• Journal of Trauma and Injury
• /
• v.24 no.2
• /
• pp.68-74
• /
• 2011

Purpose: Although pancreas injury is rare in abdominal trauma, it poses a challenge to the surgeon because its clinical features are not prominent and the presence of main duct injury cannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosed as having pancreas injury by using an explo-laparotomy. Patients successfully treated by non-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases).Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due to massive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively, three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverse outcomes.

• Radiation Oncology Journal
• /
• v.10 no.2
• /
• pp.129-135
• /
• 1992

We studied the T lymphocyte and its subpopulation percentage change in 40 patients immediately after the radiation therapy. Study population consisted of 12 patients treated at the site of head and neck region,14 patients treated at the site of thoracic region, and 14 patients treated at the site of pelvic region. Twenty two patients received radiotherapy as radical modality, and remaining 18 patients received radiotherapy as postoperative modality. Immediately after radiotherapy, total T lymphocyte (T1) percentage was decreased from $56.4\%$ to $55.2\%$, helper T cell (T4) percentage was decreased from $36.4\%$ to $34.1\%$, but suppressor T lymphocyte (T8) percentage was increased from $23.5\%$ to $25.4\%$. As a result, T4/T8 ratio was decreased from 1.57 to 1.39. This study suggested that immediate change after radiotherapy of the T lymphocyte and its subpopulation percentage was not related to the treatment volume and the degree of helper T cell decrement was not pronounced by the radiation dose increment. Long-term follow-up study En larger scale is needed to determine long term changing pattern in T lymphocyte subpopulation and its relationship to the prognosis of patients.

• Journal of radiological science and technology
• /
• v.34 no.2
• /
• pp.97-103
• /
• 2011

The Full-length examination of the femur sometimes does not show all of the femur because of the limited width in collimator and size of detectors although it is located in the diagonal direction. Aim of this study is to identify usefulness of the method of combining images which obtained from two radiographic images containing the femoral head and condyle respectively. Our group interviewed 30 radiological technologists who used both palliative DR method and SM method in their examinations of the femur of patients who were carried to the emergency rooms in Gwang-ju city from August 2007 to November 2009. We evaluated twenty images according to the contraction of femoral neck, turning of knee joints and inclusion of the femur. The examination were performed by two radiologists and six radiological technologists who have more than ten years of career. The results are as follows: SM method was graded with higher score for examination time, number of examiners, emaciation, retake and patients' discomfort (p< 0.001) while the. SM method was scored higher than the palliative DR method in the palliative DR method for examination of long bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.32 no.5
• /
• pp.401-409
• /
• 2006

Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients' age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows : 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

• Archives of Reconstructive Microsurgery
• /
• v.5 no.1
• /
• pp.35-45
• /
• 1996

After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

• Archives of Craniofacial Surgery
• /
• v.11 no.1
• /
• pp.53-57
• /
• 2010

Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

• The Journal of Pediatrics of Korean Medicine
• /
• v.12 no.1
• /
• pp.133-143
• /
• 1998

Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

• Journal of the Korean Society of Costume
• /
• v.55 no.4 s.94
• /
• pp.138-150
• /
• 2005

Phrygia headgear has an important meaning from the perspectives of costume history and cultural exchanges in ancient times. This study is to investigate the prototype of Phrygia headgear through analysis of its manufacturing methods and styles on the basis of prior studies on ancient sculptures and literatures conducted by European researchers and to examine its history and meanings. In these ways, this study will be helpful in understanding the importance of Phrygia headgear in cultural exchanges between the East and the West. Results of this study can be summarized as follows: Phrygia headgear was orn by eastern tribes, so it was a symbol of those from the east in ancient times. Phrygia headgear is frequently found in Greek artistic works of 5th to 4th century BC that depicted eastern tribes. Also, this headgear can be observed in artistic works for Mithras, Attis, or other gods. Since Phrygia headgear's shape is similar to that of Homer's helm, many researchers believe that it might be originated from Homer's helm. This headgear made of oxen scrotum(stierbeutel) or its surrounding skin has a long end at the top. This long end is round and drooping toward the front side. From such unique shape, we top. This long end is round and drooping toward the front side. From such unique shape, we top. This long end is round and drooping toward the front side. From such unique shape, we can draw a conclusion that Phrygia headgear was made of oxen scrotum and its surrounding skin. Dependingy on drooping patterns, there are various shapes, such as the round, tightly swollen one worn by Mithras, the tongue-shaped one found in Basilika S. Apolinare Nuovo's mosaic depicting three wise men, the balloon-shaped one frequently found in Greek vases depicting Scythian, and the one drooping to the side depicted in Alexandersarkophag. Further, some Phrygia headgear has covers for neck and ears. For example, Phrygia headgear worn by Persian Satrap tribe has such covers attached to the head part. Meanwhile, Phrygia headgear worn by Amazone tribe does not show such separate covers, Rather, one piece of oxen skin was tanned and finished to make such covers. Wearing Phrygia headgear can be interpreted in several ways. Use of animal's skin for wearing things is a unique aspect in ancient societies because they believed that wearing animal skin would give them power of the animal. Further, Phrygia headgear made of oxen scrotum was a symbol of reproductive power to women.

• Progress in Medical Physics
• /
• v.14 no.3
• /
• pp.189-195
• /
• 2003

The comparative analysis of a portal image and a simulation image is a very important process in radiotherapy for verifying the accuracy of an actual treatment field. In this study, we applied a chamfer-matching algorithm to compare a portal image with a simulation image and verified the accuracy of the algorithm to analyze the field matching error in the portal image. We also developed an analysis program that could analyze the two images more effectively with a chamfer-matching method and demonstrated its efficacy through a feasibility study. With virtual portal images, the accuracy of the analysis algorithm were acceptable considering the average error of shift (0.64 mm), rotation (0.32$^{\circ}$), and scale (1.61%). When the portal images of a head and neck phantom were analyzed, the accuracy and suitability of the developed analysis program was proven considering the acceptable average error of shift (1.55 mm), rotation (0.80$^{\circ}$), and scale (1.72%). We verified the applicability of a chamfer-matching algorithm to the comparative analysis of a portal image with a simulation image. The analysis program developed in this study was a practical tool to calculate the quantitative error of the treatment field in a portal image.

• Investigative Magnetic Resonance Imaging
• /
• v.10 no.2
• /
• pp.63-69
• /
• 2006

Purpose : Marrow edema and fatty degeneration of the hip joint bones could be initial and late signs in hip joint and its bone diseases respectively, which might be differentiated from age-related marrow conversion pattern. So authors have investigated normal marrow conversion pattern of the femur and acetabulum around the hip joints. Materials and methods : Three coronal MR images of 288 hip joint bones in 144 subjects, aged 2 days to 76 years divided to 8 groups every 10 years, were retrospectively analysed for the location and appearance of the converted yellow marrow. The converted yellow marrow were divided to head, neck, and trochanter in the proximal femur and below and above 50% in acetabulum of the hip. Results : The most common type of marrow conversion is the converted yellow marrow in the entire proximal femur and below 50% of acetabulum of the hip. We observed the start of marrow conversion in just before and after 2 years old and stopped at just before and after 20 years old. Conclusion : The understanding of age-related marrow conversion pattern of the hip joint bones would provide some information for differentiation from pathologic condition of them such as edema, fatty degeneration, metastasis, or leukemia.