• Title/Summary/Keyword: Pelvic injury

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A Review of the Study on Complementary and Alternative Medicine in Obstetrics (임신 중 한의학 관련 보완대체의학 활용 연구 동향 분석을 통한 한방 산과학의 활성화 방안 연구 (2000년대 연구를 중심으로))

  • Lee, Yoon-Jae;Hwang, Deok-Sang;Lee, Chang-Hoon;Lee, Kyung-Sub
    • The Journal of Korean Medicine
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    • v.30 no.1
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    • pp.137-149
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    • 2009
  • Objectives: Pregnant women could have various diseases, but the treatment of medication has the limitation that could cause fetal injury. So pregnant women have used complementary and alternative medicine in the world, but korean medicine had not been actively studied on obstetrics. This study is to investigate efficacy and safety of complementary and alternative medicine on obstetrics. Methods: We searched for papers which had pregnancy, obstetrics, complementary medicine, acupuncture and herb in the pubmed since 2000. Results: 41 papers were found. Acupuncture have the efficacy and safety on nausea, pelvic pain in pregnancy and breech presentation. Complementary alternative medicine had been studied as randomized controlled trial at various diseases in obstetric. But the method were without coordination, results were different from methods. So more clinical trials about complementary and alternative medicine would be needed. Massage and acupressure would be helpful for pregnant mood complaint. Conclusion: Complementary and alternative medicine has been proved as efficacy and safety in obstetrics, so complementary and alternative medicine would be helpful method in pregnant women. For making guidelines on complementary and alternative medicine treatment during pregnancy, more research will be needed.

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Factors for Predicting the Need for an Emergency Blood Transfusion to a Multiple Trauma Patient Using Emergency Room Transfusion Score (ETS) (다발성 외상 환자에서 Emergency Room Transfusion Score (ETS)를 이용한 응급수혈의 예측인자)

  • Jo, Hyeon Kyu;Park, Yong Jin;Kim, Sun Pyo;Kim, Seong Jung;Cho, Soo Hyung;Cho, Nam Soo
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.1-8
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    • 2015
  • Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas received an emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture.

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Fat Embolism Syndrome Which Induced Significant Cerebral Manifestation Without Respiratory Distress (호흡기 증상 없이 발생한 뇌 지방색전증 1례)

  • Kim, Hyung Geun;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.175-178
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    • 2005
  • Fat embolism syndrome is a collection of respiratory, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of clinical syndrome is low while the embolization of marrow fat appears to be an almost inevitable consequence of long bone fractures. The pathogenesis is a subject of conjecture and controversy. There are two theories which have gained acceptance(mechanical theory, biochemical theory). Onset of symptom is usually within 12 to 72 hours, but may manifest as early as 6 hours to as late as 10 days. The classic triad of fat embolism syndrome involves pulmonary changes, cerebral dysfunction and petechial rash. The cornerstone of treatment is preventing the stress response, hypovolemia and hypoxia and operative stabilization of fractures. Corticosteroid are the only drugs which have repeatedly shown a positive effect on the prevention and treatment of fat embolism syndrome. We report a case of post-traumatic fat embolism syndrome with severe cerebral involvement without respiratory distress. A 55 years old female had a traffic accident. She sustained pelvic bone fracture and both humerus fracture. Approximately 4 hours after the accident, mental status change developed without a focal neurologic deficits. She had no respiratory symptom and sign. Her brain MRI showed multiple cerebral fat embolism lesion. The patients received supportive treatment with corticosteroid, albumin. Her neurologic status stabilized over several days. After orthopedic surgery, she was discharged 62 days after admission.

Sacral Insufficiency Fractures : How to Classify?

  • Bakker, Gesa;Hattingen, Joerg;Stuetzer, Hartmut;Isenberg, Joerg
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.258-266
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    • 2018
  • Objective : The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. Methods : Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males. All patients had a computer tomography of the pelvic ring, two patients had a magnetic resonance imaging additionally : localization and involvement of the fracture lines into the sacroiliac joint, neural foramina or the spinal canal were identified. Results : Patients were aged between 46 and 98 years (mean, 79.8 years). Seventy-seven patients had an unilateral fracture of the sacral ala, 41 bilateral ala fractures and 12 patients showed a fracture of the sacral corpus : a total of 171 fractures were analyzed. The first group A included fractures of the sacral ala which were assessed to have no or less mechanical importance (n=53) : fractures with no cortical disruption ("bone bruise") (A1; n=2), cortical deformation of the anterior cortical bone (A2; n=4), and fracture of the anterolateral rim of ala (A3; n=47). Complete fractures of the sacral ala (B; n=106) : parallel to the sacroiliac joint (B1; n=63), into the sacroiliac joint (B2; n=19), and involvement of the sacral foramina respectively the spinal canal (B3; n=24). Central fractures involving the sacral corpus (C; n=12) : fracture limited to the corpus or finishing into one ala (C1; n=3), unidirectional including the neural foramina or the spinal canal or both (C2; n=2), and horizontal fractures of the corpus with bilateral sagittal completion (C3; n=8). Sixty-eight fractures proceeded into the sacroiliac joint, 34 fractures showed an injury of foramina or canal. Conclusion : The new classification allowes the differentiation of fractures of less mechanical importance and a risk assessment for possible polymethyl methacrylate leaks during sacroplasty in the direction of the neurological structures. In addition, identification of instable fractures in need for laminectomy and surgical stabilization is possible.

The Use of Internal Obturator Transposition for Perineal Herniorrhaphy in Three Dogs (개에서 내폐쇄근 변위술을 이용한 회음탈장 정복 3예)

  • Yoon, Hun-Young;Kang, Myung-Gon;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.632-636
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    • 2009
  • Three dogs presented to the Veterinary Medical Teaching Hospital of the University of Konkuk and Hangang Animal Hospital with a history of perineal swelling. No tenesmus, stranguria, or any clinical signs other than the swelling was observed by the owners in three dogs. On physical examination, the swelling was observed unilaterally in two dogs and bilaterally in a dog. Digital palpation to the swelling confirmed reducible perineal herniation in two dogs and irreducible perineal herniation in a dog. Plain radiographs revealed that no pelvic or abdominal contents other than the fat were displaced into subcutaneous perineal region in three dogs. Internal obturator transposition herniorrhaphy was performed for correction of perineal herniation in three dogs. Contralateral herniation involving fat was noted after surgery in a dog. The follow-up information was based on physical examination by veterinarians or telephone interview with owners. The owners reported that there was no evidence of complications related to surgery such as sciatic nerve injury, rectal prolapse, wound dehiscence, or perineal hernia recurrence in all dogs.

The analysis on the use experience of other medical institution for the same symptoms and the frequent diseases of outpatients of Korean medical institution: Based on the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey (한의 외래서비스 이용자의 동일 증상에 대한 타 의료기관 이용 경험과 다빈도 질환 분석: 2017년 한방의료이용 실태조사를 이용하여)

  • Cheon, Chunhoo;Kim, Jihyun;Cho, Yongkyu;Choi, Daepum;Yoon, Sanghoon;Cha, Jiewon;Jang, Bo-hyoung;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.3
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    • pp.13-20
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    • 2019
  • Objectives : The aim of this study is to investigate the use experience of other medical institution of outpatients of Korean medical institution. Methods : Cross-sectional study using the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey was conducted. Demographic variables and frequent diseases were analyzed according to the experience of using other medical institutions. The proportions of experience of using other medical institutions of patients with frequent diseases of Korean medical outpatient were analyzed. Results : Fifty-three percent of outpatient had experiencing using other medical institutions for the same symptoms. The frequent diseases of the two groups were similar. The proportion of single use of Korean medicine for injury of lumbar and pelvic, rhinitis, and menstrual disorders were relatively high. Conclusions : There was no notable difference in the frequent diseases according to use experience of other medical institution. Further studies on this topic are needed.

Understanding and Exercise of Gluteus Medius Weakness: A Systematic Review

  • Baik, Seung-min;Cynn, Heon-seock;Kim, Seok-hyun
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.27-35
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    • 2021
  • A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

Traumatic Asphyxia with Compressive Thoracic Injuries -4 Cases Report- (흉부손상에 의한 외상성 가사 4예)

  • 김현순
    • Journal of Chest Surgery
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    • v.13 no.3
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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.

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Giant Urethral Stone Presenting as a Scrotal Mass and Urethral Fistula (척추 손상 환자에서 고환 종물로 오인된 거대 요도 결석과 요도루)

  • Park, Seung Chol;Lee, Jea Whan;Choi, Jeong Woo;Hwang, Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.208-212
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    • 2017
  • A urinary calculus in the urethra is rarely seen and usually encountered in men with a urethral stricture or diverticulum. Herein, we report a rare case of a giant calculus in the urethra of a 42-year-old male patient with paraplegia after spinal cord injury due to car accident 20 years ago. A recent urologic consultation from the emergency room was performed since the patient had multidisciplinary symptoms during the day without any urination and presented with urinary difficulties due to hematuria and pain symptoms occurring with a mass in the bottom of the testicles. Abdomen and pelvic computed tomography (CT) was performed to examine the tumor mass, which was found to be absent. In addition, urethral stones were observed in the CT. Cystostomy was performed after the first urethroplasty, and the stone was removed from the urethra. Two weeks later, the patient was subjected to urethrography to remove the Foley catheter. No specific finding in voiding was detected. Giant urethral stones sometime require differentiation from tumor status. Treatment may vary according to size and location, requiring careful examination.

Electroacupuncture and "Duhuojisheng-tang" Administration for Postoperative Treatment in 3 dogs with Traumatic Spinal Cord Injury (외상성 척수 손상에 대한 척추 수술을 한 3마리의 개에서, 술 후 처치로써 전침과 독활기생탕을 적용한 증례)

  • Kim, Min-Su;Kim, Se-Hoon;Cha, Jae-Gwan;Kim, Nam-Soo;Kang, Hyung-Sub
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.318-322
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    • 2011
  • Three dogs with severe traumatic spinal cord injury (TSCI) due to falling wound were admitted to the Veterinary Medical Center, Chonbuk National University for evaluation of severe pelvic limbs paralysis without deep pain, normal defecation and urination. Based on physical examination, neurological assessment and computed tomogram (CT), the diagnosis was made as subluxation and compressed fracture. All the cases were surgically treated with dorsal laminectomy and a spondylosyndesis using pin and bone cements. For 2 weeks, the dogs didn't show any improvement. Consequently, the dogs were treated with electroacupuncture (EA) and Duhuojisheng-tang (DHJST). All the dogs got back the deep pain and presented wagged tail on 14-35 days after starting EA with DHJST. Especially, two of 3 dogs recovered almost normal ambulation and capacities of urination and defecation. But, one dog failed to regain normal ambulation due to inflammation of operative site which is thought to be caused by the bone cement. From these cases, it was thought that the combination of EA and DHJST mightbe one of the suitable therapies in dogs with no neurological improvement.