• 제목/요약/키워드: Prevent injury

검색결과 665건 처리시간 0.032초

신경계 중환자실에서 기계호흡 그래프 파형 감시와 분석 (Monitoring and Interpretation of Mechanical Ventilator Waveform in the Neuro-Intensive Care Unit)

  • 박진
    • 대한신경집중치료학회지
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    • 제11권2호
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    • pp.63-70
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    • 2018
  • Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

Surgically Removed Intrapulmonary Shotgun Pellet without Traumatic Hemopneumothorax

  • Yoon, Soo Young;Sul, Young Hoon
    • Journal of Trauma and Injury
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    • 제34권1호
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    • pp.66-69
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    • 2021
  • When treating firearms injuries, knowledge of the proper management is important because these injuries have high morbidity and mortality. However, due to strict gun safety regulations, surgeons in Asia often have limited experiences with gunshot wound management. Recently, the authors had the experience of removing a bullet that did not cause hemopneumothorax, but remained in the lung parenchyma. Due to the risk of complications that could occur if the bullet was not removed, surgical treatment was eventually performed to remove the bullet. A literature review was needed to determine whether this treatment was appropriate. We concluded that removing the bullet could prevent incidental complications. In this regard, the authors report a case along with a review of the relevant literature to suggest appropriate treatment directions for surgeons who do not have experience with gunshot wounds.

우측 전완부와 수부에 화상과 압궤손상을 입은 환자에서 즉시 근막절제술: 증례보고 (Immediate Fasciotomy for Acute Thermal Contact Burn Combined with Compression Injury of the Right Forearm and Hand: A Case Report)

  • 정승원;이승제;유경탁
    • 대한화상학회지
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    • 제23권1호
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    • pp.13-19
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    • 2020
  • Treatment of compartment syndrome is early decompressive fasciotomy to prevent dreadful sequelae of ischemic necrosis of muscles and nerves. We experienced one patient of impending or early compartment syndrome of right forearm and hand caused by a hot compress machine. We did immediate fasciotomy on forearm and late flap coverage with skin graft in this patient with good results.

상해방지를 위한 어깨정렬 보조장비 개발 (Development of Shoulder Alignment Assistance Equipment for Injury Prevention)

  • 장지영;민성민;안하나;김성겸
    • 한국컴퓨터정보학회:학술대회논문집
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    • 한국컴퓨터정보학회 2021년도 제64차 하계학술대회논문집 29권2호
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    • pp.301-302
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    • 2021
  • 현재 어깨상해는 많은 운동 참여자에게 빈번히 발생하는 질환이다. 운동 동작 시 올바르지 못한 어깨정렬로 인해 어깨의 안정성이 저해되고 그로인해 다양한 상해들이 유발되어진다. 운동 동작 시 팔꿈치와 손목간의 올바른 정렬은 어깨 안정성에 중요한 요소이다. 따라서 본 논문에서는 팔꿈치보호대와 손목밴드에 센서를 부착하여 웨어러블 장비와 함께 융복합 IT기술을 기반으로 하여 팔꿈치와 손목간의 정상범위를 직관적으로 제시하여 동적 운동 상황에서의 상해를 예방하고자 한다.

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자전거 피팅시스템 개발을 위한 부상예방 자전거 피팅에 관한 고찰 (A Study on the Injury Prevention Bicycle Fitting for the Development of Bicycle Fitting System)

  • 손경환
    • 한국컴퓨터정보학회:학술대회논문집
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    • 한국컴퓨터정보학회 2020년도 제61차 동계학술대회논문집 28권1호
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    • pp.69-70
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    • 2020
  • 본 논문에서는 자전거 피팅을 좀 더 정교하고 신속하게 진행하기 위해 자전거 피팅 소프트웨어와 하드웨어를 통합한 시스템을 개발하기 위한 DB구축을 목표로 포괄적인 자전거 피팅 방법의 표준화가 요구됨에 따라 다수의 임상결과와 실험을 통해 이에 맞는 자전거 피팅 방법을 제안한다. 이 자전거 피팅 방법은 심층상담, 자전거체크, 정교한 신체사이징 및 분석을 통해 라이더를 위한 자전거 세팅 값을 결정할 수 있으며 이 세팅 값으로 조정된 자전거에서 고정 라이딩을 통해 자세와 페달링 토크를 분석하고 이을 통해 가장 효율이 높은 세팅 값을 찾아 자전거를 라이더의 요구에 맞게 최적화 할 수 있는 피팅 방법에 대한 결과를 도출 했다. 이와 같은 피팅 방법은 자전거 라이더의 만족도를 높일 수 있으며 정확한 자전거 세팅 값을 통해 부상예방도 기대할 수 있다. 본 논문은 자전거피팅 방법에 대해 국내·외를 통틀어 가장 구체적으로 제시된 결과로 본 논문이 최종 추구하는 자전거피팅 시스템이 구현된다면 글로벌 시장에서도 인정받을 수 있는 자전거 피팅 기술로 자리 잡을 수 있다.

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백서의 국소 뇌허혈/재관류로 인한 신경손상에서 상경부 교감 신경절 블록의 급성기 및 장기 보호효과 (The Effects of Superior Cervical Sympathetic Ganglion Block on the Acute Phase Injury and Long Term Protection against Focal Cerebral Ischemia/Reperfusion Injury in Rats)

  • 전혜영;정경운;최재문;김유경;신진우;임정길;한성민
    • The Korean Journal of Pain
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    • 제21권2호
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    • pp.119-125
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    • 2008
  • Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

한국의 업무상 사망률과 사회경제적 지표와의 관련성 (The relationship between fatal occupational injury rate and socio-economic indicators in Korea)

  • 이원철;김수근;안홍엽;이관형;이은희
    • 한국산업보건학회지
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    • 제20권3호
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    • pp.168-174
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    • 2010
  • South Korea's industrial injuries are decreasing overall in the last 32 years. Nevertheless, the fatal occupational injury rate is still higher than in developed countries. This study was conducted to help prevention strategies of occupational injuries for the Republic of Korea. Fatal occupational injury rates were obtained from "Industrial Accident Analysis"of the Korean Ministry of Labor. Poisson regression was used to assess time trends. Socioeconomic indicators were obtained from the Korea Labor Institute and the Statistics Korea. Fatal occupational injury rates were adjusted by year, and Pearson correlation analysis was used to assess the relationship between the socio-economic indicators and occupational injuries. In 1975, fatal occupational injury rate was 54.8 per 100,000 workers. With somewhat up and down, it was decreased to 21.0 in 2006. An annual rate of change for the years 1975-2006 was - 1.83%, and for the years 2002-2006 was -5.02%. As economic growth rate, paricipation rate for the age less than 25 and hours of work per week or year increased, fatal occupational injury rate also increased. Conversely, as GDP per capita, paricipation rate or employment rate for female, paricipation rate for the age 25 or more, hourly compensation costs for production workers and services output as percent of GDP increased, fatal occupational injury rate decreased. By the development of safety techniques and the adoption of more legislative constraints, developed economy reduce occupational injuries. Conversely, economic growth may raise occupational injuries. Therefore, prevention strategies are needed to manage both of them. We need to make an effort to prevent occupational injuries due to not only sexual differences, but also job differences between male and female. Preventive strategies are needed to consider the characteristics of younger workers. Addition to wage, other appropriate variables for work condition should be considered together. Extending work hours is need to be regulated with systemic methods.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

탈북여성들이 경험하는 도덕적 손상에 관한 탐색적 연구: 탈북여성을 대상으로 한 질적 선행연구물 내용분석 (Exploratory study on the Moral Injury among Female North Korean Refugees: Qualitative Content Analysis of Qualitative Studies on Female North Korean Refugees)

  • 심우찬;이순민
    • 한국콘텐츠학회논문지
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    • 제18권4호
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    • pp.636-652
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    • 2018
  • 본 연구는 심리적 트라우마를 경험한 후 일상에 적응하지 못하는 현상에 대한 비정신병리적 접근으로의 도덕적 손상이라는 개념을 탈북여성의 경험을 재해석하고 이해하는데 적용시키고자 실시되었다. 이를 위해 데이터베이스 KISS와 DBpia를 이용하여 2017년 8월 13일까지 국내 학술지에 출판된 질적 연구물 중 '탈북여성' '새터민 여성' '북한이탈 여성'이라는 주제어를 포함하는 연구물을 검색 했다. 최종 선정된 총 51개의 질적 연구물의 내용분석을 실시한 결과는 다음과 같다. 첫째, 연구주제로는 적응경험, 어머니로서의 경험, 북한 체제와 전쟁에 대한 경험, 일/직업/고용 경험, 정신적인 충격에 대한 극복 및 성장과 회복탄력성의 경험, 중국에서의 삶에 관한 경험, 트라우마나 심리적인 경험, 심리적 불안함을 치료하는 과정과 효과에 대한 순으로 많이 나타났다. 둘째, 도덕적 손상으로 인해 나타날 수 있는 부정적 감정에 관한 단어는 총 260회, 존재론적 믿음에 미치는 영향과 관련된 단어는 총 82회, 인지의 변화와 관련 단어들이 총 71회, 그리고 행동의 변화와 관련 표현이 총 21회 나타났다. 셋째, 도덕적 손상의 현상을 일으키는 맥락으로 크게 '정체성 부정'과 '가족 해체'가 드러났다. 그리고 도덕적 손상을 일으킬 만한 맥락을 경험했음에도 불구하고 도덕적 손상의 흔적이 발견되지 않았던 정 반대되는 사례들 속에서 '정체성 재구성'이라는 맥락을 공통적으로 발견했다. 이러한 연구결과를 통해 탈북여성이 도덕적 손상으로부터 예방 되는, 혹은 도덕적 손상으로부터의 회복에 필요한 실천적 함의를 제언하였다.

Gypenoside XVII protects against myocardial ischemia and reperfusion injury by inhibiting ER stress-induced mitochondrial injury

  • Yu, Yingli;Wang, Min;Chen, Rongchang;Sun, Xiao;Sun, Guibo;Sun, Xiaobo
    • Journal of Ginseng Research
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    • 제45권6호
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    • pp.642-653
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    • 2021
  • Background: Effective strategies are dramatically needed to prevent and improve the recovery from myocardial ischemia and reperfusion (I/R) injury. Direct interactions between the mitochondria and endoplasmic reticulum (ER) during heart diseases have been recently investigated. This study was designed to explore the cardioprotective effects of gypenoside XVII (GP-17) against I/R injury. The roles of ER stress, mitochondrial injury, and their crosstalk within I/R injury and in GP-17einduced cardioprotection are also explored. Methods: Cardiac contractility function was recorded in Langendorff-perfused rat hearts. The effects of GP-17 on mitochondrial function including mitochondrial permeability transition pore opening, reactive oxygen species production, and respiratory function were determined using fluorescence detection kits on mitochondria isolated from the rat hearts. H9c2 cardiomyocytes were used to explore the effects of GP-17 on hypoxia/reoxygenation. Results: We found that GP-17 inhibits myocardial apoptosis, reduces cardiac dysfunction, and improves contractile recovery in rat hearts. Our results also demonstrate that apoptosis induced by I/R is predominantly mediated by ER stress and associated with mitochondrial injury. Moreover, the cardioprotective effects of GP-17 are controlled by the PI3K/AKT and P38 signaling pathways. Conclusion: GP-17 inhibits I/R-induced mitochondrial injury by delaying the onset of ER stress through the PI3K/AKT and P38 signaling pathways.