• Title/Summary/Keyword: 교통사고분석

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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Flexible Bronchoscopic Findings and Therapeutic Effects in Atelectasis of Children (소아 무기폐에서 굴곡성 기관지내시경 소견 및 치료적 유용성)

  • Shin, Mee Yong;Hwang, Jong Hee;Chung, Eun Hee;Moon, Jeong Hee;Lee, Ju Suk;Park, Yong Min;Ahn, Kang Mo;Lee, Sang Il
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1090-1096
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    • 2002
  • Purpose : We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. Methods : Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. Results : The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue( n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine($Mucomyst^{(R)}$) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. Conclusion : In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.

Tc-99m HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder (두부외상후 만성 기질성 정신장애 환자에서 Tc-99m HMPAO Brain SPECT 분석)

  • Lee, Kang-Wook;Lee, Jong-Jin;Shong, Min-Ho;Kang, Min-Hee;Ghi, Ick-Sung;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.293-300
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    • 1994
  • It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

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A CLINICAL STUDY ON ZYGOMATIC BONE FRACTURE (관골 골절에 대한 임상적 연구)

  • Ryu, Sun-Youl;Jung, Hyun;Park, Se-Chan;Oh, Yu-Keun;Park, Hong-Ju;So, Kwang-Sub;Cho, Yong-Ki;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.1
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    • pp.54-59
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    • 1999
  • This study was based on a series of 164 patients with zygomatic bone fracture treated at Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from January 1992 to December 1996. The male-to-female ratio was 7:1. Their ages ranged from 8 to 78 years, with a median age of 35.6 years. The age frequency was highest in the second decade (30.5%), and third decade (23.8%), fifth decade (16.5%) in orders. The monthly distrbution of incidence showed October to be the month in which the greatest percentage occured (14.0%). The major cause of zygomatic bone fracture was alleged traffic accidents (53.7%). The incidence of concomitant facial bone fractures was 69,5%, and maxilla fracture (52.4%) was most frequently combined. The admission route was through emergency room (72.3%) and through outpatient department (26.8%). The incidence of associated injuries was 37.2%. The intraoral approach was the major method of treatment in zygomatic bone fracture (57.1%). The most frequent type of zygoma fracture was class IV (33.5%), and class III (25.6%) was next in order of frequency. Complications were enophthalmos (7.3%), facial asymmetry (6.7%), paresthesia (6.1%), and diplopia (2.4%) These results suggest that correct diagnosis and treatment of severity of fracture, concomitant fracture, and associated injuries are necessary, and co-operative treatment with medical department should be performed to reduce postoperative complication.

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The Risk Assessment of the Fire Occurrence According to Urban Facilities in Jinju-si (진주시 도시시설물별 화재발생 위험도 평가)

  • Bae, Gyu Han;Won, Tae Hong;Yoo, Hwan Hee
    • Journal of Korean Society for Geospatial Information Science
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    • v.24 no.1
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    • pp.43-50
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    • 2016
  • Urbanization in Korea has increased significantly and subsequently, various facilities have been concentrated in urban areas at high speed in accordance with a growing urban population. Accordingly, damages have occurred due to a variety of disasters. In particular, fire damage among the social disasters caused the most severe damage in urban areas along with traffic accidents. 44,432 cases of fire occurred in 2015 in Korea. Due to these accidents, 253 were killed and property damage of 4,50 billion won was generated. However, despite the efforts to reduce a variety of damage, fire danger still remains high. In this regard, this study collected fire data, generated from 2007 to 2014 through the Jinju Fire Department and the National Fire Data System(NFDS) and calculated fire risk by analyzing the clustering of fire cases and facilities in Jinju-si based on the current DB of facilities, offered by the Ministry of Government Administration and Home Affairs. As a result, the risk ratings of fire occurrence were classified as four stages under the standards of the US Society of Fire Protection Engineers(SEPE). Business facilities, entertainment facilities, and automobile facilities were classified as the highest A grade, detached houses, Apartment houses, education facilities, sales facilities, accommodation, set of facilities, medical facilities, industrial facilities, and life service facilities were classified as U grade, and other facilities were classified as EU grade. Finally, hazardous production facilities were classified as BEU grade, the lowest grade. In addition, in the case of setting the standard with loss of life, the highest risk facility was the hazardous production facilities, while in the case of setting the standard with property damage, a set of facilities and industrial facilities showed the highest risk. In this regard, this study is expected to be effectively utilized to establish the fire reduction measures against facilities, distributed in urban space by calculating risk grades regarding the generation frequency, casualties, and property damage, through the classification of fire, occurred in the city, according to the facilities.