• Journal of Trauma and Injury
• /
• 제33권1호
• /
• pp.38-42
• /
• 2020

Purpose: Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown. Methods: In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy. Results: The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay. Conclusions: PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

• International Journal of Automotive Technology
• /
• 제5권4호
• /
• pp.247-255
• /
• 2004

The majority of real world frontal collisions involves partial overlap (offset) collision, in which only one of the two longitudinal members is used for energy absorption. This leads to dangerous intrusions of the passenger compartment. Excessive intrusion is usually generated on the impacted side causing higher contact injury risk on the occupants compared with full frontal collision. The ideal structure needs to have extendable length when the front-end structure is not capable to absorb crash energy without violating deceleration pulse requirements. A smart structure has been proposed to meet this ideal requirement. The proposed front-end structure consists of two hydraulic cylinders integrated with the front-end longitudinal members of standard vehicles. The work carried out in this paper includes developing and analyzing mathematical models of two different cases representing vehicle-to-vehicle and vehicle-to-barrier in full and offset collisions. By numerical crash simulations, this idea has been evaluated and optimized. It is proven form numerical simulations that the smart structures bring significantly lower intrusions and decelerations. In addition, it is shown that the mathematical models are valid, flexible, and can be used in an effective way to give a quick insight of real life crashes.

• BMB Reports
• /
• 제31권2호
• /
• pp.183-188
• /
• 1998

2-chloroethylethyl sulfide (CEES) is an alkylating agent that readily reacts with a wide variety of biological molecules causing metabolic abnormality. The mechanism of cell death during CEES injury is poorly understood. We have examined the effect of exposure of thymocytes with various concentrations of CEES to determine the pattern of cell death in thymocytes injury induced by CEES. In the present study, we show that two patterns of cell death occurred by either one of two mechanisms: apoptosis and necrosis. Exposure to low level of CEES (100 ${\mu}M$) for 5 h caused an induction of apoptosis on thymocytes, as identified by the following criteria: DNA fragmentation visualized by the characteristic "ladder" pattern was observed upon agarose gel electrophoresis and morphological features were revealed by microscopical observations. In contrast, exposure to high levels of CEES (500 ${\mu}M$) induce necrotic features such as cell lysis. Thus, depending on the concentrations, CEES can result in either apoptotic or necrotic cell damage. Our findings suggest that thymocytes which are not killed directly, but merely injured by low levels of CEES, are able to activate an internally-programmed cell death mechanism, whereas thymocytes receiving severe damages apparently can not.

• 대한족부족관절학회지
• /
• 제10권2호
• /
• pp.207-212
• /
• 2006

Purpose: To evaluate the results of ankle lateral malleolar fractures classified as Danis-Weber type B accompanying osteoporosis that were treated with lag screw. Materials and Methods: 15 cases of Danis-Weber type B ankle lateral malleolar fractures that had T score of less than -2.5 in BMD(bone mineral density) test were selected from June 2003 to December 2005. 10 cases were males and 5 cases were females with mean age of 59 years. The main injury mechanism was supination and external rotation. Mean follow-up period was 16 months. Clinical and radiologic evaluation was done according to Meyer and Kumler's criteria. Results: All cases showed satisfying result and mean radiologic bone union period was 3 months. Anatomic reduction and bone union was acquired in all cases without complications including wound infection, skin necrosis, delayed union and nonunion Conclusions: Lag screw fixation seem to be excellent treatment of Danis-Weber type B lateral malleolar fractures with osteoporosis as it can minimize soft tissue injury and enable anatomic reduction with firm fixation.

• 한국자동차공학회논문집
• /
• 제20권2호
• /
• pp.64-69
• /
• 2012

Head injury is one of the most common cause of deaths in car-to-pedestrian collisions. To reduce the severity of such injuries, many international safety committees have performed headform impact test for pedestrian protection. In this paper, an adult headform impactor model is developed based on the finite element (FE) method and validated through the numerical simulation. The skin material of headform impactor is known as polyvinyl chloride skin (PVC) and its material was assumed as viscoelastic. The viscoelastic parameters of headform skin are identified by a series of trial and error methods. The new developed FE adult headform impactor is verified by the drop test and FE JARI adult headform impactor provided by Madymo program.

• 한국안전학회지
• /
• 제33권6호
• /
• pp.128-135
• /
• 2018

Currently, the government selects products that are likely to cause harm to consumers as safety management targets and classifies them into three types: safety certification, safety confirmation, and supplier conformity verification. In addition, the government conducts safety surveys on products in circulation or accident products, and recalls products that are of great concern to consumer risks. In this paper, we have developed RAP (Risk Assessment method based on Probability), which is a probability based product risk assessment method, for the classification of safety management type of product and safety investigation, and have shown an application example. In this process, information is used for the CISS (Consumer Injury Surveillance System) of the Korean Consumer Agency. In addition, we apply the cluster analysis to classify the current supervised children products into three groups. Then, we confirm the effectiveness of RAP by comparing the result of RAP application, cluster analysis result and current safety management classification type. Also, we recognize the need to review the current safety management classification criteria for classifying products into three types.

• Journal of Acupuncture Research
• /
• 제38권1호
• /
• pp.79-84
• /
• 2021

The degenerative spinal cord disease cervical spondylotic myelopathy (CSM), and cervical myelopathy caused by trauma, can result in debilitating symptoms affecting quality of life. This study used acupotomy and other Korean medicine treatments (acupuncture, herbal medicine, and physical therapy) to improve the symptoms of CSM and cervical myelopathy. The visual analog scale, the modified Japanese Orthopaedic Association scale (mJOA scale), the Nurick grading system, and the American Spinal Injury Association impairment scale were used as the evaluation criteria to determine the effectiveness of treatment. The functional status of both patients improved from mild to moderate, with improved gait, local sensation, and level of pain. The degree of spinal cord injury remained the same. The findings of this study suggest that combined Korean medicine treatments including acupotomy may be helpful in the treatment of CSM and cervical myelopathy.

• 척추신경추나의학회지
• /
• 제16권2호
• /
• pp.21-28
• /
• 2021

Objectives To investigate the effectiveness of manual therapy for neck pain caused by traffic accidents. Methods We searched six electronic databases (OASIS, KISS, RISS, NDSL, MEDLINE, and Cochrane Library) to gather randomized controlled trials using the keywords 'manual theray OR chuna OR tuina' and 'whiplash injury OR neck sprain'. Results Eight RCTs were selected based on the inclusion criteria. Four studies were meta-analyses. The systematic review found a positive effect of manual therapy for whiplash injury. All studies showed a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for neck pain caused by traffic accidents. However, this study has several limitations owing to the high risk of bias. Further clinical studies and the development of a study design are required for stronger evidence.

• 대한인간공학회:학술대회논문집
• /
• 대한인간공학회 1993년도 추계학술대회논문집
• /
• pp.243-251
• /
• 1993

With the recent issuance of a dynamic side impact test regulation in the Federal Motor Vehicle Safety Standard in the United States of America, many aspects of occupant protection in side impact crashes have been under investigation. Many investigations of real world accidents, crash test results and simulation studies have established that in side impact crashes of passenger cars, thoracic and pelvic injuries of occupant are, large part, caused by occupants' impact against the interior side of the vehicle, primarily the door. This paper is concerned with the development of a lumped mass computer model, which simulates the interaction of a struck car door and an adjacent seated occupant in side impacr, based CTP code which has been successfully used in vehicle and occupant simulation. New model developments include elimination of influence of vehicle side structure stiffness in the occupant injury responses. The model was used to investigated the effect of various door padding characteristics on occupant responses to improve vehicle safety performance. The evaluation of different crush properties of door padding have also focused to understand of behavior of impacted occupant. Results from simulations, The effects of both material coefficients $C_{f}$ and p were illustrated in terms of occupant injury criteria TTI and pelvis.

• 한국도로학회논문집
• /
• 제10권1호
• /
• pp.123-134
• /
• 2008

국내에 설치되고 있는 가드레일의 단부처리시설(end treatments)은 차량의 관통이나 전복을 유발할 수 있는 형상을 하고 있어 사고 시 탑승자가치명상을 입을 가능성이 매우 높다. 실제로 차량이 가드레일의 단부에 충돌하였을 경우, 가드레일이 차량내부를 관통하여 탑승자에게 직접적인 상해를 입히는 경우가 발생되고 있다. 본 연구에서는 미국과 유럽의 성능평가기준(performance evaluation criteria)에 근거하여 국내 실정에 적합한 단부처리시설에 관한 성능평가기준(안)을 제시하였다. 또한 외국의 설치사례 및 연구사례를 조사하여 단부처리시설의 mechanism을 파악하고 국내 도로환경 에 적합한 단부처리시설을 제안하였다. LS-DYNA 프로그램을 이용한 컴퓨터 시뮬레이션을 통해 제안된 단부처 리시설에 대한 성능을 검증한 결과 성능평가기준(안)에 모두 만족한 결과를 보였으며, 개발 단부처리시설에 대한 실물차량 충돌시험을 수행한 결과 성능평가기준(안)의 탑승자 보호성능, 단부처리시설의 거동, 충돌 후 차량의 거동을 모두 만족하였다. 국내 최초로 탑승자의 안전을 고려하여 개발된 단부처리시설이 고속도로나 국도에 설치된다면 단부충돌사고의 심각성을 감소시켜 도로의 안전성을 향상시킬 수 있을 것으로 사료된다.