• Journal of Trauma and Injury
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• v.37 no.1
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.649-656
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• 2020

Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.196-202
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• 2012

Purpose: This study aimed to recognize the frequency of near-hanging patients with elevated Troponin-I (Tn-I), to obtain information necessary for treatment and prediction of prognosis by analyzing the clinical feature of near-hanging patients, and to evaluate the relevance of elevated Tn-I to abnormal result of other cardiac-related examinations. Methods: A retrospective review for the near-hanging patients, clinical record was conducted at two urban training hospitals between April, 2001 and December, 2011. We divided included patients into two groups, which one with elevated Tn-I level ($Tn-I{\geq}0.1ng/dL$) and one without it, and compared the differences in initial vital signs, cardiac enzyme tests, an electrocardiogram, echocardiography, chest X-ray, and the clinical outcomes. Results: A total of 39 patients were included, out of them, 14 patients showed rise in Tn-I level. The length of hospital stay and ICU hospitalization was more prolonged in the patient group with elevated Tn-I level than non-elevated group. As well as the incidence of endotracheal intubation and abnormal findings in echocardiography or chest X-ray was higher in the Tn-I elevated group, which is statistically significant. Conclusion: The rising of serum Tn-I level in near-hanging patients were not uncommonly observed. We believe that the cardiac-related test including Tn-I is necessary for near-hanging patients, and those who are shown abnormal result in cardiac-related test may need close observation and intensive care.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.835-841
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• 2007

The followings are concluded from the treatment of headache in Hyungsang medicine, focussed on 11 kinds of headaches in Donguibogam. Headache is classified into overall headache and migraine according to the affected region. The causes are divided into exogenous affection and internal injury; The former brings on headache due to Wind-Cold and headache due to Damp-Heat. The latter, reversal headache, headache due to adverse rising of phlegm, headache due to regurgitation of Gi, headache due to excessive Heat, headache due to excessive Damp, true headache, and alcoholic headache. Headache due to internal injury generally tends to show deficiency syndrome with external affection. Headache due to exogenous affections is common to those who have big head or white skin and to Bangkwang type, and woman. The primary causes are Wind-Cold and Wind-Heat. When the body is observed in the perspective of eight phases, Damp-Heat is to be produced in the front, and Dry-Damp, in the back. Headache due to Damp-Heat is susceptible to Yangmyeong meridian type whose body develops more in the front and to woman. In the perspective of the upper and the lower, Yangdu(that is, head) is related to Eumdu(that is, glans of penis). Headache is also caused by the problems of Eumdu ,such as deficiency of Essence in man, pathologic change of uterus in women, and San syndrome in lower abdomen. In the case of man, headache is frequently severe and difficult to treat because head is a root for man. Disharmony of Gi and blood between the right and the left brings out migraine and headache due to regurgitation of Gi. Migraine is usually accompanied by symptoms of exogenous affection and often afflicts Gi-type, Shin-type, Soyang meridian type, deer type, and Dam-type. Headache due to regurgitation of Gi is brought by Gi deficiency or blood deficiency so that symptoms of exogenous affection do not show. It is mainly common with old people and those who have sunken eyes induced by deficiency of stomach Gi. In the perspective of the upper, the middle, and the lower, the pathologic change of head, chest and abdomen also bring about headache. The pathologic cause of head is Wind-Heat ,which triggers overall headache, migraine, headache due to Wind-Cold, headache due to excessive Heat, The pathogen of chest is phlegm-Fire and brings out headache due to Damp-Heat and headache due to adverse rising of phlegm. The pathologic factor in abdomen is Cold-Damp and produces headache due to adverse rising of phlegm and headache due to excessive Damp. In case of women, headache is generally caused by phlegm-Fire and retention of undigested food.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.809-823
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• 2023

Trauma is an injury to the body that involves multiple anatomical and pathophysiological changes caused by forces acting from outside the body. The number of patients with trauma is increasing as our society becomes more sophisticated. The importance and demand of traumatology are growing due to the development and spread of treatment and diagnostic technologies. In particular, damage to the large blood vessels of the chest can be life-threatening, and the sequelae are often severe; therefore, diagnostic and therapeutic methods are becoming increasingly important. Trauma to nonaortic vessels of the thorax and aorta results in varying degrees of physical damage depending on the mechanism of the accident and anatomical damage involved. The main damage is hemorrhage from non-aortic vessels of the thorax and aorta, accompanied by hemodynamic instability and coagulation disorders, which can be life-threatening. Immediate diagnosis and rapid therapeutic access can often improve the prognosis. The treatment of trauma can be surgical or interventional, depending on the patient's condition. Among them, interventional procedures are increasingly gaining popularity owing to their convenience, rapidity, and high therapeutic effectiveness, with increasing use in more trauma centers worldwide. Typical interventional procedures for patients with thoracic trauma include embolization for non-aortic injuries and thoracic endovascular aortic repair for aortic injuries. These procedures have many advantages over surgical treatments, such as fewer internal or surgical side effects, and can be performed more quickly than surgical procedures, contributing to improved outcomes for patients with trauma.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.172-174
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• 2005

Trauma of the vascular structure is not poplular event. In obstructive atherosclerotic vascular disease, we sometimes have needed bypass surgery. The long length subcutaneous prosthetic vascular graft are vulnerable to injury. But prosthetic vessel rupture after trauma has been rare report. A 68-year-old man was referred to Department of Emergency of the Gyeongsang National University Hospital. After he had had a blunt trauma, he found a newly appearing pulsating mass of 10 cm diameter on his right chest wall. The lesion had a turbulent blood flow in the cavity of the mass by ultrasonographic finding. The lesion was a rupture of superficial prosthetic vascular graft under the skin.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.36 no.6
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• pp.699-705
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• 2012

The role of a seat belt in a vehicle is to protect the driver from injury when a crash occurs. However when a large crash occurs, the driver slips forward and receives a strong impact. To prevent this situation, improvement of seat belts is essential. In this study, the new concept of a dynamic locking tongue (DLT) for seat belts is developed. The DLT device is used to reduce the impact to the driver's chest by tightening the webbing, so the driver is protected from severe injury in a large crash. First, a finite element model of the DLT device is created using SAMCEF and structural analysis is conducted with boundary conditions similar to those found in experiments. Then, the stress in the DLT device can be calculated. Second, the shape of the DLT device is optimized using the response surface analysis method in order to minimize the stress and weight. The validity of the optimization of the DLT device is verified using structural analysis.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.384-387
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• 2009

Radial artery aneurysm is an extremely rare disease and this is usually caused by iatrogenic trauma such as arterial cannulation. Most traumatic aneurysms in the extremities are false aneurysms and most cases have occurred at the level of the wrist. Very few true aneurysms of the radial artery have been reported, with most of them being iatrogenic. A right handed 38-year-old female had a true aneurysm of the distal radial artery in the thenar groove of the palm. The patient had a history of excessive handclapping and the injury was suggestive of repetitive occupational injury due to scissoring. She underwent surgical treatment for the aneurysm of the radial artery in the thenar groove of the palm of her hand.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.971-977
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• 1999

Background: Immunologic and inflammatory responses of cardiopulmonary bypass(CPB) influence postoperative mortality and morbidity with multiple organ injury. It has been reported that ischemia/reperfusion induced-myocardial injury during CPB is causative of release of inflammatory cytokines such as interleukin-6(IL-6) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$). The purpose of this study was to detect the time course of the activated cytokine and troponin-T(TnT), and to examine the correlation between such parameters during CPB. Material and Method: The serial samples were collected from arterial blood via radial arterial catheter in 23 patients who are underwent open heart surgery (OHS) with CPB, the IL-6, TNF-$\alpha$ and TnT were checked. Result: \circled1 IL-6, TNF$\alpha$- and TnT concentration increased significantly during CPB with a peaking level of CPB-off (p 0.05). \circled2 IL-6 had highly positive correlation with aortic cross clamping time and total bypass time(r=0.80, 0.78; p 0.05, respectively). \circled3 There was no correlation among IL-6, TNF-$\alpha$ and TnT. Conclusion: In conclusion, these data showed that elevated production of serum IL-6 during CPB was attributable to ischemia/reperfusion induced-myocardial damage. IL-6 will become a new and sensitive biological marker in assessment of myocardial damage during OHS with CPB. However, further studies will be needed to apply IL-6 in more patient population.

• Fashion & Textile Research Journal
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• v.11 no.4
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• pp.621-632
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• 2009

The purpose of this study was to analyze the physical characteristic of the wheelchair users by directly measuring the disabled men who use a wheelchair and to classify body types. The subjects were 178 male wheelchair users 20-69 years range of age. The results of this study were as follows. The cause of disability was classified into four groups; Poliomyelitis(P), Spinal Cord Injury(S), Cerebral Palsy(C), Amputee(A). There was a remarkable difference in the physical characteristic of the wheelchair users due to their cause of disability. A have greater values in all the dimensions. P have the largest drop values and smaller values in the lower body dimensions. S have greater values in the height of upper body trunk, back interscye length, and chest circumference, whereas smaller values in waist front length and thigh circumference. C have smaller values in most body dimensions except circumference of lower limb. By the factor analysis on the anthropometric data came out the result to be eight factors. The result of cluster analysis using factor scores shows the body types of wheelchair users can be divided into four body types; PY, RBB, TBP, RA. PY type is short and has the largest drop values, whereas RBB type tends to have the smallest drop values. TBP type is tall and the torso tends to be larger than those of the other types. RA type has smaller values in front body dimensions and moderate values in other dimensions. The diversity in body types should be considered among the wheelchair users.