• Title/Summary/Keyword: Multiple injuries

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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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Clinical experience of ventilator therapy in chest trauma (인공호흡기 치료를 받은 흉부외상 환자의 임상적 고찰)

  • 서강석
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.59-63
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    • 1993
  • A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

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Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

  • Kim, Seon Hee;Song, Seunghwan;Cho, Ho Seong;Park, Chan Yong
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.372-375
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    • 2019
  • A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

A Wearable Safety Device for the Body Protection of Motorcyclists (모터사이클 운전자 신체보호용 안전장치 개발 프로세스)

  • Jang, Dong-Hwan
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.20 no.1
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    • pp.25-33
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    • 2021
  • This paper presents the development process for airbag safety devices fitted in motorcyclists' garments. Motorcycle riders often sustain multiple injuries in crashes since rider post-impact kinematics depend on several variables. This study proposes a newly inflatable safety system connected to the motorcycle by a cable. An airbag device with a mechanical triggering system is deployed when the cable detaches from its mounting clip. Airbag filling tests are performed to determine the mixing ratio of compressed gases with the severance of temperature. To estimate the airbag effectiveness to reduce riders' injuries, numerical analysis is performed using the finite element method. A comparative analysis (i.e., with and without the chosen device) was conducted to evaluate its protective efficacy. Prototype garments based on the proposed design have been created and have undergone sled tests. The proposed safety device could also be beneficial in accidents during other sports activities.

Associations between Physical Factors and Working Conditions and Occupational Injuries among Korean Workers (한국 근로자에서의 물리적 인자 및 근무여건과 직업성 손상 간의 관련성)

  • Park, Jung-hun;Sung, Joo-hyun;Sim, Chang-sun;Lee, Chan-boo;Park, Sang-jin;Lee, Ji-ho;Lee, Choong-ryeol
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.3
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    • pp.405-417
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    • 2015
  • Objectives: The aim of this study is to evaluate the association between physical factors, working conditions and occupational injuries among Korean workers. Methods: We used data from the 2nd Korean Working Conditions Survey, conducted in 2010. A total of 7,114 workers over 15 years of age were selected from among 10,019 Korean workers. The participants were interviewed using questionnaires. A multiple logistic regression model was used to analyze the associations among physical factors, working conditions and occupational injuries. Results: After the adjustment of socio-demographic factors, the odds ratio of injuries through physical factors such as vibration (adjusted Odds Ratio [aOR] 4.037, 95% CI 2.30-7.09), noise (aOR 4.562, 95% CI 2.64-7.89), high temperature (aOR 3.262, 95% CI 1.86-5.73), and low temperature (aOR 3.358, 95% CI 1.76-6.41) were greater in the exposed group than in the non-exposed group. The odds ratios of occupational injury(aOR 5.272, 95% CI 3.19-8.7 for very high speed work, aOR 3.303, 95% CI 1.95-5.60 for tight deadlines, and aOR 3.641, 95% CI 1.72-7.70 for not enough time to work) increased with increased work demands. Conclusions: In this study, physical factors such as vibration, noise, and high and low temperatures were significantly correlated with occupational injuries according to the increase in exposure intensity(p for trend <0.001). Also, working conditions such as high-speed work, tight deadlines and insufficient time to work showed significant associations with occupational injuries(p for trend<0.001).

Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury (둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전)

  • Ye, Jin Bong;Sul, Young Hoon;Go, Seung Je;Kwon, Oh Sang;Kim, Joong Suck;Park, ang Soon;Ku, Gwan Woo;Lee, Min Koo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.211-214
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    • 2015
  • The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.

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Clinical Observations of the Chest Trauma (흉부 손상에 대한 임상적 고찰)

  • 최명석
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.905-915
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    • 1990
  • A clinical evaluation was performed on 545 cases of the chest trauma those had been admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 11 years 5 months period from January 1978 to may 1989. Obtained results were as follows: 1. The ratio of male to female was 3.9: 1 in male predominance, and the majority[66.6%] was distributed from 3rd to 5th decade. 2. Nonpenetrating chest trauma was more common than penetrating about 4.6 times, and the most common cause of the nonpenetrating injuries was traffic accident[241/448, 53.8%] and of the penetrating injuries was stab wound[88/97, 90.7%]. 3. Only 79 cases[14.5%] were arrived to our emergency room within one hour after trauma. 4. The most common lesion due to trauma among these admitted patients was rib fracture[390/545, 71.6%], and the others were lung contusion[217/545, 39.8%], hemothorax[35%], hemopneumothorax[19.6%], and pneumothorax[11.8%] et al in decreasing order. 5. The associated injuries those required special treatment of other departments were 223 cases and its distributions were bone fractures[178/545, 32.7%], head injury[5.3%], and abdominal injury[6.6%]. 6. The others, but interesting chest injuries were follows: sternum fracture[3.1%], diaphragm rupture[2.6%], myocardial laceration and rupture[2 cases], bronchial rupture and laceration[2 cases], and traumatic thymoma rupture[1 case]. 7. The incidence of flail chest was 5.8%a[26/448] in the nonpenetrating injury, and the causes were multiple rib fracture which was in rows more than 4 rib fracture[20 cases], and sternum fracture[6 cases]. 8. We could managed the most of the patient with conservative treatment[43.1%] or closed tube thoracostomy[52.7%], but required emergency open thoracotomy in 64 cases

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Traumatic Tracheobronchial Injury: Delayed Diagnosis and Treatment Outcome

  • Hwang, Jung Joo;Kim, Young Jin;Cho, Hyun Min;Lee, Tae Yeon
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.197-201
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    • 2013
  • Background: Most traumatic tracheobronchial injuries are fatal and result in death. Some milder cases are not life threatening and are often missed at the initial presentation. Tracheobronchial rupture is difficult to diagnose in the evaluation of severe multiple trauma patients. We reviewed the traumatic tracheobronchial injuries at Konyang University and Eulji University Hospital and analyzed the clinical results. Materials and Methods: From January 2001 to December 2011, 23 consecutive cases of traumatic tracheobronchial injury after blunt trauma were reviewed retrospectively. We divided them into two groups by the time to diagnosis: group I was defined as the patients who were diagnosed within 48 hours from trauma and group II was the patients who diagnosed 48 hours after trauma. We compared the clinical parameters of the two groups. Results: There was no difference in the age and gender between the two groups. The most common cause was traffic accidents (56.5%). The Injury Severity Score (ISS) was 19.6 in group I and 27.5 in group II (p=0.06), respectively. Although the difference in the ISS was not statistically significant, group II tended toward more severe injuries than group I. Computed tomography was performed in 22 cases and tracheobronchial injury was diagnosed in 5 in group I and 6 in group II, respectively (p=0.09). Eighteen patients underwent surgical treatment and all four cases of lung resection were exclusively performed in group II (p=0.03). There were two mortality cases, and the cause of death was shock and sepsis. Conclusion: We believe that close clinical observation with suspicion and rigorous bronchoscopic evaluation are necessary to perform diagnosis earlier and preserve lung parenchyma in tracheobronchial injuries from blunt trauma.

Thoracic Trauma in Children (소아에서의 흉부외상)

  • 구본원;김성완
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.77-82
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    • 1997
  • Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

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