• Title/Summary/Keyword: Emergency radiology

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Initial Management of Radiation Injuries

  • Linnemann Roger E.
    • Journal of Radiation Protection and Research
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    • v.5 no.1
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    • pp.11-25
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    • 1980
  • The increasing utilization of radioactive isotopes in industry, medicine and research has raised the question, 'How should hospitals deal with radiation injuries when they occur?' A system for initial management of radiation injuries has been developed by Radiation Management Corporation. Radiation injuries are classified and a treatment plan outlined for each at the emergency and short term medical care phase. This system includes clinical prognosis as well as a detailed plan for quick set up or a Radiation Emergency Area in any hospital. Procedures for patient admission, preparation of the facility, general decontamination, sample taking, and wound decontamination are included.

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Clinical Profiles of Patients who Undergone Emergency Angiographic Embolization at Emergency Department (혈관 색전술을 시행한 외상 환자에 대한 임상적 고찰)

  • Sun, Jong Hyo;Kim, Jae Kwang;Lim, Yong Su;Kim, Jin Joo;Jo, Jin Sung;Hyun, Sung Youl;Jeong, Ho Sung;Yang, Hyuk Jun;Lee, Gun;Kim, Jeong Ho
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.248-253
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    • 2009
  • Purpose: Hemodynamically unstable pelvic fractures represent therapeutic challenges for the trauma team. The authors of this article have studied the clinical profiles of the angiographic intervention population at the emergency department during four years (2005~2009) to develop clinical guidelines for preventing deaths due to multiple trauma and for predicting the prognosis during initial evaluation. Methods: We performed a retrospective review of 34 patients who had undergone angiographic interventions at the emergency department and compared the differences in clinical variables between survivors and non-survivors. Results: Representative values were compared between survivors and non-survivors : RTS (revised trauma score) 7.006 (6.376~7.841) vs. 6.128 (4.298~6.494), PRC (packed red cell) units 5.5 (2.0~11.0) vs. 15 (8.0~18.5), and lactate (mmol/L) 3.0 (1.0~7.0) vs. 8.5 (3.5~10.5). RTS (p<0.01) and PRC units before angiographic interventions (p=0.01) and lactate (p=0.02) had correlations to the final outcomes. Conclusion: The availability of an angiographic suite and persistent hypotension after adequate fluid resuscitation for pelvic trauma are good indications of angiographic intervention for pelvic hemorrhage.

Role of Interventional Radiologists in Trauma Centers (외상센터에서의 인터벤션 영상의학 의사의 역할)

  • Jeong Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.784-791
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    • 2023
  • Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.

The Retrospective Study of Essential X-ray in Emergency Multiple Trauma Patients (응급 다발성 외상환자의 기본적 방사선 촬영부위에 관한 조사연구)

  • Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.19 no.2
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    • pp.51-57
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    • 1996
  • Radiography should be used judiciously and should not delay patients resuscitation. In the patient with emergency multiple trauma, three radiography should be obtained-cervical spine, anteroposterior(AP) chest, and AP pelvis. These examinations can be done in the resuscitation area, usually with a portable X-ray unit, but should not interrupt the resuscitation process. A retrospective study was carried on 157 emergency multiple trauma patients who were admitted to Yong Dong Severance Hospital from January, to December in 1995. I analyzed the types of X-ray examinations in emergency multiple trauma patients, and classified the patients by disoriented group of mentality. The results were as follows: 1. The subjects were 7.1%(157patients) of 2,208 trauma patients(7.3%) in total 30,085 emergency patients. 2. Male to female ratio was 2.57 : 1. The age distribution was highest from 31 years to 40 years(28.0% ). 3. The peak time of patient's entrance in emergency center was between 8 : 00 pm and 2 : 00 am(36.9%), and second peak time was between 2 : 00 pm and 8 : 00 pm (29.3%). 4. According to the injury type, traffic accident, motorcycle accident and falling down were 71.3%, 8.3% and 20.4% respectively. 5. According to the exposure rate of Computed Tomography, chest CT, cervical CT pelvis CT and brain CT were 39.5%, 24.2%, 69.4% and 51.6% respectively.

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Development of the Upper Wear Fixation Device for Chest AP X-ray Imaging on the Emergency Stretcher Bed (응급실 침대 위 흉부전후방향 엑스선 검사를 위한 상의고정장치 개발)

  • Lim, Woo-Taek;Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.45 no.3
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    • pp.205-211
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    • 2022
  • This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.

Ileocolic Intussusception Accompanied with Inflamed Appendix: 2 Case Reports (염증성 충수돌기를 동반한 회결장 장중첩증: 2예 보고)

  • Hyung Ju Lee;Sook Min Hwang;Young Joo Won;Ji Young Woo;Kon Hee Lee;Min Eui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.708-714
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    • 2021
  • Intussusception and acute appendicitis are common emergency conditions in children. They should be promptly differentiated in pediatric patients presenting with suggestive symptoms. However, both diseases may occur simultaneously. Herein, we present two cases of intussusception of the appendix accompanied with appendicitis.

Successful Interventional Management of Common Carotid Artery Rupture during Recurrent Parathyroid Cancer Surgery: A Case Report (재발한 부갑상선암 수술 중 발생한 총경동맥 파열의 성공적인 인터벤션 치료: 증례 보고)

  • Ye Rin Hwang;Seung Yeon Noh;Se Hwan Kwon;Joo Hyeong Oh
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1128-1133
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    • 2022
  • Common carotid artery (CCA) rupture during parathyroid cancer surgery is extremely rare and is generally life-threatening. We present a case of successful management of a ruptured CCA following the emergency placement of stent-graft in a 59-year-old male diagnosed with recurrent parathyroid cancer. During recurrent parathyroid cancer surgery, his right CCA ruptured unexpectedly, and his vital signs deteriorated rapidly despite surgical management. After stent replacement, his unstable vital signs improved and, thereafter, he was discharged without any complications.

Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Assessment of a Deep Learning Algorithm for the Detection of Rib Fractures on Whole-Body Trauma Computed Tomography

  • Thomas Weikert;Luca Andre Noordtzij;Jens Bremerich;Bram Stieltjes;Victor Parmar;Joshy Cyriac;Gregor Sommer;Alexander Walter Sauter
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.891-899
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    • 2020
  • Objective: To assess the diagnostic performance of a deep learning-based algorithm for automated detection of acute and chronic rib fractures on whole-body trauma CT. Materials and Methods: We retrospectively identified all whole-body trauma CT scans referred from the emergency department of our hospital from January to December 2018 (n = 511). Scans were categorized as positive (n = 159) or negative (n = 352) for rib fractures according to the clinically approved written CT reports, which served as the index test. The bone kernel series (1.5-mm slice thickness) served as an input for a detection prototype algorithm trained to detect both acute and chronic rib fractures based on a deep convolutional neural network. It had previously been trained on an independent sample from eight other institutions (n = 11455). Results: All CTs except one were successfully processed (510/511). The algorithm achieved a sensitivity of 87.4% and specificity of 91.5% on a per-examination level [per CT scan: rib fracture(s): yes/no]. There were 0.16 false-positives per examination (= 81/510). On a per-finding level, there were 587 true-positive findings (sensitivity: 65.7%) and 307 false-negatives. Furthermore, 97 true rib fractures were detected that were not mentioned in the written CT reports. A major factor associated with correct detection was displacement. Conclusion: We found good performance of a deep learning-based prototype algorithm detecting rib fractures on trauma CT on a per-examination level at a low rate of false-positives per case. A potential area for clinical application is its use as a screening tool to avoid false-negative radiology reports.

Hemothorax Due to Diaphragm Laceration Induced Osteochondroma of Rib - A case report- (늑골연골증이 횡격막 열상을 일으킨 혈흉 -치험 1예 -)

  • Kim Yong In;Lim Yong Su;Kim Jae Kwang;Jin Wook;Lee Chi Hoon;Lee Suk Ki;Hyun Sung Youl
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.84-87
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    • 2005
  • Spontaneous hemothorax vary in cause and are rare for hemothorax induced osteochondroma. Sometimes hemothroax is reported due to osteochondroma induced injury of diaphragm, lung, pericardium, heart, or pleura. We report a patient with diaphragm laceration due to osteochondroma.