• 대한족부족관절학회지
• /
• 제26권2호
• /
• pp.95-102
• /
• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• 대한족부족관절학회지
• /
• 제26권1호
• /
• pp.22-29
• /
• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• Journal of Chest Surgery
• /
• 제13권3호
• /
• pp.269-273
• /
• 1980

The rupture of the aorta commonly follows major blunt trauma to the thorax. It has markedly increased in recent years, paralleling the rising number of vehicular accidents. The most frequent site of rupture is the area of the isthmus, with the ascending aorta second. The diagnosis of the condition from clinical data is difficult, and aortography is used whenever aortic tear is suspected. We are presenting a case of patient who had intimal tearing of the thoracic aorta with multiple injuries. The patient underwent surgical repair 28 days after injury with left heart [LA-Femoral artery] bypass.

• Journal of Chest Surgery
• /
• 제20권1호
• /
• pp.101-105
• /
• 1987

A clinical evaluation was performed on 17 cases of the cardiac and great vessel injuries above the subclavian vessel at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital from April, 1980 to September, 1986. The results were as follows: 1. Sex distribution were 13 cases in male and 4 cases in female. In age range, second and third decades occupied in about 65% of total cases. 2. Modes of injury were penetrating wound is 14 cases and nonpenetrating wound in 3 cases. The stab wounds by knife were most frequent. 3. Time interval from injury to operation was mean 103 minutes. 4. Surgical approaches were performed with thoracotomy in 9 cases, median sternotomy in 3 cases and direct incision above the wound. 5. Sites of injury were heart in 10 cases and great vessel in 7 cases. The right ventricular injury was most common as 7 cases. 6. Operative procedures were performed with simple closure, vascular graft anastomosis and ligation. There was no postoperative death.

• Journal of Chest Surgery
• /
• 제17권4호
• /
• pp.715-722
• /
• 1984

From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.

• Journal of Korean Neurosurgical Society
• /
• 제42권2호
• /
• pp.135-140
• /
• 2007

It is not the best way to treat a hopeless patient with life-sustaining medical devices until the heart beats stop. Advanced medical technology may prolong the life for a significant period without recovery from the disease. However, it would give an unbearable economic burden to the family and the society. In 2006, we decided not to operate 9 patients with traumatic intracranial hematomas. We examined those patients with special references to possible legal and ethical problems. It is reasonable to withhold a treatment after documentation that the family never wants any life sustaining treatment when the treatment does not guarantee the meaningful life.

• Journal of Chest Surgery
• /
• 제37권10호
• /
• pp.861-864
• /
• 2004

역행성 심정지의 사용과 연관된 관상정맥동의 손상은 드물며 사망까지 가능한 합병증이다. 심내막염, 승모판막폐쇄부전증과 심비대를 보인 노인 환자에서 역행성 심정지액 투여 중에 발생한 관상정맥동의 파열과 심장내 복구 방법을 보고한다.

• Journal of Community Nutrition
• /
• 제8권2호
• /
• pp.90-95
• /
• 2006

Asian Americans is a minority population contributing approximately 4% to the total population of the United States, however it is one of the fastest growing populations. Although Asian Americans as a group have socioeconomic profiles that are similar to white Americans, significant variations exists within and across Asian ethnic groups. The top ten leading causes of death for Asian Americans includes cancer, heart diseases, stroke, unintentional injuries, diabetes, influenza and pneumonia, chronic lower respiratory disease, suicide, nephritis, and septicemia. The prevalence of obesity is lower among Asian Americans, however this should be taken with considerations specific to Asians. High salt and low calcium consumption seem to be dietary risk factors for Asian Americans, although dietary patterns are changing with acculturation. Factors affecting dietary patterns are discussed in this paper. A proactive nutrition education approach for Asian Americans should be promoting maintaining 'healthy' aspects of ethnic diets and adopting 'healthy' American diets. Collaboration with nutrition educators in Asian countries would be helpful to overcome limited resources available for researching and developing nutrition education messages and materials for Asian Americans. (J Community Nutrition 8(2): 90-95, 2006)

• Journal of Trauma and Injury
• /
• 제26권3호
• /
• pp.131-138
• /
• 2013

Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.

• 한국임상수의학회지
• /
• 제17권1호
• /
• pp.138-144
• /
• 2000

The studies were carried out to investigate the effects of esophageal thermal tube for rewarming in the hypothermia in rabbits. Thiry-one rabbits were continuously cooled with femoral arterio-venous bypass circulation to 25.0${\pm}$0.3$^{\circ}C$(profound hypothermia) of rectal temperature. The experiment was consisted with 3 esophageal thermal tube groups perfused with circulation water at 38${\pm}$1$^{\circ}C$(low, n=12), 42${\pm}$1$^{\circ}C$(medium, n=12), and 45${\pm}$1$^{\circ}C$(high, n=7). Esophageal thermla tube specially constructed double-lumen esophageal tube with circulating warm water at respective htermal grade. With this device, rewarming of the rabbits as follows; High-esophageal thermal tube group(45${\pm}$1$^{\circ}C$)had a more effect on mean arterial pressure(MAP), heart rate(HR), esophageal temperature, and rectal temperature than others groups, but the circulation water at 45$\pm$1$^{\circ}C$ may cause thermal injuries in the esophagus because esophageal temperature increased to 41.1$^{\circ}C$. Medium-esophageal thermal tube group(42${\pm}$1$^{\circ}C$) had a more effect on RR than others groups, but the circulation water at 42${\pm}$1$^{\circ}C$ may also cause thermal injuries in the esophagus if the temperature exceeds 42$^{\circ}C$ for an extended period of time because its esophageal temperature increased to 39.4$^{\circ}C$. Low-esophageal thermal tube group(38${\pm}$1$^{\circ}C$) had a more effect on MAP, RR, and esophageal temperature than others groups. In conclusion, rewarming of the central core in the treatment of profound hypothermia using the esophageal thermal tube perfused with circulation water at 38${\pm}$1$^{\circ}C$ appears to be a ideal alternative safety zone of the temperature of circulation water avoiding thermal injury in esophagus causing by out of order or lower precise thermostat of water bath to that of others groups.