• 지역사회간호학회지
• /
• 제27권4호
• /
• pp.337-345
• /
• 2016

Purpose: This study aims at identifying individual- and school-level factors associated with unintentional injuries to Korean adolescents at school by applying multilevel modeling. Methods: From the database of the eleventh Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 68,043 adolescents from the $7^{th}$ to the $12^{th}$ grades. Data were analyzed using ${\chi}^2$ test for prevalence and multilevel modeling for related factors of unintentional injuries at school. Results: About 22.9 percent of the adolescents had treatment experiences for unintentional injuries at school in the past 12 months. At the individual level, the significant factors associated with unintentional injuries at school included gender, grade, academic achievement, current smoking, alcohol consumption, frequency of high caffeine intake, depression, and relief of fatigue after sleep. At the group level, the significant factors included number of physical education per week and safety education. Conclusion: School based injury prevention programs should be sensitive to both individual- and school-level factors associated with unintentional injury at school among Korean adolescents.

• Journal of Trauma and Injury
• /
• 제30권3호
• /
• pp.87-90
• /
• 2017

Purpose: Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area. Methods: From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively. Results: Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients. Conclusions: VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.

• Childhood Kidney Diseases
• /
• 제18권1호
• /
• pp.13-17
• /
• 2014

지속적 신 대체 요법(CRRT)은 급성 신손상이 있는 중증 소아의 치료로 점차 사용이 늘어나고 있으며 CRRT의 기술과 실제 사용법이 발달하면서 작은 영아나 신생아에서도 그 사용이 조금씩 늘어나고 있다. 고암모니아혈증이나 체외막산소화 장치(ECMO) 치료 중에 발생한 급성 신손상 등의 경우 CRRT가 안전하고 효과적인 치료가 될 수 있으나, 혈관 접근이나 출혈 그리고 신생아 전용 CRRT device의 부재로 인한 여러 가지 제한점이 있다. 이 종설에서는 기본적인 CRRT의 원리를 알아보고 신생아와 영아에서 특별히 고려해야 할 사항들에 대해 알아보고자 한다.

• Journal of Trauma and Injury
• /
• 제34권4호
• /
• pp.219-224
• /
• 2021

The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon's military, adapted the "flying artillery" to serve as "flying ambulances" for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the "Thomas splint", which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.

• 대한간호학회지
• /
• 제26권3호
• /
• pp.605-622
• /
• 1996

Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.

• 한국심리학회지 : 문화 및 사회문제
• /
• 제25권4호
• /
• pp.325-351
• /
• 2019

본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 '저PTSD/중 PTG집단', '저 PTSD/고 PTG집단', '고 PTSD/고 PTG집단'으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.

• 대한두개안면성형외과학회지
• /
• 제11권1호
• /
• pp.28-32
• /
• 2010

Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.

• 대한정형외과스포츠의학회지
• /
• 제2권2호
• /
• pp.153-157
• /
• 2003

목적: 이 연구의 목적은 스키손상의 특징 및 경향을 검토하여 안전사고를 예방할 수 있는 프로그램과 보호 장비의 개발 및 사용 등에 참고가 되기 위해서이다 대상 및 방법: 1998년부터 2001년까지 한국 강원도의 한 스키 리조트에서 스키를 타다가 부상당하여 응급치료를 받은 사람들을 대상으로 설문조사하였다. 부상이란 alpine 스키 를 타던 도중에 어떤 형태의 사고로 인하여 의무실에서 의학적 치료를 필요로 했던 경우로 정의 하였다 수상을 입은 모든 스키어들은 그들의 손상 기전, 스키 실력, 스키 슬로프의 난이도등을 기입하는 설문지를 작성토록 하였다. 결과:3년간에 걸쳐 총 119명이 응급치료를 받았다. 스키 손상의 발생 빈도는 1000명당 6.4명 이었다. 스키손상은 남자가 여자보다 약간 많았으며 연령은 주로 20대였고 스키수준이 낮을수록, 난이도가 낮은 슬로프일수록 높았고, 손상형태는 염좌 및 인대손상이 가장 많았다 손상부위는 슬관절 부위가 전체의 30$\%$를 차지하였다. 결론: 스키손상은 다른 나라의 보고에 비해 여전히 증가된 경향을 보였는데 이는 스키장 안전관리 미흡 내장객수 과다. 스키 사용자의 상식 및 교육미숙 등이 중요한 원인적 요인으로 작용한다고 생각된다

• 한국직업건강간호학회지
• /
• 제27권4호
• /
• pp.224-234
• /
• 2018

Purpose: In this study, we attempted to analyze the occupational accident experience rate by working life cycle of Korean workers considering entrance and turnover in their jobs. The specific goal of this study was to calculate the accident experience rate according to workers' turnover history and previous accident experience. Methods: We constructed a cumulative data set of 90,338 cases of workers' accident experiences in their jobs from the Fourth Korean Working Conditions Survey. The accident experience rates according to workers' turnover and previous accident experiences were analyzed using descriptive statistics and analysis of variance. Results: In this study, the cumulative accident experience rate of Korean workers was found to be 5.2%. It was confirmed that the accident experience rate of workers increased as the turnover frequencies increased. In addition, we analyzed only the data of the workers who had experienced turnover and found that the accident experience rate after turnover increased about 7.5 times when workers had experienced accidents in the past. Conclusion: To prevent occupational accidents in workers, safety strategies should consider a worker's previous job history and injury experiences. It will also be necessary to focus preventive efforts on new and young workers through ongoing monitoring and on-the-job training.

• 한국치위생학회지
• /
• 제9권3호
• /
• pp.545-557
• /
• 2009

Objectives : This study was to investigate the use of mouth-guards and maxillofacial injuries and to examined the relationship among variables in athletes group. Methods : The subjects were 459(86.5%), who were 18 years or older with mean age of 20.7 years. Data was collected using a self administrated questionnaire from May 25 to June 15, 2009. We surveyed maxillofacial injuries(temporo-mandibular disorders contained) and mouth-guards usage and confidence concerning mouth-guards in athletes. The data were analysed with chi-square analysis, fisher's exact test and logistic regression using the SPSS 15.0 windows. Results : Prevalence of body or maxillofacial injuries experiences was 54.5% for athletes and 47.1% for non-athletes groups(p>0.05). The other hand, the incidence temporo-mandibular disorders was 67.0% for athletes and 49.8% for non-athletes groups(p<0.05). The experience of the use of mouth-guards was 83.3% for athletes and 78.8% for non-athletes, there were not significant differences between athletes and non-athletes groups (p>0.05). Risk factors found to be significantly related to the occurrence of maxillofacial injury were: unused mouth-guards(OR=2.83), no rules for use of mouth-guards(OR=2.46). Conclusions : Based on the findings, maxillofacial injuries experience is highly associated with mouth-guards usage, not only athletes also general people should be educated on the use of mouth-guard in order to reduce the incidence of maxillofacial injuries.