• Title/Summary/Keyword: non-emergency case

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Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

  • Lee, Hae Young;Cho, Seong Ho;Kim, Hyun Su;Moon, Jeong Min;Lee, Sangho;Kim, Jong In
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.468-471
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    • 2016
  • An 81-year-old male patient presented with complaint of a pulsating neck mass. The patient had a previous history of cervical lymphadenopathy by non-tuberculous mycobacterium infection. Rapid growth of the mass on admission and contrast enhanced computed tomography of the neck resulted in a diagnosis of non-tuberculous mycobacterium induced pseudoaneurysm. The patient underwent emergency open repair of the pseudoaneurysm. Pseudoaneurysm of the common carotid artery is regularly reported, but here we report a rare case of non-tuberculous mycobacterium induced pseudoaneurysm of the common carotid artery.

Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study

  • Kevin Y. Zhu;Kristie J. Sun;Mary A. Breslin;Mark Kalina Jr.;Tyler Moon;Ryan Furdock;Heather A. Vallier
    • 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.

COMPUTED TOMOGRAPHIC STUDY OF MAXILLOFACIAL GUNSHOT INJURIES (악안면부 총상 환자의 전산화단층사진상의 연구)

  • Park In-Woo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.26 no.2
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    • pp.65-73
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    • 1996
  • The purpose of this study was to evaluate the clinical and computed tomographic features of 7 cases of maxillofacial gunshot injuries in the suicidal patients visited the emergency room, Capital Armed Forces General Hospital. The obtained results were as follows : 1. The gunshot wounds were directed from submental area to dorsum of nose(3 cases), frontal area(1 case), orbit(1 case), infraorbital area (1 case), and lateral to nasal wing(l case). The shape of inlet in gunshot wounds were round (diameter: l-3cm) and that of outlet were oval shape(size : inlet

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Psychological burden for legal responsibility of 119 emergency personnels (119구급대원의 법적책임에 대한 심리적 부담감)

  • Lim, Jae-Man;Yun, Seok-Jeong;Lim, Gwan-Su;Kang, Shin-Kap;Choi, Eun-Sook;Seo, Kyung-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.1
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    • pp.87-96
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    • 2009
  • Purpose : To grasp the mental burden for legal responsibility that rescue members have in the performance of job. Method : Questionnaire was presented to rescue members serving in 2 direct control safety centers of fire station located in Seoul, Daejon, Incheon, Kwangju, Busan, Daegu and Ulsan. Results : 1. Questioned whether they have mental burden for legal responsibility while performing job on the site, the rescue members responded : very burdensome in 38.0%, burdensome in 56.0%, moderate in 4.5%, not burdensome in 1.0%, no burden at all in 0.5%. 2. Questioned on the first aid treat for which they have the most mental burden, the rescue members responded : intubation into trachea laryngeal mask airway(LMA) in 40.4%, automatic external defibrillator in 16.3%, securing vein providing sap(medicine) in 10.8%, basic cardiopulmonary resuscitation in 7.2%, eliminating foreign matters inserted into body in 5.4%, stanching external bleeding and treating injury in 5.4%, fixing extremities and spine by using splint in 1.8%, measuring the symptom of vitality in 1.2%, providing oxygen in 0.0%. 3. Questioned whether experiencing legal problem or firm petition(complaint) raised by patient while serving as rescue members, they responded : experiencing a complaint in 41.6%, experiencing no complaint in 58.4%. Asked to indicate the stress level in the scale of which they suffered when lawsuit or firm petition was raised, 0(weak)-10(strong), they answered 8.8 in average. 4. Questioned whether 119 rescue members put the legal responsibility in case that they cause damage to patients intentionally in performing, they responded to the inquiry 3.66 in average(of 5.00). It represented meaningful differences (F=2.874, p=.024) whether they had license or not. 5. In future, legal action will raise against the rescue member by 99% because of people's rights improvement(63.1%), high expectations for the rescue system(29.5%), non-licensed rescue members(5.1%). Conclusion : It was found that the rescue members had severe mental burden for advanced life support which was investigated to have low enforcement rate in the preceding research, for instance, intubation into trachea securing vein management by using automatic external defibrillator. To improve the qualitative level of rescue service in the fire fighting, it may be required to construct the environment that eliminates the mental burden of rescue members for legal responsibility.

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Exercise rehabilitation for recurrent extraocular muscle movement limitation after pediatric blowout fracture surgery: a case report

  • Jeong Do Park;Syeo Young Wee;Se Young Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.133-138
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    • 2023
  • White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

Model experiments for the reinforcement method of agricultural reservoirs by overtopping

  • Lee, Young-Hak;Lee, Dal-Won;Heo, Joon;Ryu, Jung-Hyun
    • Korean Journal of Agricultural Science
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    • v.47 no.1
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    • pp.163-171
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    • 2020
  • In this study, a large laboratory model experiment was conducted with the aim of developing an embankment reinforcement method to prevent overtopping, which is the main cause for the failure of agricultural reservoirs. The model experiment was carried out with concrete and asphalt as a permanent reinforcement method and with geomembrane as the emergency method at a deteriorated homogeneous reservoir. Under the non-reinforced conditions, the pattern of the failure appeared in several scour directions from the downstream slope as the overtopping began, and the width and depth of the erosion were magnified as it gradually moved to the dam crest. Under the conditions reinforced with asphalt and concrete, the overtopping was stabilized. In the case of the concrete reinforcement, it was found that the slope of the riprap boundary exhibited downward erosion by the current; thus, it was necessary to construct an extension up to the riprap joint of the upstream and downstream sides to prevent the expansion of the failure. Under the conditions reinforced with the geomembrane sheet, the overtopping was stabilized, and no seepage was found that required the emergency reinforcement method. Asphalt, concrete, and geomembrane sheet reinforcements have been shown to be capable of delaying failure for about 1 hour and 40 minutes compared to the non-reinforcement conditions. The reinforcement method is considered to be a very effective method to prevent disasters during overtopping. The pore water pressure can be used as useful data to predict the risk of failure at an embankment.

The Characteristics Related to Zolpidem-Using Suicide Attempts in Patients Who Visited Emergency Department (일 대학병원 응급실에 내원한 졸피뎀 음독 자살시도군의 특성)

  • Maeng, Heongyu;Lee, Jinhee;Min, Seongho;Kim, Min-Hyuk;Kwan, Yunna;Chin, Siyung;Kim, Heungkyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.144-152
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    • 2021
  • Objectives : The purpose of this study is to identify differences between suicide attempters who used zolpidem and others who used different methods in emergency department. Methods : This study classified 2,734 suicide attempters, who went to emergency department from 2009 to 2018, into zolpidem user group, another drug user group and non-drug user group. For these three groups, chisquare test and logistic regression analysis were conducted regarding sociodemographic feature and clinical feature related with suicide. Results : In the result of logistic regression analysis of a variable, which showed meaningful difference between suicide attempter group who used zolpidem and the other group who did not use the drug, the occurrence of zolpidem-using suicide attempers was related with the case where anxiolytics/hypnotics was used or the case where lethality and intention was low. In the drug intoxication group which showed similar feature, there was also a relevance between anxiolytics/hypnotics and the occurrence of zolpidem-using suicide attempts. Conclusions : This study identified significant difference of sociodemographic and clinical feature in suicide attempter group who used zolpidem and the other group. This result can contribute to plan further medicinal treatment in using zolpidem.

In vitro Effects of Epigallocatechin Gallate on Sister Chromatid Exchange in the Lymphocytes Exposed to Glyphosate (글라이포세이트 노출로 인한 DNA손상에 대한 녹차의 예방적 효과)

  • Park, Jung-Min;Choi, Woo-Ik;Jin, Sang-Chan;Lee, Jae-Ho;Choi, In-Jang
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.78-82
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    • 2016
  • Purpose: Green tea is known as a potent anti-oxidant, anti-carcinogen, and genetic protector. Glyphosate (N-phosphonomethyl glycine) is a widely used non-selective herbicide that causes DNA damage. The present study was conducted to investigate the protective effects of green tea in human blood lymphocytes exposed to glyphosate using the Sister Chromatid Exchange (SCE) frequency method. Methods: Peripheral blood was obtained from 10 volunteers and cultured through four different conditions. Four groups were divided into control, glyphosate only (300 ng/mL), glyphosate and low ($20{\mu}m$) concentrations of epigallocatechin gallate (EGCG) and glyphosate and high ($100{\mu}m$) concentrations of EGCG. Results: The glyphosate exposed groups had a higher mean SCE frequency ($10.33{\pm}2.50$) than the control group ($6.38{\pm}2.28$, p<0.001). The low concentrations of EGCG groups had a lower mean SCE frequency ($9.91{\pm}1.93$) than the glyphosate-only group, although this difference was not significant (p=0.219). However, the high concentration group ($9.49{\pm}1.85$) had a significantly lower SCE frequency than the glyphosate-only group (p=0.001). Conclusion: EGCG has a gene protective effect in human lymphocytes exposed to the genotoxicity of glyphosate in the case of high concentrations.

Awareness of Early Symptoms and Emergency Responses to Myocardial Infarction and Stroke in People with Diabetes Mellitus Compared to Non-diabetic Population in the Community: A Propensity Score-Matched Analysis (지역사회 당뇨병 유병자와 비유병자의 심근경색증 및 뇌졸중 조기증상과 대처방안 인지도 비교: 성향점수매칭 분석)

  • Kim, Mina;Lee, Young-Hoon;Kim, Nam-Ho
    • Health Policy and Management
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    • v.30 no.3
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    • pp.386-398
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    • 2020
  • Background: We determined the differences in awareness of myocardial infarction and stroke according to the presence or absence of diabetes mellitus in the community. Methods: The 2018 Community Health Survey identified 20,812 people with diabetes mellitus aged 40-79 years. Using 1:1 matching by propensity score, 20,812 people without diabetes mellitus but with similar sociodemographic characteristics were selected as a comparison. Outcome variables were awareness of early symptoms of myocardial infarction and stroke and awareness of coping strategies in case of occurrence. Results: There was no significant difference between nondiabetic and diabetic people in terms of recognizing all early symptoms of myocardial infarction (nondiabetic, 42.7%; diabetic, 43.0%; p=0.43) and stroke (nondiabetic, 49.4%; diabetic, 49.4%; p=0.91). In addition, no significant difference was found between nondiabetic and diabetic people in the proportion of knowing correct emergency response to myocardial infarction (nondiabetic, 84.6%; diabetic, 84.4%; p=0.56) and stroke (nondiabetic, 81.3%; diabetic, 81.4%; p=0.77). Conclusion: Since people with diabetes are at greater risk of cardiovascular disease than the general public, it is important to lower the risk of disability and death by improving their awareness of early symptoms and correct emergency response to myocardial infarction and stroke.

A Genotypical Analysis of Korean REMCs and Generation of Base Line Data for the Analysis and Evaluation for Future (REMCs) Designs Using Space Syntax

  • Ullah, Ubaid;Park, Jae Seung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.1
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    • pp.17-28
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    • 2016
  • Purpose: The purpose of this paper is to analyze the spatial configurations of a sample of Korean regional emergency medical centers (REMCs) to explore its underlying genotypes and thus produce a base line data for the analysis and evaluations of future REMCs designs using space syntax theory. Methods: Space syntax analysis was used as a major tool for the analysis and exploration of Genotype. The measures of Integration(overall integration with exterior and without exterior as well as the integration of individual clinical spaces for each center), base difference factor (DF) and Space link ratio were calculated for a sample of seven Korean REMCs. Results: The result shows a strikingly similar pattern of Syntactic measures across the sample, the mean integration of sample ranges from 0.82-0.99 with exterior (while considering the exterior space as a root) and 0.81-1.01 without exterior (considering the connections of interior spaces only with no outside connection). The base difference factor (DF) of the sample varies from 0.60-0.81 with exterior and from 0.59-0.82 without exterior. Case number-1 was identified as non-genotype with differing order of Syntactic values. Although the genotype had different forms, layouts and even sizes, these results cannot be explained by Phenotypical comparisons. Implications: This study will contribute to the configurational analysis and evaluation of existing and future Korean REMCs design and practice of emergency healthcare delivery system in Korea.