Jo, Choong Hyun;Jung, Yong Sik;Kim, Wook Hwan;Cho, Young Shin;Ahn, Jung Hwan;Min, Young Gi;Jung, Yoon Seok;Kim, Sung Hee;Lee, Kug Jong
Journal of Trauma and Injury
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v.22
no.1
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pp.77-86
/
2009
Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.
Purpose: The purpose of this work was to describe the results of treatment for motor vehiclerelated crushing injuries among children and adolescents under sixteen years in Korea. Materials and Methods: A retrospective analysis was conducted of data from children who were under sixteen year and injured foot by motor vehicles. Cases were documented 1) age at the time of injury, 2) injured site, 3) the area of accident, 4) the kind of vehicle, 5) associated injuries, 6) methods of treatment for soft tissue reconstruction and 7) complications. The relationships between the area of accident and associated injuries, and the kind of vehicle and associated injuries were analyzed using Chi-square test and Fisher exact test. Results: There were 97 children who were 15 year and younger. The mean age was 7.4 years, and 65% were boys. The left foot was more dominant side of injury (57%). Seasonal variation was seen with the number of injuries peaking during the summer (43%, p<0.05). Among the vehicles, 78.3% were the large vehicles (bus, truck or van). The where of accident was more frequent at an alley or less than two lanes of traffic. But, the relationships between the place of accident and associated injury or the kind of vehicles and associated injury were not statistically significant. The associated injury were fracture or dislocation (23 cases, 35.9%), injury of tendon (21 cases, 32.8%). There were amputation or disarticulation of foot in 8 cases (8.2%) and post-traumatic deformities such as flatfoot, hindfoot varus or valus deformities by tendon injury in 7 cases (7.2%). Conclusion: More than 50% of crushing or degloving injuries of child's foot by traffic accidents happened in boys between 5 to 9 years old. The associated injury was unrelated with size of vehicles or accident place at the time of accident. But, even though foot injury happened in an alley or one lane by small vehicles, child who hurt feet by car need thorough investigation about associated injury. If a surgeon keep in mind and treat child to associated injury necessarily, can minimize complication. Microsurgical reconstruction for soft tissue defect was prior to other methods.
The burden of injury is widely considered to be very severe in our society. Nonetheless, we don't have enough data for injury surveillance. The objective of this research is to select and supplement CORE DATA for injury surveillance. For this purpose, this study had analyzed the literature such as the Quality Assessment Report about 'Causes of Death Statistics', 'Health Insurance Statistics' and 'Hospital Discharge Injury Surveillance' according to the six dimension of Statistics Quality. The analysis result is that 'Cause of Death Statistics' and 'Health Insurance Statistics' have the usefulness as the CORE DATA for injury surveillance. But there is a significant shortcoming in the Health Insurance Statistics, which is that there is a lack of the data about the external causes of injury. For supplementing the defect, this study proposes the system that the medical institutions should obligatorily report the external causes of injury when claim National Health Insurance Medical Care Expenses. As the results of this system, we can expect 'Establishing of Injury pyramid', 'Data Connecting with the National Pension' and 'Improving the Promptness of Injury Data'. And we expect the follow-up study for the realization of this system.
As the complexity of the our environment is further complicated by advancements in industry and increase in vehicle traffic flow, the incidents of injury causing accidents are on the rise. Consequently, there is increasing emphasis on the importance of systematic and continual safety education for injury preventive behaviors. This study investigates safety related problems of elementary school students based on the PRECEDE model, proposed by Green et al.(1980 Green), to comprehensively identify the requirements of school safety education. The identified requirements were used to diagnose the current state of elementary school safety education through the analysis of multidimensional factors. A questionnaire survey was conducted on 594 sixth grade students from randomly selected 4 schools in Seoul to examine their injury preventive behaviors and to determine the educational diagnosis variables that affect it. The duration of the survey was 3 weeks starting from April 12, 1999 to May 8, 1999. A summary of the survey results are presented below; 1. Situations in which accidents have occurred were, in their order of frequency, ‘during play or sports activities within the school grounds’ was most frequent at 59.6%, ‘during play on local streets’ at 49.5%, and ‘traffic accidents’ at 41.6%. 2. Categorization of the injury preventive behavior showed that ‘not playing at high traffic flow locations such as streets and construction sites’ had the higher level of observance, while ‘wearing of helmets and joint protection devices during playing’ was least observed. 3. Considering injury preventive behaviors in relation to educational diagnosis variables indicated, for predisposing factors, lower ‘perception to injury accidents’ (p〈0.001) combined with higher ‘concerns for injury accidents’(p〈0.001), ‘practice of preventive behavior’(p〈0.001), and ‘the level of safety knowledge’(p〈0.001) resulted in significantly higher observance of injury preventive behaviors. For enabling factors, higher ‘perceived level of the school safety education’ (p〈0.001) and ‘availability of safety education resources’(p〈0.01) indicated significantly higher observance of injury preventive behaviors. For the reinforcing factor, frequent exposure to ‘safety education brochure’ (p〈0.01) and ‘audio-visual material for safety education’(p〈0.01) combined with more ‘regional safety education’ (p〈0.01), ‘home safety education’ (p〈0.01), ‘school safety education’(p〈0.001), and, ‘parents’ observance of preventive behaviors' (p〈0.001) showed significantly higher observance of injury preventive behaviors. 4. An analysis of the factors that affect injury preventive behaviors showed that the enabling factor ‘awareness of school safety education’ had the highest correlation with injury preventive behaviors followed by factors, in their order of significance, ‘practice of preventive behavior’, ‘perception to injury accidents’, ‘level of safety knowledge’, ‘parents’ observances of preventive behaviors', and ‘concerns for injury accidents.’
With the exception of gun shot wound, the incidence of penetrating injury of face and neck areas nonorganic foreign bodies is relative low. But the diagnostic evaluation and therapeutic management of penetrating facial wounds need careful decision, when the anatomic proximity of the major vessels and nerve is considered. Penetrating facial trauma with concomitant vascular injury present challenging problems, the immediate complication of this vascular injury are severe bleeding, hematoma formation, shock, obstruction of airway. The vascular injury is conformed by angiography. In this report, a industrial tool(long tack) fired by explosive air is penetrated into face and to neck. In angiograms penetrating injury of the vertebral artery is detected. We performed the embolization of the vertebral artery with coils and manual removal of the foreign body without any complication was followed.
Hwang, Kun;Jeon, Yun Moon;Ko, Yeong Seung;Kim, Yeon Soo
Archives of Plastic Surgery
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v.42
no.4
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pp.407-410
/
2015
The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001) and of middle facial injury (OR, 1.97; P<0.001) as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI), 0.67-3.00, P=0.36) was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.
Kim, Tae-Bum;Lee, Yong-Jig;Lee, Young-Keun;Woo, Sang-Hyun
Archives of Reconstructive Microsurgery
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v.16
no.1
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pp.30-38
/
2007
In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-to-end artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.
The purpose of this survey was to investigate the exercise injuries and its care methods of members in amateur tennis clubs. 176 questionnaires were surveyed from tennis players who were exercising at 6 tennis club ranges in J city, Korea. The interesting variables were parts, time slots, causes, treatments of injuries, which were analyzed based on the general and exercise characteristics of surveyees, a gender, an age, an exercise career, an exercise time, an occupation, an average earning. The results of this study were as follows: 1) In the results of analyses for the injury parts, the upper bodies injuries were more than lower body ones, the injury of back and lumbus had the highest rate among upper body injuries. In twenties, the number of injury had highest rate. 2) The main cause of injury was the carelessness of one's own. The most injury by the carelessness of one's own was a reason for a lack of warm-up. 3) The first emergency manager for the injury was mostly oneself.
The past five years, industrial accidents due to food processing machinery have been occurred 725 cases, injury by the food cutter occurred 390 cases in its. On this study, to prevent food cutter injury, an attempt is made to present the improved documentation of fundamental safety of the food cutter workplace through the injury analysis of food cutter injury and surveys on band saw machine business field. Analyzing the result of 390 cases on food cutter injury, amputation, cut, puncture occupied 75.1 percent (293 cases), compressed occupied 23.3% (91 cases), also it showed constant component without reference to gender, age, scale of work place, service period. In the survey, lack of concentration for workers have been pointed out as the biggest factor in the cause of band saw machine injury. Meanwhile, such as the EU and Japan, whereas presents safety standards about band saw machines that are tailored to each country, on the other hand, South Korea doesn't provide the standards. To prevent the food cutter injury, safety standards need to be established in consideration of amputation, cut, puncture, compressed injury and financial support is required to procure protective equipment at each place of business.
While axons in the peripheral nerve can regenerate and lead to functional recovery to a certain extent after injury, its efficacy varies depending on the severity and duration of the injury. Here, we investigated the effects of Boyanghwano-tang (BYHOT) treatment on the regenerative responses in the sciatic nerves after prolonged transection and coaptation surgery. In mice given crush injury, axonal regeneration was completed when analyzed 1 week later and did not show any difference in regenerative reponses in the distal portion of the nerve between saline- and BYHOT-treated groups. In animal models with transection and reconnection, axonal regeneration was markedly retarded compared to animals with crush injury. Regenerating axons were extended into the reconnected distal portion of the nerve more actively in animals treated with BYHOT than saline controls. Cdc2 protein was similarly induced in nerves with crush injury and with transection and recollection, and its level was lower in BYHOT-treated animal than saline control when measured 2 weeks after nerve reconnection. These results suggest that BYHOT may be useful to promote axonal regeneration in the peripheral nerve after severe injury.
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