• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.75-78
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• 2015

High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

• Korean Journal of Applied Biomechanics
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• v.15 no.3
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• pp.1-7
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• 2005

Excessive pronation and impact force during running are related to various running injuries. To prevent these injuries, three type of running shoes are used, such as cushioning, stability, and motion control. Although there were may studies about the effect of midsole hardness on impact force, no study to investigate biomechanical effect of motion control running shoes. The purpose of this study was to determine biomechanical difference between cushioning and motion control shoes during treadmill running. Specifically, plantar and rearfoot motion, impact force and loading rate, and insole pressure distribution were quantified and compared. Twenty male healthy runners experienced at treadmill running participated in this study. When they ran on treadmill at 3.83 m/s. Kinematic data were collected using a Motion Analysis eight video camera system at 240 Hz. Impact force and pressure distribution data under the heel of right foot were collected with a Pedar pressure insole system with 26 sensors at 360 Hz. Mean value of ten consecutive steps was calculated for kinematics and kinetics. A dependent paired t-test was used to compare the running shoes effect (p=0.05). For most kinematics, motion control running shoes reduced the range of rearfoot motion compared to cushioning shoes. Runners wearing motion control shoe showed less eversion angle during standing less inversion angle at heel strike, and slower eversion velocity. For kinetics, cushioning shoes has the effect to reduce impact on foot obviously. Runners wearing cushioning shoes showed less impact force and loading rate, and less peak insole pressure. For both shoes, there was greater load on the medial part of heel compared to lateral part. For pressure distribution, runners with cushioning shoes showed lower, especially on the medial heel.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.104-110
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• 2013

Purpose: Bedside ultrasonography is available in most emergency departments, and detecting the intracranial pressure is elevated is critical. Our objective is to evaluate the availability of bedside optic nerve ultrasound (ONUS) as a secondary survey for patients with head injuries in the emergency department (ED). Methods: From September, 2012, to March, 2013, we performed a prospective study of patients presenting to the ED after an accident. Patients with head injuries but without obvious ocular trauma or ocular disease were included. The ONUS was performed using a 3 to 12 MHz linear probe on closed eyelids after a primary survey. We analyzed the correlation between the brain computed tomography (CT) findings that suggested elevated intracranial pressure (ICP) and the Optic nerve sheath diameter (ONSD) measured by using ONUS. Results: A total of 81 patients were enrolled. Forty-seven had CT results consistent with elevated ICP, and their mean ONSD was $5.98{\pm}0.59$ mm; the mean ONSD of patients who showed no signs of elevated ICP on CT was $4.63{\pm}0.21$ mm. The sensitivity and the specificity for the ONSD, compared with elevated ICP, were 98.87% and 100%, respectively, when the cut-off value was set to 4.96 mm. The area under curve (AUC) was 0.997 in the receiver operating characteristic curve (ROC curve). Conclusion: An evaluation using ONUS is a simple noninvasive procedure and is a potentially useful tool as a secondary survey to identify an elevated ICP.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.698-704
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• 1989

We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

• IEMEK Journal of Embedded Systems and Applications
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• v.17 no.1
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• pp.1-7
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• 2022

The number of patients with many complications grows with the increase of aging population. As the elders and severely ill patients spend most of their time in bed, it leads to Pressure Injuries (PI) such as bedsores. Unfortunately, there is no method to automatically detect changes in patient's posture which leads to the need for a caregiver every set of times when the patient needs to be moved. Many studies are conducted to solve this inefficient problem. Yet, these studies require costly devices or use methods that disturb patient's sleeping environment. Those methods are mostly hard to implement in practice due to these reasons. We propose a method to detect posture using a three-axis acceleration sensor from the wrist band. We developed a wearable watch that measures sleep-related data. We analyzed 40 people's sleep data with a wearable module and watch to measure their postures such as supine, left-side, and right-side. Then, we compared the classified posture from the watch with the wearable module and achieved 90% accuracy. Therefore, we concluded that only by using the wearable watch, we can detect the sleeping position without any new equipment or system to diagnose the patients without discomfort during their daily lives.

• 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.

• Journal of Korean Foot and Ankle Society
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• v.25 no.1
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• pp.46-49
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• 2021

Acute compartment syndrome occurs when pressure increases within closed compartments due to injuries causing soft tissue damage. Delayed treatment can lead to undesirable consequences. This paper reports a three-year-old patient in whom a fasciotomy was performed successfully despite the potential side effects. Fasciotomy may be considered when the diagnosis and clinical symptoms of delayed compartment syndrome are clear. This study determined that the three-year-old patient would undergo a relatively smooth recovery compared to elderly patients of advanced age. Because the dorsalis pedis artery pulse was palpable, an emergency surgical treatment was performed to restore the damaged tissues and prevent further necrosis. The patient has shown a satisfactory recovery.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.12-23
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• 2023

Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

• Journal of Korean Neurosurgical Society
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• v.55 no.1
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• pp.26-31
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• 2014

Objective : Early decompressive craniectomy (DC) has been used as the first stage treatment to prevent secondary injuries in cases of severe traumatic brain injury (TBI). Postoperative management is the major factor that influences outcome. The aim of this study is to investigate the effect of postoperative management, using intracranial pressure (ICP) monitoring and including consecutive DC on the other side, on the two-week mortality in severe TBI patients treated with early DC. Methods : Seventy-eight patients with severe TBI [Glasgow Coma Scale (GCS) score <9] underwent early DC were retrospectively investigated. Among 78 patients with early DC, 53 patients were managed by conventional medical treatments and the other, 25 patients were treated under the guidance of ICP monitoring, placed during early DC. In the ICP monitoring group, consecutive DC on the other side were performed on 11 patients due to a high ICP of greater than 30 mm Hg and failure to respond to any other medical treatments. Results : The two-week mortality rate was significantly different between two groups [50.9% (27 patients) and 24% (6 patients), respectively, p=0.025]. After adjusting for confounding factors, including sex, low GCS score, and pupillary abnormalities, ICP monitoring was associated with a 78% lower likelihood of 2-week mortality (p=0.021). Conclusion : ICP monitoring in conjunction with postoperative treatment, after early DC, is associated with a significantly reduced risk of death.

• Journal of the Korea Society for Simulation
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• v.26 no.3
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• pp.1-11
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• 2017

Blast injuries in a compartment are investigated, and the effects of obstacles on blast injury are particularly analyzed by comparing injuries in the compartments with or without protruding obstacles inside. Even if blast pressure profile tends to be complicated in a confined space unlike in open field, it can be obtained in a relatively short time by using some empirical fast running models for simple confined spaces. However, a finite element method should be employed to obtain blast pressure profiles in a case with obstacles in confined spaces, because the obstacles heavily disturb blast waves. On the other hand, Axelsson SDOF(Single degree of freedom) model and ASII(Adjusted severity of injury index) injury level are employed to estimate blast injury in compartments, because the usual pressure-impulse injury criterion based on the ideal Friedlander waves in open the field cannot be applied to personnel in a confined space due to complexity of blast waves inside. In cases with obstacles, chest wall velocity was reduced by 26 to 76 percent(%) and the personnel injury in the compartment caused by blast was also reduced.