case]. Surgical mortality for resection with primary reconstruction was 6.7%, with one death due to postoperative respiratory failure and two deaths due to tracheo-innominate artery fistula.

• 한국응급구조학회지
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• 제14권1호
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• pp.5-18
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• 2010

Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.

• The Korean Journal of Pain
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• 제31권1호
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• pp.54-57
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• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.

• Journal of Oral Medicine and Pain
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• 제23권3호
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• pp.249-255
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• 1998

Mucoceles of the minor salivary glands are the most common cystic lesions affected the oral mucosa. They are believed to be the result of trauma to the salivary duct caused, for example, by biting the lip, cheek, or tongue. Surgical excision has been the most common treatment for these lesions, but occasional recurrences develop after excision because surgical trauma may damage the surrounding minor salivary glands Although various alternative nonsurgical approaches, such as steroid infection, application of gamma-linolenic acid, have also been reported, they are not used routinely, Lasers, particularly the carbon dioxide laser, have been used in the management of mucoceles. Although this treatment requires specialized equipment. Cryotherapy is another effective nonsurgical method for treating mucoceles. Clinically, cryotherapy has primarily been applied to the treatment of leukoplakia and hyperplastic, granulomatous, vascular, and pigmented lesions. Limited information, however, is available on the application of cryotherapy in salivary gland lesions, including mucoceles. A simple and easy cryotherapy to treat a mucocele on the lower lip is described. A 25 years old female patient with a mucocele on the lower lip was treated by direct application of liquid nitrogen with a cotton swab. The lesion was exposed to 4 or 5 cycles composed of freezings of 10-30 s and thawings of double the freezing times. No anesthesia was required. The lesion nearly disappeared without scar 10 days after the cryotherapy. Cryotherapy has become an established nonsurgical method, characterized by its simple application, therapeutic effectiveness, painless during the procedure and low incidence of secondary infection and hemorrhage.