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Background: Recently, the number of patients with the thorax or neck trauma has increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Most of the thorax or neck injuries can be managed with conservative methods and simple surgical procedures, but an open thoracotomy or exploration will be necessary in emergent cases. Traumas to the thorax and the neck have an extremely poor prognosis when not diagnosed and treated early. Therefore, we analyzed the results of emergent operations in patients with thorax or neck trauma and their clinical courses. Methods: A clinical evaluation was performed on 56 patients treated with emergent operations for thorax or neck trauma from January 1997 to July 2003 according to their medical Results: There were 45 males and 11 females. The mean age was 36.1 years. The modes of injury were as follows: traffic accidents 14 cases, stab wounds 27 cases, industrial disasters 7 cases, and others 8 cases. The annual distribution of cases was as follows: 1997 year 9 cases, 1998 year 6 cases, 1999 year 7 cases, 2000 year 10 cases, 2001 10 cases, 2002 6 cases and 2003 8 cases. The injured organs were 13 cases of a ruptured diaphragm, 12 cases of a ruptured lung, 7 cases of a ruptured heart, 2 case of a ruptured aorta, 9 cases of a simple vessel ruptured and 4 cases of a ruptured esophagus and trachea. There were 9 (16%) overall deaths: 6 cases in deaths among the blunt-trauma cases and 3 deaths among the stab injury cases. Conclusion: Early diagnosis and surgical treatment is essential for thorax or neck trauma, to decrease the mortality and complications. Therefore, careful diagnostic procedure, appropriate preoperative management for hypovolemia, and early surgical treatment are essential. The setup an of emergency operation system should be considered as a reform measure.
현성열(Sung Youl Hyun), 박국양(Kook Yang Park), 이재웅(Jae Woong Lee), 이창하(Chang Ha Lee), 전양빈(Yang Bin Jeon), 박철현(Chul Hyun Park), 염석란(Suk Lan Youm), 신종환(Jong Hwan Sin), 민순식(Sun Sik Min), 김재광(Jae Kwang Kim), 임용수(Yong Su) 대한흉부외과학회 2002 The Korean Journal of Thoracic and Cardiovascular Vol.35 No.12
현성열 ( Sung Youl Hyun ), 강영준 ( Young Joon Kang ), 김진주 ( Jin Joo Kim ), 김용인 ( Yong In Kim ), 김재광 ( Jae Kwang Kim ), 임용수 ( Yong Su Lim ), 양혁준 ( Hyuk Joon Yang ), 서태석 ( Tae Suk Seo ), 박희권 ( Hee Kwon Park ), 이석기 ( ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Tracheal intubation is the most common cause of Tracheal stenosis. The treatment of trachea stenosis vary according to site or size of tracheal stenosis. Thirty six age old man was transferred our hospital for evaluation of dyspnea. Subglottic stenosis was shown on bronchoscopy & chest computerized tomography(CT) scan of neck. Balloon dilatation was performed and then patient breathed at ease. Tracheal resection and end-to-end anastomosis was applied to repetitive tracheal stenosis. Balloon dilatation before surgical management makes better respiratory difficulty. We report succesful application of surgical management after balloon dilatation in repetitive tracheal stenosis patient. We will suggest that the balloon dilatation improve symptoms before tracheal resection and end-to-end anastomosis or stent, if sugery or stent insertion are not applicable due to poor status of patient.
안현철 ( Hyun Chul An ), 임용수 ( Yong Su Lim ), 조진성 ( Jin Seong Cho ), 김진주 ( Jin Joo Kim ), 양혁준 ( Hyuk Jun Yang ), 박원빈 ( Won Bin Park ), 우재혁 ( Jae Hyug Woo ), 현성열 ( Sung Youl Hyun ) 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5
Purpose: Studies have demonstrated that B-type natriuretic peptide (BNP) has a predictive value for sudden cardiac arrest in heart failure patients. The aim of this study was to investigate the usefulness of serum BNP levels for theprediction of death in post-cardiac arrest patients treated withtherapeutic hypothermia (TH). Methods: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between April 2007 and August 2010 were evaluated and divided into two groups based on death within 3 months. Initial serum BNP levels were checked and BNP levels compared between both groups. Results: A total of 162 patients were enrolled in the study. Among 162 patients, 109 patients were male (mean age of 50 years). The BNP levels of the non-survival group (n=77) were higher than those of the survival group (n=85); however, there was no statistical difference (19.45 pg/ml vs. 30.75 pg/ml, p=0.174). The BNP cutoff value of 106 pg/ml for death within 3 months had a sensitivity of 35.1% and a specificity of 78.8%. In the logistic regression analysis, BNP levels higher than 106 pg/ml were significantly associated with death within 3 months (odds ratio [OR], 2.625; 95% confidence interval [CI], 1.066-6.463) and other independent factors were BLS to ROSC (OR, 1.105; CI, 0.082- 1.038), non-VF/VT (OR, 3.698; CI, 1.632-8.380), and APACHE II score (OR, 1.117; CI, 1.035-1.204). Conclusion: Initial Serum BNP levels are related with death within 3 months for patients that received TH after OHCA. However, additional randomized and controlled studies are needed.
조현우 ( Hyun-woo Cho ), 우재혁 ( Jae-hyug Woo ), 임용수 ( Yong-su Lim ), 장재호 ( Jae-ho Jang ), 조진성 ( Jin-seong Cho ), 최재연 ( Jea-yeon Choi ), 양혁준 ( Hyuk-jun Yang ), 현성열 ( Sung-youl Hyun ) 대한응급의학회 2018 大韓應急醫學會誌 Vol.29 No.5
Objective: This paper reports the status of the advanced cardiac life support (ACLS) according to the guidelines by residents belonging to other departments other than the department of emergency medicine. The differences in status between the junior group and senior group was also investigated according to grades of residents. Methods: The ACLS performance for in-hospital cardiac arrest cases of one academic hospital, except for the cases occurring in intensive care unit between November 2015 and October 2017, were analyzed retrospectively. Data included the characteristics of residents, patients' outcomes, ACLS performance, and conventional treatment having discordance with the ACLS guidelines. Leaders during cardiopulmonary resuscitation (CPR) were divided into a junior group and senior group. Results: A total of 152 cases were enrolled in this study. Of these, 131 cases (86.2%) showed at least one treatment with inconsistency from the guidelines and the incidence of discordant treatment was similar in the two groups (55 [85.9%] vs. 76 [88.4%], P=0.657). Implicit use of sodium bicarbonate was more frequent in the senior residents group (odds ratio [OR], 3.04; 95% confidence interval [CI], 1.36-6.81). On the other hand, no use of a defibrillator was less frequent in the senior residents group (OR, 0.14; 95% CI, 0.03-0.81). Conclusion: In both groups, the rate of discordance with the ACLS guidelines during CPR were high. The rate of implicit use of sodium bicarbonate and no use of defibrillator were significantly different in the two groups. A customized education strategy for ACLS is needed for each group.