Ji Wool Ko;Giho Moon;Jin Geun Kwon;Kyoung Eun Kim;Hankaram Jeon;Kyungwon Lee
Journal of Trauma and Injury
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v.36
no.4
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pp.376-384
/
2023
Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.
Kyu-Ho Yi;Hyungkyu Bae;Soo-Bin Kim;Woo-Ram Kim;Won Lee;Ji-Soo Kim;Hee-Jin Kim
Anatomy and Cell Biology
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v.57
no.1
/
pp.13-17
/
2024
Masseter are commonly botulinum neurotoxin targeted muscle for facial contouring in aesthetic field. However, paradoxical masseteric bulging is common adverse effect that has not been discussed with ultrasonographic observations. Retrospective study has been conducted from October, 2021 to January, 2023, out of 324 patients have done blinded botulinum neurotoxin injection in the masseter at the middle and lower portion of the masseter with each side of 25 units (letibotulinum neurotoxin type A), 3 patients demonstrated paradoxical masseteric bulging has been reported and the image observed by ultrasonography by physician. Based on the observations made, we can infer that the function of the moving muscle involves twisting of the muscle fibers during contraction, along with the twisting of the deep inferior tendon, which causes the muscle to be divided into anterior and posterior compartments rather than into superficial and deep compartments of masseter. In ultrasonographic observe the skin surface of a patient with paradoxical masseteric bulging, it is observable that either the anterior or posterior part contracts significantly. The functional units of anterior and posterior compartment are observable as muscular contraction of inward movement of the muscle from either the anterior or posterior functional unit.
Kim, Ki-Hong;Hong, Ki-Jeong;Haam, Seung-Hee;Choi, Jin-Woo
Fire Science and Engineering
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v.32
no.3
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pp.116-122
/
2018
In Chemical, Biological, Radiological and Nuclear (CBRN) disaster, integrated and optimized equipment package including stretcher, isolation unit, patient monitoring and treatment equipment is essential to achieve proper treatment and prevent secondary contamination. The purpose of this study was to evaluate the efficiency and ease of use of integrated CBRN disaster equipment package for disaster medical response. This study was a randomized crossover study using a manikin simulation for emergency medical technitian (EMT). All participants used the existing devices and prototype of integrated CBRN disaster equipment package alternately. Efficiency was measured by time from vital sign change to detection or treatment application. Ease was use was measured by questionnaires for each patient monitor, stretcher care and isolation unit. 12 EMTs were enrolled. hypoxia-detection time of integrated equipment group was significantly shorter than existing equipment group (4.9 s (3.8-3.9) vs 3.5 s (2.5-3.9), p < 0.05). There was decreasing tendency of ECG change detection and facial mask oxygen supply but no statistical significance was observed. Overall satisfaction of patient monitoring device in integrated equipment group was significantly higher than existing devices (4(3.5-5) vs 3(3-3), p < 0.05). The use of integrated CBRN disaster equipment package shortened the hypoxia detection time and improved usability of vital sign monitor compared to existing devices.
Purpose: Masseter muscle is an important muscle of mastication. Because it has a great influence on the shape of low facial contour, patients who have masseteric hypertrophy show square-shaped jaw appearance. As aesthetic procedures for the reduction of the masseter muscle volume, radiofrequency ablation or botulinum toxin injection is at the center of attention. Authors studied the anatomical measurement of the thickness and width of masseter muscle and the surface mapping of the maximal thickness point using computed tomography (CT) scan to identify the useful guide for the injection of botulinum toxin in masseteric hypertrophy patients. Methods: We analyzed 2 mm-thickness OMU (ostiomeatal unit) CT of 112 normal people (224 masseter muscles) taken from June 2009 to May 2010. First, we measured the thickness, width and depth of the masseter muscle from the skin surface and analysed each by side, sex and age, respectively. The distribution of the thickness of the muscle and the correlation of thickness and width of the muscle were studied also. Second, we underwent surface mapping of the maximal thickness point using CT analysis by means of checking the vertical and horizontal distance from the angle of the mandible. Results: The average thickness and width of the masseter muscle was 17.73 mm and 40.78 mm in the male patients and were 14.33 mm and 37.42 mm in the female patients. Statistically, both figures of the male patients were larger than those of the female patients. However, the depth of the muscle from the skin surface in female patients (7.37 mm) was larger than that of the male patients (6.15 mm). There were no statistical difference in side or age. The width and thickness of the masseter muscle were in the positive correlation. The location of maximal thickness point of the masseter muscle was 27.77 mm vertically and 27.68 mm horizontally in the male patients, and 25.19 mm vertically and 25.42 mm horizontally in the female patients from the angle of mandible. Conclusion: We were able to present statistical evidence of the diagnosis and treatment of the masseteric hypertrophy regarding the anatomical measurements such as the thickness and width. And the maximal thickness point of the masseter muscle may be a useful guide for the clinical procedures of botulinum toxin injection.
Kim, Hong Il;Hwang, So Min;Ahn, Sung-Min;Lim, Kwang Ryeol;Jung, Yong Hui;Song, Jennifer K.;Jeong, Jae Yong
Archives of Craniofacial Surgery
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v.13
no.1
/
pp.68-71
/
2012
Purpose: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. Methods: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. Results: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. Conclusion: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.
Ara, Shabnam Anjum;Viquar, Uzma;Zakir, Mohammed;Husain, Gulam Mohammed;Naikodi, Mohammed Abdul Rasheed;Urooj, Mohd;Kazmi, Munawwar Husain
CELLMED
/
v.11
no.3
/
pp.13.1-13.9
/
2021
Background and Objective: Nux-vomica based traditional Unani formulation, Habb-e-Azaraqi (HAZ) is an important drug used by Unani physicians since several decades. It possesses Muqawwi-i-A'sab (nervine tonic), Muharrik-i-A'sab (nervine stimulant) properties and is an effective treatment option for diseases like Laqwa (facial palsy), Falij (paralysis), Niqris (gout) and Waja'al-Mafasil (arthritis) etc. The aim of the study is to access and provide information of HAZ for its TLC, HPTLC Fingerprinting defining its clear qualitative perspective and acute oral toxicity evaluation for its safety assessment which was not done earlier, thus contributing in the field of research. Materials and Methods: The chief ingredient, nux-vomica was detoxified as per method mentioned in Unani Pharmacopeia before its use in formulation. TLC and HPTLC was developed under four detection system i.e., UV 366nm, UV 254nm, exposure to iodine vapours and after derivatization with anisaldehyde sulphuric acid. Acute toxicity studies were performed as per OECD Guidelines 425 at a limit dose of 2000 mg/kg. Observations were done for signs of toxicity, body weight, and feed consumption at regular intervals followed by haematological and biochemistry evaluation. Results: The generated data proved the authenticity and established the TLC and HPTLC profile of the formulation. Acute toxicity revealed no significant differences in HAZ-treated animals with respect to body weight gain, feed consumption, haematology, clinical biochemistry evaluation. No significant gross pathological observation was noticed in necropsy. Conclusion: Data of the present study is substantial and scientific proof of HAZ in terms of standardization and toxicity study that can be utilize in future research activities.
Seol, Young Mi;Park, Young Eun;Kim, Seo Rin;Lee, Jae Hyung;Lee, Su Jin;Kim, Ki Uk;Cho, Jin Hoon;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Young Dae
Tuberculosis and Respiratory Diseases
/
v.61
no.1
/
pp.26-33
/
2006
Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.
Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.
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