• Journal of Trauma and Injury
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• v.23 no.2
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• pp.134-141
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• 2010

Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation.

• Journal of The Korean Association For Science Education
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• v.33 no.5
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• pp.893-910
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• 2013

The purpose of this study was to identify changes in mental models of students in the elementary school about causes of seasonal changes. During a total of eight sessions, eight sixth graders were asked to describe the causes of seasonal changes through pictures, writing and thinking aloud by using microgenetic research methods, and the changes in mental models were examined. When the research was conducted, linguistic and behavioral factors and contents of interviews of participants were recorded on video. Moreover, a variety of materials such as field observation chart were written by a researcher and mental models records were written by a student. The protocol was written by integration of collected results, and it was repeated to read and was inductively categorized. The results of this study were as follows: First, participants' mental models about causes of seasonal changes were changed in various paths within and across sessions. Participants' mental models that had been more changed in various ways were closer to the scientific model. In addition, like rotation and revolution, students who correctly established the preconceptions related to seasonal changes formed the mental models consistent with scientific concept based on new information. On the other hand, students who did not correctly establish the preconceptions did not deviate from non-scientific mental models. Second, prior knowledge, experience and information which participants held in advance, accuracy of prior knowledge, resolution of inconsistency between new knowledge and existing mental models, activation of mental models through operation of models and drawing an picture affected the changes of mental models. Teachers should provide to learners with sufficient experience which can be configured to various mental models in order to form the scientific concepts. And they need to let learners feel the doubt and resolve it through presentation of new teaching material which is inconsistent with the existing mental models.