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- 저자 : Sung Jeep Kim (검색결과 11 건)
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Temporary Closure for Sternotomy in Patient with Massive Transfusion Might Be Lethal
( Maru Kim ),( Joongsuck Kim ),( Sung Jeep Kim ),( Hang Joo Cho ) 대한외상학회 2017 大韓外傷學會誌 Vol.30 No.1
A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation. [ J Trauma Inj 2017; 30: 12-15 ]
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혈역학적으로 불안정한 골반 골절에서 진공 폐쇄 드레싱을 병용한 후복막 거즈 충전법 치료
김성집 ( Sung Jeep Kim ),김지훈 ( Ji Hoon T Kim ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.2
Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.
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Hydronephrosis during Conservative Treatment for a Renal Injury Patient
( Maru Kim ),( Joongsuck Kim ),( Sung Jeep Kim ),( Hang Joo Cho ) 대한외상학회 2017 大韓外傷學會誌 Vol.30 No.2
A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications. [ J Trauma Inj 2017; 30: 47-50 ]
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Effect of surgical timing and outcomes for appendicitis severity
Maru Kim,Sung Jeep Kim,Hang Joo Cho 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.2
Purpose: This study was aimed to evaluate the effect of time of surgery for acute appendicitis on surgical outcomes to optimize the timing of appendectomies. Methods: Medical records of patients who underwent an appendectomy were reviewed to obtain data on time of symptom onset, time of hospital presentation, and start times of surgery. Surgical findings were used to define appendicitis as either uncomplicated or complicated. The uncomplicated group included patients with simple, focal, or suppurative appendicitis, and the complicated group included patients with gangrenous, perforated appendicitis or periappendiceal abscess formation. The 2 groups were analyzed by age, sex, and time. Results: A total of 192 patients were analyzed. The mean time from symptom onset to start of operation showed a significant difference between both groups (1,652.9 minutes vs. 3,383.8 minutes, P < 0.001). The mean time from hospital visit to start of operation showed no difference between both groups (398.7 minutes vs. 402.0 minutes, P = 0.895). Operating within 24 hours of symptom onset had a relative risk of 1.738 (95% confidence interval, 1.319–2.425) for complications. Operating more than 36 hours after symptom onset was associated with an increased risk of postoperative ileus and a longer hospital stay. Conclusion: Complicated appendicitis is associated with a delay in surgery from symptom onset rather than a delay at hospital arrival. Surgeons should take into account the time from symptom onset when deciding on the timing of appendectomy. We recommend that appendectomy be performed within 36 hours from symptom onset.
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( Jayoung Lim ),( Yang Ree Kim ),( Hyo-jin Lee ),( Hang Joo Cho ),( Sung-jeep Kim ),( Kyoung Ho Choi ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1
Background:?Infection remains a major cause of mortality and morbidity after trauma. The emergence of multidrug-resistant organisms (MDRO) is responsible for limited therapeutic options. The objective of this study was to identify the prevalence and risk factors of MDRO infections in multiple trauma patients.?Methods:?We conducted a single-center, retrospective study of 820 adult patients admitted to a trauma center of Uijeongbu St. Mary's Hospital in Korea from 2014 to 2015. Only first positive culture data per organism from each specimen were analyzed. Organism considered a contaminant was excluded.?Results:?Total 515 positive cultures from 125 patients were obtained. Carbapenem-resistant Acinetobacter baummanii (CRAB, 22.1%), methicillin-resistant Staphylococcus aureus (MRSA, 14.2%), carbapenem-resistant Pseudomonas aeruginosa (2.1%), vancomycin-resistant Enterococci (1.7%), and carbapenem-resistant Enterobacteriaceae (0.6%) were isolated in multiple trauma patients. Multivariate logistic regression analysis found that, abdomen Abbreviated Injury Scale ≥3 (odds ratio [OR]=2.83; 95% confidence interval [CI]=1.07-7.89; p=0.039), intensive care treatment (OR=5.07; 95% CI=1.67-17.89; p=0.006), number of operative procedures (OR=3.49; 95% CI=1.33-9.96; p=0.014), and pneumonia (OR=5.51; 95% CI=1.97-16.96; p=0.002) were risk factors for MDRO infections. Age, sex, preexisting medical condition, Glasgow Coma Scale, type of injury, and invasive device usage were not statistically related to MDRO infections. By Kaplan-Meier analysis, the in-hospital mortality was higher in the MDRO group (18.8% vs. 5.41%; p=0.053).Conclusions:?Multiple trauma patients had high rates of CRAB and MRSA. This research suggests that trauma patients with severe abdominal injury, intensive care treatment, multiple operative procedures and pneumonia are at increased risk for MDRO infections. Recognition of the identified risk factors may help to guide the appropriate use of empirical antibiotics. Keywords: Prevalance, Multi-drug resistance, Risk factors
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Cho, Min Jeng,Kim, Jihoon,Kim, Sung Jeep,Kyoung, Kyu Hyouck,Keum, Min Ae,Park, Sung Kyun The Korean Pediatric Society 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.3
Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.
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Min-Jeng Cho,Ji Hoon Kim,Sung Jeep Kim,Kyu Hyouck Kyoung,Min Ae Keum,Sung Kyun Park 대한소아청소년과학회 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.3
Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries
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전예원(Ye-Won Jun),정헌(Hun Jung),김성집(Sung-Jeep Kim),전경화(Kyong Hwa Jun),진형민(Hyung Min Chin),박우배(Woo Bae Park) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.5
Purpose: Despite the reported advantages of laparoscopic appendectomy (LA), there is debate about the postoperative complication rates. Our study attempts to determine if laparoscopic appendectomy is safe and feasible compared with open appendectomy (OA). Methods: A retrospective review was conducted of all patients who underwent open appendectomy (OA, 2,109 cases) and laparoscopic appendectomy (LA, 500 cases) at our hospital between 1997 and 2007. Incidental and interval appendectomies were excluded from this study. Demographic data, pathology, operation time, length of hospital stay, days to regular diet, and in hospital complication rate were identified. Results: The peak age was 27 years. Seven of the 500 were converted to OA, yielding a conversion rate of 1.2%. The presence of non-visualized appendix, adhesion and technical failures were reasons for conversion. The distribution of histological stages of inflammation was comparable in both groups. The mean operating time was longer for the laparoscopic (64 min) than for the open procedure (58 min) (P<0.001). The complication rate after OA (7%) was significantly higher than that following LA (2.8%) (P=0.001). Hospital stay and frequency of analgesic administration were significantly lower in LA group than in OA group. Conclusion: Laparoscopic appendectomy is a safe and clinically beneficial operating procedure even in patients with appendicitis with peritonitis, perforation and abscess, resulting in shorter hospital stays and lower complication rates.
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