• Title/Summary/Keyword: internal injuries

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Efficacy of Temporal Fixation Using Threaded Trans-Calcaneal Pin in Patients with Ankle Fracture-Dislocation or Tibia Pilon Fractures (발목 골절 및 탈구 혹은 경골 천정 골절 환자들의 수술에 있어 경종골핀을 이용한 발목 외고정 장치를 적용했을 때의 임상적 효용성)

  • Park, Dae-Hyun;Gwak, Heui-Chul;Kim, Jung-Han;Lee, Chang-Rak;Kwon, Yong-Uk;Choo, Hye-Jung;Park, Chul-Soon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.81-86
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    • 2020
  • Purpose: Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. Materials and Methods: Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. Results: The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. Conclusion: Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

Successful Endoscopic Treatment of Hepatic Duct Confluence Injury after Blunt Abdominal Trauma: Case Report

  • Park, Chan Ik;Park, Sung Jin;Lee, Sang Bong;Yeo, Kwang Hee;Choi, Seon Uoo;Kim, Seon Hee;Kim, Jae Hun;Baek, Dong Hoon
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.93-97
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    • 2016
  • Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

Effects of Physical Characteristics Factors on Ankle Joint Injury during One Leg Drop Landing (외발 착지 시 신체적 특성 요인들이 발목 관절 상해에 미치는 영향)

  • Lee, Seong-Yeol;Lee, Hyo-Keun;Kwon, Moon-Seok
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.4
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    • pp.839-847
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    • 2020
  • The purpose of this study was to analyze the effects of ankle flexibility, gender, and Q-angle on the ankle joint injury factors during one leg drop landing. For this study, 16 males(age: 20.19±1.78 years, mass: 69.54±10.12 kg, height: 173.22±4.43 cm) and 16 females(age: 21.05±1.53 years, mass: 61.75±6.97 kg, height: 159.34±4.56 cm) in their 20's majoring in physical education using the right foot as their dominant feet were selected as subjects. First, an independent t-test of joint motion and joint moment according to the experience of ankle injury was conducted to determine the effect of physical characteristics on ankle joint injury during one leg drop landing(α = .05). Second, the variable that showed a significant difference through t-test was set as the dependent variable, and the ankle flexibility, gender difference, and Q-angle were designated as independent variables to use Multiple Linear Regression(α =. 05). As a result of this study, it was found that the group that experienced an ankle joint injury was found to use a landing strategy and technique through adduction of the ankle joint and internal rotation of the knee joint, unlike the group without an injury. It was also confirmed that this movement increases the extension moment of the ankle joint and decreases the extension moment of the hip joint. In particular, it was found that the dorsi flexion flexibility of the ankle affects the ankle and knee landing strategy, and the gender difference affects the ankle extension moment. Therefore, it was confirmed that physical characteristics factors affecting ankle joint injuries during one leg drop landing.

Indications and Estimations of the Needs for Direct Medical Control in the Patients Transported by 119 Rescuers (119 구급대에 의해 이송된 환자들 중 직접적 의료지도가 필요한 범위와 그에 따른 수요 추정)

  • Park, Jae-Young;Jung, Koo-Young;Bae, Hyun-A
    • Fire Science and Engineering
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    • v.20 no.3 s.63
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    • pp.42-47
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    • 2006
  • Direct medical control by medical doctors is an essential part of emergency medical services system (EMSS). However, the indications are not specifically defined, even in 119 system with their own medical control team. The Seoul Metropolitan Fire and Disaster Management Department has operated internal medical consultation services on its own since January 2004. Based on the experiences from these services, we reviewed the cases of the direct medical consultation and establish the indications for direct medical control. And we presumed the demand of direct medical control with the established indications. The crews of 119 in Seoul made 793 calls to Medical Control Team during November 2004. We reviewed all of the calls according to the level of consciousness (AVPU), the kinds of emergency care done by crews during transport (10 categories), and the mechanisms of injuries (9 categories). The need for direct medical control was judged by authors with reviewing the records reported by the crews and control teams. Among 23 items, 14 items assigned as the indications, which were abnormal level of consciousness (VPU), 6 kinds of emergency care, and 5 mechanisms of injures. The sum of the three of them, 7,782 cases (45.9%), was in need of direct medical control. In conclusion, about half of the patients transported by 119 crews in Seoul require direct medical control. The need for the direct medical control in Seoul was estimated as many as 260 calls per day. To fulfill the need for direct medical control and to provide a effective medical control, the direct medical control should be accomplished through the communications between the crews and the medical staffs in the local hospitals.

Clinical Experiences of Facial Asymmetries in Zygomaticomaxillary Complex Bone Fracture Patients (관골상악골 복합체 골절 환자에서의 안면 비대칭에 대한 임상경험)

  • Kang, Nak-Heon;Choi, Sang-Mun;Kim, Joo-Hak;Song, Seung-Han;Oh, Sang-Ha
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.161-165
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    • 2011
  • Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

A Literatural Study on the Traditional Korean Medical Physiotherapy (한방물리요법에 대한 문헌적 고찰)

  • Choi, Bo-Mi;Hong, Seo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.211-226
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    • 2011
  • Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

Experimental Study on Moisture Content According to Addition of Surfactants (계면활성제 첨가에 따른 함수율에 관한 실험적 연구)

  • Kim, Nam-Kyun;Rie, Dong-Ho
    • Fire Science and Engineering
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    • v.29 no.2
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    • pp.79-83
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    • 2015
  • The fire accident is a representative type of disaster that can largely impact on business. Therefore, precautionary measures and rapid initial response is very important when a disaster occurs. The storage of porous combustibles is inevitable in coal yard, plywood processing industry, and others that are currently operating. Initial fire fighting of fire and identifying the ignition point in such a porous combustible storage space are so difficult that if the initial response is failed, being led to deep-seated fire, surface fire is likely to result in secondary damage. In addition, deep-seated fire can cause personal injuries and property damage due to a large amount of toxic gases and reignition. Therefore damage reduction measures is required around the storage space to handle a porous flammable. Improving the penetration performance of the concentration of the surfactant is carried out as underlying study, which is about an deep-seated fire extinguishing efficiency augmentation when using wetting agents. The porous materials used in the experiments is radiata pine wood flour, which occupies more than 75% of the domestic wood market. Fire fighting water is selected as Butyl Di Glycol (BDG), which is being used for infiltration extinguishing agent, and the experiment was carried out by producing a standard solution. The experiment was carried out on the basis of the Deep-Seated Fire Test of NFPA 18. The amount of watering, porous material to the internal amount of penetration, and runoff measurement out of the porous material was conducted. According to experimental results, as the surface tension is reduced, the surfactant concentration macroscopic penetration rate decreases, but infiltration to a porous material is shown to have growth characteristics.

Postharvest Handling and Marketing Management for Making High Salability of Sweetpotatoes (상품성 제고를 위한 고구마 수확 후 관리 및 출하기술)

  • Jeong, Byeong-Choon
    • Proceedings of the Korean Society of Postharvest Science and Technology of Agricultural Products Conference
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    • 2001.06a
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    • pp.51-64
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    • 2001
  • The qualities including taste of sweetpotato stored during the winter which can display in the spring market in Korea are affected by availability of storage for the roots. In order to make high storage availability of sweetpotato, the postharvest handlings should be done thoroughly from the moment of harvest until shipping them to the market. A lot of procedures that must be handled carefully for improving postharvest management are as follows; digging, trimming, gathering, putting in storage containers, carrying them from field to house, curing, storing, washing, drying, selecting marketable roots, packing and shipping to the market, etc.. Sweetpotatoes have a high moisture content, and a relatively thin and delicate skin, and are sensitive to chilling, so careless postharvest handling can lead to both quantitative and qualitative losses which may be extremely high in some circumstances. From now on research has concentrated on the improvement of postharvest conditions to increase yield and lower disease rates. Storage, which makes sweetpotatoes available through out the year, benefits both the producer and the consumer. Seven very important points must be needed in order to get the best quality marketable roots in the storing of sweetpotatos : $\circled1$The storage house must be clean and sanitary, $\circled2$The crop must be harvested before the first frost to avoid low-temperature injury, $\circled3$Particular care must be taken to avoid cutting, bruising, or other injuries of the sweetpotatoes during digging, picking up, grading, placing in containers, and moving to the storage house, $\circled4$Select sound, disease-free roots for storage $\circled5$Sweetpotatoes should be stored in properly stacked containers $\circled6$Cure immediately after harvest, preferably at 32∼33$^{\circ}C$ and 90 to 95 percent relative humidity for 4 to 7 days, After curing the temperature should be reduced to 13$^{\circ}C$ to 16$^{\circ}C$ by ventilating the storage with outside air. $\circled7$Store at 12$^{\circ}C$ to 14$^{\circ}C$ and a relative humidity of 80 to 85 percent. Storage houses should be located on suitable sites and should be tightly constructed and insulated so that temperature and humidity will be uniform. Sweetpotatoes are usually not washed and graded, and lately sometimes washed, graded, waxed, before being shipped to market. Consumer packaging of sweetpotatoes in paper boxes(10-15kg) or film bags is done mainly to aid marketing. The shelf life of washed roots in consumer packs in only 1 to 2 weeks. Weight loss of roots during marketing is much less in perforated film bags than in mesh and paper bags. Perforation of 0.8 to 1kg polyethylene bags with about six 6mm holes is essential ; to lower the internal relative humidity and avoid excessive sprouting, rooting, and dampness. Development and use of better postharvest handling with good storage facilities or marketing methods can minimize sweetpotate losses and has an effect of indirectly increasing productivity and farmer’s income.

Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

The Effects of Ecklonia stolonifera Extracts on Improvement of Hepatic Function: a Double-Blind, Randomized, Placebo-Controlled Clinical Study (곰피추출물의 간기능 개선 효과 평가를 위한 12주, 무작위배정, 이중맹검, 위약-대조 인체적용시험)

  • Kim, Junghee;Kim, Eun Jin;Kang, Dahye;Kim, Hyung-Bin;Jang, Jae Young;Om, Ae-Son;Kim, Jongwook
    • Journal of Food Hygiene and Safety
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    • v.37 no.3
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    • pp.198-205
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    • 2022
  • Hepatic diseases are divided into two types: alcoholic and non-alcoholic. Non-alcoholic liver injury finally induces fatty liver and damages liver function. Many studies have demonstrated that Ecklonia stolonifera has antioxidative, anti-inflammatory, and hepatoprotective activities. We conducted a 12-week double-blind, placebo-controlled, randomized trial to examine the efficacy of E. stolonifera extracts (ESE) on biochemical markers of hepatic function. Sixty-five subjects with mild or moderate liver injuries were randomly allocated to receive either 420 mg/d of ESE or a placebo for 12 weeks. Fifty-five participants completed the trial. No significant adverse events were observed among the subjects during the study. The primary end points were changes in plasma levels of aspartate transaminase (AST), alanine transaminase (ALT), and γ-glutamyltransferase (γ-GT). The secondary end points were changes in lipid profile levels, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL). Compared with the baseline, AST and ALT levels decreased significantly in the ESE group compared to those in the placebo group (P<0.001). In addition, γ-GT levels in the ESE group were significantly lower than those in the placebo group (P=0.016). There were no differences in the TC, TG, HDL, and LDL levels between groups. In conclusion, ESE consumption for 12 weeks improved liver parameters in subjects with liver injury. Regular consumption of ESE could maintain liver health in individuals at risk of hepatic damage.