• Journal of Trauma and Injury
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• 제37권1호
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Journal of Oral Medicine and Pain
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• 제45권2호
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• pp.34-38
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• 2020

Multiple myeloma is malignant neoplasm of plasma cells. Mandible lesions are rarely the first symptoms of multiple myeloma. While sensory dysfunction and pain are the main symptoms of traumatic trigeminal neuropathy, the same oral symptoms can appear in cases of multiple myeloma with developed mandible lesions. In addition, if the radiological osteoporosis or lytic lesion is seen in older patients, further examination is required to find the cause of the symptoms. In this paper, we present a case that was tentatively diagnosed as traumatic trigeminal neuropathy after left third molar extraction, but later confirmed as multiple myeloma.

• 스마트미디어저널
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• 제7권4호
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• pp.79-89
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• 2018

In recent years, falls among elderly people have gained serious attention as a major cause of injuries. Falls often lead to fatal consequences due to lack of prompt response and rescue. Therefore, a more accurate fall detection system and an effective feature extraction technique are required to prevent and reduce the risk of such incidents. In this paper, we proposed an efficient feature extraction technique based on multiple sliding windows and validated it through a series of experiments using supervised learning algorithms. The experiments were conducted using the public datasets obtained from tri-axial accelerometers. The results depicted that extraction of the feature from adjacent sliding windows led to high accuracy in supervised machine learning-based fall detection. Also, the experiments conducted in this study suggested that the best accuracy can be achieved by keeping the window size as small as 2 seconds. With the kNN classifier and dataset from wearable sensors, the experiments achieved accuracy rates of 94%.

• 한국건축시공학회:학술대회논문집
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• 한국건축시공학회 2021년도 봄 학술논문 발표대회
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• pp.40-41
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• 2021

The construction industry has the highest occupational accidents/injuries among all industries. Korean government installed surveillance camera systems at construction sites to reduce occupational accident rates. Construction safety managers are monitoring potential hazards at the sites through surveillance system; however, the human capability of monitoring surveillance system with their own eyes has critical issues. Therefore, this study proposed to build a deep learning-based safety monitoring system that can obtain information on the recognition, location, identification of workers and heavy equipment in the construction sites by applying multiple-object tracking with instance segmentation. To evaluate the system's performance, we utilized the MS COCO and MOT challenge metrics. These results present that it is optimal for efficiently automating monitoring surveillance system task at construction sites.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Journal of Yeungnam Medical Science
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• 제10권1호
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• pp.114-126
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• 1993

최근 6년간 영남대학교 의과대학병원에서 경추골절로 진단받은 100명의 환자를 대상으로 임상 및 수술소견과 방사선학적 소견을 조사하여 다음과 같은 결과를 얻었다. 1. 가장 흔히 침범되는 곳은 하부 경추중 $C_5$와 $C_6$, 상부경추중 $C_2$였다. 2. 가장 흔히 침범되는 부위는 몸체, 추궁판, 치상돌기의 순으로 나타났다. 3. 경추골절을 일으키는 손상의 기전으로는 과굴곡 손상에 의한 경우가 53%로 가장 많았고 부위별로는 과굴곡 손상때는 몸체, 골극돌기, 부횡돌기의 골절이 많았고 과신전 손상때는 상대적으로 추궁근의 골절이 많았다. 4. 과신전(1.68 fractures/patients)때보다는 과굴곡(2.26 fractures/patients) 때 좀더 심한 손상을 입는 것으로 나타났다. 5. 추궁판만의 단독골절은 드물었고 대부분이 다른 부위의 골절과 동반되어 나타났으며 이중 70%는 과굴곡 손상때 나타났다. 6. 몸체골절은 50% 이상에서 다른 부위의 골절을 동반하고 있었는데 이들 다른 부위의 골절 중에서는 추궁판골절이 가장 많았다. 7. 두개 이상의 여러 경추를 동시에 침범한 경우의 40%가 인접하지 않은 다른 부위의 골절을 보여 어떤 한 부위의 골절이 발견되었다 하더라도 반드시 전 경추에 대한 세심한 관찰로 또 다른 골절의 유무를 살펴야겠다. 8. 골전과 동반된 전위는 대부분 과굴곡 손상에서 나타났으며 약 70%가 전방전위를 보였으며 $C_{5-6}$과 $C_{6-7}$ 사이에 가장 많았다.

• Journal of Chest Surgery
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• 제43권1호
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• pp.47-52
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• 2010

배경: 외상성 횡격막 파열은 흔하지는 않지만 응급을 요하는 손상이다. 이 연구에서는 외상성 횡격막 파열의 원인, 동반된 손상의 종류, 진단 방법, 수술 후 예후 인자 등을 알아 보고자 하였다. 대상 및 방법: 2001년 1월부터 2008년 12월까지 본원 응급실을 통해서 내원한 외상 환자들 중에서 수술을 통해서 외상성 횡격막 파열로 진단된 37명의 환자를 대상으로 하였다. 외상의 종류, 동반된 손상, 술 전 활력 징후, Injury Severity Score (ISS), 진단 방법 및 수술까지 걸린 시간, 수술 시 접근 방법, 파열부위 및 파열 정도, 파열된 횡격막을 통한 장기의 이탈 정도 등이 수술 후 사망률에 미치는 영향을 분석하였다. 결과: 둔상에 의한 경우가 30명(81.1%), 관통상에 의한 경우가 7명(18.9%)이었다. 34명 (91.9%)에서 횡격막 파열 이외에 동반된 손상이 있었으며, ISS는 평균 20.8이었다. 술 후 합병증은 총 11명(29.7%)에서 발생하였으며, 술 후 사망은 6명(16.2%)에서 발생하였다. 술 후 사망에 영향을 미치는 인자로는 술 전 기관 삽입, 술 전 저혈압, 20점 이상의 ISS 등이 있었다. 결론: 외상성 횡격막 파열은 다발성 손상의 한 부분으로 발생하는 손상이며, 수술 후 예후는 횡격막 손상 자체보다는 동반된 손상 정도에 따라 결정되었다.

• 대한영상의학회지
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• 제81권6호
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• pp.1348-1363
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• 2020

2018년에 새롭게 개정된 장기 손상척도는 이전 미국외상수술협회의 응급수술분류체계와 유사한 형식을 가지며, 고형장기 손상의 등급을 지정하는 기준을 영상(imaging), 수술(operative), 병리(pathologic) 세 가지 세트로 나누어 분류하였다. 2018년 개정에서 가장 중요한 변화는 거짓동맥류와 동정맥 누공을 포함한 혈관 손상의 다중검출CT (multidetector CT; 이하 MDCT) 소견을 정의하여 장기 손상척도에 통합한 것이다. 이전 장기 손상척도와 동일하게 세 가지 기준 중에 가장 높은 등급이 최종 등급이 된다. 또한 한 장기 내에 여러 개의 1등급 또는 2등급 소견이 있으면, 다발성 손상에 대해 3등급의 부여가 가능하다. 본 임상화보에서는 2018년 개정된 미국외상수술협회 장기 손상척도의 MDCT 소견을 소개하고자 한다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.212-218
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• 1980

A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1125-1131
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• 1992

Still a lethal injury, traumatic rupture of thoracic aorta occurs more frequently than we expect and comprises significant part of causes of deaths by blunt trauma. We recently experienced a thoracic aortic rupture accompanied by multiple injuries including pericardial and interatrial septal rupture and myocardial contusion in a patient who had been injured in a fall accident. Literatures are reviewed with the concern of early diagnosis, surgical technique and the result of operation.