• Journal of Chest Surgery
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• v.29 no.4
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• pp.433-439
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• 1996

From January 1980 to July 1995, 32 patients with blunt diaphragmatic trauma and 12 wish penetrating diaphragmatic trauma were treated at Kyungpook University Hospital. The mean age of patients with blunt trauma was 37.6 years, and with penetrating trauma 29.2 years. The mean age was older in patients with blunt trauma by 8.4 years (p< 0.05). When simple chest X-ray diagnosis was performed, 24cases (75%) of the diaphragmatic injuries were found in blunt trauma and 4 case(33%) in penetrating trauma. When opei.ations were done due to injuries of thoracic or abdominal organ, 7 diaphragmatic injuries (58%) were found in penetrating trauma. Herniation occurred in 24 patients (75%) in blunt trauma and 5 patients (42%) in penetrating truma. The size of injured diaphragms in 29 cases in which hernia was discovered was 10.9 $\pm$ 4.3cm. On the other hand, the size in 15 cases in which hernia did not occur was 3.5 $\pm$ 2.9cm. There was a remarkable difference in their size depending on the presence or absence of hernia (p< 0.051. That is, a close relation between the sire of injured diaphragms and hernia was shown. All diaphragmatic injuries were repaired primarily. In blunt trauma approach of repair were as follows : 20 (63%) thoracic, 9 abdominal, 2 thoracoabdominal, and 1 thoracic and in penetrating trauma 6 (50%) abdominal, 4 thoracic, and 2 thoracic and abdominal. The complication rate was 19% in blunt trauma and 25% in penetrating trauma. Two patients with blunt trauma died with a mortality rate of 6.3% . All patients with penetrating trauma recovered. This study suggests that diaphragmatic injury should be suspected in all patients w th blunt as well as penetrating injury of the chest and abdomen. The size of injured diaphragms was larger in blunt trauma than in penetrating trauma. For herniation, it appeared to be more common in blunt trauma. The morbidity and mortality were related primary to the severity of associated injuries.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1094-1102
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• 2001

Objective : During the trans-condylar or trans-jugular approach for the lesion of cranio-cervical junction(CCJ), its necessary to identify the accurate locations of vertebral artery(VA), internal jugular vein(IJV) and its related lower cranial nerves. These neurovascular structures can also be damaged during the operation for vascular tumor or traumatic aneurysm around extra-jugular foramen, because of their changed locations. To reduce the neurovascular injury at the operation for CCJ, morphometric relationship of its surrounding neurovascular structures based on the tip of the transverse process of atlas(C1 TP), were studied. Materials & Methods : Using 10 adult formalin fixed cadavers, tip of mastoid process(MT) and TPs of atlas and axis were exposed bilaterally after removal of occipital and posterior neck muscles. Using standard caliper, the distances were measured from the C1 TP to the following structures : 1) exit point of VA from C1 transverse foramen, 2) branching point of muscular artery from VA, 3) entry point of VA into posterior atlanto-occipital membrane(AOM), 4) branching point of C-1 nerve. In addition, the distances were measured from the mid-portion of the posterior arch of atlas to the entry point of the VA into AOM and to the exit point of the VA from C1 transverse foramen. After removal of the ventrolateral neck muscles, neurovascular structures were exposed in the extra-jugular foraminal region. Distances were then measured from the C1 TP to the following structures : 1) just extra-jugular foraminal IJV and lower cranial nerves, 2) MT and branching point of facial nerve in parotid gland. In addition, distance between MT and branching point of facial nerve was measured. Results : The VA was located at the mean distance of 12mm(range, 10.5-14mm) from the C1 transverse foramen and entered into the AOM at the mean distance of 24mm(range, 22.8-24.4mm) from the C1 TP. The mean distance from the mid portion of the C1 posterior arch was 20.6mm(range, 19.1-22.3mm) to the entry point of the VA into AOM and 38.4mm(range, 34-42.4mm) to the exit point of the VA from C1 transverse foramen. Muscular artery branched away from the posterior aspect of the transverse portion of VA below the occipital condyle at the mean distance of 22.3mm(range, 15.3-27.5mm) from the C1 TP. The C-1 nerve was identified in all specimens and ran downward through the ventroinferior surface of the transverse segment of VA and branched at the mean distance of 20mm(range, 17.7-20.3mm) from the C1 TP. The IJV was located at the mean distance of 6.7mm(range, 1-13.4mm) ventromedially from the lateral surface of the C1 TP. The XI cranial nerve ran downward on the lateral surface of the IJV at the mean distance of 5mm(range, 3-7.5mm) from the C1 TP. Both IX and X cranial nerves were located in the soft tissue between the medial aspect of the internal carotid artery(ICA) and the medial aspect of the IJV at the mean distance of 15.3mm(range, 13-24mm) and 13.7mm(range, 11-15.4mm) from the C1 TP, respectively. The IX cranial nerve ran downward ventroinferiorly crossing the lateral aspect of the ICA. The X cranial nerve ran downward posteroinferior to the IX cranial nerve and descended posterior to the ICA. The XII cranial nerve was located between the posteroinferior aspect of the IX cranial nerve and the posterior aspect of the ICA at the mean distance of 13.3mm(range, 9-15mm) ventromedially from the C1 TP. The distance between MT and C1 TP was 17.4mm(range, 12.5-23.9mm). The VII cranial nerve branched at the mean distance of 10.2mm(range, 6.8-15.3mm) ventromedially from the MT and at the mean distance of 17.3mm(range, 13-21mm) anterosuperiorly from the C1 TP. Conclusion : This study facilitates an understanding of the microsurgical anatomy of CCJ and may help to reduce the neurovascular injury at the surgery around CCJ.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.48-52
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• 2013

Purpose: Bed, living a long time is required in adult patients with brain lesions such as stroke, traumatic brain injury, and Parkinson's disease, causing pneumonia and respiratory diseases may be due to aspiration of food or saliva. In patients with recurrent pneumonia or pulmonary symptoms, there is a need to determine the possibility of pulmonary aspiration due to aspiration of saliva. Materials and Methods: Saliva due to aspiration pneumonia diagnosis in patients with brain lesions request for inspection to the Department of Nuclear Medicine, 10 patients (male 6, female 4) were included in this study. Patients were fasted before the test, $^{99m}Tc_{O4}$ 185 MBq (5 mCi) of less than 1 mL of solution was administered in the oral cavity. Administration and 20 minutes of dynamic imaging acquisition, and immediately after that the static images were acquired. Delayed scan after 2-4 hours if necessary. Results: Positivity rate of all 10 patients was 60%. In 4 patients showed positive reactions after the administration of oral cavity in a 20-minute dynamic imaging were able to confirm whether the aspiration. In the remaining 2 patients, four hours of additional delay tests were able to confirm whether the aspiration. Conclusion: Does not require changes in patient posture compared to the other checks that can be diagnosed with aspiration pneumonia. A simple test and takes less time. Therefore be useful in providing information for the diagnosis and treatment modality.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.2
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• pp.49-71
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• 2000

The purpose of this study was to serve as a basis for school health care of better quality, by making a comparative analysis of the health care satisfaction and attitude of elementary school students in consideration of their general characteristics and the presence or absence of nurse teacher. The subjects in this study were 919 selected six graders in 16 elementary schools in the city of Tongduchun, Koyang and Euijungbu, Yangju-kun and Yeunchun-kun. A survey was conducted with questionnaire designed for measurement of health care satisfaction and attitude. As a result of analyzing the data collected from June 1 through 15, 2000, the conclusions were as follows. 1) As for the general characteristics of the students investigated, the subjects included 513 boys(55.8%) and 406 girls(44.2%). The schools where 390(42.4%) students attended were located in municipal area, and the schools where 529(57.6%) students attended were located in kun area. 608(66.2%) students had a nurse teacher at their schools, while 311(33.8%) students had no nurse teacher. 498(54.2%) had an experience to use the health room this year, but 421(45.8%) had no such an experience. Their mean school life satisfaction was scored $3.42{\pm}.71$, above the average. And their health condition was rated $3.81{\pm}.87$, which implied they tended to be in good health. 2) The mean satisfaction at the health room operation was scored $3.33{\pm}.71$, above the medium level. What they were most satisfied with($4.02{\pm}1.08$) was, among the health room facilities, that there were beds. But they expressed the least satisfaction($2.83{\pm}1.17$) at the location of health room. The presence or absence of nurse teacher made a significant difference to their satisfactionat health room operation, because the students in schools with nurse teacher showed greater satisfaction($3.42{\pm}.72$) than the others in schools with no nurse teacher did($3.15{\pm}.66$). 3) Concerning their attitude to use the health room in case of disease or accident occurrence, a lot of students in schools with a nurse teacher, who had ever suffered from indigestion, headache or traumatic injury, used the health room. In schools with no nurse teacher, there was a tendency to talk to their class teachers(p<.001). The recognition of the necessity for health counseling was generally on a medium level. The counselor whom they wanted to discuss health problem with was family or friend in the largest cases. Few students discussed with class teachers in case there was a nurse teacher in school. Instead, some of them discussed with friend, family or nurse teacher, and there was a significant difference between them(p<.001). 4) The mean satisfaction at health, sanitation and environmental management was rated $3.20{\pm}.90$, above the average. The classroom lighting gave them the best satisfaction with $3.67{\pm}1.07$, but the satisfaction at toilet cleanness and disinfection was not good with $2.83{\pm}1.19$. By the presence or absence of nurse teacher, those who had a nurse teacher expressed better satisfaction at water supply facilities including hot water than the others who had no nurse teacher did(p<.001). But no significant difference was observed in the other items. 5) The health education satisfaction was rated $3.19{\pm}.99$, which was on a medium level. By item, the mean satisfaction level was $3.36{\pm}1.19$ at nurse teacher's explanation about treatment, $3.13{\pm}1.15$ at the frequency of health education, and $3.08{\pm}1.16$ at the explanation on the cause of disease. By the presence or absence of nurse teacher, the students with nurse teacher showed significantly better satisfaction at every factor0(p<.001). 6) Regarding health education attitude, their recognition of the need for school health education was scored $3.89{\pm}.96$. Those who had a nurse teacher felt it more necessary($3.96{\pm}.92$), yet the others who had no nurse teacher felt its necessity a little less($3.74{\pm}1.01$). The most preferred thing for them to learn in health education was first aid, followed by sex education, obesity prevention, safety accident prevention in school and outdoors, smoking-related health, good use of leisure time, and environmental pollution cause in the order named. According to the presence or absence of nurse teacher, there was a significant difference in sex education(p<.01), but no significant disparities were found in the other factors. The most preferred person who would offer health education was a lecturer from the outside(45.8%) and nurse teacher(45.4%). Their preference for class teacher as a person in charge of health education was just 8.8%. But the presence or absence of nurse teacher didn't produce any differences to their preference for a person in charge of health education.

• Journal of radiological science and technology
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• v.28 no.3
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• pp.203-209
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• 2005

Objective True lateral scapular image was very important to diagnosis the scapular fracture and dislocation induced by traumatic injury. The aim of this study was to know the patient rotation angle to be showing the scapular true lateral in Korean. Subjects and Materials Thirty patients(22men, 8 women, mean ages 53.4)with scapular pain, had supine anteroposterior projection taken with $32^{\circ}$, $37^{\circ}$, $42^{\circ}$ trunk rotation angle changing the manual angulation material. Radiographs were evaluated independently by 5 experienced observers(1 orthopedics surgery specialist, 1 diagnostic radiology specialist, 3 radiological technologist) They assessed overlab of vertebral border and axillary border of scapular as follows; Totally overlapping of vertebral border and axillary border is 4, partially overlapping is 3, not overlapping is 2 and oblique location with two borders is 1. All observers scored using by PACS monitor. Results $32^{\circ}$ trunk rotation was scored $1.53{\pm}0.39$, $37^{\circ}$ trunk rotation was scored $3.83{\pm}0.15$ and $42^{\circ}$trunk rotation was scored $2.17{\pm}0.43$. There was no difference(p<0.05) between group of more than 100cm of the girth of the chest and group of less than 100cm. Similarly, men and women group showed no difference(p<0.05) with trunk rotation statistically. Conclusions There was no result of trunk rotation angle to radiograph the true scapular lateral image up to date. This studies were summarized as follows; Adaptation of $37^{\circ}$ trunk rotation was the best to show the true scapular lateral image in Korean. Our results were very useful to get the true scapular lateral images in clinic.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.334-340
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• 2021

Purpose: This study analyzed the bone mineral densities of the lumbar vertebrae and femurs of patients with ankle fractures to determine the correlation between ankle fractures and osteoporosis. Materials and Methods: From April 2002 to July 2014, one hundred consecutive ankle fracture patients with bone mineral density tests performed within post-traumatic one year were enrolled. The patients were divided into three age groups according to their age at the time of injury (group 1: <50, group 2: 50-69, group 3: ≥70). The types of ankle fractures were classified into unimalleolar, bimalleolar and trimalleolar fractures. The bone mineral density was analyzed using the T score, Z score, absolute value (g/cm²) of the lumbar spine (L1-L4), femur neck, femur intertrochanter, and total femur. Results: There were 3.2 times more females with ankle fractures than males, and the prevalence of osteoporosis according to age group was 0% in the group under 50 years, 24.2% in the 50 to 69-year-old group, and 15% in the group over 70 years. Osteoporosis was found in 30% of patients with a trimalleolar fracture in the 50 to 69-year-old group. In all patient groups, a lower age indicated a higher frequency of unimalleolar fractures. The relationship between the bone mineral density and the type of fracture is that the frequency of trimalleolar fracture increased with decreasing T score of the lumbar vertebrae and the absolute value of bone mineral density (g/cm²) and the Z score of the femur neck, but there were no other indicators. Conclusion: Among the 100 patients with ankle fractures, females were more common than males, because osteoporosis was less severe in males. The incidence of unimalleolar fracture was higher than that of trimalleolar fracture. On the other hand, the correlation between the ankle fractures and the bone mineral density of the femur and lumbar spine was not significant.