• 제목/요약/키워드: Multiple injuries

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4지 신호교차로의 측면접촉사고 특성 및 사고모형 - 청주시를 사례로 - (Characteristics and Models of the Side-swipe Accident in the Case of Cheongju 4-legged Signalized Intersections)

  • 박상혁;김태영;박병호
    • 한국도로학회논문집
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    • 제11권4호
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    • pp.41-47
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    • 2009
  • 본 연구는 청주시 4지 신호교차로의 측면접촉사고를 다루고 있다. 연구의 목적은 측면접촉사고의 특성을 분석하고 관련모형을 개발하는데 있다. 이를 위해 이 연구에서는 적절한 모형의 방법론을 찾는데 중점을 두고 있다.주요 결과는 다음과 같다. 첫째, 측면접촉사고에서 부상사고는 물피사고의 약 2배 이상으로 교차로 내에서 사고가 가장 많이 일어나는 것으로 평가되었다. 아울러 측면접촉사고는 대부분 승용차 관련 사고이며, 안전운행 불이행으로 인한 것으로 분석되었다. 둘째, 다중선형회귀모형이 다중비선형회귀모형보다 통계적으로 유의한 것으로 평가되었다. 또한 최적 모형은 종속변수가 사고건수인 모형으로 분석되었다. 본 연구에서 분석된 측면접촉사고의 요인은 교통량(ADT), 교차로 면적, 우회전 전용차로, 횡단보도 수, 주도로 제한속도, 최대종단경사 및 현시 수이다.

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건설 현장 CCTV 영상을 이용한 작업자와 중장비 추출 및 다중 객체 추적 (Extraction of Workers and Heavy Equipment and Muliti-Object Tracking using Surveillance System in Construction Sites)

  • 조영운;강경수;손보식;류한국
    • 한국건축시공학회지
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    • 제21권5호
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    • pp.397-408
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    • 2021
  • 건설업은 업무상 재해 발생빈도와 사망자 수가 다른 산업군에 비해 높아 가장 위험한 산업군으로 불린다. 정부는 건설 현장에서 발생하는 산업 재해를 줄이고 예방하기 위해 CCTV 설치 의무화를 발표했다. 건설 현장의 안전 관리자는 CCTV 관제를 통해 현장의 잠재된 위험성을 찾아 제거하고 재해를 예방한다. 하지만 장시간 관제 업무는 피로도가 매우 높아 중요한 상황을 놓치는 경우가 많다. 따라서 본 연구는 딥러닝 기반 컴퓨터 비전 모형 중 개체 분할인 YOLACT와 다중 객체 추적 기법인 SORT을 적용하여 다중 클래스 다중 객체 추적 시스템을 개발하였다. 건설 현장에서 촬영한 영상으로 제안한 방법론의 성능을 MS COCO와 MOT 평가지표로 평가하였다. SORT는 YOLACT의 의존성이 높아서 작은 객체가 적은 데이터셋을 학습한 모형의 성능으로 먼 거리의 물체를 추적하는 성능이 떨어지지만, 크기가 큰 객체에서 뛰어난 성능을 나타냈다. 본 연구로 인해 딥러닝 기반 컴퓨터 비전 기법들의 안전 관제 업무에 보조 역할로 업무상 재해를 예방할 수 있을 것으로 판단된다.

대퇴골 과상부 골절 및 치료에 대한 임상적 고찰 (The Clinical Study of the Supracondylar Fracture of the Femur)

  • 안종철;김세동;안면환;서재성;이동철;이용주
    • Journal of Yeungnam Medical Science
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    • 제10권1호
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    • pp.197-211
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    • 1993
  • 1989년 12월부터 1992년 1월까지 영남대학교 의과대학 부속병원 정형외과에서 치료한 대퇴골 과상부 골절 환자중 1년 이상 원격 추시 가능한 20례를 대상으로 다음과 같은 결론을 얻었다. 1. 활동성이 많은 10-40대가 전체의 85%를 차지하였으며 남자가 70%를 차지하였다. 2. 원인으로는 교통사고가 75%, 추락사고가 15%였다. 개방성골절은 천체의 35%였으며 교통사고 군에서 약 60%를 차지하여 강력한 외상에 의한 것으로 추정되었다. 3. 골절분류는 ASIF group에 의한 분류를 하였으며 Type A가 4례, Type B가 4례, Type C가 12례로 이중 $C_2$, $C_3$가 10례로 분쇄상의 정도 및 관절면 침범정도가 심한 골절의 형태가 많았다. 4. 동반손상은 다발성 골절이 9례로 가장 많았으며 대퇴 동맥 손상이 1례 있었다. 5. Schatzker criteria에 따르면 보존적 치료 결과는 40%에서, 수술적 치료결과는 67%에서 만족할 만한 결과를 얻었다. 6. 술후 합병증으로는 관절강직 및 지연 유합등이 있었으나, 관절강직이 대부분이었고 골절부의 심한 손상으로 조기 관절 운동이 불가능 했던 경우에서 주로 발생하였다.

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다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례 (Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases)

  • 조자윤;정희경;김형기;임경훈;박진영;허승
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

지역 병원에서 동상 환자에 대한 역학에 관한 연구 및 최근 치료 (Epidemiologic Study of Frostbites and Its Current Managements in Community Hospital)

  • 김동철;민병덕;김지훈;정창은;이종건;유성훈
    • 대한화상학회지
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    • 제24권2호
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    • pp.21-29
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    • 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%).

의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가? (Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients.)

  • 문유호;김윤정;신수정;박동찬;박신율;류현욱;서강석;박정배;정제명;배지혜
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

Recovery and Return to Work After a Pelvic Fracture

  • Papasotiriou, Antonios N.;Prevezas, Nikolaos;Krikonis, Konstantinos;Alexopoulos, Evangelos C.
    • Safety and Health at Work
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    • 제8권2호
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    • pp.162-168
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    • 2017
  • Background: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. Methods: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment. Results: Almost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626-25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092-6.720) were identified as independent predictive factors of full RTW. Conclusion: PRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

Multiple Stakeholder Perspectives on Cancer Stigma in North India

  • Gupta, Adyya;Dhillon, Preet K;Govil, Jyotsna;Bumb, Dipika;Dey, Subhojit;Krishnan, Suneeta
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.6141-6147
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    • 2015
  • Background: Cancer is a leading cause of death worldwide. A large proportion of cancer deaths are preventable through early detection but there are a range of social, emotional, cultural and financial dimensions that hinder the effectiveness of cancer prevention and treatment efforts. Cancer stigma is one such barrier and is increasingly recognized as an important factor influencing health awareness and promotion, and hence, disease prevention and control. The impact and extent of stigma on the cancer early detection and care continuum is poorly understood in India. Objectives: To evaluate cancer awareness and stigma from multiple stakeholder perspectives in North India, including men and women from the general population, health care professionals and educators, and cancer survivors. Materials and Methods: A qualitative study was conducted with in-depth interviews (IDIs) and focus group discussions (FGDs) among 39 individuals over a period of 3 months in 2014. Three groups of participants were chosen purposively - 1) men and women who attended cancer screening camps held by the Indian Cancer Society, Delhi; 2) health care providers and 3) cancer survivors. Results: Most participants were unaware of what cancers are in general, their causes and ways of prevention. Attitudes of families towards cancer patients were observed to be positive and caring. Nevertheless, stigma and its impact emerged as a cross cutting theme across all groups. Cost of treatment, lack of awarenes and beliefs in alternate medicines were identified as some of the major barriers to seeking care. Conclusions: This study suggests a need for spreading awareness, knowledge about cancers and assessing associated impact among the people. Also Future research is recommended to help eradicate stigma from the society and reduce cancer-related stigma in the Indian context.

The Usefulness of Brain Magnetic Resonance Imaging with Mild Head Injury and the Negative Findings of Brain Computed Tomography

  • Kim, Du Su;Kong, Min Ho;Jang, Se Youn;Kim, Jung Hee;Kang, Dong Soo;Song, Kwan Young
    • Journal of Korean Neurosurgical Society
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    • 제54권2호
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    • pp.100-106
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    • 2013
  • Objective : To investigate the cases of intracranial abnormal brain MRI findings even in the negative brain CT scan after mild head injury. Methods : During a 2-year period (January 2009-December 2010), we prospectively evaluated both brain CT and brain MRI of 180 patients with mild head injury. Patients were classified into two groups according to presence or absence of abnormal brain MRI finding even in the negative brain CT scan after mild head injury. Two neurosurgeons and one neuroradiologist validated the images from both brain CT scan and brain MRI double blindly. Results : Intracranial injury with negative brain CT scan after mild head injury occurred in 18 patients (10.0%). Headache (51.7%) without neurologic signs was the most common symptom. Locations of intracranial lesions showing abnormal brain MRI were as follows; temporal base (n=8), frontal pole (n=5), falx cerebri (n=2), basal ganglia (n=1), tentorium (n=1), and sylvian fissure (n=1). Intracranial injury was common in patients with a loss of consciousness, symptom duration >2 weeks, or in cases of patients with linear skull fracture (p=0.00013), and also more frequent in multiple associated injury than simple one (35.7%>8.6%) (p=0.105). Conclusion : Our investigation showed that patients with mild head injury even in the negative brain CT scan had a few cases of intracranial injury. These findings indicate that even though the brain CT does not show abnormal findings, they should be thoroughly watched in further study including brain MRI in cases of multiple injuries and when their complaints are sustained.

다발성 외상 환자의 대퇴골 간부 골절에서 임시 외고정술 후 내고정술로의 전환 (Conversion to Internal Fixation after Temporary External Fixation for Femoral Shaft Fractures in Polytrauma Patients)

  • 주석규;강경운;김영우;오형근
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.151-157
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    • 2014
  • Purpose: We report the surgical outcomes for femoral shaft fractures in polytrauma patients who were temporarily treated with external fixation and subsequently converted to internal fixation. Methods: From August 2008 to April 2012, we enrolled 13 patients with multiple traumas due to high-energy injuries and concurrent femoral shaft fractures in which temporary external fixation was carried out. The mean age was 39 years, with a range from 18 to 55 years. Ten were men and 3 were women. According to the AO/OTA classification of fractures, type A was found in 5 patients, type B in 6, and type C in 2, with open fractures being found in 6 patients and femoral artery rupture occurring in 2. For internal fixation, intramedullary nailing was performed in 7 patients, and minimally-invasive fixation of locking compression plates was used in 6. Results: Of the 7 patients converted to intramedullary nailing, 1 experienced delayed union. Of the 6 patients treated with minimally-invasive plate fixation, delayed union occurred in 5, and an auto-bone graft was performed within, on average, 8 months (range: 5~10 months), leading to bone union in all cases in the final follow-up. None of the patients experienced infections or complications involving other organs after having been converted to internal fixation. During the mean follow-up of 19 months, patients achieved satisfactory functional outcomes. Conclusion: In polytrauma patients with a femoral shaft fracture who have been treated with temporary external fixation and who may need internal fixation due to the occurrence of delayed union, an appropriate internal fixation method needs to be selected based on the patient's physical status, and the fracture type.