• 한국응급구조학회지
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• 제3권1호
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• pp.20-32
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• 1999

The purpose of this retrospective research of 603 patients who were transferred to the emergency medical center of university hospital from 1 Jan, 1998 to 31 Jan, 1998 was making of basic data for emergency medical transfer system improvement countermeasure and the point at issue of overlapping reexamination ststus of patients transfered to emergency medical center of university hospital from 1,2 level hospital. The data analysis was done by SPSS, t-test, ANOVA, Pearson correlation. The results were as follows: 1. Male to female ratio was 1.7:1 and peak age group was patients over forties and under nine years of age(70.5%) 2. Traumatic patients were 17.8%, motor vehicle accident patients were 16.7% and Non-traumatic patients were 65.3%. Transferring hospital was divided into 2groups: primary hospital, secondary hospital. The majority was secondary hospital(73.3%). The result of symptom severity classification of patients transferred to 3rd emergency medical center was urgent patients 32.5%, emergency patients 33.58%, non-emergency patients 34.0% 3. Most highest score items amoung overlapping reexamination of patients transfered to emergency medical center of university hospital from 1,2 level hospital were CBC test, simple X-ray (0.93점), CBC test(0.97점), urin test(0.88점), chemistry test(0.94점), simple X-ray(0.98점), CT(0.42점), EKG(0.89점) amoung overlapping reexamination of motor vehicle accident patients were more higher reexamination score than traumatic patients and non-traumatic patients 4. CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.001), CT(P<0.01), EKG(P<0.001) amoung overlapping reexamination of patients in 2 level hospital were more higher reexamination score than 1 level hospital patients 5. About symptom severity classification of patients transferred to 3rd emergency medical center, CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.01), CT(P<0.001), EKG(P<0.001) amoung overlapping reexamination items in urgent patients were more higher reexamination score than other patients 6. Influencing variation for overlapping reexamination in hospital was CBC test(P<0.001), CT (P<0.001), MRI (P<0.05).

• 한국응급구조학회지
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• 제1권1호
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• pp.100-111
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• 1997

This is the first Korea study to evaluate the effects od the safety of ambulance driving and the occurrence of ambulance traffic accidents and to provide basic informaion for the description of various factors to reduce the ambulance traffic accidents. The major insturment of this study were Krean Self-Analysis Driver Opinionnaire. Questionnaire contains 8 items which measure driver's opinions or attitudes : driving courtesy, emotion, traffic law, speed, vehicle conditions, the use of drugs, high-risk behaviors, and human factors. To take the analysis of data, the total of 350 divers were investigated ambulance divers and others in Taejon City and others (6 City) from 1996. 1. July to 1996. 31. July. The data were analyzed by the descriptive statistics and the logistic regression - path analysis - with SPSS and SAS package program. The result are as follows : 1. There was desirable attitude group(16.2%) and undesirable attitude group(17.6%) on safety ambulance driving. 2. It have suggested that risk factors of ambulance traffic accidents much affected with emotion and speed control on safety ambulance driving < Y(Accdient) = -2.64 + 0.57 $X_1$ (Emotion Control) + 0.30 $X_2$(Seed control) + E > and motor traffic acident much affected with emotion control and high-risk behavior on safety driving < Y(Accident) = -1.11 + 0.33 $X_1$(Emotion Control) + 0.29 $X_2$(High-risk Behvior) + E > 4. The primary emphassis of ambulance drivers was make us realized that improthatnt factors on safety ambulance driving were 1)making way for emergent ambulance, 2)driver's career, 3)The ability of emergency medical technics, and the knowledge or under standing of ambulance way difficut(or easy) of accdess. 5. Almost 96.6% of respondents have agreed to necessity of emergency medical technics for ambulance drivers. 6. Almost 94.6% of respondents have consented to necessity of emergtency medical technicians for ambulance driving. 7. It have suggested that the proportion of traffic accident proportion by desitable attitude group(16.7%) was much less than that of undesirable attitude group(30.8%) on safety ambulance driving(P < 0.05)/Ps) Accidents are unplanned, unforesen incidents which can lead to harmful or unfortunate outcomes, Collisons are not accidents, since the basic cause of the majority of collisons invovles high-risk human behavior. Although there are many factors which contribute to accident causation, four basic factors seem to predominate in most traffic related situations. These four factors include: the human factor, the vehicle factor, the environmental factors and destination factor(Peto G. et al. 1995).

• 대한족부족관절학회지
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• 제11권1호
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• pp.111-114
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• 2007

Open calcaneal fracture with more than lateral half of bone loss and soft tissue defect occurred in 17 year-old male patient due to motor vehicle accident. Soft tissue defect included heel pad, peroneal tendon. Bone loss involved mainly most part of inferior tuberosity but not subtalar joint. Open dressing and debridement were done daily in operating room and antibiotics administration was started. After granulation tissue formed, femoral head allograft was performed and fixed with 6.0 mm screws to replace bone defect. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap. No sign of infection nor major osteolysis was observed in 15 months follow up period. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap.

• 보건교육건강증진학회지
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• 제10권1호
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• pp.61-71
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• 1993

Pedestrian injury have been the most important cause of death in children 1 to 14 years of age. This study was attempted to analyze the status and factors of the pedestrian safety education for primary school children. The purpose of this study was to provide the baseline study on pedestrian safety education. The data were collected from 313 respondents of 5th grade elementary school children in Seoul during April 26 through May 6, 1993. The data were cross tabulated for percent distribution and analyzed by multiple regression using SAS for personal computer program package. Major findings are as follows: (1) 50% of the respondents had never received any safety education for Pedestrian. The primary provider of pedestrian safety education was parent. (2) Respondents' knowledge on traffic rules, traffic signals, natures of motor vehicle is high(above 88%). (3) Respondents are very negative to the attitude of playing on the street and transversing under d1e overpass(about 80%). (4) 58% of respondents had never played on the street and 49% of respondents had never run on the street. (5) Factors affecting the knowledge of traffic safety was respondents' sex and job of their mothers(p＜0.05). (6) Factors affecting the attitude of traffic safety was economic status(p＜0.01). (7) Factors affecting the practice of traffic safety was education of respondents' fathers. (8) The multiple regression analysis showed that sex was statistically significant in affecting traffic accident of pedestrians (p=0.05). In order to prevent children's traffic accidents, education for pedestrians' safety by both parents and teachers should be strengthened.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.47-52
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• 2002

One of the most common problems in cord injury is pressure sores. In the early stage of pressure sores, the wound can be covered by advancing or transpositioning a local myocutaneous flap. However, it can be a great challenge to treat end-stage paraplegic patient who underwent multiple prior flaps, where continuous treatment is needed to prevent recurrent pressure sore due to infection and metabolic drain. In these patients, a local myocutaneous flap may be very difficult for coverage of the wounds. Therefore, hemipelvectomy may be considered. The authors performed a hemipelvectomy on a 33 year-old male paraplegic patient who presented with multiple, large wounds seen in end-stage pressure sores. He had a compression fracture of the lumber spine 9 years ago during a motor vehicle accident. After a wide exicision of the wound, the anterior flap was used as a fillet-flap for reconstruction. On the sixth day postoperatively, secondary repair was done due to wound dehiscence and the postoperative results have been satisfactory thus far.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.48-52
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• 2020

Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to tolerate prolonged anesthetic exposure is a driving factor for performing the minimal intervention necessary to facilitate recovery. Herein, we present a case involving the successful immediate reconstructive treatment of a severely head-injured adolescent with a composite scalp defect secondary to trauma. A 14-year-old boy sustained a severe head injury from a motor vehicle accident with a composite scalp defect in the right fronto-parietal region. The frontal lobe was exposed, and the right eye was crushed and devitalized. The patient was deeply unconscious for 3 days, without any significant improvements before reconstructive surgery was proposed due to fear of possible meningitis resulting from the exposure of brain structures. We successfully managed the patient with a fronto-parieto-occipital flap, after which the patient promptly recovered consciousness.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1050-1054
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• 2000

Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.

• 소성∙가공
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• 제27권4호
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• pp.201-210
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• 2018

An airbag is an essential automotive component used in all kinds of vehicles such as an internal combustion engine and an electric motor vehicle and is used to minimize the damage of an occupant in the event of an accident. Airbag-related parts are being monopolized by a small number of foreign companies around the world. In this situation, it is necessary to develop and research the airbag-related part molding technology for expansion of the domestic airbag-related market and corporate export. As a part of this research, we have developed a mold for airbag inflator cap. The development consists of three steps which are the design of components, analysis of the design and verification of it. In the case of the design, the transfer type mold was designed for the multi-cylindrical shaped feature. Analysis was then conducted on the design. By examining the results of analysis, changing features and numbers of punches and dies were added in the analysis and repeatedly analyzed. After the addition, proper dimensions from the analysis were achieved, and prototypes were practically produced and verified. In the case of prototype verification, Pressurizing Burst Test was conducted on the existing products and the prototype. By comparing the results of the test, the possibility of replacing the existing product of the airbag inflator cap is presented in this paper.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• 대한족부족관절학회지
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• 제9권1호
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• pp.121-124
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• 2005

The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.