• Journal of Trauma and Injury
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• 제35권2호
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• pp.84-91
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• 2022

Purpose: The aim of this study was to analyze by age group the characteristics of patients with dog bite injuries, as well as determine which factors were associated with wound infections in those patients. Methods: We reviewed patients with dog bite injuries who presented to Gachon University Gil Medical Center in Incheon, Korea from January 1, 2014 to December 31, 2018. They were classified by age group: children (0-18 years), adults (19-59 years), or elderly (≥60 years). Event profiles, wound characteristics, and infections were compared across these age groups. Multivariable logistic regression was used to identify factors associated with wound infections. Results: Of the total 972 dog bite injuries, 272 (28.0%) were in children, 606 (62.3%) were in adults, and 94 (9.7%) were in the elderly. The median age was 30 years (interquartile range, 16-48 years) and the majority of patients (60.5%) were female. The most common place of injury was at home (73.8%) and indoors (77.0%). In children, the head and neck were the most frequent sites of injury (43%), while the most frequent site in adults and the elderly (50.8% and 59.6%, respectively) was the upper extremity. The odds ratio (OR) for wound infection was 3.997 (95% confidence interval [CI], 1.279-12.491; P=0.017) for head and neck injuries and 3.881 (95% CI, 1.488-10.122; P=0.006) for lower extremity injuries. The OR for wound infection was 4.769 (95% CI, 2.167-10.494; P<0.001) for significant injuries. Elderly patients had a higher risk for wound infection than other age groups (OR, 2.586; 95% CI, 1.221-5.475; P=0.013). Conclusions: When analyzing patients with dog bite injuries, differences across age groups were found, with the elderly at the highest risk for significant injury and wound infection. It is recommended that age-specific approaches and strategies be used to prevent dog bite wound infections.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.32-38
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• 2023

Purpose: This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods: Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2018) database, were included. Patients' demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results: Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020-1.028) and using a grinder (OR, 2.073; 95% CI, 1.877-2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40-1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639-2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297-0.781). Conclusions: Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• Korean Journal of Radiology
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• 제23권10호
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• pp.986-997
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• 2022

Objective: Whether metabolic redistribution occurs in patients with white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) is unknown. This study aimed 1) to propose a measure of the brain metabolic network for an individual patient and preliminarily apply it to identify impaired metabolic networks in patients with WMHs, and 2) to explore the clinical and imaging features of metabolic redistribution in patients with WMHs. Materials and Methods: This study included 50 patients with WMHs and 70 healthy controls (HCs) who underwent ¹⁸F-fluorodeoxyglucose-positron emission tomography/MRI. Various global property parameters according to graph theory and an individual parameter of brain metabolic network called "individual contribution index" were obtained. Parameter values were compared between the WMH and HC groups. The performance of the parameters in discriminating between the two groups was assessed using the area under the receiver operating characteristic curve (AUC). The correlation between the individual contribution index and Fazekas score was assessed, and the interaction between age and individual contribution index was determined. A generalized linear model was fitted with the individual contribution index as the dependent variable and the mean standardized uptake value (SUV_mean) of nodes in the whole-brain network or seven classic functional networks as independent variables to determine their association. Results: The means ± standard deviations of the individual contribution index were (0.697 ± 10.9) × 10^-3 and (0.0967 ± 0.0545) × 10^-3 in the WMH and HC groups, respectively (p < 0.001). The AUC of the individual contribution index was 0.864 (95% confidence interval, 0.785-0.943). A positive correlation was identified between the individual contribution index and the Fazekas scores in patients with WMHs (r = 0.57, p < 0.001). Age and individual contribution index demonstrated a significant interaction effect on the Fazekas score. A significant direct association was observed between the individual contribution index and the SUV_mean of the limbic network (p < 0.001). Conclusion: The individual contribution index may demonstrate the redistribution of the brain metabolic network in patients with WMHs.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.179-183
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• 2005

Whiplash injury commonly seen in automobile accident. This type of acceleration-deceleration injury may rarely lead to unfavorable outcomes as in the case of retropharyngeal hematoma. Because this lesion has the possibility of compressing the potential airway acutely or gradually, not only the rapid assessment and treatment but also closed observation are needed. We report a case of a 20-year-old man, who sustained a whiplash injury from contact with the headrest of his seat after his car was involved in a rollover. He had no symptom except posterior neck pain initially, but complained odynophagia and acute dyspnea after 10 hours of admission. The diagnostic work-up comprising lateral radiograph, CT imaging disclosed the rare constellation of a retropharyngeal hematoma with cervical spine fractures. Medical treatment and close observation were sufficient for the patient because he had no progressive dyspnea or major dysphagia.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.135-140
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• 2005

Backgrounds: Dog bite is the most common cause of animal bites. This study was conducted to analyze dog bite patients and to compare the differences of groups based on age. Methods: We performed a retrospective analysis of patients admitted to our hospital after dog bite injuries from January 2003 through December 2004. The patients were divided into two groups based on age; group A (children, < 15 years) and group B (adult, ${\geq}15years$). Results: A total of 103 patients were enrolled in the study. Dog bite injury frequently occurred to children under 10 years of age (21%). Home was the most common place of dog bite in group A, but public place was the most common in group B (p=0.000). Face was the most frequent body region of dog bite in group A, but hand was the most frequent in group B (p=0.039). Conclusions: From this study, we found statistically significant differences between the groups. Knowledge about age-related characteristics could result in improved prevention and treatment of these injuries.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.178-182
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• 2006

Compartment syndrome has a wide spectrum from muscle pain to a life- threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.135-142
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• 2006

Purpose: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). Methods: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. Results: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. Conclusion: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.105-112
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• 2006

Purpose: Many stresses produce reactive oxygen species and bring about mechanism of antioxidant reaction. Cytokine and a neurotransmitter through the cell membrane, as well as signal transduction through the cell membrane, are used for various pathological condition of the brain, such as neurodegenerative disease. There are several antioxidant enzymes in cells (superoxcide dismutase, glutathion peroxidasae, peroxiredoxin catalase, etc.) Methods: This study used single- or double-label immunohistochemical techniques to analyze mouse spinal neuron cells expressing Prx I and Prx III after acute mobilization stress. Results: Prx I was observed in dendritic cell of the gray matter of the spinal cord, and Prx III was observed in the cytoplasm of the GM of the spinal cord. Conclusion: The results of this study will help to explain differences of expression in the distributions of the peroxiredoxin enzymes of the spinal cord.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.173-177
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• 2006

Hydrofluoric acid is a colorless gas or fuming liquid with a strong, irritating odor. Hydrofluoric acid burns are uncommon; however, if severe burn occur, they caused death from systemic effects, such as fatal cardiac arrthmia. We experienced two cases of hydrofluoric acid chemical burns on digits. These patients had typical clinical features of hydrofluoric acid chemical burns, such as pulsating pain at the burn site, as well as ischemic and necrotic skin changes. The hydrofluoric acid chemical burn was confirmed by a history of exposure. Subsequently, we made a calcium gluconate gel by mixing 20% calcium gluconate, an antagonist against hydrofluoric acid, with lubricant, and we injected 10% calcium gluconate subcutaneously when they complained of pain rated at higher than 5 on the pain scale. Simultaneously, we monitored the patients' electrocardiographs and checked their serum total calcium, ionized calcium, and magnesium levels serially. Clinical presentations and the emergency management of hydrofluoric acid chemical burns were reviewed along with the current literature. These patients were discharged without any significant complications.