• Journal of Trauma and Injury
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• 제36권3호
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• pp.295-297
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• 2023

Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

• Journal of The Korean Society of Grassland and Forage Science
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• 제34권4호
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• pp.288-295
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• 2014

This study was conducted to evaluate the effect of mixing time for TMR (total mixed rations) mixed with corn silage on particle size, peNDF (physically effective neutral detergent fiber), laceration, and ruminal in situ dry matter degradation. The study also aimed to evaluate the effect of consumption of the TMR on the milk yield and milk components of mid-lactational dairy cows. TMRs were mixed for 30 minutes (T1) and 50 minutes (T2) using the same material. All samples were then analyzed with a Penn State Particle Size Separator (PSPS). The particle size of T1 was significantly lower in the bottom pan (8 mm>) than that of T2 (p<0.01). $peNDF_{&gt;8.0}$ was significantly higher in T1 (17.18%) than in T2 (13.85%) (p<0.01). For ruminal in situ dry matter degradation of particle retention (>19 mm), no significant difference was found after 72 hours incubation, although T1 degradation was significantly higher after 24 hours incubation (p<0.01). Milk yield was no different between the groups of cows, whereas the milk fat from T1 fed cows was significantly higher (p<0.01). The results show that feeding TMR mixed for 30 minutes to dairy cows may improve the physical value of forage without negative effects on the milk yield and milk components.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.61-67
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• 2011

Purpose: Lawn trimmers are widely used to cut the weeds around graves in South Korea, but they can cause ocular injury. We investigate at the emergency room the incidence and the clinical features of ocular trauma induced by lawn trimmers. Methods:The authors analyzed 106 patients who visited Konyang University Hospital's emergency room from March 1, 2007, to October 31, 2011, because of ocular trauma caused by a lawn trimmer. Patients were sorted into two groups, severe ocular injury and mild ocular injury. Results: Over a 5-year period, 106 patients with ocular trauma caused by a lawn trimmer underwent clinical study. Most of the patient (103 patients) were males, and the average age of the patients was $51.75{\pm}11.66$ years. The incidence of ocular trauma peaked in the sixth decade of life. Most injuries occurred between July and September. Severe ocular injury developed in 46.2% of all patients. As age increased, so did the severity of the ocular injury. The impacting object was a small stone in 43.4% of all patients. Nobody wore protective gear. The most common diagnosis were corneal abrasion, followed by intraocular foreign body, corneal laceration, and sclera laceration. Fifty-four patients were followed up, and thirty-six patients of them had severe injury. The most common complication was a traumatic cataract. Conclusion: Ocular trauma induced by a lawn trimmer is more severe than general ocular trauma. We suggest that everyone using a lawn trimmer should wear protective gear and follow safety guidelines.

• Investigative Magnetic Resonance Imaging
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• 제1권1호
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• pp.154-161
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• 1997

Purpose: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. Materials and Methods: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MR!, and US at 1 day, 3 day, and 1 week after operation. Results: US was superior to MR! or spiral CT in diagnosis of diaphragmatic rupture(P(0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitivity of MRI and spiral CT increased as the size of laceration were larger, but no statistical significance was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase, US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spiral CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05). In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). Conclusion: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Child Health Nursing Research
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• 제14권1호
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• pp.5-13
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• 2008

Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

• Journal of Chest Surgery
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• 제47권4호
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• pp.406-408
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• 2014

A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

• Journal of Korean Academy of Nursing
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• 제6권2호
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• pp.39-54
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• 1976

In order to contribute to the formulation of a public health plan, the epidemiological study conducted by the record of 834 accident patients during the year Jan.1975 to Dec.1975 at Lim's clinic Chun Chon city has been analysed in hospital treatment. The accident patients were divided into Common, Psychosomatic, Industrial and Traffic. The results obtained from this study are summarized as follows ; 1. Common accident showed highest rate as 32.1%, Industrial showed 28.6% rate, Psychosomatic showed 27.2% and Traffic accident showed lower rate as 12.1%. 2. The age group from 16 to 20 years old showed the highest rate as 23.0% and the distribution of this same age group in the Kang Won Province area was 20.4%, sexual grouping shows men with the highest rate as much as 69.5%. 3. The highest rate of accidents (23.9%) occurred from 3Pm to 6Pm. The highest monthly accident rate (13.1%) occurred in July, in the most concentrated season, summer (31.3%) 4. The place of indoor accidents were highest 30.3% 5. Bruise and laceration form wounds showed highest with traffic accident victims suffering 35.0% of this bruise rate 6. Wound lesions of the upper limbs showed the highest type 28,6% by head lesions 28.2% 7. Among those completely cured after treatment(84.1% of the total), intoxication cases showed the highest rate (86.5% ) 8. From accident tims to treatment at the clinic, intoxication cases had the longest wait (77.2%) treated within six hours.

• Journal of Korean Foot and Ankle Society
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• 제10권1호
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• pp.101-104
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• 2006

Occasionally, extensor hallucis longus tendon (EHL) ruptures becames open by laceration and spontaneous rupture of EHL that has previous story of diabetes mellitus, steroid injection, systemic steroid administration, operation and rheumatoid arthritis. But, closed traumatic EHL ruptures are reported rarely. Especially, we diagnosed the closed EHL ruptures in TaeKwonDo players. We reported the 2 patients, differently treated end to end anastomosis and EHL transfer, had the course and treatment methods. Be care the prognosis can be altered according to the treatment time and method.

• Journal of Chest Surgery
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• 제25권4호
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• pp.429-434
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• 1992

We experienced a rare case of traumatic ventricular septal defect by penetrating stab injury The patient was 26-year-old women who got stab wound at the left anterior third intercostal space and left sternal border with a knife. seven hours after admission, the patient was undertaken an emergency thoracotomy due to hypovolemic shock caused by massive bleeding from transected left internal mammary artery, vein, and right ventricular outflow tract. On postoperative second day, the patient was suffered from moderate dyspnea, and arterial blood gas analysis and chest X-ray revealed hypoxemia and pulmonary edema. Right heart cardiac catheterization with Swan-Ganz Cathater showed oxygen step-up between right atrium and main pulmonary artery and a 1.6:1 ratio of pulmonary to systemic blood flow. At operation, harsh systolic thrill was palpable along right ventricular outflow tract. Through small vertical right ventriculotomy, the linear ventricular septal laceration on infundibular septum was noticed, and its size was 1.5cm with sharp margin This defeat was repaired by three interrupted matress sutures using Prolene 4-O with pledget. Her postoperative course was uneventful, and she discharged with good physical condition.