• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2017년도 춘계학술대회
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• pp.179-182
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• 2017

뇌신경계 인터벤션시술은 장시간의 시술로 인해 피부의 수포 탈모 홍반등의 방사선 피폭으로 인한 위해가 빈번히 보고되어 지고 있다. 이에 CT(computed tomography) scan 시 피부 및 방사선 감수성이 예민한 인체의 전방부에 위치한 표적장기의 방사선 피폭을 감소시킬 목적으로 제작된 bismuth 차폐체를 인체공학적인 설계에 의하여 뇌혈관계 인터벤션 시술에 적용함으로써 방사선 감수성이 비교적 예민한 두피의 방사선 피폭 저감화를 위하여 연구를 제안 하고자 한다.

• Journal of Yeungnam Medical Science
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• 제40권3호
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• pp.225-232
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• 2023

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.49-66
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• 2014

지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.12-20
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• 2010

Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.560-564
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• 2001

The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.250-255
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• 2020

Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

• 대한골관절종양학회지
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• 제6권1호
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• pp.17-21
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• 2000

목적 : 융기성 피부섬유육종은 피부에 생기는 드문 종양으로서 부적절한 절제가 잦은 재발과 예후에 영향을 미치는 것으로 보고되고 있다. 저자들이 경험한 환자를 대상으로 치료와 예후의 관계를 연구하여 적절한 치료법을 제시하고자 하였다. 대상 및 방법 : 1990년 3월부터 본원 정형외과에서 치료한 융기성 피부섬유육종 환자중 추시 기간이 최소 12개월 이상인 14례를 대상으로 치료 방법 및 최종 추시까지의 상태를 점검하였다. 전례 모두 병리학적 진단하에 치료되었으며, 재발 후 전원된 9례를 포함한 13례에서 광범위 절제술이 시행되었다. 1례는 서혜부의 신경, 혈관이 종양과 인접하여 종양내 전절제술을 시행하였고 술후 항암요법을 추가한 경우였다. 결과 : 재발후 전원되었던 9례의 평균 재발 회수는 1.3 (1~2)회였으며, 처음 수술 후 첫번째 재발까지의 기간은 평균 11.8(2~24)개월이었다. 술후 최종 추시까지(평균 추시기간 50.8개월)에서 광범위절제술로 치료한 13례에서는 재발을 볼 수 없었으나, 병소내 전절제술과 항암제치료를 하였던 예에서는 반복된 재발을 보였고, 결국 폐전이로 사망하였다. 결론 : 융기성 피부섬유육종은 반드시 생검을 통한 확진 후 초기에 광범위 절제연 이상으로 절제를 시행하여야 할 것으로 사료된다. 재발은 최소한 2년까지의 추시가 있어야 그 여부를 알 수 있을 것으로 사료된다.