• 대한방사선기술학회지:방사선기술과학
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• 제22권2호
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• 대한관절경학회지
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• 제3권1호
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• pp.35-39
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• 1999

급성 외상에 의해 발생한 슬개골전 점액낭염 중 그 크기가 거대하고 보존적 요법에 반응하지 않는 3례에 대하여 관절경을 통해 점액낭을 절제하고 경피적 다발성 연차봉합을 시행한 바, 그 술기를 소개하고 1년이상 추시상 모든예에서 합병증이나 재발없이 만족할 만한 결과를 얻었기에 그 증례를 보고하고자 한다. 본 술기는 통상적인 절개방법에서의 피부 반흔에 따른 문제와 감염 및 재발 등의 합병증을 최소화하기 위한 보완적 술기로 고안되었으며 얇고 손상받기 쉬운 피부를 보호할 수 있는 장점이 있고 점액낭이 제거된 공간에 부가적인 연차봉합을 통해 사강(dead space)을 배제하고 분리된 조직간의 견고한 접촉을 유지해 줌 으로써 술후 조기 운동을 가능케하고 재발의 가능성을 줄일 수 있어 선택적으로 적용할만한 유용한 술기라 사료된다.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.102-107
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• 2018

Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients' and doctors' satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. Results: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. Conclusion: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.50-55
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• 2010

Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.

• Journal of Chest Surgery
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• 제41권4호
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• pp.536-539
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• 2008

52세 여자는 승용차 조수석에 앉아가다가 타차와 충돌후 다발성 늑골골절과 혈기흉과 함께 다량의 출혈을 야기한 우측 전완의 절단에 가까운 손상을 입었다. 응급실에 도착시 명료하지 못한 의식과 저혈압의 소견을 보였다. 혈액량 감소 쇼크로 판단되어 다량의 혈액과 수액을 급속수액주입기(레벨 1)를 이용하여 좌측 쇄골하정맥관을 통해 주입하였다. 폐좌상의 소견이 호전되었을 때 일반 흉부 X선 사진의 좌폐야에 이물질이 확인되었다. 폐동맥조영술에서 15 cm 정도의 이물질이 좌측 폐기저동맥에 있었다. 경피적 중재시술을 통해 혈관 겸자로 잡아 제거할 수 있었다.

• 한국응급구조학회지
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• 제22권2호
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• pp.79-91
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• 2018

Purpose: To assess the satisfaction of continuing education and need assessment according to job characteristics in emergency medical technicians (EMTs). Methods: A self-reported questionnaire was completed by 222 EMTs from May 28 to July 6, 2018. It consisted of questions on the method and need of continuing education, and satisfaction regarding education time, assessed using a 5-point Likert scale. Descriptive statistics, a chi-square test, and ANOVA were used to analyze the data. Results: The responses to questions on the method of continuing education (${\rho}=.000$), satisfaction of regarding the duration of continuing education (${\rho}=.029$), method (${\rho}$< .001), and topic (${\rho}=.000$) varied according to the differences in job characteristics of EMTs. Assessment and management of patients with multiple trauma ($4.17{\pm}.735$) emerged as the most important while license examination protocol for EMTs ($3.33{\pm}.968$) was rated the least important among topics for continuing education. Separation of continuing education (${\rho}$< .001), education method (${\rho}$< .001), education topic (${\rho}$< .001), and necessity of quality management of continuing education (${\rho}$< .001) differed according to the job characteristics of EMTs. Conclusion: It is important to provide a suitable program catering to the diverse requirements of EMTs. The education programs must be tailored to the needs of level 1 and level 2 EMTs separately. To improve the quality of education, it is necessary to evaluate the continuing effects.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.5983-5991
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• 2014

Introduction: Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. Methodological Approach: The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Risk Factors: Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Conclusions: Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

• Clinical and Experimental Pediatrics
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• 제45권11호
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• pp.1422-1425
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• 2002

저자들은 태아 곤란증 때문에 제왕절개한 과체중아로 저산소성 손상을 받은 태변 흡인 증후군 환아에서 생후 3-4일경에 어깨와 등에 여러 개의 홍반성의 결절과 반이 발생하였고 악화와 완화를 반복했으며 2-3회의 바늘 흡인(needle aspiration)을 시행하였고 합병증 없이 1세경 소실되었던 신생아 피하지방괴사 1례을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제15권2호
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• pp.86-91
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• 2011

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

• Journal of Trauma and Injury
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• 제26권1호
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• pp.14-17
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• 2013

Purpose: The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen. Methods: A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery. Results: There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery. Conclusion: Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.