• 대한두개안면성형외과학회지
• /
• 제21권5호
• /
• pp.294-300
• /
• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Journal of Trauma and Injury
• /
• 제32권1호
• /
• pp.8-16
• /
• 2019

Purpose: The Essential Surgical Procedures in Trauma (ESPIT) course was developed as a model to teach necessary surgical procedures to trauma physicians. Its goals are to improve knowledge, self-confidence, and technical competence. Methods: The ESPIT course consisted of five lectures and a porcine lab operative experience. The ESPIT course has been run seven times between February 2014 and April 2016. ESPIT participants completed a questionnaire to assess self-efficacy regarding essential surgical procedures in trauma before and immediately after taking the ESPIT course. Sixty-three participants who completed both pre- and post-course questionnaires on self-efficacy were enrolled in this study. Results: The overall post-ESPIT mean self-efficacy score was higher than the pre-ESPIT mean self-efficacy score ($8.3{\pm}1.30$ and $4.5{\pm}2.13$, respectively) (p<0.001). Self-efficacy was significantly improved after the ESPIT course in general surgeons (p<0.001), thoracic and cardiovascular surgeons (p<0.001), emergency medicine doctors, and others (neurosurgeons, orthopedic surgeons) (p<0.001). The differences in self-efficacy score according to career stage (<1 year, 1-3 years, 3-5 years, and >5 years) were also statistically significant (p<0.001). Conclusions: The data of the ESPIT participants indicated that they felt that the ESPIT course improved their self-efficacy with regard to essential surgical procedures in trauma. The ESPIT course may be an effective strategy for teaching surgical procedures, thus promoting better management of traumatic injuries.

• Journal of Trauma and Injury
• /
• 제27권4호
• /
• pp.170-177
• /
• 2014

Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

• 대한간호학회지
• /
• 제48권5호
• /
• pp.565-577
• /
• 2018

Purpose: The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model. Methods: A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. Results: We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). Conclusions: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.

• Journal of Trauma and Injury
• /
• 제33권3호
• /
• pp.140-143
• /
• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an adjunct procedure for non-compressible torso hemorrhage in patients with hemorrhagic shock. With appropriate indications, REBOA should be performed for resuscitation regardless of the physician's specialty. Despite its effectiveness in traumatized patients with hemorrhagic shock, performing REBOA has been challenging due to physicians' lack of experience. Even though training in endovascular skills is mandatory, many physicians cannot undergo sufficient training because of the limited number of endovascular simulation programs. Herein, we share simulation video clips, including those of a vascular circuit model for simulation; sheath preparation; long guidewire and balloon catheter preparation; ultrasound-guided arterial access; sheath insertion or upsizing; and balloon positioning, inflation, and migration. The aim of this study was to provide educational video clips to improve physicians' endovascular skills for REBOA.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제42권1호
• /
• pp.20-30
• /
• 2016

Objectives: To validate a critical-size mandibular bone defect model in miniature pigs. Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

• 비교문화연구
• /
• 제41권
• /
• pp.33-56
• /
• 2015

트라우마 연구는 개인과 집단이 경험하는 대재앙과 재난적 사건을 다루는 데 유용한 모델을 제공해왔다. 대부분 캐시 캐루스를 비롯한 구조주의 트라우마 연구관점이 전형적인 모델이 되어 우리 삶의 거의 모든 맥락에 적용되어왔다. "트라우마의 사건-기반 모델"로 일컬어지는 이 연구 모델의 관점은 트라우마적 사건이 있는 그대로 각인되고 과거를 직접적이고 정확하게 기억하는 것에 대해서 연구의 초점을 맞춘다. 이 관점에서 트라우마적 사건 당사자는 그 사건의 진실을 전송하는 수동적인 담지자가 된다. 트라우마적 주체는 단지 사건을 겪고 견뎌낼 뿐 트라우마를 구성하고 그것을 다루는 데 있어 능동적인 역할을 할 수 없는 것이다. 결국 트라우마적 진실은 트라우마 주체의 자율성과 그/그녀의 행위가능성을 대가로 얻어진다. 여기서 문제는 주체의 자율성을 대가로 획득된 진실이 트라우마적 경험을 둘러싼 많은 문제를 해결하거나 외상을 치유하는 데 도움이 되기보다는 오히려 피해 당사자에게 치명적인 타격을 준다는 것이다. 이것은 트라우마적 사건 자체보다는 트라우마적 주체의 편에서, 즉 인적인 입장에서 트라우마를 다루는 보다 능동적인 방편이 필요하다는 점을 시사한다. 더구나 최근에는 재난 사건의 이미지가 시청자들에게 생중계로 보여 지고 그리고 즉각적으로 공적인 담론을 통해 반복적으로 되풀이해서 보여 진다. 그 만큼 사건들은 보다 더 즉시 트라우마적이 되기 쉽기 때문에 사람들은 예전보다 더 그들 자신을 트라우마적 피해자로 볼 가능성이 높다. 피해자의 입장에서 트라우마를 다루는 능동적인 방편을 탐구해야 하는 이유가 바로 여기에 있다. 이 논문은 문학과 이론 텍스트를 통해서 트라우마 연구의 전형적인 모델, "트라우마 사건-기반 모델"의 한계를 비판적으로 검토함으로써 트라우마적 과거가 있는 그대로 도래하는 것이 피해자에게 어떤 치명적인 영향을 주는가를 드러내 보이고 트라우마 주체의 입장에서 트라우마를 다루는 능동적인 방편으로서 "서사 기억"을 제시하고자 한다.

• Journal of Trauma and Injury
• /
• 제37권1호
• /
• pp.28-36
• /
• 2024

Purpose: Recent advancements in interventional radiology have made angioembolization an invaluable modality in trauma care. Angioembolization is typically performed by interventional radiologists. In this study, we aimed to investigate the safety and efficacy of emergency angioembolization performed by trauma surgeons. Methods: We identified trauma patients who underwent emergency angiography due to significant trauma-related hemorrhage between January 2020 and June 2023 at Jeju Regional Trauma Center. Until May 2022, two dedicated interventional radiologists performed emergency angiography at our center. However, since June 2022, a trauma surgeon with a background and experience in vascular surgery has performed emergency angiography for trauma-related bleeding. The indications for trauma surgeon-performed angiography included significant hemorrhage from liver injury, pelvic injury, splenic injury, or kidney injury. We assessed the angiography results according to the operator of the initial angiographic procedure. The term "failure of the first angioembolization" was defined as rebleeding from any cause, encompassing patients who underwent either re-embolization due to rebleeding or surgery due to rebleeding. Results: No significant differences were found between the interventional radiologists and the trauma surgeon in terms of re-embolization due to rebleeding, surgery due to rebleeding, or the overall failure rate of the first angioembolization. Mortality and morbidity rates were also similar between the two groups. In a multivariable logistic regression analysis evaluating failure after the first angioembolization, pelvic embolization emerged as the sole significant risk factor (adjusted odds ratio, 3.29; 95% confidence interval, 1.05-10.33; P=0.041). Trauma surgeon-performed angioembolization was not deemed a significant risk factor in the multivariable logistic regression model. Conclusions: Trauma surgeons, when equipped with the necessary endovascular skills and experience, can safely perform angioembolization. To further improve quality control, an enhanced training curriculum for trauma surgeons is warranted.

• 대한치과의사협회지
• /
• 제56권6호
• /
• pp.333-338
• /
• 2018

The mouth guard is a device with elasticity to be installed in the oral cavity. It has a function to reduce the trauma in the oral cavity and to protect the teeth and surrounding tissues from trauma. The purpose of mouth guard is to prevent trauma and concussion. It is mandatory to wear a mouthguard in sports where there is a lot of contact and the possibility of trauma or concussion in the mouth area is high. The mouse guard is divided into a stock type, a mouth formed type, and a custom made type according to the manufacturing method. The custom made type is made on the individual dentition model and has excellent retention because of its excellent fit. Also, the effect of trauma prevention is excellent. It is possible to design and adjust by the dentist and reduce the complaint the athlete has about the mouthguard. In this article, the process of making a dentist-customized mouthguard was described.

• 한국정보통신학회논문지
• /
• 제21권2호
• /
• pp.361-366
• /
• 2017

최근 가상현실의 기술이 발달함에 따라 게임중독, 알코올 중독 등에 대한 가상현실 치료 프로그램이 개발되고 있다. 본 연구는 다문화 청소년의 트라우마 중재를 하기 위하여 가상현실에 기반한 인지행동치료 프로그램을 구현하는 개발과정의 모형을 제시하고자 한다. 인지행동치료의 가상현실 프로그램개발은 크게 3단계로 나누어진다. 제1단계에서는 다문화청소년이 트라우마로 인하여 경험한 주요 감정과 표출된 문제를 포함한 트라우마의 특성들을 파악하고 제2단계에서는 트라우마에 대한 인지행동치료를 목표로 한 시나리오를 구성의 전개과정과 범위의 내용을 제시되어야 한다. 최종 제3단계서는 시나리오 콘텐츠의 가상현실프로그램 구현에 대한 타당성 검토를 통해 다문화청소년의 긍정적 변화를 이끌 수 있는 중재 프로그램 개발의 가능성을 제안하였다.