From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.
Objectives : This study sought to identify the Korean medicine treatment satisfaction of 3,000 patients who are 19 or older with experiences of being treated with Korean medicine at Korean medicine clinics or Korean medicine hospitals after experiencing traffic accidents. Methods : Frequency analysis was carried out to identify the effectiveness and satisfaction of Korean medicine services, and independent sample t-test was carried out to compare the satisfaction of users with different characteristics. Lastly, cross analysis(chi-square) was carried out to examine the relation between satisfaction and willingness to recommend. Results : Firstly, 91.3% of the patients were satisfied with the medical services provided at Korean medicine clinics, with the most satisfactory Korean medicine treatments in the order of acupuncture, moxibustion, cupping, Korean physical therapy, herbal acupuncture, Chuna manual therapy, herbal medicine, and others. Secondly, 71.3% of the patients answered that outpatient treatment was appropriate while 65.3% of the patients answered that hospitalized treatment was appropriate regarding duration of treatment at Korean medicine clinics, mostly being satisfied with the treatment duration at Korean medicine clinics and Korean medicine hospitals. Thirdly, in a survey on effectiveness of Korean medicine treatment compared to occidental medicine treatment, 85.9% of the patients answered: "the effectiveness of Korean medicine treatment is higher compared to occidental medicine or similar". Conclusion : From the results of this study, it was identified that satisfaction of Korean medicine treatment is high in motor insurance, and that higher satisfaction led to higher willingness to recommend Korean medicine treatment to others. Based on such results, the expansion of the role of Korean medicine could be understood.
Jang, Yoon Soo;So, Byung Hak;Jeong, Won Jung;Cha, Kyung Man;Kim, Hyung Min
Journal of Trauma and Injury
/
v.31
no.3
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pp.151-158
/
2018
Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.
Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.
Purpose: For prevention and suitable administration, the effect of age on the severity of injuries in traffic accidents should be considered when evaluating a patient, but there have not been enough epidemiological studies that evaluate the age factor in traffic accidents. For that reason, we investigated old-aged patients who were involved in traffic accidents (65 years old or more) and who were admitted to the emergency department of a college hospital in an urban city of Korea. Methods: We collected data from traffic-accident patients who came to the emergency room of a university hospital in Seoul from Jan.1, 2004 to Dec.31, 2005. We compared their abilities to ambulate and the RTSs (Revised trauma scores) by using a LSD (least significant difference), linear regression. Results: A total of 1460 patients were included. The mean RTS of all traffic-accident patients was $7.77{\pm}0.280$. The scores for drivers and passengers, motor-cycle drivers and passengers, bicycle drivers and passengers, and pedestrians were $7.79{\pm}0.21$, $7.78{\pm}0.22$, $7.54{\pm}0.25$, $7.77{\pm}0.20$, and $7.80{\pm}0.21$ respectively (p=0.000). There was no statistically significant difference between the RTS of patients over 65 years and that of other patients. In a regression analysis, the number of patients over 45 ages who were able to ambulate was lower than that of younger people, independently of other influencing factors (B=-0.330, R-square = 0.243, p=0.000). Conclusion: We expected that RTS of old age group more than 65 years old will significantly lower than that of others, but there was no statistically significant difference.
Kim, Duk-Hwan;Cho, Young-Duck;Kim, Jung-Youn;Yoon, Young-Hoon;Lee, Sung-Woo;Moon, Sung-Woo;Choi, Sung-Hyuk
Journal of Trauma and Injury
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v.25
no.4
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pp.132-138
/
2012
Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.
Objectives The purpose of this study is to compare the effects of ShinBaro pharmacopuncture and Jungsongouhyul pharmacopuncture on whiplash injury by traffic accident. Methods This study was carried out on 30 patients who received treatment in Jaseng Hospital of Korean Medicine. 30 patients were divided ShinBaro pharmacopuncture group and Jungsongouhyul pharmacopuncture group. Visual analog scale (VAS) and neck disability index (NDI) were compared after treatment. Results 1) Both the ShinBaro group and Jungsongouhyul group showed significant improvement in the visual analog scale (VAS) and neck disability index (NDI) after 3 weeks of treatment. 2) The VAS and NDI of the ShinBaro group decreased gradually with treatment. The VAS scores showed significant improvement up to week 2, but although week 3 showed further improvement compared to week 2, the difference did not reach statistical significance. The NDI scores showed significant improvement consistantly throughout the treatment period. 3) The VAS and NDI of the Jungsongouhyul group decreased with treatment also. The VAS scores significantly improved up to week 2, but though week 3 showed further improvement in comparison to week 2, the difference did not reach statistical significance. The NDI scores showed significant improvement consistantly throughout the treatment period. 4) Although the ShinBaro group showed a swifter decline than the Jungsongouhyul group in both VAS and NDI scores, the difference was not statistically significant. Conclusions We found out that ShinBaro pharmacopuncture group and Jungsongouhyul pharmacopuncture group is effective and useful in whiplash injury by traffic accident. And, further studies will be needed.
Kim, Kwang Seog;Lee, Han Gyeol;Shin, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
Archives of Craniofacial Surgery
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v.19
no.4
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pp.270-274
/
2018
Background: Nasal bone fractures occur frequently because the nasal bone is located at the forefront of the face. The goal of this study was to examine the cause, change in severity, change in incidence, and demographics of nasal bone fracture according to today's lifestyle. Methods: A total of 2,092 patients diagnosed as having nasal bone fractures at our department between 2002 and 2017 were included in this study. We retrospectively examined patients' medical records to extract information regarding age, sex, cause of injury, combined facial bone fractures, and related injuries such as skull base fracture, spinal cord injury, brain hemorrhage, and other bone fractures. Fracture severity was classified by nasal bone fracture type. Results: No statistically significant difference was found in annual number of patients treated for nasal bone fracture. The proportion of patients who underwent closed reduction was significantly decreased over time for those with nasal bone fractures caused by traffic accidents. However, it was not significantly changed for those with nasal bone fractures due to other causes. The number of patients with combined facial bone fractures increased over time. Incidences of severe nasal bone fracture also increased over time. Conclusion: The study suggested that there is a decrease in the frequency and increase in the severity of nasal bone fracture due to traffic accident. Many protective devices prevent nasal bone fractures caused by a small amount of external force; however, these devices are not effective against higher amounts of external force. This study highlights the importance of preoperative thorough evaluation to manage patients with nasal bone fractures due to traffic accident.
Purpose: This study was to examine the effect of Progressive Muscle Relaxation Therapy on stress and anxiety of traffic accident patients. Method: Subjects of this study were 39 hospitalized patients at orthopedic ward. An experimental group received Progressive Muscle Relaxation Therapy five times each week for four weeks beginning from the fourth day following the injury, whereas a control group received regular care. A tape of Jacobson's Progressive Muscle Relaxation Therapy recorded in Korean by the Rheumatoid Health Academic Society was used for relaxation therapy. Data were analyzed using SPSS 13.0 for Windows. Results: Patients who received Progressive Muscle Relaxation Therapy experienced lower level of stress (t=-9.829, p<.001) and anxiety (t=-15.303, p<.001) than those who did not. Conclusion: Progressive Muscle Relaxation Therapy may be an effective nursing intervention to reduce levels of stress and anxiety of traffic accident patients.
Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.
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