• Journal of Trauma and Injury
• /
• v.35 no.4
• /
• pp.282-286
• /
• 2022

Complete cricotracheal separation, which is the most severe type of laryngeal trauma, is an uncommonly seen injury that clinicians have limited experience in managing. However, it is potentially fatal. Due to limited exposure to this condition, mismanagement can occur, which may further aggravate the patient's condition. The most crucial part of managing this injury is to establish a secure airway. Tracheostomy under local anesthesia is the preferred method of airway stabilization, in order to avoid further injuries to the airway caused by endotracheal intubation. Here, we discuss the management of complete cricotracheal separation based on a case experienced in the east coast region of Malaysia, where this type of injury is rarely encountered.

• Clinical and Experimental Pediatrics
• /
• v.59 no.3
• /
• pp.145-148
• /
• 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.6
• /
• pp.380-382
• /
• 2013

We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.18 no.6
• /
• pp.375-378
• /
• 2018

Endotracheal intubation is commonly associated with laryngeal injury that often resolves spontaneously without any complication. However, stenosis or granulomatous lesions are generally found on the tracheal wall or vocal process at the tube cuff level, caused by excessive cuff pressure. We present a case of fatal vocal cord granuloma leading to dyspnea following orthognathic surgery and sustained intubation for 14 hours.

• International Journal of Highway Engineering
• /
• v.16 no.5
• /
• pp.143-154
• /
• 2014

PURPOSES : This study drew factors affecting motorcycle accidents in Seoul by severity using an ordered probit model and aimed to analyze and verify the drawn influence factors. METHODS : As the severity of the accidents could be classified into three types (fatal injury, serious injury and minor injury), this study drew the factors affecting accidents by a comparative analysis employing an ordered probit model, removed the variables that would not secure significance sequentially to construct a model with high explanatory power regarding the factors affecting the severity of motorcycle accidents, and calculated the marginal effect of each factor to understand the degree of each factor's impact on the severity. First, Model 1 put in all variables; Model 2 was constructed by removing the variables of the road surface conditions that could not meet the level of significance (p=0.608); Model 3 was constructed by removing gender variable (p=0.423); and Model 4 was constructed finally by removing age variable (p=0.320). RESULTS : As a result of an analysis, statistically significant variables were time of occurrence, type of accident, road alignment and motorcycle displacement, and it turned out that the impacts on the severity were in the following order: a road alignment of left downhill, the type of motorcycle-to-vehicle accidents and a road alignment of a flatland on the left. The significance of the models was tested using the likelihood ratio, the level of significance and suitability statistics about them, and as a result of the test, the significance level and suitability of the constructed models were all excellent. In addition, the model accuracy indicating the accuracy of a predicted value compared to that of the value actually observed was 70.3% for minor injury; 70.1% for serious injury; and 68.6% for fatal injury, and the overall accuracy was 70.2%, which was very high. CONCLUSIONS : As a result of an analysis of motorcycle accidents in Seoul through the ordered probit model and the marginal effect, it turned out that their severity increased in nighttime accidents as compared to daytime ones and gradually increased in the order of motorcycle-to-vehicle accidents, motorcycle-to-person ones and the ones involving motorcycle only. As a result of an analysis, the severity of accidents in road alignments of left downhill, left flatland and straight downhill increased as compared to those in a road alignment of straight flatland and that the severity of accidents of motorcycles with a displacement larger than 50cc was higher than that of those with a displacement smaller than 50cc.

• Journal of Preventive Medicine and Public Health
• /
• v.37 no.3
• /
• pp.274-281
• /
• 2004

Objectives : This study was performed to investigate the injury rates and risk factors for preschool children in Daegu city and Kyungpook province. Method : A questionnaire survey about medically attended injuries during the preschool period was performed in nine primary schools located in Daegu city, Pohang city and Goryung County. The overall injury rate was estimated using person-year. The causes and patterns of the injuries, and their risk factors were examined. Result : A total of 469 medically attended injuries were reported in 330 of the 959 study subjects during the preschool period. The overall annual injury rate was 7.5 per 100 children. The injury rate increased sharply during the period from infant (2.4) to 1 year of age (7.5), and the peak injury rate (9.2) was reported for 5 year olds. The most common causes of injuries were falling (36.0%), followed by being struck by an object (23.7%), and traffic accidents (14.1%). Among the traffic accidents, 72.8% occurred while playing on the road, riding a bicycle or roller-skating. A proportional hazard model showed that males (hazard ratio=1.49, p<0.001 compared with female) and the mother's higher education level (hazard ratio of college or higher= 1.51, p=0.013; high school=1.32, p=0.085 compared with those of middle school or lower) were significant risk factors of childhood injury. Conclusion : The results of this study suggested that efforts for children's safety should be made, especially from the toddler stage, and in male children. To develop a more specific childhood injury prevention program, a surveillance system for injuries should be established. Further study of the relationship between mother's occupation and injury rates is also needed.

• Journal of Chest Surgery
• /
• v.7 no.1
• /
• pp.23-30
• /
• 1974

During the 35 month period from November 1966 to November 1967 and from June 1971 to March 1973 I had experienced 127 cases of non fatal wounds of chest in Viet-Nam. .Among these 127 cases, 62[45.4%] were gun shot wounds, 49[35.8%] were shrapnel wounds and the other were traffic accident. stab wounds and miscellanous. Approximately 21% of gun shot wound were perforating and 79% were penetrating but all cases of shrapnel wounds were penetrating. Of these 127 cases. 90% evacuated to hospital within 6 hours and average time 2.5 hours. The tranfusion requirement of these cases ranged from zero to 36 pints of whole blood with an average of 2.600cc. Initial intrathoracic findings were hemopneumothorax and hemothorax mostly. and the incidence of open thoracotomy was 9.5%[12cases] and closed thoracotomy was 82.8%[104cases], which were contrast to the reports from Korean conflict. I had experienced 24 cases with complication, such as large hematoma in lung parenchyme[8 cases], atelectasis[4 cases], pyothorax [3 cases], pneumonia [3 cases], fibrothorax [3 cases], pleural effusion [2 cases] and wound infection [2 cases]. Mortality rate for entire group was 4.7% but the cases associated with brain injury was 100%, with spinal cord injury was 50%, with large vessel 50%, and abdominal injury was 33.3%, and nobody died solely of thoracic injury.

• Journal of Korean Neurosurgical Society
• /
• v.51 no.4
• /
• pp.227-229
• /
• 2012

Iatrogenic vascular injuries during lumbar disc surgery may occur rarely but they are serious complications, which can be fatal without appropriate management Prompt diagnosis and management of these complications are imperative to prevent a desperate outcome. A 72-year-Old female with proximal left common iliac artery iatrogenic injury during lumbar discectomy was successfully treated by percutaneous deployment of a stent graft in an emergency setting. Postprocedural angiogram demonstrated complete exclusion of the iliac artery laceration. The patient became hemodynamically stable. Two weeks later she complained of vascular claudication. Follow-up angiography revealed decreased arterial flow in the opposite common iliac artery. An additional kissing stent was inserted into the right common iliac artery and the symptoms of vascular claudication disappeared. Endovascular stenting offers a safe and effective method for the treatment of an iatrogenic arterial laceration, particularly in a critical condition. But, the contralateral iliac arterial flow should be kept intact in case of proximal iliac artery injury. Otherwise, additional treatments may be needed.

• Safety and Health at Work
• /
• v.10 no.2
• /
• pp.151-165
• /
• 2019

Background: Despite improvements in safety performance, the number and severity of mining-related injuries remain high and unacceptable, indicating that further reduction can be achieved. This study examines occupational accident statistics of the Ghanaian mining industry and identifies priority areas, warranting intervention measures and further investigations. Methods: A total of 202 fatal and nonfatal injury reports over a 10-year period were obtained from five mines and the Inspectorate Division of the Minerals Commission of Ghana, and they were analyzed. Results: Results of the analyses show that the involvement of mining equipment, the task being performed, the injury type, and the mechanism of injury remain as priorities. For instance, mining equipment was associated with 85% of all injuries and 90% of all fatalities, with mobile equipment, component/part, and hand tools being the leading equipment types. In addition, mechanics/repairmen, truck operators, and laborers were the most affected ones, and the most dangerous activities included maintenance, operating mobile equipment, and clean up/clearing. Conclusion: Results of this analysis will enable authorities of mines to develop targeted interventions to improve their safety performance. To improve the safety of the mines, further research and prevention efforts are recommended.

• Journal of the Korea Safety Management & Science
• /
• v.18 no.1
• /
• pp.9-15
• /
• 2016

In this study, the current regulations to be adequate in industrial site have to be renew in order to prevent the fatal injuries by mobile cranes. Fatal injury analyses were conducted with several accident cases by the mobile cranes. For each accident, the causes of the injuries were examined and proper safety measures were proposed. This study proposed a revision of the standard guideline as an accident prevention measures through in-depth analysis of fatal accidents. First, fatality rate per 10,000 persons by the mobiles cranes was 0.57 in 2011. Second, the in-depth analysis of the mobile crane accidents showed that the main factors of the accidents were the overturn of mobile crane, the fracture of connection part between mobile crane boom and rope, the breaking of rope and the misunderstanding over the signal between a mobile crane driver and workers around a mobile crane. Third, the order of high defection of connecting parts was bucket bolt, bracket and extension parts. Fourth, since there were several cases of overturn of mobile crane by itself in the in-depth analysis of the mobile crane, the over slop-proof device was proposed as the main alternative in this study. Fifth, the revision of standards of safety factor that shall be more than 10, of connecting parts of mobile crane was proposed.