• Journal of Trauma and Injury
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• 제27권2호
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• pp.33-37
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• 2014

Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

• Tuberculosis and Respiratory Diseases
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• 제38권1호
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• pp.70-73
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• 1991

We have experienced a case of lung injury caused by accidental inhalation of ammonia gas in a 34 year-old-man. By the explosion of ammonia tank in a refrigerator boat he inhaled ammonia gas. Several minutes later, he suffered from severe dyspnea and visual loss. On arrival at emergency room, analysis of arterial blood gas revealed severe hypoxemia and his chest film showed bilateral pulmonary infiltrates. Under the impression of adult respiratory distress syndrome, mechanical ventilator was applied to the patient. After recovery from ARDS and tracheal edema, he complained of some hemoptysis and productive sputum during the admission. So we checked bronchoscopy and bronchograpy which showed tracheal bullae just above carina and tubular bronchiectatic change in the right lower lobe. We report a case of lung injuries-ARDS, tracheal bullae, and bronchiectasis-caused by inhalation of ammonia gas with the review of the relevant literatures.

• 한국안전학회지
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• 제20권4호
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• pp.138-147
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• 2005

The accidents which occurred between during february of 1997 to December of 2004 at the 2nd Daegu subway construction site have been classified. The accident types of injuries include accidental falls, falling objects which consist 53.4% of all accidents. This result is higher than the same types of accidents occurring at construction sites which are 46.3%. It was found that the 3.4 times more accidents are caused from safety measures and working methods than problems caused by lack of supervision. 78.0% of the accidents occurred at stations and at the ventilation area. 31.9% of the accidents occurred when the operation was near completion($81.0%{\sim}100.0%$) which means there was pressure to complete the operation to meet the set due date. In the case of 50.0% of the accidents were caused by workers with less than two month work experience. And lumbago is 6.9%, especially lumbago didn't showed before. Maybe accident should increase if not reduce a possibility of danger. In this study a literature search has been conducted for the cause of these accident types and respective suggestions are provided.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• 대한화상학회지
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• 제24권2호
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• pp.30-33
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• 2021

Purpose: Dalgona, a kind of candy made of caramelized sugar, is a popular snack for children. Given the popularity of preparing dalgona, increasingly many patients are treated for burns sustained while preparing dalgona. We report the clinical features and dangers of burns from dalgona. Methods: We retrospectively reviewed the clinical records of 11 inpatients and outpatients who had been treated for burns they received while preparing dalgona from March 2020 to December 2020. The data reviewed were age, sex, the severity of the burn, the size and location of the burn, the type of treatment, and the place where the injury occurred. Results: The age of the patients ranged from 3 to 19 years, and the average age was 10.2 years (2 male, 9 female). Three patients had superficial second-degree burns, while eight had deep second-degree or third-degree burns. Most of the cases were treated with a local skin flap or skin graft. All the burned lesions were on the hands and feet. In all cases, the burns occurred at home due to accidental spillage. Conclusion: Most of the patients were children and teenagers, and they had serious burns. Therefore, we report these findings to emphasize the need for public awareness of the potential for burn injuries to occur during dalgona preparation.

• 근관절건강학회지
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• 제30권3호
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• pp.218-229
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• 2023

Purpose: This study aimed to assess and compare the effectiveness of various fall prevention interventions in hospitals through a network meta-analysis. Methods: A network meta-analysis was conducted using the "netmeta" package in R software (v4.1), employing a frequency method. Odds ratios of fall rates and injurious fall rates were utilized to confirm the effects of interventions for fall prevention. Comparative rankings of these interventions were determined using cumulative probability (P-score). Results: Comparative rankings via cumulative probability (P-scores) revealed individualized education as the most effective intervention for fall incidence (P-Score 87.8%). Followed by fall-preventing sensors (60.9%), multicomponent interventions (47.4%), usual care (33.2%), and environmental modification (20.7%). For fall-related injuries, individualized education ranked highest (P-Score 97.1%), followed by multicomponent interventions (76.0%), usual care (47.6%), environmental modification (24.2%), and fall-preventing sensors (5.1%). Conclusion: This study provides valuable insights into the relative effectiveness of diverse interventions in preventing fall incidence through network meta-analysis. The findings aim to support nurses in making informed decisions when implementing fall prevention strategies in clinical practice.

• 한국응급구조학회지
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• 제3권1호
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• 대한화상학회지
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• 제24권2호
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• pp.21-29
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• 2021

Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin^®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

• 대한장애인치과학회지
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• 제6권2호
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• pp.116-119
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• 2010

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

• Clinical and Experimental Pediatrics
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• 제46권2호
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• pp.198-202
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• 2003

국내 소아에서는 아직 화학 물질 흡입화상에 대한 보고가 없는 상태로 저자들은 수영장 창고에서 수영장 물의 살균, 소독제인 이염화이소시안산 나트륨과 차아염소산 칼슘을 잘못 혼합하던 중 발생한 소독제 분말 가스 폭발 반응에 노출되어 급격한 호흡 곤란증이 있었던 증례 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.