• 정신신체의학
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• 제24권1호
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• pp.43-53
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• 2016

연구목적 심리외상에 노출된 이후 신체증상이 매우 빈번히 발생하곤 한다. 이러한 신체증상은 사회기능과 직업기능 및 환자-의사 관계와 종종 연관되지만 외상후스트레스장애 진단 범주에 포함되지 않은 상태이다. 본 논문에서는 이러한 신체증상의 기전, 흔한 임상양상, 그리고 치료에 대해 고찰하고자 한다. 방 법 PubMed, Scopus, Google Scholar, KoreaMed, KISS와 같은 학술검색엔진을 사용하여 2016년 3월 31일까지 검색된 심리외상 노출 이후 신체증상에 관한 자료를 바탕으로 연구하였다. 결 과 심리외상 노출 이후의 신체증상의 발생 기전은 심리적인 측면과 생리적인 측면으로 구분될 수 있었다. 심리기전은 정신역동이론, 인지행동이론, 그리고 다른 이론들이 포함되었다. 생리기전은 신경내분비 및 면역계, 자율신경계, 중추 신경계의 변화로 설명되었다. 심리외상과 연관된 신체증상은 두경부, 흉부, 복부, 기타 근골격계, 피부 및 면역계에서 나타나는 다양한 건강문제로 표현되었다. 이러한 신체증상의 표준화된 치료에 대한 연구는 매우 부족하였다. 결 론 임상의와 재난정신건강지원 실무자는 심리외상에 대한 개입이나 PTSD 치료 동안 동반된 신체증상에 대해 항상 염두에 두어야 한다. 심리외상과 PTSD에서 보이는 이러한 신체증상에 대해 더 많은 연구가 진행될 필요가 있다.

• 대한후두음성언어의학회지
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• 제32권1호
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• pp.39-42
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• 2021

Granuloma is an uncommon benign disease that develops in the process of wound healing. Pharyngeal or laryngeal granuloma can be associated with gastric reflux, mechanical injury or trauma including intubation, voice abuse, or foreign body. 50-year-old female was transferred to our institute with a huge mass occupying the upper aerodigestive tract causing dysphagia. The patient has been suffering from a brain hemorrhage for several months and was kept in bed due to the quadriplegia with stuporous mental status, and was tracheotomized. On examination, the whole oropharynx and hypopharynx was covered by a smooth-surfaced soft big diffuse granular mass, which extended down to the upper trachea through the larynx. The huge granuloma was successfully removed with surgery and was found to have a pedunculating stalk on the oropharyngeal posterior wall with a small mucosal defect, suggestive of the origin of the mass. The defect was closed primarily after the cauterization. The patient is now followed up regularly without any recurrence of the disease.

• 대한두개안면성형외과학회지
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• 제22권4호
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• pp.183-192
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• 2021

Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.

• Hip & pelvis
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• 제35권3호
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• pp.157-163
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• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.

• Journal of Chest Surgery
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• 제10권1호
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• pp.38-43
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• 1977

With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

• Archives of Reconstructive Microsurgery
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• 제4권1호
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• pp.23-32
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• 1995

Severe upper and lower extremity trauma may result in soft tissue loss with exposed bone and the subsequence of risk of chronic osteomyelitis or malunion of fracture fragments. Such injuries present a major reconstructive problem. But Since the introduction of microsugical technique, free muscle and myocutaneous flaps were employed to provide coverage of severely injured defects. Since Tai and Hasegawa(1974) first reported a breast reconstruction using by rectus abdominis myocuraneous flap, the free rectus myocutaneous flap has been widely employed for breast reconstuction, head and neck reconstruction, and extremity reconstruction in these days. The authors present their successful experience with free rectus abdominis muscle and rectus abdominis myocutaneous flaps for upper and low extremity reconstruction. From Nov. 94, to May 95, Five cases of severely injured extremites due to trauma or contact burn were treated with free rectus abdominis muscle flap or free rectus abdominis myocutaneous flap. All flaps except 1 case were survived without severe complications. As free muscle or myocutaneous flap, the free rectus abdominis flap has the advantages of a reliable pedicle, easy dissection, and an acceptable donor site, so it seems logical to apply the free rectus abdominis flap to apply in upper and lower extremity reconstruction.

• 한국직업건강간호학회지
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• 제6권1호
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• pp.44-52
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• 1997

This study was carried out from January to March in 1996 to investigate subjective symptoms of cumulative trauma disorder (CTD). This survey was done by questionnaire of the Personal Ergonomics Profiles (PEP), which was developed by Johnson & Johnson. Number of respondents was 365 employees who were working in three furniture manufactories in Kwangjoo at Province Kyungki. The results were as follows : 1. There was no difference between clerical and labor workers in pain frequencies classified by general characteristics. However, labor workers showed statistically significant differences between working process in pain frequencies. Employees undertaking lifting work showed highest scores in frequencies of pain complaints. Comparing the number of pain occurrences, the married and the female was resulted in high score than the single and the male. There was no differences between ages and working experiences in group. 2. According to the mean frequency of body pain, the back was the most part to be complained in 1. 16 and followed by shoulder, neck, knee, wrist/hand, and forearm in order. Although, the study results showed that the workers working in furniture manufacture were not shown that they have had severe CTD, the female, the married and the the lifting workers were indicated as risk groups to CTD. Therefore, the development of backache prevention programe is necessary to manage pain control and to reduce health risks of CTD employees in their work environment.

• Journal of Chest Surgery
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• 제23권3호
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• pp.572-576
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• 1990

A complete transection of left main bronchus was repaired by end to end anastomosis 5 months after the chest trauma in the Yeungnam University Hospital. The patient was a 36 years old male who had been injured bluntly by a heavy package on the left chest. The initial symptoms and signs were dyspnea, chest pain and subcutaneous emphysema on the left neck, but on admission at our hospital his chief complaint was only mild left chest discomfort. The preoperative chest X-ray findings 5 months after the trauma revealed total collapse of the left lung, deviation of trachea to the left, elevation of left diaphragm, abrupt discontinuation in the course of an air-filled left main bronchus and bronchoscopy showed that the left main bronchus was completely occluded, without any signs of inflammation, approximately 4 cm from the carina. The operation was performed through standard posterolateral thoracotomy incision at the fifth intercostal space. There was not any suppuration within the transected lung but plenty of white mucus which was removed by forceful suction. The transected bronchial edges were debrided and anastomosed primarily by end to end with interrupted nonabsorbable sutures. The suture line was reinforced with a pleural flap. The postoperative course was uneventful and pulmonary function following operation improved progressively and proved the delayed repair to have a reasonable decision.

• Imaging Science in Dentistry
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• 제48권4호
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• pp.295-300
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• 2018

This report presents a clinical case of trauma due to assault with a knife, and describes the importance of using the correct imaging modality in cases of facial penetrating trauma involving the superficial and deep anatomical planes. Penetrating wounds in the maxillofacial region are rare and poorly reported, but can result in serious complications that are difficult to resolve and may compromise the patient's quality of life, especially when large blood vessels or other vital structures are involved. Thus, it is essential to determine the extent of the affected blood vessels and the proximity of the retained object to the anatomical structures. In this case, digital subtraction angiography was the imaging modality chosen. The use of appropriate imaging examinations allows a proper map of the surgical field, reducing the chances of vascular damage during the surgical procedure.

• Journal of Oral Medicine and Pain
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• 제48권4호
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• pp.181-185
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• 2023

We present a case report of a 52-year-old male patient who suffered head trauma in a car accident and subsequently experienced taste and smell disorders. Following the accident, the patient reported difficulty detecting salty and sour tastes and diminished olfactory perception. Neurosurgical evaluation revealed subarachnoid and subdural hemorrhages, while otolaryngology investigations revealed hyposmia-a decreased sense of smell. Upon referral to the Department of Oral Medicine, a comprehensive assessment revealed a general bilateral reduction in taste sensation, particularly ageusia for salty taste. Electric taste-detection thresholds significantly exceeded the normal ranges. Integrating our findings from neurosurgery, otolaryngology, and oral medicine resulted in a diagnosis of mixed chemosensory disorder attributed to head trauma. This case highlights the intricate interplay of alterations in taste and smell following head injury, emphasizing the significance of multidisciplinary evaluations in diagnosing mixed chemosensory disorders resulting from traumatic brain injury.