• Journal of Trauma and Injury
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• v.36 no.3
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Journal of Trauma and Injury
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• v.29 no.1
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• pp.28-32
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• 2016

Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.550-556
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• 2002

Microscopic polyangiitis is a systemic small-vessel vasculitis that is associated primarily with necrotizing glomerulonephritis and pulmonary capillaritis. A recurrent and diffuse alveolar hemorrhage due to pulmonary capillaritis is the main clinical manifestation of lung involvement. Recently, and interstitial lung disease that mimics idiopathic pulmonary fibrosis was reported to be rarely associated with microscopic polyangiitis. Here we report two patients with microscopic polyangiitis who showed a honeycomb lung at the time of the initial diagnosis with a brief review of relevant literature.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.155-160
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• 2016

Purpose: Two years have passed since a level I trauma center was officially opened in the Gacheon Gil Hospital, South Korea. We analyzed 2014 and 2015 registered patient data from the Korean Trauma Data Base (KTDB) to identify trends in trauma patient care and factors that influence the quality of trauma care at the Gacheon Gil trauma center. Methods: Data was extracted from the KTDB included patient age, sex, systolic blood pressure at emergency room arrival, revised trauma score, injury severity score, trauma injury severity score, transfusion amount, and the cause of death was analyzed. Results: A total of 3269 trauma patients were admitted to our trauma center in 2014 and 3225 in 2015. Demographics and mechanism of injury were not significantly different between years. The severity of trauma injury was decreased in 2015 although the mortality rate was slightly increased. This requires further analysis. Conclusion: The aim of this study was to determine the general status and trends in trauma incidence and management outcomes for the Incheon area. We noted no significant changes in trauma status from 2014 to 2015. We need to collect and review trauma patient data over a long period in order to elucidate trauma incidence and management trends in the trauma field. Finally, studies using trauma patient data will indicate appropriate quality control factors for trauma care and help to improve the quality of trauma management.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.170-177
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• 2014

Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.123-128
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• 2015

Purpose: Establishment of the trauma system changed quality of trauma care in many countries. As one of the first designated level 1 trauma center in Korea, we analyzed trauma registration data in 2014. Methods: Data was extracted from Korean Trauma Data Base (KTDB) that was started from august 2013. Variables related to demographics and trauma was collected through the year 2014. Results: There were 3269 trauma patients who admitted to our hospital and registered to KTDB in 2014. Median age was 49 years, 64.4% were men, and 90% of patients were blunt in mechanism. Median injury severity score (ISS) was 5, mean revised trauma score (RTS) was 7.65. There were 138 (4.2%) deaths and 87 (2.7%) patients of them was death after admission. Conclusion: This is the first report using KTDB registration from our institution. Trauma volume is appropriate but it should be compared with other trauma centers in Korea. In future national analysis of KTDB is mandatory.

• Tuberculosis and Respiratory Diseases
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• v.75 no.1
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• pp.28-31
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• 2013

Methotrexate (MTX) has been established as a standard disease-modifying anti-rheumatic drug. If adequate disease control is achieved for a reasonable period of time, tapering the MTX dosage is recommended because the chronic use of MTX can result in opportunistic infection. We present here a case of a woman with rheumatoid arthritis taking MTX, and the woman developed actively caseating endobronchial Mycobacterium intracellulare disease with pulmonary infiltrations. After discontinuing the MTX, the patient was able to tolerate 18 months of antimycobacterial treatment without flare ups of rheumatoid arthritis, and she completely recovered from nontuberculous mycobacterial respiratory disease.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.212-217
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• 2009

Purpose: To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma Methods: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008. Results: The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region. Conclusion: From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.

• Proceedings of the KIEE Conference
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• 2009.07a
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• pp.60_61
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• 2009

최근 국내에서 345kV GIL(Gas Insulated Transmission Lines) 시스템의 실 계통 도입이 검토되고 있다. 현재까지 GIL은 원자력 발전소에서 주변압기로부터 스위치 야드까지 1km 미만의 거리에 소규모로 설치되어 운영되고 있다. 하지만 향후 본격적으로 GIL 시스템이 도입된다면 발전소 구내뿐만 아니라 수 km 이상 되는 송전급 선로에도 적용될 것이 예상된다. 현재 GIL의 시스(외함)는 100~120m 정도마다 접지를 하는 직접접지 형태를 취하고 있으나 시스에 흐르는 순환전류가 부하전류의 97% 이상 된다. 따라서 이에 따른 손실이 많이 발생되고 있어 도체에 흘릴 수 있는 허용전류 값이 감소하게 된다. 본 논문에서는 GIL 시스템에 크로스본드 접지방식을 적용하였을 때 시스 순환전류 감소 효과에 대해서 검토하고, 아울러 뇌써지나 스위칭 써지에 의한 절연통의 열화 등에 대비하기 위하여 절연통보호장치의 설치 방안에 대해서 검토하였다.

• Proceedings of the KIEE Conference
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• 2009.07a
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• pp.264_265
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• 2009

최근 국내에서 가스절연송전선(GIL : Gas Insulated Transmission Line)의 실계통 도입을 위하여 345kV급 GIL의 개발 및 적용을 위한 연구 및 검토가 수행되고 있다. 가공선로의 일부구간을 GIL로 대치하는 데 있어서, 변전소측이 원거리일 경우에는 변전소 내부의 차단기나 단로기 등 개폐 써지에 의한 과전압의 영향은 감쇄효과로 인하여 그다지 크지 않지만, 현재 설치 예정선로와 같이 변전소 측과의 거리가 약 2.6[km]로 짧을 경우 차단기 동작에 의한 개폐써지의 영향을 무시할 수 없게 된다. 따라서 본 논문에서는 GIL 시스템이 가공송전선로와 연계된 경우 근접한 변전소단에서 개폐를 가정하였을 때, GIL 시스템과 가공송전선로에서 발생할 수 있는 개폐과전압에 대하여 과도해석 프로그램인 EMTP를 이용하여 검토하였다.