Purpose: It is important to begin a transfusion safely and appropriately as soon as possible in a hemorrhagic shock patient. A group $O^+$ unmatched pack red blood cell (universal $O^+$) transfusion may satisfy that requirement. We report our experiences with universal $O^+$ to compare its usefulness for hemorrhagic shock patients with that of a matched pack red blood cell transfusion in the emergency department (ED). Methods: This is a retrospective study. Patients who had systolic blood pressure of less than 90 mmHg or a pulse rate of more than 120 beats per minute in the ED were included, and their medical records were reviewed. The collected data were demographic data, vital signs, blood test results, time to transfusion, the amount of transfusion, complications, and diagnoses. We calculated the emergency transfusion score (ETS) based on the patients' medical records. Results: Two hundred thirty-five patients were included. Forty-eight patients (36 trauma and 12 non-trauma patients) were transfused with a universal $O^+$. These patients had less time to transfusion compared with the cross-matched transfusion groups (35${\pm}$42 versus $170{\pm}187$ minutes, p<0.001). There were no differences in complications between groups (p=0.076). Of the patients who were transfused with universal $O^+$, 94.4% got more than 3 ETS. Conclusion: The universal $O^+$ transfusion, compared with matched pack red blood cell transfusion, should be a useful treatment for ED hemorrhagic shock patient due to its having a shorter time to transfusion without an increase in complications.
The proper management of the pediatric facial bone fracture is critical in the facial bone development. This study characterizes the surgically treated patient population suffering from facial bone fractures by the use of current data from a large series consisting of 201 cases. The data was gathered through a retrospective chart review of patients surgically treated for facial bone fractures at the department of plastic and reconstructive surgery, Sanggye Paik hospital, Inje university medical center, collected over 10-years period from January, 1993 to December, 2002. Data regarding patient demographics(age, sex), seasonal distribution, location of fractures, and the causes of injury with admission periods, were collected. In total, there were 201cases of pediatric facial bone fractures. Male patients outnumbered female patients by a 5.48: 1 ratio and were found to engage in a wider range of behaviors that resulted in facial bone fractures. Physical violence was the leading cause of pediatric facial bone fractures(27.9%), followed by sports-related mechanisms (22.9%) and falling down(17.9%). The most prevalent age group was 11-15 years-old(71.1%) and there was a 14.3% prevalence in March. Among the location of fractures, the nasal bone was the most prevalent, accounting for 82.3% of injuries, followed by the orbit(9.95%), and the mandible fractures(7.5%). Most patients(59.7%) were treated within 6-9 days after trauma and the mean hospitalization period was 8-11 days. We should follow up the surgically treated patients, and they will be further evaluated about postoperative sequele and effect on the facial bone development. These studies demonstrate differences in the demographics and clinical presentation that, if applied to patients, will enable a more accurate diagnosis and proper management.
Journal of The Korean Society of Clinical Toxicology
/
v.11
no.2
/
pp.81-88
/
2013
Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.
Kang, Seung Ku;Yun, Ju Sik;Kim, Sang Hyung;Song, Sang Yun;Jung, Yochun;Na, Kook Joo
Journal of Chest Surgery
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v.48
no.1
/
pp.40-45
/
2015
Background: Surgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs. Methods: We retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed. Results: There were 36 males (67.9%) and 17 females (32.1%); the mean age was $49.2{\pm}11.8$ years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant ($120.0{\pm}45.6$ minutes vs. $161.5{\pm}71.1$ minutes, p=0.08). A significant difference was found in the length of the hospital stay ($9.0{\pm}3.2$ days vs. $16.5{\pm}5.4$ days, p<0.001). Conclusion: The thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.
Kim, Dong Chul;Min, Byung Duk;Kim, Ji Hoon;Chung, Chang Eun;Lee, Chong Kun;Yu, Sung Hoon
Journal of the Korean Burn Society
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v.24
no.2
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pp.21-29
/
2021
Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).
Journal of the Korean Society of Food Science and Nutrition
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v.16
no.4
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pp.287-293
/
1987
The present study was designed to be link a part of the research on the investigation on daily life and consciousness of the longevous people in Korea, and to investigate the health conditions, and the attitude on disease and suffering of longevous people in the past. 1. By the health conditions of longevous people between 40 ana 60 years, 'very good' showed the highest figure of 71.0%, followed by 'ordinary' (21.6%). Consequently it is found that 92.6% of total longevous people surveyed maintained the good health conditions above ordinary. 2. Of the experiences of disease and/or injury after 60 years of longevous people, 'never' showed the highest figure of 74.7%, while 'had' showed the only 22.6% of total longevous people surveyed. 3. Of the details of disease and/or injury after 60 years of longevous people, 'digestive disease' showed the highest figure of 32.6 %, followed by 'apoplexia cerebri & hypertensions' (14.0%) and 'heart disease' (14.0%), and followed by 'respiratory disease' (12.8%). 4. Of the experiences of suffering between 40 and 60 years of longevous people, 'never' showed 55.7% of total longevous people surveyed, while the frequency of suffering decreased in the order of 'once' (22.7%), '2 times' (15. 8%) and '3 times' (4.7%). By the details of suffering between 40 and 60 years of longevous people, 'family life' showed the highest figure of 85. 1%, followed by 'business' (10. 1%). 5. By the attitude on suffering of longevous people, 'tried to forget soon' showed the highest figure of 31.2%, followed by 'continuous worried' (33. 3%), and followed by 'not worried' (7.2%).
Background: Facial hyperhidrosis patients have as much difficulty in personal relationships as the palmar and axillary hyperhidrosis patients. There have been no appropriate treatment, but recently, satisfactory results have been obtained through sympathetic blockade. Thoracoscopic thoracic sympathectomy for facial hyperhidrosis has been known to resect cervicothoracic (stellate) ganglion, but its inherent complications such as Horner syndrome have made the surgeons hesitant to use this method. We, through our experiences in treating palmar and axillary hyperhidrosis for the past 6 years, believed that T2 sympathicotomy would be enough for facial hyperhidrosis and have experimented and obtained satisfactory results. Material and Method: From June 1997 to May 1998, 38 consecutive patients underwent bilateral thoracoscopic T2 sympathicotomy with 2mm instruments at Seoul National University Hospital. Result: All patients were relieved of excessive sweating in their faces immediately after the operation. Postoperatively, 5 patients (13.2%) required insertion of chest tubes because 3 had incomplete reexpansion of the lung, and 2 had hemothorax from severe adhesion. Other complications related to the surgical procedures, such as Horner's syndrome, and brachial plexus injury, were not detected in any cases. The mean hospital stay was mean 1.7$\pm$0.9 days after surgery. Conclusion: T2 sympathetic ganglion is the appropriate resection site for facial hyperhidrosis, and complications such as Horner syndrome can be prevented by not cutting the stellate ganglion. In addition, it is possible to perform the operation by using a 2 mm thoracoscopic instrument, and may obtain much better results.
The Installation, Maintence, and Safety Control of Fire-fighting Systems Act of South Korea regulates that over 30-storey high-rise buildings including underground spaces should vitally perform the Performance-based Design to minimize property damage and personal injury as a fire risk assessment in advance. Therefore a PBD designer such as a fire safety professional engineer evaluate occupant's life safety by a scientific methodology. In order to evaluate the life safety, fire safety designers calculate the Required Safety Egress Time (RSET) which does not have the legal criteria regarding the standard method of calculation yet. So this way has been showing different results depending upon the designer's choice, knowledges and experiences. In this study, RSET calculation methods by six designers respectively were analysed from the thirteen reports of real performance based design projects conducted in Busan for a last five years. In particular, the Response Time calculation methods which have the most powerful effect for figuring the RSET are compared with the other designer's to deduce an error value.
Pain is subjective and greatly influenced by prior experiences, but it is real. Pain associated with an organic(objective) pathology is more easily explained and treated. However, atypical or unexplainable pain is usually a source of greater confusion and frustration. Pain may be divided into four general diagnostic categories. 1) pain with anatomic features and objective findings 2) pain with anatomic features and without objective findings 3) pain with non-anatomic features associated with stress and somatization 4) pain with non-anatomic features associated with perceived physical injury. There is a well-established relationship between emotional, physical and/or sexual abuse history and development of chronic pain. It has been suggested that the link between somatization and abuse involves a paradoxical pattern of hiding feelings and reality, while seeking acknowledgment of suffering. History of abuse may physiologically and developmentally increase a person's susceptability to pain and organic changes can be associated with psychogenic disease. Patients with chronic pain should be treated with multidisciplinary approaches including exercise, meditation, cognitive therapy, medications, and biofeedback. Cognitive therapy alters patient's cognition and management of pain and alleviates pain, especially associated with stress. Antidepressants are the most commonly used medications and pain control effects have no relation with mood changes. Biofeedback with relaxation training, exercise and meditation may also be effective in pain control.
This study explored keywords and key topics by collecting posts related to 'self-Iinjury' and 'suicide' through Twitter. The study subjects were selected as posts containing related hashtags related to self-injury and suicide from October 29, 2019 to November 30, 2020. Text mining based on collected posts resulted in a total of 11 key topics: -6 related to 'self-Iinjury' and 5 related to 'suicide'. The main message in the topic is as follows. First, looking at the main messages contained in the topic, they honestly expressed self-harm and suicide experiences that are difficult to express offline online, and used SNS as a channelpath for requesting help requests. Second, there were common and discriminatory characteristics in posts related to 'self-Iinjury' and 'suicide'. Although topics related to 'self-Iinjury' mainly revealed emotional control and interpersonal functions of self-harm, messages related to 'suicide' showed more clearly messages about suicide prevention addressing and social problems. These results are meaningful in that they can understand the opinions of people who have experienced self-harm and suicide accidents and the public voice on self-harm and suicide-related issues could be better understood, and that this study seeks for effective self-harm and suicide prevention and intervention measures for self-harm and suicide issues.
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