• 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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• 제19권1호
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• pp.1-7
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• 2006

Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

• 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.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.103-106
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• 2018

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

• 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.

• 대한교통학회지
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• 제35권6호
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• pp.499-510
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• 2017

2016년 우리나라 교통사고 사망자 수 4,292명 중, 노인사고 사망자 수는 1,732명에 달한다. 그럼에도, 고령 보행자의 도로횡단 특성에 대한 연구는 많지 않다. 본 연구는 보행자와 차량 간의 횡단특성을 고령 보행자 측면에서 조사 및 분석한 연구이다. 연구에서는 2개 지역, 6개 지점에 대한 횡단 조사를 실시하였으며 주요 결과를 간략히 살펴보면 다음과 같다. 첫째, 도로 횡단 시 고령자는 626건의 상충상황 중에서 528건(84.3%), 비고령자는 478건의 상충상황 중에서 303건(63.3%)이 위험상황으로 나타나, 고령자가 비고령자에 비하여 3.11배의 높은 통계적으로 유의한 위험상황에 직면하는 경향을 보였다. 둘째, 고령자의 경우 전체 626건의 상충상황 중에서 519건(82.9%)의 무단횡단이 나타났고, 비고령자의 경우 478건의 상충 상황 중에서 375건(78.5%)를 보여, 고령자가 비고령자에 비하여 1.34배의 높은 통계적으로 유의한 무단횡단 경향을 보였다. 셋째, 보행자안전간격(Pedestrian Safety Margin, PSM)을 분석결과 고령자의 PSM은 3.33초, 비고령자의 PSM은 4.04초로 고령자의 PSM은 비고령자보다 약 17.5%가 작은 경향을 보였다. 넷째, 접근하는 차량의 속도를 30km/h 이하 차량, 30-50km/h 차량, 50km/h 이상인 차량으로 나누어 보행자 안전간격의 차이를 검토해 본 결과 속도30km/h 미만 차량과 속도 30km/h 이상 50km/h 미만 차량의 PSM은 유의미한 차이를 보이지 않지만, 속도가 50km/h 이상인 차량과의 상충은 30km/h 미만과 30km/h 이상 50km/h 미만보다 PSM 이 유의미하게 작아진다. 다섯째, 위험상황의 임계치를 PSM 2.5초 이하로 설정한 경우, 고령자가 비고령자 보다 1.59-2.53배 위험하게 횡단하는 경향을 보였다. 이러한 연구 결과는 향후 고령 보행자와 비고령보행자의 횡단 행태 차이를 토대로 고령 보행자안전대책, 자율주행차량의 안전 등의 기반 연구로 활용할 수 있다.

• 재활복지
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• 제22권3호
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• pp.225-257
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• 2018

본 연구의 목적은 청각장애인이 경험하는 위험상황과 청각 대체기술로 사용하는 보조기기 사용실태를 조사하여 청각증강 기술 개발의 적용점을 모색하는 데 있다. 이를 위해 청각장애 등급을 판정받은 청각장애인을 대상으로 설문조사하여 총 355명의 자료를 분석에 사용하였다. 연구결과 첫째, 소리 및 진동을 인지한 경험이 없는 상황으로 교통수단, 사물, 자연 영역 순으로 높게 나타났다. 이 중 교통수단의 소리와 진동을 인지하지 못한 비율이 높아 일상생활에서 청각장애인이 경험하는 위험 가능성이 높은 것으로 조사되었다. 둘째, 청각장애인이 경험한 위험상황은 교통사고, 보행사고, 가정에서의 일상생활 순으로 높게 조사되었다. 셋째, 위험상황 인식과 알림을 위한 보조기기로 2G폰/스마트폰, 진동디지털알람시계, 경광등, 진동손목시계의 인지도가 높았으며, 2G폰/스마트폰의 만족도가 가장 높았다. 넷째, 의사소통을 위한 보조기기로 보청기, 스마트폰, 영상전화기, 인공와우, 2G폰 순으로 인지도가 높았으며, 스마트폰을 사용하였을 경우 만족도와 의사소통 개선정도가 가장 높게 조사되었다. 마지막으로 청각증강 기술 개발을 위해 고려할 점으로 휴대/착용 편의성, 가격, 동작 정확도 순으로 선호하였으며, 알림 전달 방식은 시각(문자와 빛)을 활용한 알림방식을 선호하였다. 연구결과에 근거하여 위험상황에서 청각장애인의 청각증강 기술 개발을 위한 정책적, 실천적 방안을 제시하였다.

• 대한토목학회논문집
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• 제40권1호
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• pp.1-11
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• 2020

도로변에 설치된 중대형 지주구조물은 적절히 방호되지 않고 차량에 노출된 경우 충돌 시 심각한 차량 파손과 탑승자 상해로 이어진다. 북미지역이나 유럽은 차량에 노출된 지주에 대한 충돌피해를 줄이기 위하여 일반적으로 분리식 지주를 사용하고 있으나 분리된 지주의 낙하 시 2차 사고의 위험이 상존한다. 이를 해결하기 위한 방법으로 슬라이딩 지주가 제안되었다. 본 논문은 국도와 지방도에 많이 쓰이는 무게 507 kg의 편주식 지주구조에 대하여 기존의 방식으로 기초에 강결된 경우와 슬라이딩 지주로 개선된 경우에 대한 1.3 ton-60 km/h, 1.3 ton-80 km/h의 충돌실험을 실시하여 강결지주의 위험도를 보이고 슬라이딩지주의 감충성능(Crashworthiness)을 입증하였다. 한편 차량중심에서 계측된 가속도가 차량과 지주의 운동을 동시에 나타낸다고 보는 기존의 충돌해석 방법 대신 고속촬영 데이터를 이용하여 지주를 차량의 운동과 분리시켜 충돌과정을 단계별로 설명함으로써 감충성능을 갖는 지주설계의 기초를 제시하였다.