• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2021년도 추계학술대회
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• pp.167-169
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• 2021

충청남도 도서지역에 주민들이 정기적으로 이용할 수 있는 공공의료시설은 보건진료소 14개, 건강생활지원센터 1개, 병원선 1척이 전부이며, 이러한 시설과 장비로는 중증외상, 뇌혈관·심혈관 질환 등의 응급환자 발생 시 효과적으로 대응할 수 없다. 가장 신속한 응급환자 이송 수단은 단국대학교병원(천안시 소재)에 배치된 닥터헬기를 이용하는 것이다. 그러나 배치된 닥터헬기는 1대 뿐이고, 야간에는 운항을 할 수 없으며, 충청남도 전 지역을 담당하므로 다수 환자 발생 시에는 신속한 이송에 한계가 있다. 따라서 4차 산업의 한 분야인 도심 항공 모빌리티(UAM) 산업과 도서지역 응급환자 이송체계의 문제점을 보완하는 '충남형 닥터UAM 개발'의 필요성을 검토하고자 한다.

• 대한정형외과학회지
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• 제55권3호
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• pp.271-275
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• 2020

외상은 횡문근육종을 포함한 일부 육종의 발생에 영향을 미친다고 알려져 있고 수술 후 반흔이나 화상 흉터, 골절 부위, 금속 내고정물 주위에서 수년 간의 잠복기를 거쳐 육종을 일으킨 사례들이 드물게 보고되고 있다. 저자들은 컨베이어 벨트에 의해 압궤상을 입은 전완부에 11년 뒤 발생한 횡문근육종의 사례를 경험하였다. 조직 손상으로 인한 염증 반응, 많은 방사선 촬영에 대한 노출, 금속 내고정물, 감각 및 운동 마비로 인한 무의식적이고 반복적인 손상이 육종의 발생에 영향을 미쳤으리라고 생각된다. 이러한 광범위한 조직 손상 후에는 육종 발생 가능성을 염두에 두고 육종 유발 요인에 대한 노출에 주의를 기울여야 하겠다.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.370-376
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• 2011

Objective : Posttraumatic cerebral infarction (PTCI), an infarction in well-defined arterial distributions after head trauma, is a known complication in patients with severe head trauma. The primary aims of this study were to evaluate the clinical and radiographic characteristics of PTCI, and to assess the effect on outcome of decompressive hemicraniectomy (DHC) in patients with PTCI. Methods : We present a retrospective analysis of 20 patients with PTCI who were treated between January 2003 and August 2005. Twelve patients among them showed malignant PTCI, which is defined as PTCI including the territory of Middle Cerebral Artery (MCA). Medical records and radiologic imaging studies of patients were reviewed. Results : Infarction of posterior cerebral artery distribution was the most common site of PTCI. Fourteen patients underwent DHC an average of 16 hours after trauma. The overall mortality rate was 75%. Glasgow outcome scale (GOS) of survivors showed that one patient was remained in a persistent vegetative state, two patients were severely disabled and only two patients were moderately disabled at the time of discharge. Despite aggressive treatments, all patients with malignant PTCI had died. Malignant PTCI was the indicator of poor clinical outcome. Furthermore, Glasgow coma scale (GCS) at the admission was the most valuable prognostic factor. Significant correlation was observed between a GCS less than 5 on admission and high mortality (p<0.05). Conclusion : In patients who developed non-malignant PTCI and GCS higher than 5 after head injury, early DHC and duroplasty should be considered, before occurrence of irreversible ischemic brain damage. High mortality rate was observed in patients with malignant PTCI or PTCI with a GCS of 3-5 at the admission. A large prospective randomized controlled study will be required to justify for aggressive treatments including DHC and medical treatment in these patients.

• 구강회복응용과학지
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• 제26권4호
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• pp.477-482
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• 2010

다수 구치부 상실을 가진 환자의 경우 상실 공간으로 대합치의 정출 및 잔존 전치부 저작으로 인한 교합 외상이 발생한다. 대합치의 정출로 인해 교합 평면이 붕괴되고 구치부 지지 상실로 잔존 치아의 심한 마모를 보이게 된다. 이 경우 보철 수복 공간을 확보하고 교합 평면을 바로잡기 위해서 최소한의 수직 고경을 높여 잔존 치아와 상실된 치아 부위의 수복치료가 필요하게 된다. 본 증례의 환자는 다수 구치 상실로 인한 저작 곤란 및 마모된 전치로 인한 심미적 문제로 내원한 환자이다. 보철 수복을 위한 치아 삭제 전 가역적인 거상 장치를 2개월간 사용한 뒤, 비가역적인 치아 삭제 후 임시 수복물을 3개월간 사용하여 총 5개월간 최종 수복물에 대한 적응 여부를 관찰하였다. 수직 고경 거상량은 3mm로 비교적 작은 양이었고 저작계가 증가된 수직 고경에 대해 특별한 병적 변화 없이 적응하였다. 최종 수복물은 중심 교합시 전체 치아가 균등하게 접촉하고 측방운동시 견치에 의해 즉각적으로 이개되도록 하였으며 금속 교합면를 부여하여 장기적으로 과도한 근육 활성 및 교합 외상, 도재의 파절을 방지하고자 하였다. 이상의 치료를 통해 교합 붕괴 환자를 안정적인 보철 수복물로 재건한 치험예를 보고하고자 한다.

• Imaging Science in Dentistry
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• 제45권2호
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• pp.103-108
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• 2015

Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

• Journal of Chest Surgery
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• 제28권9호
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• pp.847-850
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• 1995

For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

• 대한족부족관절학회지
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• 제19권2호
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• pp.73-76
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• 2015

The calcaneal insufficiency avulsion fracture usually occurs in an area of fused apophysis in adults without significant history of trauma or overuse activities. It is an uncommon injury which has been described in patients with complicated diabetes, Charcot neuroarthropathy, amyloidosis with neuropathy, severe osteoporosis, and other conditions. Discussion of the issue of fracture location is still not sufficient. We report on a case of a 50-year-old male who experienced a non-traumatic diabetic calcaneal insufficiency fracture. Intraoperatively, a biopsy specimen was obtained from the exposed fracture site for histological study. We assume that the calcaneal fused apophyseal line is the weak point of failure due to various incomplete mixtures of trabecular bone, woven bone, and cartilaginous tissues, and may fail when repeated tensile stress is imposed.

• The Korean Journal of Pain
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• 제21권3호
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• pp.248-251
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• 2008

The clinical syndrome of posttraumatic syringomyelia can complicate major spinal trauma and develops many months after spinal injury. The 50-90% of patients experienced the pain and especially the component of central pain. In patients with central pain following spinal cord injury, ketamine has been shown to be an effective analgesic. We report a case of posttraumatic syringomyelia in a 30-year-old woman who complained of central pain, weakness of both legs and dysesthesia. She had not responded to pulsed radiofrequency, or lidocaine infusion therapy, but a continuous intravenous infusion of ketamine, an N-methyl-D-asparate receptor antagonist, reduced her severe central pain. In conclusion, a ketamine infusion therapy resulted in a significant reduction of central pain without decreasing of motor power and function.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.112-115
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• 2013

The incidence and importance of tricuspid valve regurgitation after a blunt chest injury has risen with the increase in the number of automobile accidents and steering wheel traumas. This kind of injury has been reported more frequently in the last decade because of the better diagnostic procedures and understanding of the pathology. However, tricuspid valve regurgitation following a blunt chest injury can still be easily missed because most patients do not show symptoms at the time of the trauma. A 55-year-old male patient presented himself at our facility after suffering a chest injury from an automobile accident. His transthoracic echocardiography (TTE) revealed severe tricuspid valve regurgitation due to the prolapse of his anterior valve leaflet. We report a case of asymptomatic tricuspid regurgitation that developed after a blunt chest injury.

• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.244-248
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• 2020

The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.