• Title/Summary/Keyword: Multiple injuries

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Prognosis of Pulmonary Function in Patients with Multiple Rib Fractures

  • Park, Hee Beom;Hyun, Sung Youl;Kim, Jin Joo;Jang, Yeon Sik
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.179-185
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    • 2017
  • Purpose: Rib fracture is the most common complication of blunt thoracic trauma. We investigated the effect of rib fracture on pulmonary function in the conservatively treated patients. Methods: From January 2000 to February 2017, we reviewed the records of 72 patients with rib fracture and pulmonary function tests were performed. According to the number of rib fractures, patients were classified into two groups: less than six fractured ribs (group A) and more than six fractured ribs (group B). The groups were compared concerning demographics, underlying diseases, associated thoracic injuries, surgery, mechanical ventilator times, days spent in the intensive care unit and pulmonary function test. Results: There were no statistically significant differences in the demographic data between the two groups. Mean hospitalization was 13.5 days in group A and 27.0 days in group B (p<0.001). There was no statistically significant difference between the two groups in the pulmonary function test. Conclusions: We conclude that pulmonary function is restored by conservative treatment in patients with rib fractures even if the number of rib fractures increases. In patients with multiple rib fractures, studies comparing open rib fixation and conservative treatment of long term pulmonary function are required.

Three-dimensional printing for craniomaxillofacial regeneration

  • Gaviria, Laura;Pearson, Joseph J.;Montelongo, Sergio A.;Guda, Teja;Ong, Joo L.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.288-298
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    • 2017
  • Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.

A Study on Childhood Injury (학령전개 아동의 사고실태)

  • Kim Hee Soon;Kang Kyu Sook;Lee Ean Sook
    • Child Health Nursing Research
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    • v.5 no.3
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    • pp.349-357
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    • 1999
  • Injuries are important causes of death and disability. The Purpose of this study was to determine how often preschoolers have injuries and what factors affect the injury occurrences. The sample consisted of 360 Preschoolers who were registered at eight nurseries located in Sedaemoongu. Seoul. The data were analyzed using the SAS PC statistical package. The results of the study are as follows: During last 12 months 73.1% of 360 preschoolers had accidental injuries In an analysis of the location where the injury took place, showed that the most places were in the nursery(17.3%) and around home(14.4%), and the most place inside home were in the bedroom(13.9%) and living room(13.9%). There were the diverse and injurious risks inside the home as well as around home. The most frequent type of injury was abrasion(27.5%) and most children injured their legs(28.3%). They were treated most frequently at home(52.8%) and usually emergency treatment was performed by family members with disinfection being the main type of first aid To identify factors related to injury occurrence, multiple logistic regression was performed and the main factors were the age of child, active tendency, and mother's education level.

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Usefulness of the Base Deficit as an Injury-severity Indicator in Multiple-trauma Patients with Head Injuries (두부손상을 동반한 다발성 외상환자에서 중증도 평가지표로서 염기결핍의 유용성)

  • Kim, Bongjoo;Kang, Taekyung;Choi, Seungwoon;Kim, Hyejin;Oh, Sungchan;Cho, Sukjin;Ryu, Seokyong
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.223-229
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    • 2012
  • Purpose: The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries. Methods: Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor ($$ISS{\leq_-}15$$)-injury and major ($$ISS{\geq_-}16$$)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups. Results: In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups($-6.86{\pm}2.40mmol/L$ vs. $-1.37{\pm}0.73mmol/L$, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups($-2.50{\pm}1.28mmol/L$ vs. $-1.51{\pm}0.74mmol/L$, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832). Conclusion: We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.

Chest Trauma by Triller Accident: 8 Cases (경운기 사고에 의한 흉부손상 8례의 임상적 고찰)

  • 이지원
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.83-86
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    • 1981
  • Eight cases by power tiller accidents experienced for 3 years from Jan. 1978 to Dec. 1980 were studied clinically. The results are as follows: 1. The most of the patients were thirties to fifties, and the incidence rate of male to female 7:1. 2. The common injuries were hemopneumothorax and multiple rib fractures [respectively and the other associated injuries were hepatic and delayed splenic ruptures, and fractures of the another sites. 3. The accident forms were overturning [50.0%], falling down from the power tiller [37.5%], and collision against the power tiller [12.5%]. 4. All of the drivers and 75% of the passengers in the patients were drunken states at the accident time. 5. The common methods of treatment were closed thoracostomy [62.5%], conservative treatment [37.5%], and exploratory laparotomy [25.0%].

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Sixth and Twelfth Cranial Nerve Palsies Following Basal Skull Fracture Involving Clivus and Occipital Condyle

  • Kim, Sung-Hoon;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.305-307
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    • 2012
  • Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

Extracorporeal Membrane Oxygenation Treatment of Traumatic Lung Injury - 2 cases - (외상성 폐손상시 체외막형 산화기 치료 - 2 예 -)

  • Yang, Jin-Sung;Shin, Hwa-Kyun;Her, Keun;Won, Yong-Soon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.155-158
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    • 2011
  • Mechanical ventilation is usually the treatment of choice for severe respiratory failure associated with trauma. However, in case of severe hypoxia, mechanical ventilation may not be sufficient for gas exchange in lungs. Patients with Acute Respiratory Distress Syndrome (ARDS) undergo difficulties in oxygen and carbon dioxide exchange. Extracorporeal Membrane Oxygenation (ECMO) is the ideal therapeutic option for those patients with severe traumatic injuries. ECMO allows lungs to reserve their functions and decreases further lung injuries while increasing survival rate at the same time. We report two cases of patients with traumatic ARDS and Multiple Organ Failure including compromised heart function. The preservation of lung function was successful using ECMO therapy.

A Case of Severe Thoracoabdominal Impalement by a Steel Bar

  • Kim, Ki Tae;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.481-484
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    • 2016
  • A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up.

Laryngotracheal Separation for Chronic Intractable Aspiration (만성 흡인에 대한 후두기관 분리술의 유용성)

  • 이강진;성명훈;박범정;성원진;노종렬;민양기;이철희;이재서;김광현
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.140-145
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    • 2001
  • Background and Objectives: Intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The purpose of this study was to review the authors’experience and Patient outcome with the laryngotracheal separation (LTS) procedure. Materials and Methods A retrospective review of 9 patients who underwent LTS between 1996 and 2001 was conducted. Ages ranged from 3 to 72 years. Results : Seven patients were expected to have morbid aspiration as a consequence of acquired neurologic injuries and two were congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care and minor procedure. Following LTS, aspiration was effectively controlled in all patients and four were able to tolerate a regular diet. Conclusion : LTS is a low-risk, successful. definitive procedure which decreases the potential for aspiration, pulmonary complication, hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and Poor speech potential.

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Surgical Corretion of Ebstein's Anomaly -Report of One Case- (Ebstein 심기형의 외과적 치료 -1례 보고-)

  • 권은수
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1027-1030
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    • 1994
  • We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. Seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases[traffic accident 7 and crash injury 2] and penetrating wound in 1 case[stab wound]. The common symptoms were dyspnea[60%], chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, the rupture site was all located in the left[ 9 cases ]. In the penetrating wound, the rupture site was located in the right[1 case]. The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabdominal approach in 1 case. The postoperative mortality was 10%[1/10]. The cause of death was multiple organ failure with pulmonary edema.

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