• Title/Summary/Keyword: Multiple injuries

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Revascularization of Popliteal Artery Injury in Trauma Around Knee Joint (슬관절주위 외상에 의한 슬와동맥 손상의 재혈관화)

  • Han, Soo-Hong;Shin, Dong-Eun;Dan, Jin-Myung;Kim, Chul
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.7-13
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    • 2008
  • Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

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Psychological Distress and Occupational Injury: Findings from the National Health Interview Survey 2000-2003

  • Kim, Jae-Young
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.200-207
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    • 2008
  • Objectives : This study examined whether serious psychological distress (SPD) is associated with occupational injury among US employees. Methods : The employed population aged 18-64 years was examined (n=101,855) using data from the National Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler 6-item Psychological Distress Scale (K-6), a screening scale designed to identify persons with serious mental illness. The predicted marginal prevalence of psychological distress and occupational injury with the adjusted odds ratio were estimated using multiple logistic regression analyses. Results : The age-adjusted 3-month prevalence of occupational injury was $0.80{\pm}0.12%$ in workers with SPD, which was 37% greater than in workers without SPD ($0.58{\pm}0.03%$). The odds of occupational injury in workers with SPD were higher compared to workers without SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education, occupation, and activity limitation by at least one medical condition. Male, service and blue collar occupation, and activity limiation by co-morbidity showed significantly higher odds of occupational injury for workers with SPD. Conclusions : The findings suggest that SPD accounts for an increased likelihood of occupational injury among US employees. A further longitudinal study is needed to differentiate the mechanism or causal pathways linking individual injury risk at the workplace, SPD, and socioeconomic factors.

The review of factors of pressure sores associated with a wheelchair seating (휠체어 착석과 욕창 발생 관련 요인의 고찰)

  • Jeong Dong-Hoon;Kong Jin-Yong;Kwon Hyuk-Cheol
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.229-238
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    • 2000
  • A properly prescribed wheelchair may be able to normalize tone. decrease pathologic reflex activity, improve postural symmetry, enhance range of movement, maintain and/or improve skin conduit)n. increase comfort and sitting tolerance, decrease fatigue, and improve function of the autonomic nervous system. Whereas a poorly prescribed one can actually exacerbate the problems associated with a disability. Maintained for longer without relief, pressure concentrations may also lead to tissue breakdown. Pressure sores continue to be a major problem for many disabled individuals. Many groups of disabled individuals have a very high incidence of pressure sores, including those individuals with spinal cord injuries. hemiplegia, multiple sclerosis. cancer. and the disabled geriatric population. It is important to understand the factors which predispose an individuals to the development of a pressure sores. Those factors can divided into extrinsic factors, related to the individual's immediate environment and intrinsic factors. related to their medical or physical condition. Pressure sores are generally preventable through sensible pressure management based on an understanding of the causes of pressure sores, risk factors and methods of redistributing pressure.

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Satisfaction regarding the usage of emergency treatment service (사고환자의 응급의료 서비스에 대한 만족도와 영향요인 분석)

  • Park Ho-Ran;Moon Jung-Soon;Youn Sung-Ja
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.293-303
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    • 2000
  • This study was designed to acknowledge the satisfaction levels of patients who have been treated in the emergency center. Specifically, to acknowledge the factors influencing patient's satisfaction levels related in the usage of emergency centers. Data was collected through patients who have used anyone of four emergency centers of university hospitals holding over 550 hospital beds, and located in Seoul. Questionnaires consisted of 31 questions. Cronbach's alpha was 0.94. Data analysis was executed with the SAS program by t-test, ANOVA and stepwise multiple regression. The results were summarized as follows. (1) The total average score for the level of satisfaction was 3.3. Regarding the service of doctors and nurses, the score was high. While the score regarding reception process, payment and second hand environment were relatively low. (2) There was a differentiation in the level of satisfaction according to the type of injured. Patents of industrial calamities had the highest level of satisfaction while patient injured by traffic accidents had the lowest level of satisfaction. (3) The factors that affect the level of satisfaction were presence of medical insurance, lapse time until treatment and the education level of the patient. Based on this, we will provide the basic data of satisfaction levels according to the characteristics of patients and the types of injuries for improvement of emergency treatment centers.

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Growth Responses of Petunia as Affected by Several Pollutants in Vitro (Petunia 조직배양시 몇가지 공해물질이 생장반응에 미치는 영향)

  • 백기엽;최성렬;이재욱;최주견
    • Journal of Plant Biology
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    • v.27 no.3
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    • pp.139-147
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    • 1984
  • This in vitro study was employed to clarify the effects of several pollutants i.e. $SO_2$, fluoride, cadmium(Cd), aluminum(Al) and NaCl, on the organogenesis and growth responses of shoot-tip, stem and multiple-buds segments derived from hypocotyl or cotyledon culture of petunia seedlings. ${Na_2}{SO_3}$levels of more than 200$\mu{g}$/ml had significantly reduced organogenesis, growth, and chlorophyll content. The injuries caused by ${Na_2}{SO_3}$, concentration of more than 400$\mu{g}$/ml were alleviated by increasing hydrogenion concentration of medium, indicating some relationship between two factors. Organogenesis was not affected by the fluoride concentration up to 100ppm in the media, but the growth and chlorophyll content were greatly reduced by the fluoride. The effect of Cd depended on the explant sources used for the culture; 1.0ppm was effective for fresh weight increase in shoot tip culture, and 3.0ppm in stem segments culture. Organogenesis and growth were greatly reduced by more than 10.0 Cd treatment. Growth and formation of shoots were better with Na conc. of 0.3% compared to control, but those of roots were inhibited. Na concentration goes over 1.0%, organogenesis and subsequent growth were inhibited, and chlorophyll synthesis was drastically reduced. Chlorophyll content was increased on the medium supplemented with Al 50$\mu{g}$/ml compared to control. However the formation and growth of shoots were greatly inhibited with more than 400$\mu{g}$/ml and roots were not produced at all.

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A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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Adult Tracheoesophageal Fistula Incidentally Found on General Endotracheal Anesthesia - A Case Report - (전신마취 중 우연히 발견된 성인에서의 고립성 기관식도루 - 1례 보고 -)

  • 백완기;김현태;심상석;조상록
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.413-417
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    • 1998
  • We describe a case of adult tracheoesophageal fisula incidentally found during laparotomy. A 41 year old male came to the emergency room due to multiple injuries from a car accident. An emergent laparotomy was given to the patient to rule out hemoperitoneum, and progressive distension of the stomach was noted with each positive pressure ventilation. The diagnosis of tracheoesophageal fistula was made via an intraoperative esophagogram. Detailed inquiry of the patient's history from his mother together with extensive destructive changes over the right upper lung field on the patient's chest X ray suggested that the fistula was longstanding and not of traumatic origin, obviating the need of urgent operation. The fistula was divided via the right thoracotomy 24 days later. Postoperative course was uneventful.

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Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car - Report of 2 cases - (자동차의 사이드미러가 흉강에 박힌 채로 내원한 흉부관통상 - 2례 보고 -)

  • Kim, Soo Sung
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.47-51
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    • 2007
  • Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

Re-establishment of occlusion after unilateral condylar fracture (편측성 하악 과두 골절 후의 교합 관계 회복)

  • Kim, Yoo-Kyung;Park, Sung-Ho;Roh, Byoung-Duck
    • Restorative Dentistry and Endodontics
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    • v.37 no.2
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    • pp.110-113
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    • 2012
  • Complications resulting from condylar fracture include occlusal disturbance due to loss of leverage from temporomandibular joint (TMJ). In general, closed reduction with active physical training has been performed, and under favorable circumstances, adaptation occurs in attempt to restore the articulation. The patient in this case report had unilateral condylar fracture accompanied with multiple teeth injuries, but he was left without any dental treatment for 1 mon which led to unrestorable occlusal collapse. Fortunately, delayed surgical repositioning of dislocated maxillary anterior teeth followed by consistent long-term physical training has been proved successful. Normal occlusion and satisfactory remodeling of condyle were obtained on 10 mon follow-up.

Factors Influencing Posttraumatic Stress Disorder Symptoms in Burn Injured Patients : Embitterment, Depression and Meaning in Life (화상환자의 외상후 스트레스 장애 증상에 대한 영향 요인 : 울분, 우울, 삶의 의미)

  • Hwang, Jihyun;Lee, Boung Chul;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.15 no.1
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    • pp.29-34
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    • 2019
  • Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.