Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Kim, Kyoung-Soo;Kang, Hee-In;Kil, Yong-Kab;Kim, Jae-Seong;Lee, Young;Seo, Hyun-Soo;Hong, Soon-Min;Park, Jun-Woo
Maxillofacial Plastic and Reconstructive Surgery
/
v.31
no.6
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pp.519-525
/
2009
The population were increased by industrialization and urbanization of the modern society and social activities of the person were rapid increased too. Subsequently the number of motor vehicle accident, sports accident and industrial accident were increased, resulting in the number of oral and maxillofacial trauma were increased. Because of the mandible relatively protruded among the facial bone, the most frequent associated oral and maxillofacial injuries was mandible fracture in the trauma center setting. A clinical study on 411 patients with mandibular fracture who visited in Department of Oral and Maxillofacial Surgery, Chun-chon Sacred Heart Hospital during 10 years(1997-2006) was done by analysing sex, age, mode, fracture site and treatment method
Now we are encountering with a growing number of severe head and neck injuries owing to automobile accidents, violence, and industrial injuries etc. In these circumstances, emergency tracheostomy and neurosurgical treatment are frequently necessary. When cervical trauma was ignored at initial stage, significant complications and sequelae may follow. So it deserves attention that meticulous and thoughtful treatments should be given to the cervical injuries as well as head injuries. We have recently experienced a case of laryngeal stenosis resulted from head and neck trauma. The patient was a 20-year-old male who underwent craniectomy and tracheostomy at another hospital about one and a half years prior to admission. With multistaged operations, we were able to re-establish an adequate natural air way.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.8
no.1
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pp.24-35
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1998
Cumulative trauma disorders(CTDs) have been a growing problems for US and European industries with higher incidence rate every year. The increase and their associated costs has led companies to form committes and implement programs to address this problem. In our country, we have just started to recognize and to work on the problems in industry. This study conducted an ergonomic analysis for typical jobs of ship building industry which was not usually surveyed for CTD problem. A baseline CTD checklist which was supposed to do a risk assessment was developed and applied in this study. Initially, we considered five major parts in the checklist which consisted of personal, frequency, posture, force, and miscellaneous information. Most jobs in ship building industry were much different from typical assembly work and VDT work that have been major part of the previous CTD studies. Specifically, job characteristics in terms of frequency and posture were quite different. There were relatively long cycle time, awkward postures for whole body (not just for upper extremities). Also, CTD risk scores based on checklist were a lot higher than the scores for VDT jobs which was a case of preceding application of the checklist. Specifically, grinding jobs turned out to be the most risky one in terms of CTDs. In conclusion, usual CTD prevention guidelines are not likely to he effective in this type of industry. An individual job based interventions are strongly suggested to have a good control of CTD problems in ship building industry.
Journal of Korea Society of Industrial Information Systems
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v.6
no.4
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pp.12-21
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2001
Recently, as work strength is deepened, as well, labor environments is changed, simple and iterative worker's Cumulative Trauma Disorders(CTD) is gradually being increased. Accordingly, this study was designed to represent its system design to carry out their iterative and simple task by machine through the difference of muscle fatigue between worker on handling line and worker under the work environments by Air Balance System for the purpose of analyzing their muscle fatigue test according to fulfillment of iterative and simple task. From the result of this study, with regard to the comparison of muscle fatigue between work on handling line and work on automation line on the occasion of refractory brick loading, their muscle fatigue extent under the work environments by Air Balance system was lower than it of handling by AMEG(64.1%), MF(65.3%), MPF(64.3%), ZCR(63.6%) respectively. And also, generally there showed similar transfer at the aspect of muscle mobilization. In other words, we can say that work environments by Air Balance System is beneficial at the aspect of alleviating works' fatigue extent on handling line. As well, the result of this study shows that worker's exposure to Cumulative Trauma Disorders(CTD) is relatively low.
Journal of Korean Society of Industrial and Systems Engineering
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v.22
no.52
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pp.323-335
/
1999
Spinal injuries are common these days and are increasing due to the increasing sports activities, auto-related accidents, and occupational incidences. Most of spinal injuries of strain and sprain are associated with trauma and resulted in loss of optimal musculoskeletal system in spinal column area. Some of these injuries requires surgical treatments. Fortunately, some people with spinal disorder are achieving outstanding results with the chiropractic care which utilizes muscle stimulation and strengthening, traction therapy, and spinal adjustments. These treatments using chiropractic table can ease pain by restoring alignment, improving mobility, and relieving pain and stiffness in neck and spinal areas. The purpose of this study was thus to gather the comprehensive information about spinal injuries, to define the specific dimensions, and to recommend functions of chiropractic table specially suited for Korean. This study was an integrated approach in applying the concepts of biomechanical correction of the musculoskeletal system. Also, this study was to utilize a knowledge of physics, ergonomics, and rehabilitation to the development of spine cure medicine.
Journal of Korean Society of Industrial and Systems Engineering
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v.24
no.65
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pp.31-40
/
2001
We Propose an improved shovel design to minimize physical discomfort and the risk of cumulative trauma disorder at shoveling tasks. The specifications of shovels in Korean standard data were scrutinized to check if they met the anthropometric specification of Korean population in 1997. We also applied "Body Map" pictograph and self-conscious checklist to field survey to analyze the discomfort of shoveling task. Thirty male subjects whose age were ranging from 18 to 65 voluntarily participated in the experiment. The measurement results show that shoveling workers were exposed to hazards of CTD's. Especially, when workers were involved in ditch digging and construction their trunk vend more than 120 degree. In order to compare the new designed shovel and the traditional K.S shovel, an analysis of variance was performed and we obtained very strong evidence that the new designed shovel was better in reducing physical discomfort. According to the results from electromyograrn experiment the new shovel contributed to improving subjective comfort level and reducing low back muscle fatigue. For futher study, the research may be extended to determine the relationship among shovel sharpness, type, digging motion and digging force.ing force.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.11
no.1
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pp.56-69
/
2001
Objectives : This study was designed to develop and standardize a checklist for ergonomic risk factors, and to provide ergonomic guidelines for managing cumulative trauma disorders (CTDs) in automobile assembly lines. Methods : The Checklist for Ergonomic Risk Factors (CERF-1) was developed based on the results of previous studies, and then modified after performing pilot study. Information on the symptoms possibly related with CTDs was obtained using a self-reported Questionnaire from 465 automobile assembly workers. Their job conditions were examined to assess risk factors through both direct observation and video analysis. Results : Rate of detecting risky job through CERF-1 was 85.6%, and was similar to that (88.8%) by Occupational Safety and Health Adminstration(OSHA) checklist but higher than that (63.7%) by American National Standards Institute(ANSI) Z-365. Relationship of the exposure scores derived from CERF-1 with levels of symptom was greater (r=0.49) than OSHA (r=0.28) and ANSI Z-365 (r=0.22). Considering the relationship, jobs scoring higher than 16 could be classified as the Risk Job. and lower than 16 as the Low Risk Job. Sensitivity and specificity of the Risk Job were 92.5 % and 31.5 %, respectively. Odds ratio (OR) after age adjustment was 5.69 (95 % confidence interval 3.15-10.29) for the Risk Job, and these ORs were significantly different from those of the Low Risk Job. The exposure scores were Quite valid, in that the scores at the main survey were significantly correlated with those at the follow-up survey, as suggested by test-retest(r=0.88) and inter-rater reliability(r=0.80). Conclusions : The CERF-1, developed in this study, will be an efficient tool for evaluation of risk jobs for CTDs in automobile assembly lines, and can be used easily by health care providers.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.3
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pp.423-428
/
2019
The role of angioembolization has increased because of increases in nonoperative treatment for traumatic splenic injury. We report here a case of successful treatment of iatrogenic pseudoaneurysm of the femoral artery by thrombin injection with coil embolization. A 55-year-old female was admitted to our hospital because of blunt trauma. Computed tomography (CT) revealed a grade V splenic injury with contrast extravasation; therefore, angioembolization was performed. Three days after admission, follow-up CT scan revealed rebleeding from the spleen, and repeat angioembolization was performed. Seven days after admission, an approximately $7.0cm{\times}4.0cm-sized$ pseudoaneurysm was found on follow-up CT scan and there was no bleeding from the spleen. Although thrombin was injected into the aneurysmal sac, there was still inflow of blood, as observed on color-doppler ultrasound. Therefore, coil embolization to the neck of the aneurysm was performed. On angiography, there was no contrast filling into the sac. The size of the pseudoaneurysmal sac had decreased on follow-up CT scan, and the patient was discharged to home without complications. We successfully treated a giant pseudoaneurysm of the femoral artery using thrombin and coil embolization.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.12
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pp.227-236
/
2018
This study was conducted to define hippocampal volume differences between a stress-laid group and normal individual group via meta-analysis. This investigation included studies that contained hippocampal volume measurements in association with stress from 1990 to 2016. Magnetic resonance imaging (MRI) measurements of hippocampal volumes were used to determine the mean size, standard deviation and sample size. The pooled effect size was measured by the standardized mean difference (SMD) with a 95% confidence interval. This meta-analysis included 13 studies comprising 374 stress subjects and 439 normal subjects. Eight studies targeted war-related veterans and holocaust survivors, while five targeted personal trauma associated with childhood abuse, rape, accident or financial hardship. The overall mean effect size (Hedges' g) was -0.70 (-1.04; -0.37). Overall, the SMD value was -0.70, with a moderate effect size, but high heterogeneity. Depending on the characteristics of the stressor, studies were divided by subgroups of war-related veterans and subjects with personal trauma and then analyzed again. In the war-related subgroup, the Hedges' g was -0.47 (-0.78; -0.16), while in the personal stressor-related subgroup it was -0.91 (-1.57; -0.26). These results indicate that there was a significant negative correlation between psychological stress and hippocampal volume.
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