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Cerebral Fat Embolism That Was Initially Negative on Diffusion-Weighted Magnetic Resonance Imaging
( Seung Je Go ),( Yun Su Mun ),( Seung Ho Bang ),( Yong Han Cha ),( Young Hoon Sul ),( Jin Bong Ye ),( Jae Guk Kim ) 대한외상학회 2021 大韓外傷學會誌 Vol.34 No.2
Fat embolism syndrome is a rare, but serious condition that occurs in patients with fractures of the long bones or who undergo orthopedic surgery. The main clinical features of fat embolism syndrome are an altered mental status, hypoxia, and petechial rash. Cerebral fat embolism is the most severe manifestation of fat embolism syndrome because it can lead to an altered mental status. The diagnosis of cerebral fat embolism is clinical, but brain magnetic resonance image (MRI) is helpful. There is usually an interval until symptoms, such as an altered mental status, develop after trauma. We report a case of cerebral fat embolism in which the patient’s mental status deteriorated several hours after trauma and the initial findings were negative on diffusion-weighted MRI.
외상성 경부 척수 손상 환자에서 동반된 소장 천공: 증례보고
고승제 ( Seung Je Go ),윤정석 ( Jeung Seuk Yoon ),윤정호 ( Jung Ho Yun ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.4
A 66 year-old woman had cervical spinal cord injury by an automobile. We performed emergency operation for partial quadriplegia. She recovered from motor weakness gradually, but complained of abdominal distension and mild dyspnea. A physical examination of her abdomen did not have tenderness and rebound tenderness. She underwent a decubitus view of chest X-ray due to aggravated dyspnea at postoperative 4 days. We detected free air gas of abdomen and immediately identified a cause of pneumoperitoneum by abdominal computed tomography. We performed an emergent laparotomy and confirmed a jejunal perforation. After an operation, she recovered well and is under rehabilitation.
디지털 트윈 구현을 위한 3차원 공간정보 구축사례 연구
김승엽 ( Seung-yub Kim ),이호현 ( Ho-hyun Lee ),최은수 ( Eun-soo Choi ),고제웅 ( Je-ung Go ) 한국지리정보학회 2020 한국지리정보학회지 Vol.23 No.3
In the 4th industrial revolution, research on solving urban problems using ICT technology is emerging. Representatively, research is being conducted mainly focusing on smart cities. 3D geo-spatial. Various case studies on smart cities are being conducted to solve urban problems, and in order to effectively implement smart cities, it is implemented on the basis of a digital twin interconnecting physical and virtual environments. To implement a digital twin, the concept of space is essential, and spatial information that composes the real world is also essential. Therefore, in order to implement the digital twin, this study conducted a study on the construction and modeling of 3D geo-spatial information based on the national spatial information establishment regulations and the international standard CityGML for buildings, water facilities, and transportation facilities in Jeonju. In Jeonju, the research area, the LOD was defined, and the possibility of digital twin based on geo-spatial information was determined through data collection, analysis, and construction for each detail. In this study, it is meaningful that a plan to construct geo-spatial information for the implementation of a digital twin is presented, and the result of the construction is modeled as an urban standard model. The results of study are expected to be used as reference for detailed construction plans and standard establishment by governments and local governments promoting smart city and digital twin construction in the future.
Experience of Penetrating Gunshot Wound on Head in Korea
( Hong Rye Kim ),( Seung Je Go ),( Young Hoon Sul ),( Jin Bong Ye ),( Jin Young Lee ),( Jung Hee Choi ),( Seoung Myoung Choi ),( Yook Kim ),( Su Young Yoon ) 대한외상학회 2018 大韓外傷學會誌 Vol.31 No.2
Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.
Bowel Necrosis Associated with Enteral Feeding in a Postoperative Patient
( Moon Soo Lee ),( Seung Je Go ),( Ji Hyun Ku ),( Ye Jin Jeon ),( So Yeon Yun ),( Bo Young Mun ) 한국정맥경장영양학회 2015 한국정맥경장영양학회 학술대회집 Vol.2015 No.-
A 42-year-old woman presented to the emergency department with peristaltic abdominal pain. She had a history of total gastrectomy and Roux-en-Y esophagojejunostomy due to gastric cancer 1 year ago at another hospital and suffered from recurrent ileus during 1 year three times. A exploratory laparotomy revealed internal hernia of small bowel, but intestinal ischemia was not observed. Manual reduction of herniated bowel and entero-enterostomy were performed, but tracheal aspiration developed during anesthesia. Aspiration pneumonia progressed to the acute respiratory distress syndrome (ARDS) on postoperative day (POD) 2. Vital signs were stabilized and inotropic therapy was discontinued on POD 7. ARDS was improved, so ECMO was stopped on POD 19. Enteral feeding was started on POD 23 with a balanced formula (350 mOsm/kg H2O) at a rate of 25 ml/hr and advanced to a goal of 75 ml/h every day. She had the abdominal discomfort at 5 days after enteral feeding and fever (38.0oC). Abdominal CT revealed the small bowel infarction with pneumatosis intestinalis and portomesenteric vein gas. We confirmed small bowel necrosis on the previous herniated bowel and performed bowel resection and enterostomy. She was resolved from ARDS and transferred to general ward on POD 55. We report a rare case of bowel necrosis associated with enteral feeding in a postoperative patient with herniated small bowel.