• 대한간호학회지
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• 제22권4호
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• pp.464-475
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• 1992

Head Injuries due to traffic accidents are now the leading cause of death and long term disability in males between 30-50 years. Many patients with head injuries experience mild dysfunction of cognition without major neurosurgical problems, and this may interfere with successful rehabilitation. However, not many studies have been done to investigate the cognitive functioning following mild head injuries. The purpose of this study was to obtain injured patient's dermographic data including medical, neuropsychological and social data, and to investigate the cause of injury and alcohol use at the time of injury. This study focused on the recovery of cognitive function in patients with head injuries and used the Mini Mental State Examination(MMSE) score and its correlation with dermographic and social data. Data on 77 patients with minor head injuries who were admitted to the department of Neurosurgery in 3 and I hospital in Dae Jun from September 1991 to February 1992 were analyzed. The findings of this study are as follows ; 1) Out of the 77 cases reviewed in this study, 62 were male, 15 were female. 2) A higher incidence of injury was observed between 7:00 PM and 12:00 PM. 3) The most common cause of head injury in traffic accidents was pedestrian accidents, and the next most frequent cause was motorcycle accidents. 4) Thirteen of the 77 cases in this study were under the influence of alcohol at the time of injury, and they were all male. 5) The MMSE scores one month after injury and at discharge were significantly lower in patients with head injuries that included skull fractures than in patients without skull fractures, suggesting lower cognitive function in patients with skull fractures. 6) The level of consciousness at admission and three days after admission measured by the GCS for drivers under the influence of alcohol was lower than for sober drivers. The MMSE score was also lower for drunken drivers. 7) The MMSE score one month after the injury had a reciprocal relationship with the age of the patient. 8) The MMSE score one month after the injury and at discharge were highly correlated with the duration of unconsciousness. 9) The MMSE score one month after injury and at discharge were highly correlated with the GCS scores at admission, three days after admission, and one week after admission.

• Advances in pediatric surgery
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• 제13권2호
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• pp.119-126
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• 2007

Trauma is one of the leading causes of death in children. Abdominal trauma is about 10 % of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.296-299
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• 2012

The aorta is the most common major thoracic artery injured by blunt chest trauma. Injuries to major aortic arch branch arteries can also occur but are much less common than aortic injuries in the setting of blunt trauma. Although internal mammary artery (IMA) injury is uncommon and rarely diagnosed in cases of blunt chest trauma, it is one of the important sources of bleeding in chest trauma. IMA bleeding can cause ongoing blood loss and may lead to serious conditions such as extensive hemothorax, anterior mediastinal hematoma or its catastrophic complication, cardiac tamponade. However such arotic and branch artery injuries are not easily detected by plain radiograph, and are detected indirectly because of associated mediastinal hematoma. Herein, we report a case of IMA injury caused by blunt chest trauma secondary to pedestrian traffic accident. The injured patient was successfully treated by transcatheter arterial embolization (TAE).

• 한국재난정보학회 논문집
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• 제7권1호
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• pp.12-20
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• 2011

본 연구는 군중집회 및 군중눌림 현상의 문헌조사 및 분석에 근거하여 군중집회 및 군중집회에서의 인명피해의 특성을 알아보고자 수행되었다. 대규모 군중집회 시 인명 피해의 특성은 참가자 수와 군중 밀도가 군중집회 종류와 특성에 따라 다른 영향을 미치고 있었다. 군중 집회에 영향을 주는 변수와 그 원인들은 상황에 따라 다양한 정 혹은 부의 영향을 미치고 있었으며 그 변수들은 날씨, 참가자 수, 행사 기간, 실외와 실내, 착석과 이동, 행사 유형, 군중 감정상태, 술 혹은 약물, 군중 밀도, 관련 시설, 참가자 연령 등이었다. 이 중 군중 눌림현상은 실험적으로도 연구가 가능하였고, 사고가 유발되는 물리적 기전으로 보아 군중 압력과 군중 밀도 및 압력의 지속 시간에 영향을 받았으나 사망에 이르는 구체적인 압력 수치를 도출하려면 인간 신체와 관련된 여러 외부적 영향으로 인하여 추가적 연구가 더 필요하다.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.175-182
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• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2011년도 추계학술대회 논문집
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• pp.769-770
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• 2011

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2006년도 춘계학술발표논문집
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• pp.109-111
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• 2006

본 논문은 보행자 머리 상해치 예측을 통해 보행자 보호 법규의 만족여부를 판단하는 시스템을 구축 하는데 있다. 차량의 FE DATA와 더미 DATA를 입력하고, MADYMO solver를 이용하여 해석을 수행한다. 이를 통해 나온 결과 HIC(머리상해치)와 보행자 보호 법규에서 제시하는 HIC(머리상해치)와 비교를 통해 만족여부를 판단한다. 강화되는 보행자 보호 법규를 만족시키기 위해 차량시스템을 개선을 유도 하고 이를 통해 차량 대 보행자 사고 시 보행자의 생명을 구하는데 그 궁극적인 목적이 있다.

• Journal of Trauma and Injury
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• 제25권2호
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• pp.44-48
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• 2012

Purpose: The management of splenic injuries has shifted from a splenectomy to splenic preservation owing to immunity. The purpose of this study was to assess the kinds of management and outcomes through a review of our experience with splenic injuries. Methods: We retrospectively reviewed 47 patients with traumatic splenic injuries using by electronic medical records from Jan. 2007 and Dec. 2011. Splenic injuries were classified according to the American Association for the Surgery of Trauma (AAST) grading system. Results: There were 11 falls, 11 traffic accidents, 10 motorcylcle accidents, 10 pedestrian accidents and 5 abdominal blunt traumas. Low-grade injured patients (${\leq}$ Grade III) were 29 of 43(61.7%), and High-grade injured patients (${\geq}$ Grade IV) were 18 of 43(38.3%). In 34 patients, non-surgical treatment was performed, and 14 patients underwent a splenectomy. There were relatively more high-grade in older patients, and the high-grade-injury group showed need for a transfusion (p=0.002), more need for a splenectomy (p<0.001), a longer mean hospital stay (p=0.036), a longer ICU stay (p=0.045) and more combined organ injury (p=0.036). Conclusion: Conservative treatment should be considered in low-grade-injury patients (${\leq}$ Grade III). A Splenectomy was performed on 56% of the patients with Grade IV injuries, so a splenectomy should be considered carefully in such patients. In patients with a grade V injury, we think surgical treatment may be needed.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.201-205
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• 2006

Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.151-158
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• 2018

Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.