• Journal of Trauma and Injury
• /
• 제30권3호
• /
• pp.91-97
• /
• 2017

Purpose: Purpose: The prognostic factors of non-operative management (NOM) in high-grade spleen injuries have been extensively studied, but factors that would help treatment decisions are lacking. We compared the characteristics of the patients to identify the factors affecting treatment choices. Methods: This is a review of 207 blunt spleen injury patients from January 2004 to December 2013. We compared clinical features and mortality between surgery and NOM, and used multivariate regression analysis to find the factor most strongly associated with prognosis. Results: Of the 207 patients, 107 had high-grade spleen injury patents (grade III or above). Of these, 42 patients underwent surgery and 65 patients underwent NOM. The mortality was 7% following surgery, 3% with NOM. The amount of packed red blood cells transfused in the first 24 hours and spleen injury grade were associated with management type, and mortality was highly associated with activated partial thromboplastin time (aPTT) and spleen injury grade. Conclusions: The grade of spleen injury was associated with management and mortality, so correctly assessing the spleen injury grade is important.

• Journal of Trauma and Injury
• /
• 제28권4호
• /
• pp.284-291
• /
• 2015

The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

• 보건교육건강증진학회지
• /
• 제23권3호
• /
• pp.135-147
• /
• 2006

Objective: This study was performed to identify the related factors of exercise injury throughout the actual cases among patients. Method: The subjects of the study consisted of 304 patients(209 male and 95 female) over 20's in seoul and kyonggi area, and data collected by using questionnaires were analyzed with SPSS/WIN 11.0 program. To prove the relative factors of exercise injury from hospital patients Results: 1) It was found that the general degree of exercise injury showed significant difference regarding gender, age and education level. In other words, if it was male, young and high school graduate, the portion of exercise injury for the person was higher than others. On the other hand, the duration of medical treatment for the patient, who is male, old and college graduate took longer than the others. 2) It demonstrated that the lower extremity was most intensively damaged due to the exercise injury, especially, knees and ankles had the most portion of exercise injury and a sprain was the most common form of exercise injury for these body parts. 3) The degree of exercise injury regarding of exercise maintains significant difference with the frequency of exercise. In fact, the more exercise was done by a person such as 3 to 4 days a week, the less duration of medical treatment for the person was taken. 4) It also showed that there was significant difference between the habit of exercise and the degree of exercise injury. In other words, a person had better exercise habit, it took the person less duration of medical treatment. As well, if someone had better warming up, he or she had lower degree of exercise injury after all. Conclusion: Consequently, according to the data, the research suggested that the male needed more carefulness than the female in exercise. Old age people needed to be more careful of getting sprain of knee and ankle in particular. As well, it concluded that people needed not only enough warming up before doing exercise but also positive habit of exercise in order to minimize the exercise injury.

• Archives of Plastic Surgery
• /
• 제34권2호
• /
• pp.269-273
• /
• 2007

Purpose: High-pressure injection(HPI) injury is an injury caused by accidental injection of substances by industrial equipment. HPI injury of the hand is a serious injury that can be potentially devastating. There have been a number of publications on the results of its treatment and its functional outcome of these hands. Unfortunately, the clinical outcomes were unsatisfactory following an initial treatment approach of digital expression of the injection material, elevation, soaks, dressing changes, and antibiotics. Methods: A 43-year-old right handed man sustained a high pressure injection injury to the tip of the left index finger. The injected material was industrial paint thinner. Tissue necrosis was noted at the pulp of the finger. Several debridements and irrigation were required. A pedicled chest flap transfer was performed on the eighteenth day after injury as the dorsal nail complex remained viable. This is a retrospective review of our experience with high-pressure finger injection injury caused by paint. A literature review, retrospective chart and radiologic review were presented. Results: Follow-up length was about 1 year. The injuried hand was left nondominant hand, the index. Patient complaints were cold intolerance, paresthesia, contact pain, and impairment of activities of daily living. Conclusion: The outcome of high-pressure injection injuries of the hand is affected by many factors. The time between injury and operative treatment has been regarded as a key determinant by a number of authors. The nature of the injected material is probably more important. It has been noted by many authors that injuries with paints have a worse outcome than those with oil or grease. This study confirms the fact that high-pressure injection injury caused by paint thinner to the hand is a significant problem. Virtually a patient suffers sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.

• 대한정형외과스포츠의학회지
• /
• 제3권2호
• /
• pp.107-110
• /
• 2004

슬관절 손상과 동통의 치료 방법은 크게 보존적 치료와 수술적 치료로 나눌 수 있다. 보존적 치료로도 충분한 경우에도 과도한 수술적 치료를 시행하는 것을 볼 수 있는데, 이는 여러가지 면에서 바람직하지 않다. 따라서 손상의 기전을 명확히 알고 치료 방법을 선택하여 야 하겠다. 여기에서는 슬관절 손상 환자에서 손상 기전을 알아보고, 치료에 있어 보존적인 방법에 대해 알아보고자 한다.

• 대한기관식도과학회지
• /
• 제14권1호
• /
• pp.42-45
• /
• 2008

Tracheal injury associated with esophageal injury due to fish bone is very rare. Also, treatment of mediastinitis due to esophageal perforation when it is diagnosed late remains controversial. We report the case that we have successfully experienced treatment of mediastinitis due to tracheal and esophageal injury by fish bone.

• Natural Product Sciences
• /
• 제28권4호
• /
• pp.194-200
• /
• 2022

Albizia julibrissin Durazz. (AJ; family Minosaceae) is widely distributed worldwide, and its stem bark has been used as a traditional herbal medicine. Acute kidney injury (AKI) is a clinical syndrome that results in sudden loss of renal function. This study aimed to investigate the effects of AJ against cisplatin-induced AKI using a human kidney proximal tubule epithelial cell line (HK-2) and cisplatin-treated mice. In vitro, cisplatin treatment increased apoptosis in HK-2 cells. However, AJ treatment decreased apoptosis of cisplatin-treated HK-2 cells. In vivo, cisplatin treatment accelerated renal injury by increasing the levels of renal injury markers, such as blood urea nitrogen, creatinine, kidney injury molecule 1, and neutrophil gelatinase-associated lipocalin, which were reversed by AJ treatment. Histopathologically, AJ treatment resulted in decreased renal damage with less tubular necrosis and brush border desquamation compared with the AKI group. Additionally, cisplatin treatment upregulated mitochondrial fission, a pathological characteristic of AKI, which was downregulated by AJ treatment. Along with increased mitochondrial fission, AJ treatment also reduced cisplatin-induced apoptosis. These results suggest that AJ may be a potential therapeutic agent for cisplatin-induced AKI.

• Journal of Trauma and Injury
• /
• 제24권2호
• /
• pp.111-117
• /
• 2011

Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

• 척추신경추나의학회지
• /
• 제6권2호
• /
• pp.97-107
• /
• 2011

Objectives : The purpose of this study is to report two cases of improvement in meniscal injury induced knee pain after M.S.T(Motion Style Treatment). Methods : Two patients diagnosed as meniscal injury were improved by M.S.T(Motion Style Treatment). This study was measured by Numerical Rating Scale(NRS) score and physical examination. Results : In this study, in the end of continuous M.S.T(Motion Style Treatment), patient's knee pain had improved. Numerical Rating Scale(NRS) were also decreased. Conclusions : As seen in this two cases of patients of knee pain who were diagnosed as meniscal injury, M.S.T(Motion Style Treatment) has a positive effect to control pain with knee pain who are diagnosed as meniscal injury.

• Journal of Trauma and Injury
• /
• 제28권3호
• /
• pp.129-133
• /
• 2015

Purpose: The purpose of this study is to evaluate the surgical outcome of duodenal injuries and to analyze the risk factors related to the leakage after surgical treatment. Methods: A retrospective review of 31 patients with duodenal injuries who managed by surgical treatment was conducted from December 2000 to May 2014. The demographic characteristics, injury mechanism, site of duodenal injury, association of intraabdominal organ injuries, injury severity score (ISS), abdominal abbreviated injury scale (AIS), injury-operation time lag, surgical treatment methods, complications, and mortality were reviewed. Results: Duodenal injury was more common in male. Twenty four (77.4%) patients were injured by blunt trauma. The most common injury site was in the second portion of the duodenum (n=19, 58.6%). Fourteen patients (45.2%) had other associated intraabdominal organ injuries. The mean ISS is $13.6{\pm}9.6$. The mean AIS is $8.9{\pm}6.5$. Eighteen patients (58.1%) were treated by primary closure. The remaining 13 patients underwent various operations, including exploratory laparotomy (n=4), pancreaticoduodenectomy (n=3), pyloric exclusion (n=3), Resection with end-to-end anastomosis (n=2), and duodenojejunostomy (n=1). Most common postoperative complications were intraabdominal abscess (n=9) and renal failure (n=9). Mortality rate was 9.7%. Conclusion: ISS, AIS>10, operative time, pancreaticoduodenectomy, sepsis, and renal failure are significant predictors of a postoperative leak after duodenal injury. Careful management is needed to prevent a potential leak in patient with these findings.