• 제목/요약/키워드: Multiple injuries

검색결과 266건 처리시간 0.031초

다발성 늑골골절의 외상성 혈기흉 발생에 대한 영향 (Influence of Multiple Rib Fracture upon Traumatic Hemo-pneumothorax)

  • 양승준;이제원;진상찬;주명돈;최우익
    • Journal of Trauma and Injury
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    • 제21권2호
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    • pp.91-99
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    • 2008
  • Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was $3.7{\pm}2.1$, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.

Urethral Pressure Measurement as a Tool for the Urodynamic Diagnosis of Detrusor Sphincter Dyssynergia

  • Corona, Lauren E.;Cameron, Anne P.;Clemens, J. Quentin;Qin, Yongmei;Stoffel, John T.
    • International Neurourology Journal
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    • 제22권4호
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    • pp.268-274
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    • 2018
  • Purpose: To describe a technique for urodynamic diagnosis of detrusor sphincter dyssynergia (DSD) using urethral pressure measurements and examine potential associations between urethral pressure and bladder physiology among patients with DSD. Methods: Multiple sclerosis (MS) and spinal cord injured (SCI) patients with known DSD diagnosed on videourodynamics (via electromyography or voiding cystourethrography) were retrospectively identified. Data from SCI and MS patients with detrusor overactivity (DO) without DSD were abstracted as control group. Urodynamics tracings were reviewed and urethral pressure DSD was defined based on comparison of DSD and control groups. Results: Seventy-two patients with DSD were identified. Sixty-two (86%) had >20 cm $H_2O$ urethral pressure amplitude during detrusor contraction. By comparison, 5 of 23 (22%) of control group had amplitude of >20 cm $H_2O$ during episode of DO. Mean duration of urethral pressure DSD episode was 66 seconds (range, 10-500 seconds) and mean urethral pressure amplitude was 73 cm $H_2O$ (range, 1-256 cm $H_2O$). Longer (>30 seconds) DSD episodes were significantly associated with male sex (81% vs. 50%, P=0.013) and higher bladder capacity (389 mL vs. 219 mL, P=0.0004). Urethral pressure amplitude measurements during DSD were not associated with significant urodynamic variables or neurologic pathology. Conclusions: Urethral pressure amplitude of >20 cm $H_2O$ during detrusor contraction occurred in 86% of patients with known DSD. Longer DSD episodes were associated with larger bladder capacity. Further studies exploring the relationship between urethral pressure measurements and bladder physiology could phenotype DSD as a measurable variable rather than a categorical observation.

Length of hospital stay among oral and maxillofacial patients: a retrospective study

  • Tan, Fo Yew;Selvaraju, Kalpana;Audimulam, Harshinie;Yong, Zhi Chuan;Adnan, Tassha Hilda;Balasundram, Sathesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권1호
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    • pp.25-33
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    • 2021
  • Objectives: Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. Materials and Methods: Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. Results: A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. Conclusion: The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.

Reduction of comminuted fractures of the anterior wall of the frontal sinus using threaded Kirschner wires and a small eyebrow incision

  • Lee, Da Woon;Kwak, Si Hyun;Choi, Hwan Jun;Kim, Jun Hyuk
    • 대한두개안면성형외과학회지
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    • 제23권5호
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    • pp.220-227
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    • 2022
  • Background: Frontal sinus fractures are relatively rare. Their surgical management significantly differs depending on whether the posterior wall is invaded and the clinical features vary. A bicoronal incision or endoscopic approach can be used. However, the minimally invasive approach has been attracting attention, leading us to introduce a simple and effective surgical method using multiple-threaded Kirschner wires. Methods: All patients had isolated anterior wall fractures without nasofrontal duct impairment. The depth from the skin to the posterior wall was measured using computed tomography to prevent injury. The edge of the bone segment on the skin was marked, a threaded Kirschner wire was inserted into the center of the bone segment, and multiple Kirschner wires were gently reduced simultaneously. Results: Surgery was performed on 11 patients. Among them, seven patients required additional support for appropriate fracture reduction. Therefore, a periosteal elevator was used as an adjunct through a small sub-brow incision because the reduction was incomplete with the Kirschner wire alone. The reduction results were confirmed using facial bone computed tomography 1 to 3 days postoperatively. The follow-up period was 3 to 12 months. Conclusion: The patients had no complications and were satisfied with the surgical results. Here we demonstrated an easy and successful procedure to reduce a pure anterior wall frontal sinus fracture via non-invasive threaded Kirschner wire reduction.

A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • 제47권4호
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    • pp.406-408
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    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

Effects of Protease Treatment and Animal Behavior on the Dissociative Culture of Aplysia Neurons

  • Lee, Nuribalhae;Rim, Young-Soo;Kaang, Bong-Kiun
    • Animal cells and systems
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    • 제13권3호
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    • pp.267-274
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    • 2009
  • The dissociative culture technique of Aplysia neuron is one of the key methods that have been used for studies of cellular and molecular mechanisms of neuronal functioning. However, despite the advantages this method offers as an experimental model, its technical efficiency has had room for improvement. In this study, we examined certain putative factors that might affect the culture quality. The effects of neuronal damage induced by physical injuries, heat shock, and surface protein degradation were evaluated along with the correlation between the culture quality and animal behavior. As a result, we found that physical injury can be a critical factor that affects culture quality, whereas the heat shock and surface protein degradation had negligible effect on it. In addition, we discovered that siphon retraction time was not a good measurement for healthy neurons. Based on these findings, we suggest here an improved method in which the degree of physical injury is reduced by means of multiple protease treatment.

수부손상 근로자의 통증, 신체상 및 만족도에 관한 연구 (The Relationship among Pain, Body Image and Satisfaction in Hand-injured Workers)

  • 윤순영;김민숙
    • 한국직업건강간호학회지
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    • 제19권2호
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    • pp.205-216
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    • 2010
  • Purpose: The purpose of this study was to explore relationship among pain, body image and satisfaction in hand-injured workers. Methods: Using a sample of 96 out-patient workers with hand injuries, pain, body image and satisfaction were measured by VAS and Modified Jung Keum-hee's Tennesee Self Concept Scale. Repeated measured ANOVA and a Bonferroni correction for multiple statistical testing during post hoc analyses were conducted to evaluate relationship among pain, body image and satisfaction in hand-injured workers. Result: Functional satisfaction(r=.46, p<.001) and appearance satisfaction(r=.55, p<.001) significantly increased by treatment satisfaction. Functional satisfaction(r=.35, p=.001) and appearance satisfaction(r=.31, p=.002) increased by body image. But treatment satisfaction(r=-.20, p=.049), functional satisfaction (r=-.34, p=.001) and appearance satisfaction (r=-.39, p<.001) significantly decreased by pain. Conclusion: Poor pain management was related to bad body image and treatment satisfaction. Therefore, interventions targeting at pain management are needed for hand-injured workers.

치매환자 실종방지를 위한 대중교통 기반 위치관리 플랫폼 개발 (Development of a Public Transport-Based Location Management Platform for Preventing Missing Persons with Dementia)

  • 염세혁;손선영;구정식;이왕훈
    • 센서학회지
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    • 제28권6호
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    • pp.385-389
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    • 2019
  • As we become an aging society, the number of dementia patients increases every year (an estimated 10% of the elderly, equating to 1.27 million in 30 years). In addition, 17,000 cases of missing people with disabilities and dementia are reported annually, indicating that more than one person per hour goes missing. More than 50% of those who are lost suffer injuries (some of which are fatal) within 24 hours after going missing. This is why measures are urgently required to ensure safety of the elderly. The core function of the disappearances prevention system proposed by this research group is to identify and respond early to deviations of dementia patients from their homes or facilities by identifying the location of the occurrence of disappearance, so that real-time notifications occur when a they leave the protected area. In addition, multiple receivers and public transportation integrated terminals share information when a patient leaves and uses public transportation to ensure their safe return. Most existing beacon-based positioning service models have fixed signal transmitters and are serviced in the form of transport receivers, but the proposed service model has users wearing the BLE beacon and receivers fixed.

Comparison Analysis of Lower Extremities Activity while Walking Downhill according to the Height of Heel for Women in 20's

  • Kim, Hyeun-Ae;Kim, Hee-Tak
    • 국제물리치료학회지
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    • 제2권2호
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    • pp.324-328
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    • 2011
  • The purpose of this study is to measure the effect of change in heel height on lower extremities activity of young women on high-heeled shoes that young women prefer from more kinetic and realistic perspective as this study changes the degree of slope on a treadmill. The study subjects are 15 young and healthy women who do not have any external injuries or problem with walking and understand the purpose of this study clearly. They wore three different height of heels(1cm, 7cm, 12cm) and walked on a treadmill at a constant speed of 3km/h. EMG value of four muscles (anterior tibial muscle, gastrocnemius muscle, straight muscle of thigh, and biceps muscle of thigh) were collected when walking and the change according to the height of heels were analyzed using one-way ANOVA. Multiple comparison analysis on anterior tibial muscle and heel height showed that the group with 12cm heel showed significantly high muscle activation compared to the groups with 1cm and 7cm heels. The result of this study can be used for various perspectives from inferring and mediating problems caused by wearing high heels on different ground slopes for a long time.

원위피판술을 시행한 환자의 손가락에 수술용 고무장갑을 이용한 간단한 조형법 (Simple Molding Method for Post-distant Flap Stated Finger by Using Surgical Rubber Gloves)

  • 김호길;최환준;김미선;신호성;탁민성
    • Archives of Plastic Surgery
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    • 제33권2호
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    • pp.263-267
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    • 2006
  • In both cosmetic and functional aspects, loss of digital pulp is a common problem. Compound or composite defects of the hand and fingers with exposed denuded tendon, bone, joint, or neurovascular structures may require flap coverage. Most often these lesions can be repaired by using simple local flap, neurovascular flap, thenar flap, and cross-finger flap. But microvascular reconstruction is sometimes needed for large defects. But Authors do not recommend these procedures in case of severe crushing injuries involving multiple finger pulp losses because they have possibility of damage of the vascular network and infection. So we applied distant flaps such as chest flaps, groin flaps, abdominal flaps and etc. And then we applied surgical rubber gloves for remodeling the flap after cutaneous healing. We have acquired satisfactory results, after the simple molding method for distant flap finger by using surgical rubber gloves treatment.