• Journal of Trauma and Injury
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• v.36 no.3
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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.

• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.87-102
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• 2002

Injury has now replaced disease as the biggest single cause of death in children after their first birthday. Each day child dies from preventable, unintentional injury and the medical cost of these injury is increasing remarkably. It is necessary to develope injury prevention models to explain, predict, manage, evaluate and analyze the information about accident. The purpose of this paper is, firstly, to investigate parent's actions regarding safety measures at home and secondly, to identify the influencing factors of parents' safety behaviors. The selection of such factors is guided by the theoretical framework of the Pender's Health Promotion Model. Method ; The questionnaire was developed on the basis of other investigations, through pilot testing, peer review, and review by field health workers. The questionnaire was completed by 231 mothers of young children. Data was collected between April and May 2002. Variable Use of three different domains of safety behavior, safety habits, supervision and perception of safety devices, were listed. Mothers were self reported on internal locus of control, mother & child relationships, and marital intimacy. Also the elements of the Health Promotion Model: perceived benefit, barrier, threat, and self-efficacy, were surveyed. Results & discussion The results indicate that most parents take considerable action to reduce household hazards. The constructs derived from the Model were statistically significant differences for a small part of the variables on parental behavior to reduce hazards in the home, such as age, education, economic status, self-efficacy, perceived benefit, internal locus of control. Future studies ought to include social influences, such as expectations, perceived norms, knowledge, and child-related variables, relevant to parental safety measures in their home.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.93-96
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• 2014

Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.813-817
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• 2007

Purpose: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. Methods: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua $splint^{(R)}$, externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. Results: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. Conclusion: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua $splint^{(R)}$ would be a good alternative to prevent for collapse in unstable zygomatic arch fractures

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.117-124
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• 2018

Purpose: This study was to analyze clinical and epidemiological characteristics of elderly patients who were admitted to the emergency department (ED) due to falls by separating male and female. Methods: We retrospectively analyzed the fall patients aged 65 years or older from the data of the in-depth surveillance study of injured patients visit to the ED under the supervision of the Korea Centers for Disease Control and Prevention (KCDC) from 2011 to 2016 by separating male and female. Results: A total of 361,588 elderly fall patients were analyzed and, among them, 14,429 (37.3%) were males and 24,208 (62.7%) were females. Male and female showed similar frequency of damage happening season. However, they showed falling accident mostly on winter. The time of injury occurrence is mostly from 12:00 to 18:00 with 4,949 (34.3%) male and 8,564 (35.4%) female. Most falls occurred in daily activities, accounting for 7,614 (52.8%) in males and 14,957 (61.8%) in females, respectively. Unintentional damage accounted for the most part and 7,395 (51.2%) of male and 15,343 (63.4%) of female were injured indoors. Head and neck were the most common site of injuring, with 8,392 (58.2%) in males and 7,851 (32.4%) in females. According to ED examination outcomes, most of the patients were discharged, while the majority of the hospitalized patients were admitted to the general patient room. Conclusions: The elderly falls occurred mostly from 12:00 to 18:00, during winter and to elderly women. Also, they happened unintentionally indoors in everyday life, mostly. Proved clinical, epidemiological characteristics from this research will be used as useful indicator at validity research of development of prevent program of falling accident for elderly people.

• Physical Therapy Korea
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• v.13 no.4
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• pp.16-22
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• 2006

Falling is a serious problem associated with aging. Unintentional injury, which most often results from falling, is one of the leading causes of death in elderly people. The purpose of this study is to investigate the risk factors of falls and to compare characteristics of people who fall with that of non-fallers among the rural community-dwelling elderly of Korea. A sample of 201 people, living in the community, aged 60 years and over was taken from the members of a center for seniors located in Jecheon city. The mean age of the participants was 70.5 years of age. The participants are comprised of 151 women and 50 men. Eighty four of the 201 participants (41.8%) fell during the previous year. Twenty two of the fallers (26.2%) fell down more than two times. It was found that fallers had poorer eyesight, multiple chronic diseases and a more difficult time walking than non-fallers. In the logistic regression analysis of falls, only the difficulty of walking one kilometer (OR=2.4) and chronic diseases (OR=2.5) have shown an increased risk of falls. The risk of recurrent falls is, in addition, influenced by the difficulty of walking one kilometer. The result of our study shows that the impairment of mobility was the strongest risk factor of recurrent falling.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.82-85
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• 2022

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or "e-liquid" leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

• Korean Journal of Health Education and Promotion
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• v.22 no.4
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• pp.41-56
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• 2005

Objectives: More than 80% of unintentional injury was related to risk-taking behaviors involved in child accidents. Therefore, diverse care and concerns on safety should be provided from teachers as well as parents to build child safety behaviors. The purpose of this study was to identify the effects of safety concerns from students, teachers, and parents on elementary students' safety behaviors in Korea. Methods: The 5th and 6th grade students participated in this study in 14 elementary schools in Korea and the total number of students was 1,033. The study schools were selected by the stratified cluster sampling method throughout 7 metropolitan areas in Korea. Data were collected by the self-administered survey and the questionnaires were delivered to the vice-principals of the designated schools by ground postal service and the vice-principals conducted survey data collection. The questions on students' safety concerns, teachers' safety concerns, parents' safety concerns, safety practices, safety education, and demographics were included in the survey. All survey responses were encoded into SPSS program and t-test, ANOVA, and multiple regression analysis were utilized. Results: The students taking accidents one time more per year were more than 60% and the two thirds of them recognized that their accidents were due to their risk behaviors. Parents' education on safety practices was more frequent than teachers' education; furthermore, teachers' concerns on safety behaviors were poorer than students' or parents' concerns. In terms of safety behaviors, the scores of fire and home-related safety behavior were high but the scores of traffic and bicycle, in particular, helmet wearing practice were low. Three concerns from students, parents, and teachers all were significantly related to children's safety behaviors. Conclusions: In conclusion, safety concerns from the close networks are the important indicator of child safety behaviors and, the safety training programs, therefore, for parents and teachers as well as for students need to be developed for improving children's safe behaviors.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.49-66
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• 2014

Traditionally, cervical interventions have been performed under fluoroscopy. But radiation exposure is the major concern when obtaining fluoroscopic images and even under real-time fluoroscopy with contrast media or CT guidance, some cases of serious spinal cord injuries, cerebellar and brain stem infarction have been reported by unintentional intra-arterial injections especially during the transforaminal root blocks. Recently, the use of ultrasound-guided cervical interventions have increased. Ultrasound offers visualization of soft tissues including major neurovascular structures and also allows to observe the spread of injectant materials around the target structure. Ultrasound is radiation free, easy to use and the image can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound allows visualization of major nerves and vessels and thus leads to improve safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore reviewed to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.

• Journal of the Korean Society of Safety
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• v.37 no.3
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• pp.52-59
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• 2022

Conventionally, all the unsafe acts by human beings in relation to industrial accidents have been regarded as unintentional human errors. Exceptionally, however, in the cases with fatalities, seriously injured workers, and/or losses that evoked social issues, attention was paid to violating related laws and regulations for finding out some people to be prosecuted and given judicial punishments. As Heinrich stated, injury or loss in an accident is quite a random variable, so it can be unfair to utilize it as a criterion for prosecution or punishment. The present study was conducted to comprehend how categorizing intentional violations in unsafe acts might disrupt conventional conclusions about the industrial accident process. It was also intended to seek out the right direction for countermeasures by examining unsafe acts comprehensively rather than limiting the analysis to human errors only. In an analysis of 150 industrial accident cases that caused fatalities and featured relatively clear accident scenarios, the results showed that only 36.0% (54 cases) of the workers recognized the situation they confronted as risky, out of which 29.6% (16 cases) thought of the risk as trivial. In addition, even when the risks were recognized, most workers attempted to solve the hazardous situations in ways that violated rules or regulations. If analyzed with a focus on human errors, accidents can be attributed to personal deviations. However, if considered with an emphasis on safety rules or regulations, the focus will naturally move to the question of whether the workers intentionally violated them or not. As a consequence, failure of managerial efforts may be highlighted. Therefore, it was concluded that management should consider unsafe acts comprehensively, with violations included in principle, during accident investigations and the development of countermeasures to prevent future accidents.