• Title/Summary/Keyword: Trauma system

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Direction of Development of Reaction to Bio-terrorism (생물테러리즘 대응을 위한 기술적 측면의 발전방향)

  • Lee, Kwang-Iyeol;Kim, Chang-Ho
    • Korean Security Journal
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    • no.14
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    • pp.311-336
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    • 2007
  • This study examines the concepts of counter-act against the Bio-terrorism and the reaction system in advanced countries, thereby to find out reaction system necessary to Korea. Acts on anti-Bio-terrorism is divided to detection stage, protection stage, diagnosis stage and detoxication and neutralization stage according to flow of event occurrence. As for detection stage, Korea is developing it as contact type, while advanced countries are under development of the devices that may detect the terrorism from the remote distance. It is necessary for Korea to develop the remote-distant detection system as well as the contact type of device that may promptly operate. Among the protection gears, the quality of Korea's gas mask is recognized worldwide, but that of other outfits should be improved by applying the state-of-art science technology. The diagnosis device also should be developed to the extent that the dispatched initial action team may make immediate decisions necessary in the field. As the current trends for detoxication materials worldwide require the improvement to new materials harmless to human body and equipment, Korea is also required to acquire those materials. The technology for neutralization means the development of vaccine and antibiotics and it requires the development made by shared efforts worldwide. For this purpose, it is necessary to further develop Korea's medical technology. In addition, the further efforts are required in terms of reaction manual, training model, public communication efforts and preparation for trauma syndrome.

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Clinical Experiences and Usefulness of Cervical Posterior Stabilization with Polyaxial Screw-Rod System

  • Hwang, In-Chang;Kang, Dong-Ho;Han, Jong-Woo;Park, In-Sung;Lee, Chul-Hee;Park, Sun-Young
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.311-316
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    • 2007
  • Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

Analysis of Arrival Information and Status of the Patients in Emergency Department (응급의료센터 환자의 내원 정보 및 실태 분석)

  • Lee, Sam-Beom;Do, Byung-Soo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.277-282
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    • 1999
  • Background: For effective and systematic management of patients in the emergency department(ED), the data on patient arrival and status in ED of Yeungnam University Hospital were evaluated. Materials and Methods: During the seven days from Apr. 1 to Apr. 7, 1998, the general patient information such as onset time and place, factors associated with transportation, causes of admission, cared department and patient disposition were recorded. Results: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3. Male to female ratio was 1:0.71. Daily staying patients were 17.3, and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk(57.3%). transportation by car(58.0%), place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of departments which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred patient-to-another-hospital was zero. Conclusion: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

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A Review on the Improvement of the Meaning and Composition Requirements of Interference with Fire Protection Activities - Focusing on Interference with 119 EMS Activities - (소방활동방해죄의 의미와 구성요건 개선에 관한 검토 -119구급활동 방해를 중심으로-)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.105-124
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    • 2023
  • Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

Esthetic Restoration of Complicated Crown-Root Fractures Utilizing Orthodontic Extrusion (복합 치관-치근 파절의 교정적 정출술을 이용한 심미적 수복)

  • Kim, Minji;Kim, Jinyoung;Kim, Suhyun;Lim, Sumin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.60-69
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    • 2016
  • Complicated crown-root fracture of permanent incisors cause esthetic, functional, and psychological problems to patients. Therefore, treatment is important and multidisciplinary treatment is required. This case report describes the clinical procedures involved in the treatment of trauma-induced complicated crown-root fractures in the maxillary incisor of two young patients. Conventional root canal treatment and apexification were performed in each patient. To expose the fracture margins to the supragingival level and to reestablish the biologic width, orthodontic extrusions with fixed appliances were performed followed by a retention period. During the retention period, fiber-optic posts and cores were built up and provisional crowns were placed. Finally, ceramic crowns manufactured using a computer-aided design/computer-aided manufacturing (CAD/CAM) system were placed. In both patients, the teeth presented satisfactory functional and esthetic outcomes without relapse. The periodontal tissues were healthy.

The Comparison of Balance using Cumberland Ankle Instability Tool to Stable and Instability Ankle (Cumberland 발목 불안정성 도구에 의한 안정성과 불안정성 발목의 균형 비교)

  • Kim, Ki-Jong;Jega, Hyuk;Jun, Hyun-Ju;Choi, Bum-Jin;Choi, Hyun-Jin;Yu, Seong-Hun;Kim, Young-Eok
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.361-368
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    • 2013
  • PURPOSE: The purpose of this study was to investigate the comparison of balance on Stable Ankle(SA), Instability Ankle(IA) using Cumberland Ankle Instability Tool(CAIT). METHODS: Total 54(SA: 27, IA: 27) subjects were volunteered to participate in the study. SA can be defined CAIT score ${\geq}28$, with no history of injury to ankle. IA can be defined persisting symptoms of giving way and ${\leq}24$ on the CAIT after ankle sprain. the balance measured using Biodex Balance System$^{(R)}$(BBS). BBS instability protocols used static, dynamic balance level less stable(2), moderate stable(4) and level more stable(8). RESULTS: There were significant differences at overall, Anterior-Posterior(AP), Medial-Lateral(ML) of static balance, dynamic balance level 2, 4. The dynamic balance level 8 found significant difference at ML, but not found significant differences at overall, AP. CONCLUSION: We suggest that CAIT is acquired more exact information for IA intervention, as balance measured.

Pulp revascularization with and without platelet-rich plasma in two anterior teeth with horizontal radicular fractures: a case report

  • Arango-Gomez, Edison;Nino-Barrera, Javier Laureano;Nino, Gustavo;Jordan, Freddy;Sossa-Rojas, Henry
    • Restorative Dentistry and Endodontics
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    • v.44 no.4
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    • pp.35.1-35.10
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    • 2019
  • Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

Reconstruction of High-Pressure Paint Gun Injection Injured Finger Using Free Flaps with T-Shaped Pedicles and Multiple Venous Anastomoses

  • Lee, Jun Beom;Choi, Hwan Jun;Kim, Jun Hyuk;Cheon, Nam Ju;Lee, Young Man
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.75-78
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    • 2015
  • High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

Machine Learning Approach to Blood Stasis Pattern Identification Based on Self-reported Symptoms (기계학습을 적용한 자기보고 증상 기반의 어혈 변증 모델 구축)

  • Kim, Hyunho;Yang, Seung-Bum;Kang, Yeonseok;Park, Young-Bae;Kim, Jae-Hyo
    • Korean Journal of Acupuncture
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    • v.33 no.3
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    • pp.102-113
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    • 2016
  • Objectives : This study is aimed at developing and discussing the prediction model of blood stasis pattern of traditional Korean medicine(TKM) using machine learning algorithms: multiple logistic regression and decision tree model. Methods : First, we reviewed the blood stasis(BS) questionnaires of Korean, Chinese, and Japanese version to make a integrated BS questionnaire of patient-reported outcomes. Through a human subject research, patients-reported BS symptoms data were acquired. Next, experts decisions of 5 Korean medicine doctor were also acquired, and supervised learning models were developed using multiple logistic regression and decision tree. Results : Integrated BS questionnaire with 24 items was developed. Multiple logistic regression models with accuracy of 0.92(male) and 0.95(female) validated by 10-folds cross-validation were constructed. By decision tree modeling methods, male model with 8 decision node and female model with 6 decision node were made. In the both models, symptoms of 'recent physical trauma', 'chest pain', 'numbness', and 'menstrual disorder(female only)' were considered as important factors. Conclusions : Because machine learning, especially supervised learning, can reveal and suggest important or essential factors among the very various symptoms making up a pattern identification, it can be a very useful tool in researching diagnostics of TKM. With a proper patient-reported outcomes or well-structured database, it can also be applied to a pre-screening solutions of healthcare system in Mibyoung stage.

Acute Pancreatitis Associated with Varicella Infection in an Immunocompetent Child (정상 면역기능을 가진 소아에서 수두 감염 후에 발생한 급성 췌장염 1예)

  • Oh, Ki-Won;Kim, Joon-Sung;Kim, Ja-Hyeong;Park, Sang-Kyu;Jeong, Jin-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.75-79
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    • 2008
  • Blunt trauma, drugs, infection, congenital anomalies of the pancreaticobiliary system, and multisystem diseases are the main causes of acute pancreatitis in children. Various viruses can cause acute pancreatitis, but varicella-induced pancreatitis is unusual and generally observed in adults or immunocompromised patients. We report a rare case of acute pancreatitis associated with varicella-zoster virus infection in a 6-year-old immunocompetent girl. The patient initially presented complaining of severe abdominal pain and repetitive vomiting. The patient had multiple cutaneous crusts that has been caused by preceding varicella infection and had elevated values of serum amylase and lipase. Abdominal ultrasonography demonstrated swelling of the pancreas and pancreatic duct dilatation, findings which were compatible with acute pancreatitis. The patient's clinical and laboratory abnormalities were completely normalized through conservative treatment consisting of fasting, total parenteral nutrition, and analgesic therapy.

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