• 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.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.377-383
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• 2012

Objective : Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. Methods : Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. Results : Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. Conclusion : NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.68-74
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• 2011

Purpose: Although pancreas injury is rare in abdominal trauma, it poses a challenge to the surgeon because its clinical features are not prominent and the presence of main duct injury cannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosed as having pancreas injury by using an explo-laparotomy. Patients successfully treated by non-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases).Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due to massive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively, three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverse outcomes.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.582-591
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• 2018

Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.

• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.40-48
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• 1999

The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.

• Journal of Korean Biological Nursing Science
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• v.22 no.1
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• pp.45-52
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• 2020

Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍²-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.177-189
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• 2010

Traumatic injury is one of the leading causes of morbidity and mortality in children. This is a clinical review of pediatric blunt abdominal trauma. A retrospective analysis of the 112 children with blunt abdominal trauma aged 15 years or less treated at the Department of Pediatric Surgery, Chonbuk National University Hospital was performed. The analysis included age, sex, injury mechanism, number and site of the injured organ, management and outcomes. The average age of occurrence was 7.6 years, and the peak age was between 6 and 8 years. There was a male preponderance with a male to female ratio of 2.3:1. The most common cause of blunt abdominal trauma was traffic accidents (61.6 %), principally involving pedestrians (79.7 %). The accident prone times were between 8:00 AM and 8:00 PM, the weekends (40.2 %), and the winter respectively. Thirthy-five patients (31.2 %) had multiple intra-abdominal organ injuries and the most common injured organ was the liver. Seventy-four cases (66.1 %) were managed non-operatively and eleven cases (9.8 %) expired. Of the patients who were treated surgically or were to be operated on one patient died before surgery, the remainder died during or after surgery. Risk factors such as number of injured organ, systolic and diastolic blood pressure, and trauma scores by Glasgow coma scale (GCS), Pediatric trauma score (PTS), revised trauma score (RTS), injury severe score (ISS), TRISS were significantly correlated with mortality rate.

• Physical Therapy Korea
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• v.30 no.1
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• pp.15-22
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• 2023

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.190-198
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• 2022

Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

• The korean journal of orthodontics
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• v.21 no.2 s.34
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• pp.259-272
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• 1991

Orthodontic traction has been suggested as the treatment of choice for intrusive luxation injuries. Prior research has shown orthodontic forces to be ineffective in the presence of ankylosis or in cases with zero mobility following the injury. If orthodontic traction is to be effective, it must be initiated prior to the onset of ankylosis. The purpose of this study was to describe the effects of intrusive luxation at various times following the injury, and to determine the time of the onset of ankylosis, and to examine what effect immediate partial luxation has on the onset of ankylosis. Eight young mongrel dogs were utilized for this study. Intrusive luxation was produced with an axial impact using a gravity hammer and a specially designed holding device on 4 teeth (2 max. and 2 man. first premolars) in each dog. The teeth were intruded approximately 3-4mm in an axial direction. One maxillary and one mandibular premolars were partially luxated with the other two teeth being untouched. Pre and posttrauma tooth position was documented with plaster models and radiographs taken with an individualized X-ray jig. Dogs were sacrificed immediately following the injury and at 1, 2, 4, 7, 10, 14 and 21 days respectively. Tetracycline was administered as a vital bone marker 24 hours before sacrifice. Block sections of the tooth and alveolus were prepared for decalcified and non decalcified histologic sections. The effects of traumatic intrusion were analyzed by means of model casts, radiographs, tetracycline bone marking and histologic preparations. The results obtained were as follows: 1. The animal sacrificed immediately following the injury displayed alveolar fractures, torn periodontal ligaments, and areas of direct tooth-bone contact. 2. The odontoblastic layer of the pulp was disorganized as early as 24 hours after the injury. 3. Bony remodeling was noted at 4 days along with active surface resorption. 4. Ankylosis was first seen 7 days after the injury. 5. Osteogenesis in the dentin (thick tetracycline bands) was observed 7 days after the injury. 6. There was no progressive root resorption and ankylosis where the periodontal ligament has been healed. 7. The Luxated group showed significantly more root resolution and ankylosis than the Nonluxated group with increased observation periods. The results suggest that ankylosis may occur within the first week following the injury, and hence orthodontic traction should be initiated as soon after the injury as possible.