• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.39-42
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• 2023

A ruptured Achilles tendon at the calcaneus attachment, which does not include a bone that can be fixed, is called 'sleeve avulsion'. A small amount of tendon in the calcaneal region can be sutured to the proximal portion of the ruptured Achilles tendon or insufficient bone to be fixed. Hence, tendon-bone healing is expected, but the results are not good compared to other parts of the tear. The incidence of Achilles tendon rupture is 7 to 40 per 100,000 patients, and 25% of patients undergo direct suture or reconstruction surgery, and 7.6% of patients with sleeve avulsion injuries undergo surgery. Surgical treatment may be a better choice for Achilles tendon sleeve avulsion because no successful case of conservative treatment has been reported. Distal wounds above the ruptured tendon adjacent to the bony eminence can have wound healing problems because of the thin, soft tissue and hypovascularity. An appropriate surgical method must be selected for each patient.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

• Journal of Trauma and Injury
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• v.29 no.1
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• pp.1-7
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• 2016

Purpose: Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma. Methods: From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups. Results: In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was $6.89{\pm}1.59$ (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was $24.36{\pm}7.16$ (range: 11-34) in the blunt group; the mean RTS was $7.56{\pm}0.41$ (range: 7.11-7.84), and the mean ISS was $13{\pm}5.26$ (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups. Conclusion: Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.20-27
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• 2024

Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

• Proceedings of the Korean Vacuum Society Conference
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• 2010.02a
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• pp.44-45
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• 2010

We are currently conducting studies on culturing and biocompatibility assessment of various cells such as neural stem cells and induced pluripotent stem cells(IPS cells) on carbon nanotube (CNT), on nerve regeneration electrodes, and on silicon wafers with a focus on developing nerve integrated CNT based bio devices for interfacing with living organisms, in order to develop brain-machine interfaces (BMI). In addition, we are carried out the chemical modification of carbon nanotube (mainly SWCNTs)-based bio-nanosensors by the plasma ion irradiation (plasma activation) method, and provide a characteristic evaluation of a bio-nanosensor using bovine serum albumin (BSA)/anti-BSA binding and oligonucleotide hybridization. On the other hand, the researches in the case of "novel plasma" have been widely conducted in the fields of chemistry, solid physics, and nanomaterial science. From the above-mentioned background, we are conducting basic experiments on direct irradiation of body tissues and cells using a micro-spot atmospheric pressure plasma source. The device is a coaxial structure having a tungsten wire installed inside a glass capillary, and a grounded ring electrode wrapped on the outside. The conditions of plasma generation are as follows: applied voltage: 5-9 kV, frequency: 1-3 kHz, helium (He) gas flow: 1-1.5 L/min, and plasma irradiation time: 1-300 sec. The experiment was conducted by preparing a culture medium containing mouse fibroblasts (NIH3T3) on a culture dish. A culture dish irradiated with plasma was introduced into a $CO_2$-incubator. The small animals used in the experiment involving plasma irradiation into living tissue were rat, rabbit, and pick and are deeply anesthetized with the gas anesthesia. According to the dependency of cell numbers against the plasma irradiation time, when only He gas was flowed, the growth of cells was inhibited as the floatation of cells caused by gas agitation inside the culture was promoted. On the other hand, there was no floatation of cells and healthy growth was observed when plasma was irradiated. Furthermore, in an experiment testing the effects of plasma irradiation on rats that were artificially given burn wounds, no evidence of electric shock injuries was found in the irradiated areas. In fact, the observed evidence of healing and improvements of the burn wounds suggested the presence of healing effects due to the growth factors in the tissues. Therefore, it appears that the interaction due to ion/radicalcollisions causes a substantial effect on the proliferation of growth factors such as epidermal growth factor (EGF), nerve growth factor (NGF), and transforming growth factor (TGF) that are present in the cells.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.60-66
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• 2024

Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

• Korean journal of applied entomology
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• v.46 no.1 s.145
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• pp.141-145
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• 2007

Maggot therapy (MT) has been re-introduced for non-healing wounds such as pressure sore, diabetic and necrotic ulcers, as well as infected surgical wounds, burn, and trauma injuries since early 1990s. For the production of sterile maggot of proper developmental stage, Lucilia sericata were studied on developmental periods of immature stages on liver agar medium under six different temperatures such as 15.4, 20.6, 22.5, 26.2, 29.1, and $33.0^{\circ}C$, and adult longevity and egg Production under $29^{\circ}C$. The periods of eggs and larvae of the 1st and the 2nd instars were shortest at $33^{\circ}C$ by 9.0, 14.0 and 18.6 hours, respectively. The periods of the 3rd instar larvae and pupae were shortest at $29.1^{\circ}C$ by 285.0 and 171.0 hours, respectively. Developmental zero point and total effective temperature far the development of each stage were calculated based on the developmental periods. Adults of both female and male lived more than one month. Females laid an average of 338.5 eggs through 2.7 times of egg laying throughout her lifetime.

• Safety and Health at Work
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• v.2 no.4
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• pp.321-327
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• 2011

Objectives: To find out from an analysis of empirical data the levels of influence, which a labor union (LU) and Occupational Safety and Health Committee (OSHC) have in reducing the occupational injury and illness rate (OIIR) through their accident prevention activities in manufacturing industries with five or more employees. Methods: The empirical data used in this study are the Occupational Safety and Health Tendency survey data, Occupational Accident Compensation data and labor productivity and sales data for the years 2003 to 2007. By matching these three sources of data, a final data set (n = 280) was developed and analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). Results: It was found that a workplace with a LU has a lower OIIR than one without a LU. In manufacturing industries with five or more employees in 2007, the OIIR of the workplaces without a LU was 0.87%, while that of workplaces with a LU was much lower at 0.45%. In addition, workplaces with an established OSHC had a lower OIIR than those without an OSHC. Conclusion: It was found that the OIIR of workplaces with a LU is lower than those without a LU. Moreover, those with the OSHC usually had a lower OIIR than those without. The workplace OIIR may have an impact on management performance because the rate is negatively correlated with labor productivity and sales. In the long run, the OIIR of workplaces will be reduced when workers and employers join forces and recognize that the safety and health activities of the workplace are necessary, not only for securing the health rights of the workers, but also for raising labor productivity.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.357-362
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• 2018

Background The most common complication after tendon repair is the development of adhesion, with subsequent rupture. Methods In this study, we present a new method in which the tendon healing contact surface is increased to reduce these complications. The tendons of chickens in groups 1, 3, and 5 were transversely cut and repaired with in the traditional fashion with double-modified Kessler method and 5/0 polypropylene. In the other groups, 3 mm of the tendon was removed from the proximal half of the upper end and from the distal half of the lower end of the tendon, and they were repaired with the modified Kessler method. The tendons of the chickens in groups 1 and 2 were evaluated immediatelly after surgery. Groups 3 and 4 were evaluated at 4 weeks after surgery. Groups 5 and 6 were evaluated at 6 weeks. Results Increases in transient inflammation and connective tissue formation were observed more clearly in the group treated with the new method in histopathological investigations at weeks 4 and 6. The stretching test showed statistically significant differences between groups 3 and 4 (P<0.05) and groups 5 and 6 (P<0.05). Conclusions When repairing tendons with the new method, the healing surface increases and the direction of collagen fibers at the surface changes. Because of these effects, the strength of the tendon healing line increases; we therefore expect that this technique will enable patients to safely engage in early active exercise after the operation, with less risk of tendon rupture.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.166-175
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• 2020

Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.