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Penetrating chest trauma from a "less lethal" bean bag in the United States: a case report

  • Gloria Sanin;Gabriel Cambronero;Megan E. Lundy;William T. Terzian;Martin D. Avery;Samuel P. Carmichael II;Maggie Bosley
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.421-424
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    • 2023
  • This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.

Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report (반충손상 기전에 의한 간문맥손상에 대한 증례 보고)

  • Joonghyun Yoo;Sung-Joon Park;Seung Hwa Lee;Hwan Hoon Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1594-1599
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    • 2021
  • A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

Comparision of Signal-Averaged Electrocardiography (SAECG) Determined by Flank Lead System (FLS) and Pyramidal Lead System (PLS) in Healthy Young Adults (정상 성인의 직교유도체제와 피라미드유도체제에 의한 신호 가산 평균심전도의 비교)

  • Jang, Byeong-Ik;Kang, Seung-Ho;Kim, Hyeung-Il;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.179-189
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    • 1993
  • It has recently become possible to record electrical activity originating from abnormally conducting myocardium from the body surface with high - gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. Selection of subjects : For this study, normal healthy young adult volunteers (age: mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. Signal-averaged electrocardiography : In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz(p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration.

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Acoustic Characterization of Three Seamounts Located in the Northwest of Marshall Islands, Western Pacific (서태평양 마샬제도 북서쪽에 위치한 세 해저산에 대한 음향상 연구)

  • Lee, Tae-Gook;Lee, Kie-Hwa;Moon, Jai-Woon;Jung, Mee-Sook;Kim, Hyun-Sub;Lee, Sang-Mook
    • Journal of the Korean Geophysical Society
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    • v.7 no.3
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    • pp.193-206
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    • 2004
  • Geophysical data including chirp (3 7 kHz) subbottom profile and detailed bathymetry were obtained over three seamounts in the Ogasawara Fracture Zone (OFZ) of the western Pacific, as a part of manganese crust survey onboard R/V Onnuri in 2003. The OFZ is a 150-km-wide, 600-km-long rift zone, which separates the East Mariana and Pigafetta Basin. The OFZ is unique in that it includes many seamounts (e.g., Magellan Seamounts andseamounts on the Dutton Ridge). The sub-seafloor acoustic echoes obtained near the OFZ were classified into following types on the basis of their characteristics: types I-1(pelagic sediment with parallel or subparallel reflectors), I-2 (pelagic sediment with no internal reflectors), and III-1 (reef build-up complex) on summit; types II-1 and III-2 (basement outcrop) on flank rift zone and upper slope, respectively; type III-3 (slump) on the lower slope and embayment between the flank rift zones; types II-2 (debrite) on the base of slope and basin floor; and types II-3 (turbidite or pelagic sediment) and II-4 (turbidite) on the basin floor. The mass-wasting that produced the complex of type II-2 debrite and III-3 slump on the lower slope and basin may have been caused by (1) strong tensional stress in the OFZ which may cause the numerous fissures or basement faults and (2) complex of the faults on the summit and steep upper slope. The variations in the echo type of pelagic sediment in the summit of seamounts may be related with the changes in the depositional and/or erosional environments. Type I-2 pelagic sediment, which is characterized by a thin and intermittent coverage, was probably deposited at a sheltered area when the current was strong, whereas type I-1 pelagic deposit occurred during a stage of progressive sedimentation.

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A study on characteristics and physiological variables of chest pain induced by exercise test in angina suspected patients (협심증이 의심되는 환자에서 운동부하검사로 유발되는 흉통의 양상과 생리적 변인에 관한 연구)

  • Cho, Mi-Kyoung;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.2 no.2
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    • pp.1-19
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    • 2000
  • The purpose of this study was to identify the characteristics and physiological variables of chest pain induced by exercise test in angina suspected patients. The subjects of this study consisted of 28 inpatients and outpatients aged between 40 and 75 who underwent treadmill test at exercise testing laboratory of S-University from January 2000 to June 2000. Subjects were interviewed with questionnaire regarding sociodemography, the past health history and history related to chest pain before the exercise test. Subjects were interviewed with questionnaire concerning quality, intensity, duration of chest pain induced by walking on the treadmill(Marquette, U.S.A. 1992) according to Bruce protocol following exercise test. Systolic and diastolic blood pressure were measured before, during and after the test, heart rate was determined by ECG. The results of this study were as follows ; 1) Quality of chest pain induced by exercise test were feeling stiffness 19(67.9%), heavy 10(36.0%), exploded 9(32.1%), crushing, suffocating, tight 8(28.6%), stuffy, prickly 7(25.0%), burning 6(21.4%), clasp 5(17.9%), cleaved, tensed, piercing 3(10.7%), perfectly fitting, sore 2(7.1%), tearing, tingling, ticklish, heartburn 1(3.6%). 2) Mean score of VAS(intensity of pain) following exercise test was $5.79{\pm}2.27$ and mean duration of chest pain after the test was $7.83{\pm}5.31$ minutes. 3) Sites of chest-pain induced by exercise test were middle site 11(39.3%), left-chest 10(35.6%), right-chest 6(21.5%). Radiation site of chest-pain was neck(18.0%), right flank site 1(3.6%), left shoulder & arm 2(7.1%) and back 1(3.6%). 4) Symptoms other than chest-pain induced by exercise test were dyspnea 21(75.6%), perspiration 14(50.4%), fatigue 12(43.2%), leg-pain 11(39.6%), dizziness 7(25.2%) anxiety toward chest-pain 3(10.8%), thirst 2(7.1%), and palpation, headache and tingling sensation of hand and leg 1(3.6%). 5) Mean MET(intensity of exercise) during the exercise test was $7.64{\pm}2.57$ and mean RPE(rating of perceived exertion) was $15.89{\pm}2.36$. Mean duration of exercise was $6.79{\pm}2.88$. 6) correlation coefficients between RPE and VAS was 0.500(p=0.003), those between MET and VAS was 0.287(p=0.069) and those between either depression or elevation of ST segment and VAS was 0.236(p=0.114). 7) There was a significant difference in mean systolic pressure between before and after the test as $146.29{\pm}28.18mmHg$ and $177.96{\pm}28.82mmHg$(t=-5.640, p=0.000), a significant difference in mean diastolic blood pressure between before and after the test as $84.85{\pm}15.07mmHg$ and $88.89{\pm}13.72mmHg$(t=-2.082, p=0.047), and there was a significant difference in mean heart-rate between before and after the test as $81.89{\pm}12.22/min$ and $160.68{\pm}21.77/min$(t=-21.255, p=0.000).

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Magnetic Characteristics of TA19-1 and TA19-2 Seamounts in the Lau Basin, the South Western Pacific (남서태평양 라우분지 TA19-1 해산과 TA19-2 해산의 지자기 특성 연구)

  • Kim, Chang Hwan
    • Economic and Environmental Geology
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    • v.47 no.4
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    • pp.395-404
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    • 2014
  • We conducted the geophysical survey of possible hydrothermal vent sites at 2009, in the Lau Basin, the south western Pacific and analyzed the magnetic characteristics of TA19-1 and TA19-2 seamounts. TA19-1 is a cone-shaped seamount with a caldera summit. TA19-2 seamount is bigger and shows more complicated topography than TA19-1 seamount. TA19-2 has a large caldera, a summit in the west side of the caldera and several crests. Simple dipole anomalies with a high over the north and a low over the south occur in TA19-1 seamount. High magnetic anomalies are located in the northern flank and the summit of TA19-2 seamount and low anomalies around the summit and the caldera. The results of bathymetry and magnetic data suggest that TA19-2 seamount might have more complicated magmatic process than TA19-1. Low magnetization zones are located over the summit, the calderas and the caldera rims. The magnetization lows indicate that submarine hydrothermal vents, along faults and fracture zones, could have caused an alteration of magnetic minerals. The magnetization highs over the summit and the calderas might have been related with later magmatisms like volcanic sills, intrusions.

Development of a scale to Measure the Self Concept of Cesarean Section Mothers. (제왕절개술 산모의 자아개념 측정 도구 개발)

  • 이미라;조정호
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.131-141
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    • 1990
  • Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother- infant interaction due to fatigue, lack of early mother - infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother- infant interactions in future. The purposes of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to find their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc+package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast. (-) I have a good appetite now. (+) I feel pains in my flank. (-) I feel fine now. (+) My body seems to have returned to its prepregnant state. (+) Thinking of the delivery process, I feel sorry. (-) I want to hold my baby in my arms. (+) I want to keep my own life, even if I became a mother. (-) I want to delegate the care of the baby to my mother / mother in law. (-) I think baby is my alter ego. (+) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was .8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers(t=-5.51, df=266, p=0.007). 4. The criterion validity of this scale was tested indirectly. Though this scale could discriminate the differences in the self concept between cesarean section and vaginal delivery mothers, the five items on the personal self concept scale didn's show any differences between cesarean section and vaginal delivery mothers. Therefore, the study indicates that those who shows lower values in the personal self concept measurement, that is, lower than 12.03 points, could be regaled as “risk mothers” 5. Further studies using this scale to clarify the influencing factors on negative self concept are strongly recommended.

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A Mechanism Analysis of Landspout Generation Occurred over Ilsan on June 10 2014 using a Numerical Model (수치모델을 활용한 2014년 6월 10일 일산 용오름 발생 메커니즘 분석)

  • In, So-Ra;Jung, Sueng-Pil;Shim, JaeKwan;Choi, Byoung-Choel
    • Journal of the Korean earth science society
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    • v.37 no.4
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    • pp.187-199
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    • 2016
  • The purpose of this study is to investigate the formation mechanism of landspout by using the Cloud Resolving Storm Simulator (CReSS). The landspout occurred over Ilsan, Goyang City, the Republic of Korea on June 10, 2014 with the damage of a private property. In synoptic environment, a cold dry air on the upper layers of the atmosphere, and there was an advection with warm and humid air in the lower atmosphere. Temperature differences between upper and lower layers resulted in thermal instability. The storm began to arise at 1920 KST and reached the mature stage in ten minutes. The cloud top height was estimated at 9 km and the hook echo was appeared at the rear of a storm in simulation result. Model results showed that the downburst was generated in the developed storm over the Ilsan area. This downburst caused the horizontal flow when it diverged near the surface. The horizontal flow was switched to updraft at the rear of storm, and the rear-flank downdrafts (RFDs) current occurred from simulation result. The RFDs took down the vertical flow to the surface. After then, the vertical vorticity could be generated on the surface in simulation result. Subsequently, the vertical vorticity was stretched to form a landspout. The cyclonic vorticity of echo hook from simulation was greater than $3{\times}10^{-2}s^{-1}$(height of 360 m) and landspout diameter was estimated at 1 km.

A Review Study of the Royal Bangquet menu on the 24th of king Kojong in Chosun Dynasty (고종 24년 진찬의궤 찬문에 대한 분석적 연구)

  • 한복진;황혜성;한복려;김상보;이성우;박혜원
    • Journal of the East Asian Society of Dietary Life
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    • v.1 no.3
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    • pp.259-276
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    • 1991
  • The review of side dishes, oereal dishes and seasonings of the banquet on the 24th year of King Kojong in Chosun Dynasty were summarized as follows: 1. Ten kinds of soups(=Tang), that is Yyolguja Tang$.$Guja Tang$.$Keumjung Tang$.$Whanja Tang$.$Jap Tang$.$Gol Tang$.$Seunggiwa Tang$.$Jeopo Tang$.$Haesam Tang$.$Yang Tang were served. The most frequently served soup among them was Yyolguja Tang. 2. Various kinds of dried meat/fish were piled up most highly among dishes. Sliced beef and minced beef among dried meats, white cud$.$yellow cud$.$flatfish$.$skate$.$shark$.$octopus$.$dried abalone$.$cuttle fish$.$dried scallop were piled up together. 3. Sliced of boiled beef/pork and gelatined knuckles were assorted. Boiled meat which was made of beef, pork, lamb, liver, stomach, brisket and plat flank of caw was chiefly used for boiled beef, hams for boiled pork, mediumsized lamb for boiled lamb. And the legs and stomach of caw, old chicken, mullet were used for gelatined knuckle. 4. Three kinds of pan-frying dishes that was stomach and liver of caw, and mullet were usually piled up, If one kind in one dish, sea cucumber and mullet were used respectively. 5. Boiled abalone was dried abalone with soaked, sliced and boiled down in soysauce. 6. Roasted dish was usually made of assorted food stuffs. Sometimes chicken an pheasant was used for roasted dish. 7. Steamed dish was like this : assorted beef, fresh abalone, sea cucumber, mullet, young pork, chicken, dried abalone. 8. Raw dish was made of intestine of caw, fresh abalone and mullet. 9. Poached egg was serving decorated with red pepper, pine-nut and green onion. 10. Seasoned green-been-jelly was served only one time. 11. Radish kimchi was served only one time. 12. Chief foods were nuddle and stuffed bun. 13. Served seasings were honey, mustard, soysauce with vinegar, salt. Review from banquet menu, 34 kinds of side dishes were served : 10 kinds of soup, dried fish/meat, boiled beef, boiled pork, gelatined knuckle, 5 kinds of panfrying, boiled-down-abalone in soysauce, 3 kinds of roast, 5 kinds of steamed, 3 kinds of raw dishes, pouched egg, green-bean-jelly, kimchi. 4 kinds of chief foods were served : nuddle, dry nuddle, 2 kinds of dumping.

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Characterization of a Novel cry1-Type Gene from Bacillus thuringiensis subsp. alesti Strain LY-99

  • Qi, Xu Feng;Li, Ming Shun;Choi, Jae-Young;Roh, Jong-Yul;Song, Ji Zhen;Wang, Yong;Jin, Byung-Rae;Je, Yeon-Ho;Li, Jian Hong
    • International Journal of Industrial Entomology and Biomaterials
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    • v.18 no.1
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    • pp.18-27
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    • 2009
  • B. thuringiensis strain LY-99 belonging to subsp. alesti (H3a3c), was isolated from Chinese tobacco warehouse and showed significantly high toxicity to Plutella xylostella. For the identification of the cry1-type genes from B. thuringiensis LY-99, an extended multiplex PCRrestriction fragment length polymorphism (PCRRFLP) method was established by using two pairs of universal primers based on the conserved regions of the cry1-type genes to amplify around 2.4 kb cry1-type gene fragments. Then the DNA fragment was cloned into pGEM-T Easy vector and digested with EcoRI and EcoRV enzymes. Through this method, a known cry1-type gene was successfully identified from the reference strain, B. thuringiensis subsp. alesti. In addition, the RFLP patterns revealed that B. thuringiensis LY-99 included a novel cry1A-type gene in addition to cry1Aa, cry1Ac, cry1Be and cry1Ea genes. The novel cry1A-type gene was designated cry1Ah2 (Genbank accession No DQ269474). An inverse PCR method was used to amplify the flank regions of cry1Ah2 gene. Finally, 3143 bp HindIII fragment from B. thuringiensis LY-99 plasmid DNA including 5' region and partial ORF was amplified, and sequence analysis revealed that cry1Ah2 gene from LY-99 showed 89.31% of maximum sequence similarity with cry1Ac1 crystal protein gene. In addition, the deduced amino acid sequence of Cry1Ah2 protein shared 87.80% of maximum identity with that of Cry1Ac2. This protein therefore belongs to a new class of B. thuringiensis crystal proteins.