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연세대학교 치과병원에 내원한 야간응급환자의 임상적 연구
심현구(Hyun Goo Shim),이의웅(Eui Wung Lee) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.2
This is a retrospective study on nighttime emergency patients. The study was based on a series of 1,029 patients treated as nighttime emergency patients at dental hospital, Yonsei medical center from Jan. l, 1980, to Dec. 31 ,1984. The obtained results were as follows : 1. Yearly increased emergency patients rate was 22% and the highest monthly distribution showed in October. The age distribution ranged from 8 months to 80 years with the peak incidence occurring in the 20- to 30- year age group (32.4%) and the ratio of male to female was 2.3 : 1. Trauma (76.3%) was the most frequent cause in nighttime emergency and dentoalveolar hemorrhage (7.5%) and acute odontogenic infection (7.3%) were next in order of frequency. According to the analysis by the districts, 39.5% of the total patients resided in Seo Dai Mun ku, Ma Po ku, and Eun Pyung ku near this hospital. 72.9% of the total patients visited directly to the emergency room. 2. In the trauma group, peak incidence occurred in the 20- to 30- year group (31.2%) and the ratio of male to female was 2.6 : 1. Falls (43.2%) was the most frequent cause, followed by fight (27.6%) and traffic accident (21.9%). Frequent sites of soft tissue injury were upper and lower lip and gingiva. Simple laceration (85.4%) was the most common type of soft tissue injury. As to the teeth and alveolar injury, the most common site was the upper anterior region (69.6%). Luxation of tooth (48.4%) was the most common type. The most common site of facial bone fractures was mandible (76.1%), zygoma complex 14.4%), maxilla (8.0%) in order. Frequent fracture sites of mandible were symphysis (50.0%) and angle region (20.6%). 77 cases (42.3%) were treated by open reduction, 56 cases(30.8%) were treated by closed reduction and 49 cases (26.9%) were examined only. 3. In the acute odontogenic infection group, acute cellulitis (54.7%) was the most common for the nighttime emergency call and the infection of lower 3rd molar (32%) was the most common etiologic factor. 4. In the dentoalveolar hemorrhage group, a major cause was postoperative hemorrhage (72.9%) and hemostasis was obtained by pressure dressing mainly (46.8%). All 18 cases of the complicated exodontics group were transferred from local dental clinics for the failure of removal of fractured roots and condemned tooth was the lower 3rd molar (83.3%) mostly. 5. In the TMJ dislocation group, the peak incidence showed in the 20- to 30- year group (40.7%) and acute pulpitis (70.2%) was the most common and its frequent site was 1st molar (33.3%) in other group.
박형식(Hyung Sik Park),심현구(Hyun Goo Shim),이의홍(E. H. Lee),이정구(Jeong Gu Lee) 대한악안면성형재건외과학회 1986 Maxillofacial Plastic Reconstructive Surgery Vol.8 No.1
This is a report of an uncommon Case of chronic maxillary sinusitis due to prolonged retention of Iatrogenic Foreign Body in Rt. maxillary sinus of 31 year-old female. The authers treated the patient by surgical intervention of the inflamed and enlarged mucosa of antrum, and extirpated two picces of Iodoform-gauze strips during enucleation of the antral mucosa. The results are as follows. l. The differential diagnosis of many maxillary sinus diseases is often difficult due to their similar clinical and radiological entities. 2. Severe inflammatory disease of maxillary sinus due to long-term retention of the radiolucent foreign bodies is not easy to differentiate it from malignant diseases an clinical and radiological examination, because invisible finding of foreign bodies or retentive haziness of antral cavity, poor healing of the wound and severe destruction of surrounding bone due to prolonged chronic infection may be disoriented to the findings of malignant disease. 3. It is essential to give every possible efforts and careful observation on the intraoral drains, because oral cavity is a dynamic moving organ which is not possible to maintain these properly. And so, these must be especially reinforced during drain for large cystic cavity of oral region or maxillary sinus.
이충국(Choong Kook Lee),심현구(Hyun Goo Shim) 대한악안면성형재건외과학회 1985 Maxillofacial Plastic Reconstructive Surgery Vol.7 No.1
This is a report of bilateral condylar fractures in 6-Y-0 female and 50-Y-0 male patients treated by functional treatment, as known mechanotherapy. The principle of the functional treatment is that it induce active training of masticatory muscles by hinge, protrusive and lateral movements primarily and transformative growth of fractured condyle follows secondarily. We used Benoist` appliance which provides extraoral elastic forces to masticatory muscles. The results were as follows: 1. This provides active training of masticatory muscles, especially external pterygoid muscle. 2. Follow up studies revealed good functions and remodeling of fractured condylar fragments.
이충국(Choong Kook Lee),심현구(Hyun Goo Shim),이용환(Yong Hwan Lee) 대한악안면성형재건외과학회 1986 Maxillofacial Plastic Reconstructive Surgery Vol.8 No.1
This is a report of mandibular defect in 14-Y-0 male patient due to traumatic avulsion, which is treated by functional treatment. Maintaining the proximal and distal segments of the mandible in their normal positions after avulsion or surgical removal of a portion of the mandible is important. Failure to do so will result in fragment rotation and drifting and scarring of tissues and absence of a bed for the graft is the another problem which complicate reconstruction. We used functional mouth opening guider for prevention of the above problems. The obtained results were as follows; 1. Normal occlusion and mouth opening pattern without lateral and medial displacement were observed. 2. Rigid fixation is possible because of prevention of prevention of fragment collapse and soft tissue constriction for bone grafting.
조대술을 이용한 소아의 상악골에 발생한 함치성 낭종의 치험예
이충국(Choong Kook Lee),심현구(Hyun Goo Shim) 대한구강악안면외과학회 1984 대한구강악안면외과학회지 Vol.10 No.2
This is a report of a case of dentigerous cyst treated by marsupialization followed by cyst enucleation and orthodontic treatment in 8 y-o child. The results were as follows: 1. The marsupialization technique prevented loss of permanent teeth and allowed them to erupt into its normal position in the arch. 2. Cyst enucleation followed by orthodontic treatment was performed and obtained good functional and esthetic results.
박형식(Hyung Sik Park),심현구(Hyun Goo Shim) 대한악안면성형재건외과학회 1985 Maxillofacial Plastic Reconstructive Surgery Vol.7 No.1
This is to report a rare case of trismus followed by accidenta1 penetration of a metal harpoon into the medial site of right subcondyle through submandibular area in 6-yr-old boy. The authors treated this patient by successful removal of foreign body without undue trauma on vital structures, physiotherapy, and administration of some of skeletal muscle relaxants and anti- inflammatory agents. The results were as follows. 1. The accidental trauma by foreign bodies on maxillofacial region are common in the preschool age group, but severe penetrating injuries as this have been rarely encountered. 2. The injury on the masticator muscles or ligaments of external area of TMJ can produce not only temporary trismus due to inflammation but also prolonged limitation of mouth opening by chronic proliferation of fibrous tissue on injured soft tissue. 3. These complications may Ca0ee abnormal growth and development of mandible in active growth age, therefore future growth and function of mandible should be attentioned. It may be treated by functional physiotherapy combined with chemotherapy. Especially, in the pre-school age group, prognosis of such treatment is affected by co-operation of patient and his parents.
이충국(Choong Kook Lee),양성익(Sung Ik Yang),심현구(Hyun Goo Shim) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.1
This is a report of 5 odontogenic cysts treated by marsupialization and delayed enucleation or marsupialization only. The results were as follows; 1. The marsupialization and delayed enucleation technique allows rapid bone regeneration and eruption of the impacted canine in case 1. 2. Good results were obtained functionally and esthetically in all cases. 3. Follow up studies reveal no complication and recurrence.
이충국(Choong Kook Lee),양성익(Sung Ik Yang),이용환(Yong Hwan Lee),이의홍(Eui Hong Lee),심현구(Hyun Goo Shim),차인호(In Ho Cha) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.1
In many cases, orthognathic surgical cases require multiple osteotomies in the maxilla and mandible to achieve the most desirable results. We have treated 7 patients with the dentofacial deformities by simultaneous repositioning of the maxilla and mandible. The results are as follows: 1. The mean duration of the surgical procedure was 9.56 hours. 2. The mean length of hospitalization was 8.86 days. 3. All patients required blood transfusions. They received a mean of 3.86 pints. 4. No patients experienced significant airway embarrasment requring emergency procedures.