1.Corneal Foreign Body Removal by Emergency Physicians.
Sang Kyu YOON ; Sang Cheon CHOI ; Gi Woon KIM ; Young Gi MIN ; Joon Pil CHO
Journal of the Korean Society of Emergency Medicine 2003;14(1):1-4
PURPOSE: This study was performed to evaluate the success rate and the safety in the treatment of corneal foreign body injury by an emergency physician trained in their removal. METHODS: Any patients presenting at the emergency department of a large university-based residency teaching hospital with corneal foreign body injuries during ninety months were included in this prospective study. Twenty patients were eligible. Junior residents participated in this study. They were taught to remove corneal foreign bodies by the attending emergency physician. Healing evaluation was performed by an ophthalmologist. Patients not presenting for a visit were contacted by telephone, and information was collected on the assessment of discomfort and the presence of symptoms. RESULTS: All corneal foreign bodies were successfully removed, and no adverse effects were noted. CONCLUSION: Corneal foreign body removal by emergency physician, if properly trained, appears to be successful and safe.
Cornea
;
Emergencies*
;
Emergency Service, Hospital
;
Foreign Bodies*
;
Hospitals, Teaching
;
Humans
;
Internship and Residency
;
Prospective Studies
;
Telephone
2.Cardiovascular Manifestations and Clinical Course after Acute Carbon Monoxide Poisoning.
In Soo LEE ; Yoon Seok JUNG ; Young Gi MIN ; Gi Woon KIM ; Sang Cheon CHOI
Journal of The Korean Society of Clinical Toxicology 2012;10(2):103-110
PURPOSE: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. METHODS: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. RESULTS: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echocardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patientswere discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were 2.53+/-2.29 and 2.19+/-2.12, respectively (p=0.860). CONCLUSION: Cardiovascular manifestations occurafter acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant initself in the clinical course, and the short-term prognosis of cardiac toxicityis unlikely to be unfavorable in acute CO poisoning.
Carbon
;
Carbon Monoxide
;
Carbon Monoxide Poisoning
;
Echocardiography
;
Electrocardiography
;
Emergencies
;
Humans
;
Hypokinesia
;
Hypotension
;
Prognosis
;
Retrospective Studies
3.Comparison of the Accuracies of Tw o Methods of Performing the Tongue Blade Test in Mandibular Fractures.
Sang Kyu YOON ; Sang Cheon CHOI ; Gi Woon KIM
Journal of the Korean Society of Emergency Medicine 2005;16(3):352-355
PURPOSE: This study was performed to evaluate the accuracy of two different methods of performing the tongue blade test (TBT) on patients with mandible fractures. METHODS: A prospective randomized trial was performed over 28 months, and the accuracy of TBT for the diagnosis of patients with mandibular fractures was evaluated using the radiographic confirmative diagnosis as the gold standard. A consecutive sample of 126 patients (36 mandibular fractures) were enrolled to this study. Method A is addressed the patient's ability to grasp a tongue blade between his teeth and hold the blade against a twistling motion, and Method B is to addressed the patient's ability to grasp a tongue blade between his teeth and then to hold the tongue blade against the examiner's mild effort to remove it. We compared the accuracy of the two methods. RESULTS: The sensitivity of method A was 95.0% (19/20), and that of method B was 93.8% (15/16). The specificities of the two methods were 68.8% and 64.4%, respectively. No statistically significant difference was found between the two methods (p>0.05). CONCLUSIONS: Based on this study, we conclude that we can choose either of the two method and that both methods of TBT are highly effective screening tests for diagnosing mandibular fractures.
Diagnosis
;
Hand Strength
;
Humans
;
Mandible
;
Mandibular Fractures*
;
Mass Screening
;
Prospective Studies
;
Tongue*
;
Tooth
4.Sprengel Deformity with Bilateral Huge Omovertebra.
The Journal of the Korean Orthopaedic Association 2013;48(4):319-323
Sprengel's deformity is characterized by the congenital migration of the scapula superiorly in relation to the thoracic cage. Other congenital anomalies, such as Klippel-Feil syndrome, may occur in combination with Sprengel's deformity. We report on a case of Sprengel's deformity with a huge bilateral omovertebrae, which was combined with the clinical features of Klippel-Feil syndrome, including cervical fusion, short neck, low posterior hairline, and limitation of neck motion. However, no other deformities or functional defects were observed.
Congenital Abnormalities
;
Klippel-Feil Syndrome
;
Neck
;
Scapula
;
Shoulder Joint
5.Injuries Associated with the 580 km University Student Grand Voluntary Road March: Focus on Foot Injuries.
Sang Cheon CHOI ; Young Gi MIN ; In Soo LEE ; Gi Ho YOON ; Bo Ra KANG ; Yoon Seok JUNG ; Joon Pil CHO ; Gi Woon KIM
Journal of Korean Medical Science 2013;28(12):1814-1821
College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 +/- 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries.
Adult
;
Blister/complications/*epidemiology
;
Body Mass Index
;
Female
;
Foot Injuries/complications/*epidemiology
;
Humans
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Incidence
;
Male
;
Pain/epidemiology/etiology
;
Questionnaires
;
Spine/radiography
;
Students
;
Time Factors
;
Universities
;
*Walking
;
Young Adult
6.Prospective Comparison of the Traditional Method with a Extraoral Method for Temporomandibular Joint Reduction.
Jung Hwan AHN ; Ji Yoon JUNG ; Ki Woon KIM ; Yoon Seok JUNG ; Young Gi MIN
Journal of the Korean Society of Emergency Medicine 2005;16(6):635-639
PURPOSE: The usual technique of temporomandibular joint (TMJ) reduction, recommended by most emergency medicine textbooks, consists of downward forces applied to the mandible. However, it has been the authors' experience that conscious sedation and significant force is required to achieve reduction. For that reason, we designed a new method of TMJ reduction. The purpose of our study is to introduce the new method of TMJ reduction and to compare the traditional method with the new method. METHODS: We performed a prospective, randomized trial with 52 patients who were diagnosed as having a TMJ dislocation. The patients were divided into two groups: the group treated with the traditional method (25 cases) and treated with the new method (27cases). Patients with histories of trauma or inflammatory signs were excluded from this study. The new method is an extraoral approach in which the operator applies the coronoid process on the face in the posteroinferior direction. RESULTS: Age, sex, and history of TMJ dislocation showed no statistical differences between the two groups. Reduction of the TMJ dislocation was achieved in 15 (60.0%) of the traditional method group and in 25 (92.6%) of the new method group (p=0.005). The means of the reduction time were 11.8+/-6.2 sec in the traditional method group and 6.6 +/- 3.3 sec in the new method group (p=0.007). CONCLUSION: The new method was an effective treatment for TMJ dislocation without any sedations. I had a higher success rate and a shorter reduction time than traditional method.
Conscious Sedation
;
Dislocations
;
Emergency Medicine
;
Humans
;
Mandible
;
Prospective Studies*
;
Temporomandibular Joint*
7.Recent 10-Year Experience of One Regional Emergency Center and Recommendation for Hyperbaric Oxygen Therapy (HBOT).
Jung Hoon YOON ; Gi Woon KIM ; Yoon Seok JUNG ; Cheol Soo HAN ; Young Gi MIN ; Joon Pil CHO ; Sang Cheon CHOI
Journal of The Korean Society of Clinical Toxicology 2013;11(2):81-88
PURPOSE: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. METHODS: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. RESULTS: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time* frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis? in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). CONCLUSION: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.
Academic Medical Centers
;
Carbon Monoxide
;
Earache
;
Electronic Mail
;
Emergencies*
;
Humans
;
Hyperbaric Oxygenation*
;
Critical Care
;
Mastoid
;
Mastoiditis
;
Medical Records
;
Oxygen
;
Retrospective Studies
;
Skin Care
;
Wounds and Injuries
8.Systemic Complications occurring after Korean Venomous Snake Bite, with focus on Hematologic and Neurologic Complications.
Eun Jung PARK ; Sang Kyu YOON ; Jung Hwan AHN ; Sang Cheon CHOI ; Gi Woon KIM ; Young Gi MIN ; Kuk Jong LEE ; Ho Sung JUNG ; Yoon Seok JUNG
Journal of The Korean Society of Clinical Toxicology 2009;7(2):90-96
PURPOSE: This study explored and evaluated the systemic complications resulting from the bite of Korean venomous snake, focussing on hematologic and neurologic features. METHODS: Medical records (demographic data, clinical measurements including laboratory results, severity score, and amount of antidote administration, and hospitalization course) of consecutive patients who presented with snakebites to two university teaching hospital during a 10-year period were retrospectively reviewed. Subgroup analysis was conducted for evaluations of anti-acetylcholine esterase administration in complicated victims. RESULTS: The 170 patients displayed occurrence rates of hematologic and neurologic complications of 12.9% and 20.6%, respectively. Among 22 patients with hematologic complications, isolated thrombocytopenia was evident in eight patients (36.4%), prothrombin time (PT)/activated partial thromboplastin time (aPTT) prolongation in 11 patients (50.0%), and both in three patients (13.6%). The mean time to recovery was 4.5+/-1.8 days for isolated thrombocytopenia, and 5.1+/-1.8 days for PT and aPTT prolongation. Hematologic complications could occur suddenly 1~4 days after hospitalization. Among 35 patients with neurologic complications, dizziness was evident in 16 patients (45.7%), and diplopia / blurred vision in 19 patients (54.3%). The mean time to recovery was 3.4+/-0.6 days in patients receiving anti-acetylcholine esterase and 6.9+/-1.8 days in those not receiving anti-acetylcholine esterase (p=0.00). CONCLUSION: Occurrence rates of hematologic and neurologic complications following venomous snake bite differed as compared to other studies conducted in Korea. Onset of hematologic complications can occur rapidly days after admittance. Anti-acetylcholine esterase administration may be effective in treating neurologic complications.
Bites and Stings
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Diplopia
;
Dizziness
;
Hospitalization
;
Hospitals, Teaching
;
Humans
;
Korea
;
Medical Records
;
Partial Thromboplastin Time
;
Prothrombin Time
;
Retrospective Studies
;
Snake Bites
;
Snakes
;
Thrombocytopenia
;
Venoms
;
Vision, Ocular
9.Efficacy and Safety of Etomidate Used as a Sedative for Rapid Sequence Intubation in the Emergency Department.
Sang Cheon CHOI ; Gi Woon KIM ; Young Gi MIN ; Sang Kyu YOON ; Joon Pil CHO ; Yoon Seok JUNG
Journal of the Korean Society of Emergency Medicine 2002;13(4):503-507
PURPOSE: The purpose of this study was to estimate the efficacy and the safety of etomidate for rapid sequence intubation (RSI) in the emergency department. METHODS: A retrospective analysis by chart review was done for patients who had needed intubation in the emergency department of Ajou university hospital from July 1999 to June 2000. RESULTS: Three hundred (300) patients were enrolled in this study. Etomidates were used for 170 patients and Thiopental for 130 patients. In the Etomidate group, the average systolic blood pressures (SBP) were 127.7+/-42.2mmHg prior to etomidate administration and 125.6+/-40.9mmHg after. The average diastolic blood pressures (DBP) were 78.1+/-22.4 mmHg prior to etomidate administration and 79.1+/-21.3 mmHg after. There was no significant change in blood pressure after the use of etomidate. The average intubation time was about 3.9 minutes. Eight (8) patients experienced myoclonus and three (3) of vomiting after the use of etomidate. In the thiopental group, statistically significant decreases in the average SBP and DBP were seen after the administration of thiopental sodium. Twelve (12) patients had decreased blood pressure and one (1) patient arrhythmia after Thiopental administration. The average intubation time was about 5.9 minutes. CONCLUSION: The intubation time for etomidate group was superior to that for thiopental group. Also, in the etomidate group, no significant changes in the hemodynamic variables were noted during RSI. This study supports the efficacy and the safety of etomidate for RSI in the emergency department.
Arrhythmias, Cardiac
;
Blood Pressure
;
Emergencies*
;
Emergency Service, Hospital*
;
Etomidate*
;
Hemodynamics
;
Humans
;
Intubation*
;
Myoclonus
;
Retrospective Studies
;
Thiopental
;
Vomiting
10.Removal of Esophageal Blunt Foreign Bodies by Using a Foley Balloon Catheter in the Emergency Department.
Gi Woon KIM ; Si Young KIM ; Christopher C LEE ; Chol KIM ; Yoon Seok JUNG
Journal of the Korean Society of Emergency Medicine 2001;12(4):359-368
BACKGROUND: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. METHODS: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. RESULTS: Total number of patients enrolled in this study was 38. 22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70+/-0.28 hours while that for the esophagoscope group was 5.96+/-2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 60 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). CONCLUSION: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.
Anesthesia
;
Anoxia
;
Catheters*
;
Emergencies*
;
Emergency Service, Hospital*
;
Esophagoscopes
;
Esophagus
;
Foreign Bodies*
;
Humans
;
Operating Rooms
;
Prospective Studies
;
Specialization