The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.
This study was designed to acknowledge the satisfaction levels of patients who have been treated in the emergency center. Specifically, to acknowledge the factors influencing patient's satisfaction levels related in the usage of emergency centers. Data was collected through patients who have used anyone of four emergency centers of university hospitals holding over 550 hospital beds, and located in Seoul. Questionnaires consisted of 31 questions. Cronbach's alpha was 0.94. Data analysis was executed with the SAS program by t-test, ANOVA and stepwise multiple regression. The results were summarized as follows. (1) The total average score for the level of satisfaction was 3.3. Regarding the service of doctors and nurses, the score was high. While the score regarding reception process, payment and second hand environment were relatively low. (2) There was a differentiation in the level of satisfaction according to the type of injured. Patents of industrial calamities had the highest level of satisfaction while patient injured by traffic accidents had the lowest level of satisfaction. (3) The factors that affect the level of satisfaction were presence of medical insurance, lapse time until treatment and the education level of the patient. Based on this, we will provide the basic data of satisfaction levels according to the characteristics of patients and the types of injuries for improvement of emergency treatment centers.
Purpose: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. Materials and Methods: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. Results: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. Conclusions: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.
Kim, Joon-Yun;Cho, Won-Gae;Park, Jong-Hwan;Lee, Chong-Kyun;Kim, Yong-Chun;Kim, Don-Kyoun
Journal of Preventive Medicine and Public Health
/
v.5
no.1
/
pp.49-56
/
1972
During the Period from 22th to November 26th, 1971, An Epidemiological Survey was performed on the Accident which was occurred by Leakage of Chloride Gases in A Chemical Industry, one of Wul San Industrial Areas. The obtained results were as follows; 1. The largest damage was observed at Yeo Cheon Dong, 5.38 Km2 in Area and 8,192 in the Residents. 2. By the age distribution of Yeo Cheon Dong, The largest damaged area resulting from chloride accident, the age group of between 10 and 39 was highly occupied with 55.2% Of all Yeo Cheon residents. 3. The number of patient was 436 totally, 198 in male and 238 in female. 4. By the age group distribution of the patient, in case of male, the largest group was under 20 age (96) and female, between 20 and 40 age group. 5. By the educational level of the patient, No-Education group was 116 (26.6%), and primary school, middle school and high school were respectively 168 (38.5%), 68 (15.6%) and 12 (2.8%). 6. By the occupational distribution of the patient, No-Occupation group was 49.7%, students and agriculture were respectively 14.4% and 8.1%. 7. By the complaints of the patient, most of all were for respiratory tract, those are coughing (56.9%), chest tightness (35.6%), sore throat (24.8%), and so forth. 8. By the injured domestic animal, the Dog was most highly injured with 46.2%.
Lee, Kug Jong;Kim, Jae Yong;Lee, Kang Hyun;Suh, Gil Joon;Youn, Yeo Kyu
Journal of Trauma and Injury
/
v.18
no.1
/
pp.1-16
/
2005
An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.
Objective : The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. Methods : In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. Results : Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value= 0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. Conclusion : The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.
KIM Young Mog;PARK Mi Yeon;MOK Jong Soo;KIM Ji Hoe;CHANG Dong Suck
Korean Journal of Fisheries and Aquatic Sciences
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v.36
no.3
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pp.193-197
/
2003
Psychrotrophic characteristics of Listeria monocytogenes YM-7 showed similar growth at $8^{\circ}C$ as L. monocytogenes ATCC 15313. But it showed different growth pattern at $4^{\circ}C.$ Thus the isolated strain from the Patient can not grow at $4^{\circ}C,$ while L. monocytogenes ATCC 15313 grow slowly. Number of the injured cells of L. monocytogenes YM-7 was higher at $-3^{\circ}C$ than at $-18^{\circ}C$ in phosphate buffer solution. The rate of the injured cell was higher in the TSB (tryptic soy broth) medium than in phosphate buffer solution at $-3^{\circ}C$ and $-18^{\circ}C.$ When L. monocytogenes YM-7 stored at $-18^{\circ}C$ in homogenized fish muscle, the cell numbers decreased by 2-3 log cycles in 12 weeks.
A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.
Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.
Kwon, Seong Gyu;Kwon, Yang Woo;Lee, Tae Wook;Park, Gyu Tae;Kim, Jae Ho
Biomaterials Research
/
v.22
no.4
/
pp.311-318
/
2018
Background: Tissue regeneration includes delivering specific types of cells or cell products to injured tissues or organs for restoration of tissue and organ function. Stem cell therapy has drawn considerable attention since transplantation of stem cells can overcome the limitations of autologous transplantation of patient's tissues; however, it is not perfect for treating diseases. To overcome the hurdles associated with stem cell therapy, tissue engineering techniques have been developed. Development of stem cell technology in combination with tissue engineering has opened new ways of producing engineered tissue substitutes. Several studies have shown that this combination of tissue engineering and stem cell technologies enhances cell viability, differentiation, and therapeutic efficacy of transplanted stem cells. Main body: Stem cells that can be used for tissue regeneration include mesenchymal stem cells, embryonic stem cells, and induced pluripotent stem cells. Transplantation of stem cells alone into injured tissues exhibited low therapeutic efficacy due to poor viability and diminished regenerative activity of transplanted cells. In this review, we will discuss the progress of biomedical engineering, including scaffolds, biomaterials, and tissue engineering techniques to overcome the low therapeutic efficacy of stem cells and to treat human diseases. Conclusion: The combination of stem cell and tissue engineering techniques overcomes the limitations of stem cells in therapy of human diseases, and presents a new path toward regeneration of injured tissues.
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