• Title/Summary/Keyword: 대인 외상

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Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury (둔상에 의한 흉부대동맥 손상에서 TEVAR에 관한 임상연구)

  • Ku, Gwan Woo;Choi, Jin Ho;Choi, Min Suk;Park, Sang Soon;Sul, Young Hoon;Go, Seung Je;Ye, Jin Bong;Kim, Joong Suck;Kim, Yeong Cheol;Hwang, Jung Joo
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.232-240
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    • 2015
  • Purpose: Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury. Methods: Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014. Results: Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was $105.64{\pm}24.60mm\;Hg$, and the mean heart rate was $103.64{\pm}20.02per$ minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was $21.82{\pm}16.37hours$. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur. Conclusion: Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.

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LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan syndrome: 증례보고)

  • Kim, Myoung-Gook;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.284-289
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    • 2011
  • Lesch-Nyhan syndrome is a disease caused by metabolic disorder of purine. General muscle stiffness and hyposomia are shown from infancy and symptoms can include involuntary or irregular movements of arms and legs, mental retardation, and compulsive self-mutilating behaviors. Self-mutilating behaviors begin at approximately the first year or sometimes at late teens. The patients bite their lips, especially lower lip, tongue, buccal mucosa, hands and fingers. Tongue and lips can be injured or mutilated in severe cases. As the patient gets older, self-mutilating behaviors become more serious and extensive and secondary infection of injured areas is possible. Periodic soft tissue damage due to self-mutilating may evolve to cancer. Medical treatment, appliance treatment, extraction of tooth and surgical operation was attempted to control self-mutilaing behaviors. We hereby report the case of child Lesch-Nyhan syndrome patient who has self-inflicted labial damage as chief complaint. When patient was treated with conservate therapy, such as removable or fixed appliance, the frequency of labial damage could be subdued and yielded favorable results.

A Clinical Study of Facial Paralysis (안명신경 손상 환자의 임상적 고찰)

  • Huh, Choon-Bok;Suh, Tae-Soo
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.643-650
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    • 1998
  • Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory

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A Clinical Study of Intercostal Neuropathy after Rib Fracture (늑골 골절 후 발생한 늑간 신경병증의 임상적 연구)

  • Kang, Jung-Hun;Lee, Seog-Ki;Seo, Min-Bum;Na, Jeong-Yeop;Jang, Jae-Hyouk;Kim, Kweon-Young
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.53-57
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    • 2010
  • Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

Non-surgical Treatment for Secondary Spontaneous Pneumothorax Associated with Bacterial Pneumonia in a Beagle Dog (비글견에서 세균성 폐렴으로 인한 속발성 자발 기흉의 비외과적 치료)

  • Han, Hyun-Jung;Yoon, Hun-Young;Kim, Jun-Young;Jang, Ha-Young;Choi, Seok-Hwa;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.31-36
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    • 2008
  • One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

Arthroscopic Evaluation on Intra-Articular Pathology in Recurrent Shoulder Dislocation Aged Over 40 Years (40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구)

  • Min, Woo-Kie;Kim, Ju-Eun;Cho, Hwan-Seong;Kim, Poong-Taek;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.215-220
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    • 2009
  • Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

Research About Students' Horizontal Heterophoria in Near Distance with Maddox Rod (Maddox Rod를 사용한 대학생의 근거리 수평사위에 대한 고찰)

  • Choi, Kyong-Seo
    • Journal of Korean Ophthalmic Optics Society
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    • v.14 no.3
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    • pp.59-63
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    • 2009
  • Purpose: To investigate the near horizontal heterophoria of the college students in their twenties on north Kyonggi Province. Methods: The all subjects had not experienced any ocular surgery and have no disease and their mean age is 22.9. As 122 subjects, they are 50 emmetropes and 72 ametropes. The ametropes are all myopia. After distance visual acuity correction with subjective and objective refraction test, evaluated their horizontal heterophoria with red maddox rod. Results: In maddox rod test, the subjects consist of orthophoria 4.9%, esophoria 9.8% and exophoria 85.3%. In the emmetropes orthophoria is 8%, esophoria is also 8% and exophoria is 84%. In the ametropes orthophoria is 2.8%, esophoria is 11.1% and exophoria is 86.1%. The mean size of horizontal heterophoria is esophoria 3.59PD (prism diopter), exophoria 7.04PD and in the emmetropes esophoria is 3.25PD, exophoria is 6.60PD. In the ametropes esophoria is 3.75PD and exophoria is 7.34PD. Conclusions: In the emmetropoes the orthophoria is more than in the ametropes and the esophoria and exophoria is more in the ametropes. But the differences between the heterophoria and emmetropia or ametropia were not significant (p>0.05). The mean size of heterophoria is higher in the ametropes than in the emmetropoes. The distribution range of heterophoria is wider in the male subjects than the female subjects.

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Pathways to homelessness: The case of young adults in Korea (남성 청년의 노숙진입 시기에 따른 노숙 경로)

  • Kim, Soyoung
    • Korean Journal of Social Welfare Studies
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    • v.47 no.4
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    • pp.151-181
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    • 2016
  • The objective of the study is to identify the sub-path of entry into homelessness of young men and enhance understanding them. In specific, homeless risk factors were extracted through their experiences, and based on which the entry paths into homelessness were drawn. The homeless young adults were divided into two groups of those who became homeless in their adolescence and those who entered into homelessness after 19 and their differences were analyzed. As a results, the most prominent differences between the two sub-groups included individual and social factors; most of those who entered homelessness after 19 had physical or psychological problems, while the other group showed delinquency factors in adolescence and adulthood. As for social factors, the former group experienced more financial damage in the process of achieving independence before being homeless, while the latter group had relatively more experience of physical and psychological damage such as bullying, harassment and violence before being homeless and financial frauds. As for investigating the causality relationship of key homeless risk factors by adding a variable of time, and based on which, a constant pattern of entry paths toward homelessness was drawn among each sub-group of homeless young adults. For policy on homelessness, it is required to develop according to the characteristics of homeless young adults. Especially, a specific approach is necessary for the different homeless pathways by sub-group. Furthermore, the study indicated that management and preemptive responses for various homeless risk factors that homeless young adults experienced throughout their lifetime could be important prevention policy against homelessness.

Rothko's Painting-Image and the Expansion of the Real: Lacan, Zizek, and Wilber (로스코의 회화이미지와 실재의 확장 : 라깡, 지젝, 그리고 윌버)

  • Bae, Chul-young
    • Journal of Korean Philosophical Society
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    • v.117
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    • pp.85-111
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    • 2011
  • Topics with which chis paper deals are as following; (1)Zizek's interpretation of Rothko's painting, (2)Lacan's gaze and picture, (3)the real as object a, (4)primal jouissance and death-drive, (5)a new identity of man-emptiness in Zizek, (6) existential level and existential conflict, (7)a variety of meanings of emptiness, (8)transpecsonal drive and meditation, (9) the different Real-Emptiness, (10)Rochko's painting and transpersonal drive.

An autoethnography on the Development and counseling Experience of Non-face-to-face Mental Health Mobile Service Platform of Mental Health Social Welfare expert (정신건강사회복지 전문가의 비대면 정신건강 모바일 서비스 플랫폼 개발 및 상담 경험에 관한 자문화기술지)

  • Lee, Sol-Ji
    • Journal of Internet of Things and Convergence
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    • v.8 no.5
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    • pp.63-70
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    • 2022
  • This study is a study that collects and analyzes data through An autoethnographyon as one of method of qualitative research, through which researcher have experienced firsthand in the process of developmenting and counseling there a new concept professional mental health mobile service platform as a mental health social welfare expert. The results of this study are as follows.First, there are people in Korea who are directly exposed to mental health issues and need to receive professional medical services, but there are also quite a few members of the public who have a desire for general mental health services, although the level of therapeutic intervention is not required. Second, considering the characteristics of modern society and especially in the pandemic situation of infectious diseases such as COVID-19, more and more people are preferring various mental health service platforms using mobile devices. Third, all generations complain of mental health issues such as family problems, stress, interpersonal relationships, and occupations, and other mental health problems such as self-harm and suicide accidents are frequently mentioned in connection with mental disorders such as depression, anxiety disorder, addiction, and post-traumatic stress disorder. Fourth, youngth s were exposed to various mental health-related issues, and above all, they were complaining of serious mental health problems such as self-harm and suicide accidents. Fifth, in delivering professional mental health services, mental health experts with the ability also to provide professional services online through mobile devices are needed as well offline. Finally, based on the results of this study, policy and practical suggestions related to the provision of mental health services in the future, and directions for follow-up studies were suggested.