• Journal of Trauma and Injury
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• v.19 no.2
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• pp.201-205
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• 2006

Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.1-7
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• 2006

Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.175-182
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• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.103-106
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• 2018

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.119-126
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• 2007

Trauma is one of the leading causes of death in children. Abdominal trauma is about 10 % of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.

• Journal of Korean Society of Transportation
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• v.35 no.6
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• pp.499-510
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• 2017

Traffic accident fatalities in Korea in 2016 was 4,292 and 1,732 cases were deaths of elderly people. In spite of this, the researches on behaviors of the elderly when crossing roads, are rather limited. The purpose of this study is to investigate and analyze road crossing behavior characteristics of the elderly, when crossing roads, especially focusing on the characteristics of pedestrians and vehicles. Cross-sectional data was collected from six different sites in two regions and the following results was identified. First, at road crossings, 528 cases(84.3%) out of 626 conflict situations of the elderly and 303 cases(63.3%) out of 478 conflict situations of the non-elderly pedestrians were found to be dangerous, respectively. The elderly tend to face a statistically significant risk of 3.11 times higher than that of non-elderly people. Second, 519 cases(82.9%) of jaywalking occurred in 626 conflict cases of the elderly and 375 cases(78.5%) of jaywalking in 478 conflict events of non-elderly persons, which indicates the elderly's 1.34 times higher trend compared with the non-elderly's. Third, the pedestrian safety margin (PSM) analysis showed that the PSM of the elderly and the non-elderly were 3.33 seconds and 4.04 seconds respectively, which is 17.5% high. Fourth, the difference in pedestrian safety interval was examined by dividing the speed of approaching vehicle into less than 30km/h, above 30km/h and less than 50km/h, and over 50km/h. There was no significant difference between the PSM of coming vehicles with the speed less than 30km/h and the PSM of approaching with the speed 30km/h~50km/h, but the conflicts with vehicle of the speed above 50km/h show significantly lower PSM than with vehicle speed of 30km/h~50km/h. Finally, when the risk threshold is set to less than 2.5 seconds, the analysis shows that older pedestrians tend to cross roads dangerously 1.59~2.53 times than younger pedestrians. The results set forth here can be used as a basis for constructing the elderly safety measures at present and a potential basis for autonomous vehicle safety application in the future for solving the issue of the difference in crossing behavior between elderly and non-elderly pedestrians.

• 재활복지
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• v.22 no.3
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• pp.225-257
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• 2018

The purpose of this study is to find the application point of hearing augmentation technology development through examining the risk context experience of people with hearing impairment and the use of assistive device used as an alternative technology. Data of 355 people with hearing impairment with official disability grading was analyzed. The results of this study are first, research participants had no experience of recognizing any sound or vibration in situations highest in the order of means of transportation, material, and nature. Especially the ratio of being unable to recognize the sound and vibration of means of transportation was high, which implies the high possibility of people with hearing impairment experiencing risk. Secondly, the risk context that people with hearing impairment will most likely to experience are highest in the order of traffic accident, pedestrian accident, and daily life at home. Thirdly, the recognition of 2G phone/smart phone, vibrating digital alarm clock, light bar, vibrating wrist watch as assistive device for risk context awareness and notification was high and the satisfaction level of 2G phone/smart phone was the highest. Fourthly, the research participants had high recognition of assistive device for communication in the order of hearing aid, smart phone, videophone, cochlear implant and 2G phone and it was found that the satisfaction level and communication improvement level was the highest using the smart phone. Lastly, for the development of hearing augmentation technology the research participants recognized the importance of portable/wear convenience, price, and motion accuracy and for notification delivery means they preferred the method of using sight(text and light). Based on the results of this study policy and practical plans for hearing augmentation technology development for people with hearing impairment in risk context are proposed.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.40 no.1
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• pp.1-11
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• 2020

Medium to large post structures installed along the roadside without proper protection can lead to serious vehicle damage and occupant injury at the impact. In North America and Europe, splitting systems such as slip base or breakaway device are used to reduce impacts. But the system has the risk of secondary accident when the splitted post falls down to the traffic or pedestrian. Sliding Post have been proposed as a way to solve this problem. By studying the crash test results of the 1.3ton and 0.9ton vehicle with 60 km/h and 80 km/h to a Rigidly Fixed Post (RFP) and Sliding Post (SP), danger of the conventional RFP and crashworthiness of the SP have been proven. While collision analysis only from the acceleration measured at the center of the vehicle assumes the motion of the post is the same as that of the vehicle, in this paper, by adding high speed film data to the analysis with vehicle acceleration could have separate the post motion from the vehicle motion. It gives better explanations on the movement of post and vehicle in each distinctive time step and provides basics to the crashworthy post design.