• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.251-256
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• 2012

오늘날 삶의 질에 대한 관심이 고조되면서 일반 대중에게서도 레져 및 스포츠가 활성화됨에 따라 구강악안면영역 외상의 발생빈도도 높아지고 있다. 이러한 구강악안면영역의 외상을 예방하기 위해 구강보호장치 사용의 중요성이 커지고 있으며, 그 중 가장 많이 사용되는 것이 마우스가드이다. 마우스가드는 1) 치아에 가해지는 충격을 흡수하고 변형시켜 치아의 손상을 방지; 2) 입술, 혀, 치은 등 연조직의 열상을 예방; 3) 충격의 발생 시 반대측 치아가 접촉되는 것을 예방; 4) 하악골을 안정화시켜 하악각 또는 하악과두의 파절을 유발할만한 충격을 흡수시킴; 그리고 5) 목 또는 뇌손상을 예방할 수 있다. 이렇듯 마우스가드가 구강악안면영역의 외상방지에 효과적이지만, 운동선수나 일반 대중들에게는 널리 보급되어 있지 않고 그 중요성에 대한 인식률도 저조한 실정이다. 레져나 스포츠 활동 시 나타날 수 있는 구강악안면 외상 예방에 가장 효과적인 마우스가드의 종류, 재료, 제작 시 고려할 사항 등을 알아보고, 사용실태에 대한 고찰을 통해 마우스가드의 중요성에 대한 인식과 대중화에 도움이 되고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.281-288
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• 2001

림프관종의 치료에 있어 전통적으로 수술적요법만이 선호되어져 왔으나 최근 Ogita 등에 의해 소개된 OK-432는 안전성과 효과면에서 기존의 경화제에 비해 뚜렷이 구별되는 효과를 지니고 있는 것으로 여러 저자등에 의해 보고되고 있다. 특히 수술이 매우 어려운 부위에 존재하는 경우라든지 수술후 재발된 증례등에서 일차 혹은 이차적으로 투여하여 높은 성공률을 보였다고 하였고 더불어 OK-432 투여후 시행된 수술시에도 섬유성유착등의 어려움없이 병소를 절제할 수 있다고 하였다. 본 증례의 경우도 일차적인 OK-432 투여후 8개월째 시행된 이차적인 수술에서 큰 어려움없이 병소를 절제할 수 있었다. 이에 저자등은 좌측 혀 및 구강저와 경부의 급성 부종으로 인한 호흡부전 및 대설증의 증상을 보여 본원 소아과에서 의뢰된 생후 5개월된 환자에게 병력 및 임상검사와 방사선적 검사를 시행한 결과 림프관종으로 진단하고 일차적으로 흡입천자를 통한 감압술과 OK-432 를 통한 경화요법을 시행하였고 이차적인 연속수술을 시행하여 병소를 완전히 절제하였으며 술후 현재까지 재발소견없이 양호한 결과를 보였기에 이에 보고하고자 한다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.8.2-8
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• 1982

애성이란 음성의 질적 변화를 의미하는 것으로 이는 후두의 가장 대표적인 주 증상이다. 애성의 원인으로는 현재까지 알려져 있는것만 해도 약50 여종이 있다고 하며 그중 virus에 의한 상기도 감염증이 가장 많은 비율을 차지하고 있는 것으로 알려져 있고, 후두결절 및 풀립, 후두마비, 후두암, 후두유두종, 후두결핵등의 순으로 발생하는 것으로 알려져 있다. 최근 저자들은 본원에 입원중인 환자로서 애성 때문에 본 이비인후과로 진찰의뢰된 환자중 비교적 보기드문 질환과 동반된 애성환자 4예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 증예1. 29세 남자로서 교통사고로 후두부에 외상을 입은후 1 달만에 애성이 발생. 후두경 소견상 좌측성대의 paramedian paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예2. 53세 남자로서 clonorchis sinensis로 일반외과에서 전신 삽관마취하에 choledochostomy를 시행한 6 일후에 애성이 발생. 후두경 소견상 좌측성대의 median paralysis가 인정되었음. 증예3. 56세 남자로서 Aortic Aneurysm으로 내과에 입원한 환자로 입원전 3개월부터 애성이 발생. 후두경 소견상 좌측성대의 intermediate position paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예4. 74세 남자로서 Bronchogenic Ca.로 내과에 입원중인 환자로 입원 3년전부터 애성이 발생. 후두경 소견상 우측성대의 paramedian paralysis가 인정되었음

• Journal of Trauma and Injury
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• 제22권1호
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• pp.51-56
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• 2009

Purpose: The purpose of this study was to investigate environmental factors contributing to childhood home slip-down injuries. Methods: Among a total of 2,812 injured children in our Customer Injury Surveillance System (CISS), we performed a prospective study on 262 children with home slip-down injuries who visited the pediatric emergency department of Asan Medical Center between March 2008 and February 2009. We made a frequency analysis on parameters such as activities just before the accident, the presence of any obstacles or lubricant materials, specific home place in the home where the injuries occurred, flooring materials on which the slip-down happened, additional objects hit after slip down, the site and kind of injury, the duration of therapy, and the disposition. Results: Walking was the most common activity just before the injury. Because rooms and bathrooms were most common places in the home for slip down injuries, laminated papers/ vinyl floor coverings and tiles were the most common flooring materials used in the places where the injuries occured. Most commonly, no obstacles caused the children to slip down, but the furniture, stairs, doorsills, wetness, or soapy fluid followed after that. Over half of the children who slipped (58%) also collided with other than the floor itself after the slip-down, most common objects hit were the edges of the furniture, and doorsills, followed by stairways. The head and neck were the most commonly injured sites, and a laceration was the most common kind of injury. Most children needed less than 1 week of therapy, only 4 children (1.53%) admitted. There were no mortalities. Conclusion: The environmental factors contributing to slip-down injuries were the bathroom, laminated papers/vinyl floors, the furniture, stairs, doorsills, and wetness or soapy fluid. Especially, the furniture, stairs, and doorsills can be both primary obstacles and secondary collision objects. For the safety of our children, we must consider these factors on housing, when decorating or remodeling our house.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.186-195
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• 1994

Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

• 한국임상수의학회지
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• 제31권6호
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• pp.519-522
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• 2014

2년령 2 kg 말티즈가 진행성 사지마비와 목의 통증으로 내원하였다. 개는 알 수 없는 외상 이후 지난 2주간 스테로이드로 처치되었으나 점진적으로 상태가 악화되었고, 사지마비 상태가 되었다. 내원 시 개는 보행이 불가능한 사지마비 상태를 보였다. 방사선 사진과 CT 결과, C2의 가로골절과, 환추관절과 C2-C3의 불완전 탈구가 발견되었다. 추가적으로, MRI 상에서 뇌수종이 관찰되었다. Screw, Wire 와 PMMA를 사용한 C1-C3의 안정화가 시행되었다. 수술 후 4주에 임상 증상이 개선되었고, 개는 수술 6주 후에 이전과 마찬가지로 보행이 가능하였다. 본 증례의 Screw, Wire 와 PMMA를 안정화로 경추 골절을 효과적으로 치료하였다.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.32-38
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• 2023

Purpose: This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods: Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2018) database, were included. Patients' demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results: Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020-1.028) and using a grinder (OR, 2.073; 95% CI, 1.877-2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40-1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639-2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297-0.781). Conclusions: Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.168-175
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• 2003

근위 상완골 골절은 골절의 형태에 따라 크게 관절편 또는 해부학적 경부, 대 결절, 소 결절, 상완골 간부 또는 외과적 경부의 4개의 골절편으로 나눌 수 있다. 현재 널리 사용되고 있는 Neer의 근위 상완골 골절의 분류는 골절선에 의해 골절편을 나누는 분류가 아니며, 1 cm이상전이나 45$^{\circ}$ 이상의 각형성 이 있는 경 우를 전 이 골절편으로 생각하였다. 골절에 대한 관혈적 정 복 및 내고정술의 일차적 적응증은 골다공증이 없는 젊은 환자에서 발생된 튼튼한 내고정물을 시행할 수 있는 삼분 골절로 만족할 만한 결과를 위해 술후 오랜 기간동안 시행할 재활치료에 잘견딜수 있는 활동력 이 좋은 환자여야 한다. 수술적 치료의 절대적 적응증은 개방성 골절 ,혈관이 나 신경 손상이 동반될 때 , 정복이 불가능한 골절 탈구등이다. 반대로 환자가 골다공증이 심하거나, 근위 상완 골절편의 분쇄정도가 심하며 , 튼튼한 내고정을 시행할 가능성 이 희박한 나이가 많은 경 우에는 관혈적 정복 및 내고정술보다 일차적 인공삽입물을 이 용한 관절성형 술을 시행한 후 조기 재활 치료를 시행하는 것을 고려할 수 있다. 상완골 근위부 골절의 수술적 요법에는 다양한 수술 기법과 이에 따른 여러 합병증이 발생할 수 있으며 지속적 이고 체계적 인 재활 치 료가 꼭 필요하다. 여러 수술 기 법 중 관혈적 정복 및 장력 대 강선 기법을 시행할 때 만족할 만한 결과를 얻 을 수 있다. 이 방법 은 수술적 기법이 어렵지 않고, 골에 대한 고정과 함께 회전근 개의 건부착 부위에 대한 봉합을 추가할 수 있으나 역시 여러 가지 합병증이 있으므로 골절의 양상이 나 환자의 상태 ,환자의 활동력 등을 고려하여 치료 방법을 결정하여야 할것으로 사료된다.EX>46N으로, 슬개건-티타늄 간섭나사군이평균 1067.4$\pm$145N에서평균 601.8$\pm$134N으로, 슬개건-생체흡수성간섭나사군이평균 987.1$\pm$168N에서588.7$\pm$124N으로각각40$\%$, 39$\%$, 50$\%$, 24$\%$, 44$\%$, 40$\%$가감소하였다. 결론: 수술후초기고정력은슬괵건을LA나사(R) 또는Semifix(R)로고정하는방법과슬개건을티타늄및생체흡수성간섭나사로고정하는방법등이우수하였으며, 슬괵건을생체흡수성간섭나사나Endobutton(R)으로 고정하는 방법 등은고정력이 상대적으로매우약함을 알수있었다. 최대인장력은단순인장검사로는이상의대퇴골측고정방법의고정력이초기부하를견뎌내는데충분하다고생각되었으나주기성부하실험후현저히감소되어충분한초기안정성을제공하지못함을알수있었다.를 나타내었다. 또한 3m깊이에서의 측방 선량분포에서 Spoiler의 거리변화(6, 10cm)는 심부선량의 변화에 영향을 주지 않는 것으로 확인할 수 있었다. 그리고 위의 실험측정치를 치료계획 시스템에 입력하여 선량분포를 확인한 결과 Spoiler를 사용하는 경우 OPEN에 비해 선량분포 영역을 표면으로 끌어 올릴 수 있으며 Bolus 보다 피부 보호효과는 어느 정도 유지가 되는 것을 보여주었다. 4.결론 이와 같이 Spoiler는 Bolus와 비교하여 6MV 광자선의 build up 영역을 표면으로 증가시키는 동시에 Skin Sparing(피부보호)효과를 유지할 수 있으며 두경부암의 치료에서 Spoiler의 사용이 가능한 조건으로는 조사면이

• 한국환경보건학회지
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• 제17권2호
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• pp.78-94
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• 1991

The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure pain. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu Kyung Pook University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as follows: 1. Among the 179 cases, 51.6 % were male and 48.4 % were female. The two largest age groups were 30~39, 31.8 % and 20~29, 27.4 %. Among the 179 cases, 51.6% were married, the largest family number was 2 to 3, 41.1% and 4 to 5, 25.6%. Educationally, graduation from high school was the largest group, 46.4% among the patients, followed by middle school and primary school. The largest group income level was from 40~69만원, 45.2%. The largest group of patients who worked over 50 hrs. a week was 52.0%. The largest group of patients who worked less than 1 year was 44.7%, of the patients in work places of less than 100 people, 60.3% were injured and in work places of 100~299 people, 20.1% were injured. In manufacturing, the lagest group injured was 55.3%, the next group was transport, stroage, communication. The largest group of production workers injured was 40.2%. 2. The cause of injury in the largest group was facility problems, 33.5%. The next group was unsafe habits, 30.2% a lack of safety knowledge, 17.9% and insufficient supervision, 12.3%. The 30~39 year age group was head the highest number of injuries, 40.4% work places with more than 10 yeras of work, 44.4% work palces with more than 1000 people, 56.3% and mining accidents, 80.0%. Among these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries 28.5% as the largest group, followed by falls & falling objects 17.3%, fire & electric 15.1%, struke by an object 14.5%, followed by overaction and vehicular accidents. The accident pattern showed 46.4 % among workers over the 50 year age group, workers in the 5~10 year group, 50.0 % places employing more than 1000 workers, 35.3 % : construction 73.7%, and construction workers 57.1%, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures 54.8%, trauma 14.5%, amputation 11.7%, open wound, and burns. The largest number of fractures occurred in people in the 30~39 year age group, 63.2 % over 10 years of work, 55.6% in work places of 300~400 people, 63.6% construction 63.2% and general workers 57.2 %. 5. The largest group of injuries was upper extremity 45.3%, lower extremity 24.0%, trunk 18.5 % and head or neck 12.2%. Of these groups, upper extremity injuries were the highest in those less 20 years old 75.0%, less than 1 years of work 59.5%, in work places of 500~999 people 60.0%, manufacturing 56.6 % and production workers 55.6%. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 August, 22 people July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work(r=.2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation(r =.4372) p<0.001.