• Title/Summary/Keyword: Traffic accident

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Clinical Analysis of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에 대한 임상적 고찰)

  • 권영무;신현종
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.517-523
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    • 1997
  • The records of 14 patients with traumatic diaphragmatic rupture seen at Dongguk University Hospital from February 1992 through December 1995 were reviewed. Ten patients were male and four were female(M:F=2.5:1). The age distribution ranged from 17 to 73 years with the mean age of 41.7 years. The 14 patients included 12 who had blunt trauma(traffic accident 11, crushing injury 1) and 2 with penetrating diaphragmatic rupture(stab wound 2). Of those 12 blunt trauma, 7 patients(58.3%) were left sided and 5(41.7%) involved the right hemidiaphragm. The diagnosis was made preoperatively in 8 patients (57.1%) and during surgery in 6(42.9%). All right-sided injuries were repaired through a thoracotomy and left-sided defects were corrected through a laparotomy in 6, laparotomy and thoracotomy in 1. There were 2(14.3%) operative deaths that were caused by myocardial infarction and the sequelae of combined injuries.

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Reconstruction of Greater Trochanteric defect using Lumbar Artery Perforator Free Flap - A Case Report - (요추부 천공지 유리피판을 이용한 대전자부 결손의 재건 - 증례보고 -)

  • Heo, Chan-Yeong;Baek, Rong-Min;Minn, Kyung-Won;Eun, Seok-Chan
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.48-51
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    • 2007
  • There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

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A Study on Adjustment of Daily Living and Body Image of Patients with Low Back Pain (요통환자의 신체상과 생활적응에 관한 연구)

  • 구희서
    • Korean Journal of Health Education and Promotion
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    • v.6 no.1
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    • pp.91-105
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    • 1989
  • The purpose of this study is to identify the body images of patints with low back pain and their status on adjustment of daily living. The data were collected from 11 general hospitals during Feburary 2, 1987 through May 30,1987. One hundred and ninety five subjects having physical therapy treatment because of low back pain were analyzed. For measurement of body image, 11 pairs of adjectives were used on semantic differential scale, and for measurement of adjustment of daily living, 10 items were used on a likert type scale. Results of the study are summerised as follows. 1. The average patient age were 34yeats and 62% of the patients were men. High school grade completed were 43.1% and Cause of Low Back Pain were respctively;Unknown etiology 31.8%, lifting heavy objects 27.7%, Traffic accident and injury 17.9%. Types of treatment were;medication plus physical therapy 54.9%, physical therapy only 22.6%. Average treatment duration were 24.5 months. 2. There were significant difference in the body image between before low back pain and after low back pain. The body image before low back pain were 59.89(Mean) but after low back pain were 37,24(Mean) and two groups were statistically significant (t=21.3, p<0.00l). 3. there were no significant difference in the body image between the male and female.(t=1.49, p>0.05) 4. The correlation between body image and adjustment of daily living. in both sexes showed positive correlation coefficient; male(r=0.4648, p<0.00l) female(r=0.4516, p<0.00l) respectively. It means that patients with positive body image can adjust well in daily living. 5. The relation between the body image and general variables revealed sigificant difference with occupation and age.(F=2.12 p<0.05, F=3.48 p<0.05). That is different occupation and different age groups can show different body image. In conculsion with the above results, It is my strong belief that multidisciplinary approach including the concept of body image and patient education about postural care, activities of daily living, lifting mechanics should be applied in treating and dealing with those patients.

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Arthroscopic Treatment of Post-traumatic Stiff Shoulder by Rotator Interval Bridging Scar Adhesion - Case Report - (회전근 개 간격의 가교 반흔 유착에 의한 외상성 견관절 강직증의 관절경적 치료 - 증례 보고 -)

  • Kim Young-Mo;Rhee Kwang-Jin;Kim Kyung-Cheon;Byun Byung-Nam
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.41-45
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    • 2004
  • In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

A Clinical Analysis of Pediatric Head Injuries (소아 두부외상의 임상적 분석)

  • Hyun, Dong Keun;Ha, Young Soo;Park, Chong Oon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.54-59
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    • 2001
  • Objectives : With the advancement of a social life, the pediatric head injuries(PHI) occur greater than ever. Since the PHI differs from adult head injury with regards to mechanism of trauma, prognosis, and mortality, it is important to identify the characteristics of the PHI for its proper treatments and prognosis. Methods : For this study, a series of 365 PHI patients under 15 years of age who were admitted to our hospital, were evaluated from January 1991 to December 1996. The clinical variable studied were age, sex, Glasgow coma score(GCS), causes of trauma, diagnosis, symptoms, associated injuries and Glasgow outcome score (GOS). The characteristics of PHI were evaluated according to presentations of skull fractures, intracranial hemorrhages, associated injuries, GCS at admission and GOS. Results : Mean age of the studied patients was 6.51 years of age. The majority of PHI patients were under the 7 years of age(66.7%). The ratio of male to female was 2.2:1. Seasonally, PHI occurred more frequently during March to August(61.6%). The main causes of the injuries were accidental falls and traffic accidents(47.1% and 46.3%). One hundred ninety seven(54%) patients suffered from skull fractures and 110(30.1%) patients were developed intracranial hemorrhages and acute epidural hematomas(17.8%) which were the most common intracranial hemorrhages. There was statistical significance between skull fractures and intracranial hemorrhage (p=0.032) and between GCS and GOS(p=0.001). However, there was no statistical significance between skull fractures and intracranial hemorrhage(epidural hematomas, subdural hematomas, and intracerebral, intraventricular and subarachnoid hemorrhage)(p=0.061, 0.251 and 0.880). Also there were no significance of prognosis between under the seven and over the 8 years of age(p=0.349). Conclusions : The core management for PHI is prevention from its occurrences. However, when unexpected accident occurs, early diagnosis and treatment for PHI by through examination for associated injuries and other damages even if there is no skull fracture are essential in managing patient's outcome.

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Endoscopic Removal of Traumatic Intracerebral Hematoma via Superolateral Keyhole (외상성 뇌실질내 혈종에 대한 상측방 키홀을 통한 내시경적 혈종 제거)

  • Park, Sung-Jin;Ha, Ho-Gyun;Jung, Ho;Lee, Sang-Keol;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.249-254
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    • 2000
  • Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.

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Anterior Screw Fixation of Type II Odontoid Fracture (제 II 형 치상돌기 골절에서 전방경유 나사못 고정술)

  • Kim, Myung-Jin;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyu;Hamm, In-Suk;Park, Yeun-Mook;Kim, Seung-Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1461-1468
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    • 2000
  • Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

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Influence of Trauma on the Surgical Outcome in Patients with Ossification of the Posterior Longitudinal Ligament of the Cervical Spine (외상이 경추 후종인대 골화증 환자의 수술결과에 미치는 영향)

  • Chin, Dong-Kyu;Jin, Byung-Ho;Cho, Yong-Eun;Yoon, Do-Heum;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.904-909
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    • 2000
  • Objectives : Most cases of cervical ossification of the posterior longitudinal ligament(OPLL) present with myelopathy or myeloradiculopathy, which sometimes is further complicated by minor trauma to the spinal cord. The main purpose of surgery in these patients is the alleviation symptoms but also as protection against further deterioration. The purpose of this study is to analyze the influence of trauma on the surgical outcome in patients with cervical OPLL. Methods : Over the past 13 years, we have operated on 123 patients with myelopathy associated with cevical OPLL. Among these, thirty patients had cervical cord injury associated with major or minor trauma and their clinical and radiographic data were reviewed retrosepctively. Results : As to cause of trauma, seventeen were related with traffic accident and 13 were related with minor slipping injury. The pre- and post-operative motor power were significantly weaker in the patients with trauma, but the degree of motor improvement was significantly higher(trauma group : $0.90{\pm}1.49$, non-trauma group : $0.41{\pm}0.80$). Conclusion : These results indicate that even indirect minor trauma to the cervical spine can cause irreversible changes to the spinal cord if this is associated with underlying cervical stenosis with OPLL. Although less favorable results may be anticipated in patients with trauma, operative decompression could improve motor power and protect further deterioration.

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A study on the detection of DDoS attack using the IP Spoofing (IP 스푸핑을 통한 DDoS 공격 탐지 방안에 대한 연구)

  • Seo, Jung-Woo;Lee, Sang-Jin
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.25 no.1
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    • pp.147-153
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    • 2015
  • Since the DoS(Denial of Service) attack is still an important vulnerable element in many web service sites, sites including public institution should try their best in constructing defensive systems. Recently, DDoS(Distributed Denial of Service) has been raised by prompting mass network traffic that uses NTP's monlist function or DoS attack has been made related to the DNS infrastructure which is impossible for direct defense. For instance, in June 2013, there has been an outbreak of an infringement accident where Computing and Information Agency was the target. There was a DNS application DoS attack which made the public institution's Information System impossible to run its normal services. Like this, since there is a high possibility in having an extensive damage due to the characteristics of DDoS in attacking unspecific information service and not being limited to a particular information system, efforts have to be made in order to minimize cyber threats. This thesis proposes a method for using TTL (Time To Live) value in IP header to detect DDoS attack with IP spoofing, which occurs when data is transmitted under the agreed regulation between the international and domestic information system.

Research on Augmented Reality Services in Bridge for Navigational Safety (안전항해를 위한 선교용 증강현실 서비스에 관한 연구)

  • Oh, Jaeyong;Park, Sekil;Kim, Sun-Young;Kwon, Ohseok
    • Journal of Navigation and Port Research
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    • v.37 no.3
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    • pp.245-250
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    • 2013
  • As maritime traffic increases and ships get bigger and faster, the risk of maritime accident increases. According to the recent reports on maritime accidents, more than 80% of the maritime accidents occur due to navigational mistakes and/or human errors. Even though many kinds of navigation systems based on new technology have been developed to reduce maritime accidents, we need to research the method for expressing and providing information. The efficient navigation system should be able to display information simply and intuitively to make decision quickly and accurately. In this paper, we proposed augmented reality based navigation system which can be utilized in bridge of the ships and described the services for navigational safety.