• Title/Summary/Keyword: Cervical spine injury

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Indications and findings of flexible bronchoscopy in trauma field in Korea: a case series

  • Dongsub Noh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.206-209
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    • 2023
  • Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

Clinical Analysis of 2,048 Musculoskeletal Patients Who Visited the Traffic Accident Clinic of a Korean Medicine Hospital (교통사고로 한방병원에 내원한 근골격계 환자 2,048명에 대한 임상적 분석)

  • Do, Ho-Jeong;Shin, Ye-Sle;Kim, Chang-Eun;Song, Hyun-Seop;Shin, Jae-Kwon;Gang, Byeong-Gu;Koh, Won-Il;Jeon, Se-Hwan;Cho, Yong-Kyu;Kim, Eun-Soo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.11-23
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    • 2016
  • Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

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A Case of Atypical Distribution of Pulmonary Tuberculosis in Bedridden Patient with Quadriplegia (사지마비로 장기 침상안정 환자에서 폐결핵 발생부위 변화 1예)

  • Hwang, Hun-Gyu;Jung, Eun-Jung;Lim, Gune-Il;Yang, Seung-Boo;Im, Han-Hyeok
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.1
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    • pp.52-55
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    • 2010
  • Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

Theoretical Basis and Application of the Neurac Technique Which Uses the Sling Exercise Therapy (슬링운동치료를 이 용한 Neurac 기법의 이론적 근거와 적용방법)

  • Kim, Suhn-Yeop;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.2
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    • pp.52-65
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    • 2006
  • Sling exercises therapy can speak as appliable comprehensive exercises therapy technique efficiently in general exercise field for injured worker's rehabilitation process and health improvement patient or athlete, injury or disease that have pain or dysfunction to neuromuscular system using that shake. At 1990 an early stage, because physical therapist and doctors of medical treatment developed country norway of north europe cooperate sling exercises therapy's concept trend spreading worldwide establishing theory newly based on scientific basic be. Musculoskeletal system, old man and young child's nervous system injurer's treatment and exercise and industry worker's rehabilitation process, athlete's rehabilitation etc. several fields introduced in early 2000s to Korea apply. Sling exercises therapy neuromuscular system disease continuous abatement as general concept of active exercise and treatment that use sling exercises equipment by purpose know can. This review article wishes to introduce about neuromuscular activation, "Neurac" technique that can speak as step developed more concept based on application principle etc, of basic sling exercises effort's change by suspension point's change that is concept, stability exercises principle, open kinetic chain exercises and closed kinetic chain exercises. Arranged about Plateau potential's characteristic and working mechanism and Neurac technique's application method that can say as Neurac technique's neuro-physiologic base, and presented treatment method of lumbar part disease and cervical part, shoulder joint part disease to application example. Because plateau potential forward player that induce using Neurac technique in part muscles that act role that keep spine surrounding stability in this article keeps muscle's contraction continuously, between global and local muscles, presented several study findings that can cause affirmative change in insufficient muscle adjustment state such as imbalance of muscles' action order. Expect that case studies that use this Neurac technique here after consist continuously.

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Survey of the Need for the Development of a Simulated Training Program that Reproduces Automobile Accidents (자동차 사고를 재현한 시뮬레이션 교육 프로그램 개발을 위한 요구도 조사)

  • Kang, Min-Ju
    • Fire Science and Engineering
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    • v.33 no.1
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    • pp.179-187
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    • 2019
  • This study performed a survey on the need for an automobile accident-simulation training program for 60 emergency workers and nine emergency medical professors. The results showed that the need for cervical spine immobilization use was highest (76.8%) in first-aid requiring simulation training, and the need for head injury was highest (75.4%) in the scenario requiring simulation training. Based on the 43-month working experience of emergency workers, the uses of pneumatic anti-shock garment, KED, and the need for rapid extrication were significantly different between the two groups (p=0.01, p=0.05). In addition, the scenario showed statistically significant differences in the need for face, abdomen, and other injuries in both group (p=0.05, p=0.04, p=0.03). The needs of emergency workers and emergency medical professors for an automobile accident simulation-training program were high, and the development of a simulation program is needed.

The Clinical Study on 120 Cases with Traffic Accident (교통사고 환자 120례에 대한 임상적 고찰)

  • Lee, Ji-Eun;Jung, Hyo-Keun;Ryu, Chung-Ryul;Cho, Myoung-Rae;Wi, Jun;Ryu, Mi-Seon;Kim, Ja-Young
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.135-143
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    • 2008
  • Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

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Sixth Cranial Nerve (Abducens Nerve) Palsy after Preoperative Halo-Pelvic Traction for Severe Scoliosis with Chiari I Malformation (키아리 1형 기형을 동반한 고도 척추 측만증에서 수술 전 Halo-Pelvic 견인 후 발생한 6번 뇌신경(외전신경) 마비)

  • Hwang, Jae-Kwang;Lee, Choon Sung;Choi, Shin Woo;Kim, Chung-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.534-539
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    • 2020
  • The management of severe scoliosis remains a challenge to spine surgeons. The rapid intraoperative correction of severe scoliosis may increase the risk of perioperative complications, such as neurological compromise and implant failure. To minimize these risks, various preoperative traction methods have been employed to achieve partial correction before performing definitive corrective surgery. On the other hand, some studies have shown that one of the complications associated with halo traction could lead to cranial nerve palsy, with the sixth nerve (abducens nerve) being most commonly affected. To reduce the complications, gradual increases in the traction weight and detailed neurological examinations are needed, particularly for patients who have previously undergone brain or cervical surgery. The authors report a case of sixth cranial nerve palsy by preoperative halo-pelvic traction in patients with severe scoliosis who underwent previous decompression surgery for a Chiari I malformation with a review of the relevant literature.

Multi-Level Anterior Interbody Fusion with Internal Fixation in Cervical Spine (다분절 경추 유합 및 내고정 수술결과)

  • Jeon, Woo-Youl;Bae, Jang-Ho;Jung, Byoung-Woo;Kim, Seong-Ho;Kim, Oh-Lyong;Choi, Byung-Yon;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.55-60
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    • 2001
  • Objective : The purpose of the present study was to examine neurologic changes, fusion rate and degree of kyphosis from the surgical results of those patients who underwent multi-level anterior interbody fusion and internal fixation. Methods : Among 63 cases of the patients who received multi-level anterior interbody fusion and internal fixation in 5 years between 1995 to 1999 at the neurosurgery department, we performed a retrospective study in 52 cases that could be followed up with dynamic view imaging ; the results were compared and analyzed. The analysis was based on the results of history taking, physical findings and radiologic findings, and Odom criteria were used to classify those cases with neurologic changes. Results : Among those 52 cases in whom the follow-up was possible for at least a year and dynamic view imaging was possible, bone fusion was seen in 93% of the trauma cases and 95% in the non-trauma cases and overall bone fusion was observed in 94% of the cases. Bone fusion was seen in 93% of the autobone cases, 95% of the allobone cases, and 94% of the Mesh cases. Radiologic changes were observed by comparing the lateral view after surgery ; kyphosis was seen in 53% of the autobone cases, in 70% of the allobone cases, and in 35% of Mesh cases ; in 45% and 60% of the non-trauma cases and trauma cases, respectively ; and in 55% of the 2 level fusion cases and 46% of the 3 level fusion cases. Neurologic changes classified according to Odom criteria showed excellent result in 48% of all the cases, good in 23%, fair in 4%, and poor in 25%. Conclusion : Even those cases with multi-level fusion, a high fusion rate could be obtained by performing anterior interbody fusion and internal fixation ; those cases with kyphosis were related more with the presence or absence of posterior compartment injury rather than the fusion level ; and those trauma cases showed not much difference in the fusion rate compared with non-trauma cases but had a high possibility of kyphosis.

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Statistical Study of the Patient of Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital in Daejeon - from September, 2019 to September, 2022 - (대전대 OO한방병원 침구의학과 환자들에 대한 통계적 분석 - 2019년 9월부터 2022년 9월까지 -)

  • So Jeong Kim;Hyun Jin Jang;Min Ju Kim;Hyeon Kyu Choi;Pil Je Park;Yeon Soo Kang;Hong Kyoung Kim;Jeong Kyo Jeong;Ju Hyun Jeon;Young Il Kim
    • The Journal of Korean Medicine
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    • v.44 no.2
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    • pp.20-33
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    • 2023
  • Objectives: This study is designed to statistically analyze the features of patients who visited to Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital for 3 years. Methods: This study retrospectively analyzed the medical records of patients at Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital using IBM SPSS ver. 27.0 for Windows. Results: 1. In the analysis of the total number of patients, those in their 30s accounted for the highest percentage, male patients had a higher rate. 2. In the analysis of KCD-8 code, spinal stenosis and fractures in areas other than the spine were the most common in the 70s and older, and cervical sprains were the most common in other. 3. In the analysis of the number of hospitalizations, patients classified as illness or higher age had more re-hospitalization than patients classified as injury or lower age in first-time care. 4. In the analysis of hospitalization duration, patients classified as illness, female or higher age had longer hospitalization duration than patients classified as accident, male or lower age in first-time care. Conclusion: We expect that the results of this study would be used as reference materials for analyzing medical consumption condition of Department of Acupuncture and Moxibustion.