• Journal of Preventive Medicine and Public Health
• /
• v.14 no.1
• /
• pp.89-96
• /
• 1981

Of 2,740 industries in Jeonbug area which are covered by industrial insurance policy, 462 facilities which the accidents related to industry occured during the year of 1979 were studied. and the results are summarized as follows: 1. The accidents related to industry occured in 462 industries of the total 2,740 industrial facilities in Jeonbug area as of 1979. 2. The incidence rate of accident per 1,000 workers was 34.3 (49.2 in male workers and 12.8 in female workers), the frequency rate of the total industries in jeonbug area was 13.36, and severity rate was 1.3. 3. The frequency rates and severity rates by type of industry in study area were quite different to compare with those of national rates. 4. The incidence rate of construction industry was 223.6 per 1,000 workers, and that of transportation-communication industries were 78.6. 5. The proportion of industrial accidents of $20{\sim}24$ age group was 22.1 per cent of the total accidents, and the proportions decreased according to age increase. 6. The incidence rate in the industry having less than 49 workers was 20.6 per 1,000 workers, that of industry with $50{\sim]99$ workers was 26.7, that of industry with $100{\sim}199$ was 51.9, that of industry with $200{\sim}499$ was 80.2 and that of with more than 500 worker was 40.7. 7. The accidents which occured in the workers with experience of less than one year was 69.4 per cent of the total accidents, otherwise, the longer the workers have worked the less accident they have. 8. The most accidents occured in tile shift between 10 to 12 o'clock, and 16 to 18 hour 9. The primary causes of the industrial accidents were found to be collisions, machinery falling objects and falls. 10. The site of injury by type of industry were quite different, and the major site of injury was finger. 11. The laceration and open injuries of the accidents related to industry were 37.2 per cent of the total cases, and fractures or dislocations were 23.5 per cent, and contusions were 6.5 per cent. 12. Death rate of industrial accident was 5.0 per 10,000 workers, and those of industry were 47.6 in transportation, 42.8 in construction industry, 24.4 in mine industry, and 2.0 in manufacturing industry.

• Archives of Plastic Surgery
• /
• v.38 no.2
• /
• pp.199-202
• /
• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• Research in Community and Public Health Nursing
• /
• v.7 no.1
• /
• pp.138-153
• /
• 1996

Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.29 no.3
• /
• pp.413-417
• /
• 2002

Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1981.05a
• /
• pp.8.5-9
• /
• 1981

Foreign body in the esophagus is not uncommon in the otolaryngological field and esophageal perforation followed by mediastinitis is one of the most serious complications. Authors had experienced such case developed in 69 year old female patient. This woman swallowed a piece of sharp glass accidentally. Severe pain and swelling around the neck developed after ingestion. Marked subcutaneous emphysema was noted on first examination. By esophagoscopy, longitudinal laceration at right lateral wall of the cervical esophagus was noted and a lot of food debries were removed through this perforation, but foreign body could not be found. On third hospital day, patient complained chest pain and dyspnea. Mediastinal widening was noted on chest P-A. Tracheostomy was performed on next day and neck swelling decreased much. In spite of massive antibiotics, mediastinal abscess was developed and external drainage was performed on 15th hospital day. She was discharged on 38th hospital day with marked improvement and recovered completely on follow-up study. Still, we do not know where the foreign body is located.

• Archives of Plastic Surgery
• /
• v.38 no.5
• /
• pp.616-620
• /
• 2011

Purpose: Mayer-Rokitansky-Kuster syndrome (MRK) is second common cause of primary amenorrhea. It is a syndrome of vaginal aplasia and Mullerian duct anomaly. Vaginal aplasia varies from agenesis of whole vagina to aplasia of upper 2/3. For reconstructing vagina, various methods are introduced. Gracilis myocutaneous flap was the first attempt in that the flap is used in vaginal reconstruction. Various flap-based vaginal reconstruction methods have been introduced. Modified Singapore flap (pedicled neurovascular pudendal thigh fasciocutaneous flap) is one of those methods that used posterior labial artery as pedicle, and pudendal nerve branch as sensory root. As its donor lies on inguinal crease that is easily hidden and there are benefits on sexual intercourse by early sensory recovery, authors think that modified Singapore flap is effective for young MRK syndrome patients. Methods: Eight patients underwent surgery between 2008 and 2010. The flap was designed on both groin area with external pudendal artery branch as a pedicle. All flaps were fixated in pelvic cavity with absorbable suture, and additional compression on neovaginal wall was supplied by polyvinyl alcohol sponge ($Merocel^{(R)}$). Results: All patients were successfully reconstructed without flap related complications such as congestion or partial flap loss. The average size of the flap (each side) was 69.34 $cm^2$. Polyvinyl alcohol sponge ($Merocel^{(R)}$) was inserted into neovagina for 5 days on every patient. One case of rectal laceration was occurred while making pelvic pocket by OBGY team. Other complications such as lumen narrowing, wound contracture or vaginal prolapsed were not reported during 8 months of follow up. Conclusion: Modified Singapore flap is a sensate fasciocutaneous flap that is thinner than other myocutaneous flap such as VRAM, and more durable over skin graft. Therefore this is a good choice for vaginal reconstruction in MRK syndrome. And known complications of Modified Singapore flap could be reduced with careful procedure and mild compression techniques.

• Korean Journal of Hazardous Materials
• /
• v.2 no.1
• /
• pp.18-26
• /
• 2014

We analyzed the demand of competent authorities requiring adequate technical information for initial investigation of chemical accidents. Reflecting technical reports on chemical accident response by environmental agencies in the U.S. and Canada, we presented information on environmental diffusion and toxic effects available for the first chemical accident response. Hydrogen fluoride may have the risk potential to corrode metals and cause serious burns and eye damages. In case of inhalation or intake, it could have severe health effects. The substance itself is inflammable, but once heated, it decomposes producing corrosive and toxic fume. In case of contact with water, it can produce toxic, corrosive, flammable or explosive gases and its solution, a strong acid, may react fiercely with a base. In case of hydrogen fluoride leak, the preventive measures are to decrease steam generation in exposed sites, prevent the transfer of vapor cloud and promptly respond using inflammable substances including calcium carbonate, sodium bicarbonate, ground limestone, dried soil, dry sand, vermiculite, fly ash and powder cement. The method for fire fighting is to suppress fire with manless hose stanchions or monitor nozzles by wearing the whole body protective clothing equipped with over-pressure self-contained breathing apparatus from distance. In case of transport accident accompanied with fire, evacuation distance is 1,600m radius. In cae of fire, fire suppression needs to be performed using dry chemicals, CO₂, water spray, water fog, and alcohol-resistance foam, etc. The major symptoms by exposure route are dyspnoea, bronchitis, chemical pneumonia and pulmonary edema for respiration, skin laceration, dermatitis, burn, frostbite and erythema for eyes, and nausea, diarrhea, stomachache, and tissue destruction for digestive organs. In atmosphere, its persistency is low, and its bioaccumulation in aquatic organism is also low.

• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.20-27
• /
• 2024

Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.5
• /
• pp.2293-2303
• /
• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.4
• /
• pp.1690-1698
• /
• 2012

As alcohol use is one of the most important risk factors for injuries, this study was intended to clarify and evaluate any relationship between drinking patterns and the incidence rates/specific characteristics of injuries in adult populations, using a widely accepted tool, the Alcohol Use Disorders Identification Test (chronic alcohol drinking behaviors measurement, hereinafter the AUDIT) developed by the World Health Organization to help to assess the behaviors in a more accurate and reliable manner. This study used the data collected from the 2009 Korea National Health and Nutrition Examination Survey (KNHANES), in which 7,511 of 7,893 adult participants aged ${\geq}19$ years answered the questions about injuries, and excluding 104 non-respondents, 6,258 of participants in the questionnaire survey of drinking patterns were finally analyzed. The incidence rates and specific characteristics of injuries as classified by the AUDIT categories (i.e., body regions, types and mechanisms) were assessed and estimated in terms of their relative risk using t-test, ANOVA, and logistic regression. SPSS 19.0 statistical package software was employed for statistical analyses. These analyses indicate that the incidence rates of overall injuries were significantly higher in male respondents than in female respondents. The risks of alcohol use related injuries were 8.3 times higher in male respondents than in female ones. Regarding educational background, high school graduates showed the highest rates in the AUDIT with significant difference from the other groups. The married group and the group of respondents having monthly income estimated at KRW 2.01 to 3 million also showed the highest rates in the AUDIT compared to the other groups, indicating statistically significant difference. Significantly increased in problematic drinkers and those with alcohol dependence, the incidence rate of injuries body regions was 0.0371 in the head/neck, and with respect to the AUDIT and the mechanisms of external causes of injuries, transport accidents ranked first, followed by slippage, others, crash and fall. In regard to the classified types of injuries, it was statistically significant in others (e.g., laceration, contusion, addiction, or penetrating wound). In conclusion, the mechanisms of external causes of injuries as well as injuries attributed to alcohol use are very important, and a strategy is required to reduce such the injuries in the manner of decreasing the frequency of drinking after motivation by professional counsellors.