• Journal of Trauma and Injury
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• 제26권3호
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• pp.243-247
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• 2013

Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• 대한한방내과학회지
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• 제40권6호
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• pp.1179-1192
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• 2019

Objectives: The purpose of this study was to prepare basic data to build an Oriental medicine support system for sexual violence victims through a survey on perceptions of Korean medical doctors about sexual violence. Methods: From 18 September 2019 to 24 September 2019, the online survey was conducted by both Korean medical doctors and students of the Korean Medical College. Thereafter, a quantitative statistical analysis was conducted on data from a total of 1,011 respondents, including 749 doctors and 262 students. Results and Conclusions: Many of the doctors and the students who answered were not fully aware of public services and legal systems related to sexual violence. Most Korean doctors had very little experience in treating victims of sexual violence. Most respondents thought that the number of designated Oriental medicine institutions for sexual violence victims should increase, and related education and Oriental medicine manuals would be essential. Most respondents said that information about trauma treatment would be essential. In addition, the Korean medicine group showed overall good scores in the perception of sexual violence. However, there were statistically significant differences in perception between males and female, and among age groups. We hope that this study could be used as basic data for establishing an Oriental medicine support system for sexual violence victims.

• 한국산업정보학회논문지
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• 제6권4호
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• pp.12-21
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• 2001

최근 들어 작업강도가 심화, 노동환경의 변화 등으로 단순반복작업자의 누적외상장애가 많이 발생하고 있다. 따라서, 본 연구는 단순반복작업자의 근피로도를 분석하기 위하여 수작업과 Air Balance 시스템 설계장치를 이용할 때 각 근육의 피로도의 차이를 밝히고 단순반복작업의 기계에 의한 시스템설계제안을 목적하였다. 연구 결과, 내화벽돌 적재작업시에 수작업과 Air Balance 시스템을 이용한 근피로도 비교에서 Air Balance를 이용한 적재작업에서는 수작업 대비 근육별 AEMG 64.1%, MF 65.3%, MPF 64.3%, ZCR 63.6%로 근피로도가 낮게 나타났다. 근육의 동원정도는 전체적으로 비슷한 천이를 보였다. 즉, Aire Balance시스템을 사용하는 것이 수작업보다 근피로도 값은 낮게 나타났으며, 누적외상성 질환에 대한 노출도 작은 것으로 나타났다.

• Journal of Microbiology and Biotechnology
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• 제33권8호
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• pp.1101-1110
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• 2023

Streptococcus mutans is the primary causative agent of caries, which is one of the most common human diseases. Thus, rapid and early detection of cariogenic bacteria is critical for its prevention. This study investigated the combination of loop-mediated isothermal amplification (LAMP) and microfluid technology to quantitatively detect S. mutans. A low-cost, rapid microfluidic chip using LAMP technology was developed to amplify and detect bacteria at 2.2-2.2 × 10⁶ colony-forming units (CFU)/ml and its detection limits were compared to those of standard polymerase chain reaction. A visualization system was established to quantitatively determine the experimental results, and a functional relationship between the bacterial concentration and quantitative results was established. The detection limit of S. mutans using this microfluidic chip was 2.2 CFU/ml, which was lower than that of the standard approach. After quantification, the experimental results showed a good linear relationship with the concentration of S. mutans, thereby confirming the effectiveness and accuracy of the custom-made integrated LAMP microfluidic system for the detection of S. mutans. The microfluidic system described herein may represent a promising simple detection method for the specific and rapid testing of individuals at risk of caries.

• 대한장애인치과학회지
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• 제9권2호
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• pp.127-130
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• 2013

Hypoxic ischemic encephalopathy (HIE) is an important cause of permanent damage to central nervous system cells, most cases with oxygen deprivation in the nenonate due to birth asphyxia. Survival children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other permanent neuro-developmental disabilities. This article report two cases of the children with HIE who had be traumatized on their teeth from oropharyngeal airway (OPA) in the emergency situation. The patients with the disease accompanying seizure or convulsion, needs special consideration for the prevention from dental trauma in emergency airway management.

• 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.

• 한국산업정보학회논문지
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• 제6권3호
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• pp.79-86
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• 2001

신종 직업병 중 누적외상성질환(Cumulative Trauma Disorders)은 고도로 분업화된 현대 산업환경에서 주로 수작업을 수행하는 종사자에게 발생된다. 본 연구는 단순반복근로자의 누적외상성질환에 노출되는 정도를 EMG시스템을 이용하여 분석한 결과는 다음과 같다. AEMG에서는 작업경과에 따라 근피로도는 증가하다가 작업 완료시에는 근피로도가 내화벽돌을 들기 전보다 감소하였다. MF와 MPF에에서는 천극근, 다열근의 근피로도가 많은 것으로 나타났다. ZCR에서는 모든 내화벽돌의 무게에서 작업전과 작업후의 근피로도가 가장 낮게 나타났다. 종합적으로 작업진행이 계속됨에 따라 근육피로도는 증가하고 있었고, 단순반복운반작업시에 천극근과 다열관에 대한 근피로도가 큰 것으로 나타났다.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.128-133
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• 2009

Purpose: Bicycle riding is a healthy and cheap form of transportation and a popular form of recreation. This study aims to evaluate the epidemiology and the factors affecting the severity of bicycle-related injuries and to find effective methods for preventing injuries. Methods: This is a retrospective study of the patients'characteristics, the injury severity, the injury location, the effect of safety equipment on the bicycle injury based on information collected through the NEDIS (National Emergency Department Information System) from 1,284,429 patients who visited 55 emergency rooms nationwide. Results: During the research period throughout 55 emergency rooms 5,671 patients were seen because of bicycle injuries. The male-to-female ratio was 3.1:1, the median age 28 years old, and 42.6% of the patients were younger than 20 years old. Injury sites were mostly in the extremities(46.7%), the head(32.4%), and the face(14%), and 70.3% of severely injured patients had accompanying head trauma. Males aged 65 and older was possibly associated with severe head trauma. Of the patients who provided helmet information 4.8%(71patients) used helmets, and 95.2%(1392 patients) did not. In this group of patients providing helmet information, none of those wearing helmets died, but 0.4% of those not wearing helmets died. Conclusion: In this study, most bicycle injuries occurred in young adult men. From now, there seems to be a need for more effort on publicity activities on bicycle injuries and on the education of children and teenagers, who show a high incidence rate, and of senior citizens (over 65 years old) who show a high severity rate, about using a safety helmet to reduce the severity of injury.