A Case Study of a Patient with Penetrating Neck Injuries caused by a Nail Gun

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.

Effectiveness, Preference and Ease of Passive Release Techniques Using a Syringe for Endotracheal Tube Cuff Inflation

PURPOSE: Inappropriate cuff inflations cause many complications. A conventional pilot balloon palpation technique is insufficient to detect high cuff pressures, but is still preferred. Hence, we conducted this study to identify effectiveness, preference and ease of use of a new estimation technique named "passive release technique" for endotracheal tube cuff inflation. METHODS: Twenty-nine nurses inflated cuffs by a pilot balloon palpation technique in manikins inserted with a 7.5 mm endotracheal tube. Then, being educated about passive release techniques, they inflated cuffs using such a passive release technique. Intracuff pressures and air volumes were measured by manometers and syringes. Preference and ease of use between the two methods were scored using a 10-point Likert scale. RESULTS: For the pilot balloon palpation technique, only 4 nurses (13.8%) inflated cuffs within the normal range of pressures (normal: 15 to 30 mb) with an average of 39.3+/-34.0 cmH2O. For the passive release technique, 19 nurses (65.5%) inflated cuffs within the normal range of pressures with an average of 24.2+/-9.3 cmH2O (McNemar's test, p<0.01). In the pilot balloon palpation technique, inflated air volumes of 7.8+/-2.0 ml were not significantly different from inflated air volumes 8.5+/-1.2 ml (p=0.07) for the passive release technique. But the difference was found to be statistically significant in a variance ratio test (F-test) (p<0.01). In view of preference and ease of use between the two methods, mean values were not statistically different, 7.3+/-2.0 vs. 7.0+/-2.0 and 7.0+/-2.3 vs. 7.3+/-2.4, respectively. CONCLUSION: When direct intracuff measurement is not available, a passive release technique using a syringe is an effective and easy method to achieve cuff inflation.

Clinical Study of Patients with All-Terrain Vehicle-related Injuries in a General Hospital

PURPOSE: Recently, all-terrain vehicle (ATV)-related injuries have increased. The purpose of this study was to evaluate and analyze the ATV injuries in Korea. METHODS: We analyzed the patients who visited Chuncheon Sacred Heart Hospital emergency center with ATVrelated injuries, from 2004 January to 2008 December. The injury severity was evaluated according to the injury severity score (ISS), the revised trauma score (RTS), and the yrauma score and the injury severity score (TRISS). RESULTS: From 2004 to 2008, a total of 78 cases, 28 male and 50 female, of ATV-related injuries were reviewed. The annual incidence had increased 22.5-fold from 2004(2 cases) to 2008(45 cases). The age ranged from 8 to 68 years (median, 24 years). The most frequently injured site was the lower extremity(48.7%). The primary mechanism of injury was roll-over(35.9%), the next was falling down (33.3%). Eighty-two percent(82%) of accidents occurred on paved roads when ATVs are legislated for off-road use only. The average ISS was 6.8. In cases including both the driver and the passenger, the ISS of passengers was higher than that of drivers(7.4 vs. 4.7). Fifty percent (50%) of patients required an operation. The rate of admission was 62.8%. The average length of hospital stay was 25 days. Eighty-one percent (81%) of patients had no previous experience of operating an ATV. Sixty-seven percent (67%) of patients did not receive any formal training before operating an ATVs. CONCLUSION: Both the incidence and severity of ATV-related injuries are increasing in Korea. There is a lack of regulation enforcement and public awareness of the dangers of ATV use. The wearing of appropriate safety equipment and sufficient education about driving skills can reduce the ATVrelated injuries.

A Foreign Body Found in the Pulmonary Artery of a Traffic Accident Victim with a Chest Injury and Near-amputation of the Upper Extremity: A case report / 대한흉부외과학회지

We present a case with a foreign body in the left pulmonary artery, found in a traffic accident victim. A 52- year-old woman sitting in the passenger side of a car had massive bleeding and near complete amputation of her right forearm in addition to multiple rib fractures and a hemopneumothorax. At arrival to the emergency room, the patient had signs of shock; she was anemic, drowsy and hypotensive. A large volume of blood and crystalloid fluids were administered via the left subclavian vein with a rapid infusion device (Level 1(R)). As the lung contusion improved, a foreign body was noticed in the left lung field on plain x-rays. Pulmonary angiography was performed and revealed a 15 cm foreign body in the left basal segment of the common pulmonary artery. The foreign body was successfully retrieved using vascular forceps via the percutaneous femoral vein approach.

Screening for Antifungal Endophytic Fungi Against Six Plant Pathogenic Fungi

A total of 187 endophytic fungi were isolated from 11 plant species, which were collected from 11 locations in Korea. Their antifungal activities were screened in vivo by antifungal bioassays after they were cultured in potato dextrose broth and rice solid media. Antifungal activity against plant pathogenic fungi such as Magnaporthe grisea (rice blast), Corticium sasaki (rice sheath blight), Botrytis cinerea (tomato gray mold), Phytophthora infestans (tomato late blight), Puccinia recondita (wheat leaf rust), and Blumeria graminis f. sp. hordei (barley powdery mildew) was determined in vivo by observing the inhibition of plant disease development. Twenty (11.7%) endophytic fungi fermentation broths were able to control, by more than 90%, at least one of the six plant diseases tested. Among 187 liquid broths, the F0010 strain isolated from Abies holophylla had the most potent disease control activity; it showed control values of more than 90% against five plant diseases, except for tomato late blight. On the other hand, fourteen (7.5%) solid culture extracts exhibited potent disease control values of more than 90% against one of six plant diseases. The screening results of this study strongly suggested that metabolites of plant endophytic fungi could be good potential sources for screening programs of bioactive natural products.