• Journal of Chest Surgery
• /
• v.13 no.1
• /
• pp.60-65
• /
• 1980

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

• Child Health Nursing Research
• /
• v.5 no.2
• /
• pp.136-150
• /
• 1999

The subjects, under 18 old, 2,694 children who visited ER during 1998, were surveyed by the Triage and other statitical data. The results were as follows 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage ; critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER ; 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting : the 20:00 - 22:00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%), Mar. and May(9% respectively, Dec. and July(6.7%) respectively. The children who visted ER in spring and autumn showed higher portion than those of summer and winter. 6. Results ; admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%), The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER ; 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped. was 34.4%, PS was 20.8%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visting ; the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means . by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.3
• /
• pp.171-176
• /
• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• Pediatric Infection and Vaccine
• /
• v.30 no.3
• /
• pp.165-172
• /
• 2023

Pyogenic liver abscess is a rare condition in healthy children in developed countries, but it can have severe consequences if diagnosis and treatment are delayed. Staphylococcus aureus is the most commonly identified cause of pyogenic liver abscess worldwide, while Klebsiella pneumoniae is the predominant causative agent in Korea. However, cases of pyogenic liver abscess caused by anaerobic bacteria have also been rarely reported. A 14-year-old boy presented to the emergency room with fever and pain in the upper right abdomen. He exhibited tenderness in the right upper quadrant, elevated white blood cell count, anemia, and elevated liver enzyme levels. Abdominal computed tomography with contrast revealed pyogenic liver abscess. The patient underwent percutaneous catheter drainage for two weeks and received a 4-week course of antibiotic therapy. Prevotella intermedia, an anaerobic bacterium commonly found in the oral flora, was isolated from the drained pus. However, no evidence was found suggesting that the infection originated from a dental source. This case highlights the importance of considering the possibility of pyogenic liver abscess even in otherwise healthy children.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.1
• /
• pp.54-59
• /
• 1999

This study was based on a series of 164 patients with zygomatic bone fracture treated at Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from January 1992 to December 1996. The male-to-female ratio was 7:1. Their ages ranged from 8 to 78 years, with a median age of 35.6 years. The age frequency was highest in the second decade (30.5%), and third decade (23.8%), fifth decade (16.5%) in orders. The monthly distrbution of incidence showed October to be the month in which the greatest percentage occured (14.0%). The major cause of zygomatic bone fracture was alleged traffic accidents (53.7%). The incidence of concomitant facial bone fractures was 69,5%, and maxilla fracture (52.4%) was most frequently combined. The admission route was through emergency room (72.3%) and through outpatient department (26.8%). The incidence of associated injuries was 37.2%. The intraoral approach was the major method of treatment in zygomatic bone fracture (57.1%). The most frequent type of zygoma fracture was class IV (33.5%), and class III (25.6%) was next in order of frequency. Complications were enophthalmos (7.3%), facial asymmetry (6.7%), paresthesia (6.1%), and diplopia (2.4%) These results suggest that correct diagnosis and treatment of severity of fracture, concomitant fracture, and associated injuries are necessary, and co-operative treatment with medical department should be performed to reduce postoperative complication.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.2
• /
• pp.155-162
• /
• 2001

This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

• Child Health Nursing Research
• /
• v.2 no.1
• /
• pp.112-126
• /
• 1996

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.2
• /
• pp.186-191
• /
• 2012

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia, cold compression and adequate medication should be done.