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Jung Joo Hwang 11 Articles
Experiences of Video-assisted Thoracic Surgery in Trauma
Dongsub Noh, Chan kyu Lee, Jung Joo Hwang, Hyun Min Cho
J Trauma Inj. 2017;30(3):87-90.   Published online October 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.3.87
  • 1,941 View
  • 11 Download
AbstractAbstract PDF
PURPOSE
Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area.
METHODS
From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively.
RESULTS
Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients.
CONCLUSIONS
VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.
Summary
The Surgical Outcome for Patients with Tracheobronchial Injury in Blunt Group and Penetrating Group
Chang Wan Kim, Jung Joo Hwang, Hyun Min Cho, Jeong Su Cho, Ho Seok I, Yeong Dae Kim, Do Hyung Kim
J Trauma Inj. 2016;29(1):1-7.   Published online March 31, 2016
DOI: https://doi.org/10.20408/jti.2016.29.1.1
  • 2,070 View
  • 28 Download
  • 2 Citations
AbstractAbstract PDF
PURPOSE
Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma.
METHODS
From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups.
RESULTS
In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was 6.89±1.59 (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was 24.36±7.16 (range: 11-34) in the blunt group; the mean RTS was 7.56±0.41 (range: 7.11-7.84), and the mean ISS was 13±5.26 (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups.
CONCLUSION
Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma.
Summary

Citations

Citations to this article as recorded by  
  • A Case of Total Laryngectomy after Severe Penetrating Laryngeal Trauma
    Youngjin Cho, Sung-Chan Shin, Byung-Joo Lee, Yong-Il Cheon
    Journal of Clinical Otolaryngology Head and Neck .2022; 33(4): 250.     CrossRef
  • Damage Control of Laryngotracheal Trauma: The Golden Day
    Mario Alain Herrera, Luis Fernando Tintinago, William Victoria, Carlos Alberto Ordoñez, Michael Parra, Mateo Betancourt-Cajiao, Yaset Caicedo, Monica Guzman, Linda M. Gallego, Adolfo Gonzalez Hadad, Luis Fernando Pino, Jose Julian Serna, Alberto García, C
    Colombia médica.2020;[Epub]     CrossRef
Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury
Gwan Woo Ku, Jin Ho Choi, Min Suk Choi, Sang Soon Park, Young Hoon Sul, Seung Je Go, Jin Bong Ye, Joong Suck Kim, Yeong Cheol Kim, Jung Joo Hwang
J Trauma Inj. 2015;28(4):232-240.   Published online December 31, 2015
DOI: https://doi.org/10.20408/jti.2015.28.4.232
  • 2,371 View
  • 13 Download
AbstractAbstract PDF
PURPOSE
Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury.
METHODS
Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014.
RESULTS
Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was 105.64+/-24.60 mm Hg, and the mean heart rate was 103.64+/-20.02 per minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was 21.82+/-16.37 hours. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur.
CONCLUSION
Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.
Summary
PARK Index for Preventable Major Trauma Death Rate
Chan Yong Park, Byungchul Yu, Ho Hyun Kim, Jung Joo Hwang, Jungnam Lee, Hyun Min Cho, Han Na Park
J Trauma Inj. 2015;28(3):115-122.   Published online September 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.3.115
  • 2,445 View
  • 13 Download
  • 3 Citations
AbstractAbstract PDF
PURPOSE
To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator.
METHODS
The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25.
RESULTS
The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%.
CONCLUSION
PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.
Summary

Citations

Citations to this article as recorded by  
  • Comparison of Outcomes at Trauma Centers versus Non-Trauma Centers for Severe Traumatic Brain Injury
    Tae Seok Jeong, Dae Han Choi, Woo Kyung Kim
    Journal of Korean Neurosurgical Society.2023; 66(1): 63.     CrossRef
  • Comparison of Preventable Trauma Death Rates in Patients With Traumatic Brain Injury Before and After the Establishment of Regional Trauma Center: A Single Center Experience
    Dae Han Choi, Tae Seok Jeong, Myung Jin Jang
    Korean Journal of Neurotrauma.2023; 19(2): 227.     CrossRef
  • PARK Index and S-score Can Be Good Quality Indicators for the Preventable Mortality in a Single Trauma Center
    Chan Yong Park, Kyung Hag Lee, Na Yun Lee, Su Ji Kim, Hyun Min Cho, Chan Kyu Lee
    Journal of Trauma and Injury.2017; 30(4): 126.     CrossRef
Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor
Seon Hee Kim, Sun Woo Choi, Sung Jin Park, Kwang Hee Yeo, Chang Wan Kim, Sang Bong Lee, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho
J Trauma Inj. 2015;28(2):71-74.   Published online June 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.2.71
  • 2,700 View
  • 6 Download
AbstractAbstract PDF
Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.
Summary
Successful Angiographic Embolization of Superficial Circumflex Iliac Artery Rupture Caused by Blunt Abdominal Trauma: A Case Report
Sang Bong Lee, Sung Jin Park, Kwang Hee Yeo, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Chang Wan Kim, Seon Uoo Choi, Seon Hee Kim, Jung Joo Hwang, Hyun Min Cho
J Trauma Inj. 2015;28(1):39-42.   Published online March 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.1.39
  • 1,988 View
  • 16 Download
AbstractAbstract PDF
Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.
Summary
Delayed Aortic Injury Caused by a Posterior Rib Fracture: A Case Report
Chang Wan Kim, Seon Uoo Choi, Seon Hee Kim, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho, Seung Hwan Song, Jeong Su Cho
J Trauma Inj. 2015;28(1):31-33.   Published online March 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.1.31
  • 1,883 View
  • 6 Download
AbstractAbstract PDF
Traumatic aortic injury is well recognized as a primary cause of instantaneous death in victims of thoracic blunt trauma presenting with an aortic rupture or dissection, particularly after a deceleration injury. However, a direct aortic injury caused by a fractured rib segment after blunt thoracic trauma is extremely rare. We report the case of a 43-year-old male patient who experienced an aortic injury caused by the sharp edge of a fractured rib after multiple rib fractures due to blunt thoracic trauma.
Summary
Incidence of Venous Thromboembolism in Pelvic and Acetabular Fractures in the Korean Population
Sang Ki Lee, Jae Won Lee, Jung Joo Hwang
J Trauma Inj. 2013;26(3):74-80.
  • 1,076 View
  • 5 Download
AbstractAbstract PDF
PURPOSE
There are no detailed reports on the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Korean population.
METHODS
The cases of 67 Korean patients with pelvic and acetabular fractures treated at our hospital from January 2009 to February 2012 were analyzed retrospectively. Until May 2010, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded 20 microg/ml at 5 days after trauma and surgery, or increased to greater than 20 microg/ml after a period of decline. After May 2010, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed on all patients. The effects of the presence of a pelvic and/or acetabular fracture, and the effects of fracture type, accompanying injuries, and screening strategies on the incidences of VTE were investigated.
RESULTS
Overall, 26 patients(38.8%) were diagnosed with VTE and PTE in 14(20.9%). All were asymptomatic. Significantly higher incidences of VTE and PTE were observed in trauma patients with pelvic and acetabular fractures than in trauma patients without pelvic and acetabula fractures treated during the same period. No significant differences were observed in the incidences of VTE and PTE between patients with pelvic fractures, and patients with acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates for VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance.
CONCLUSION
In the Korean population, we should be vigilant for a high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures.
Summary
Ureteral Injury Caused By Blunt Trauma: A Case Report
Oh Sang Kwon, Yun Su Mun, Seung Hwo Woo, Hyun Young Han, Jung Joo Hwang, Jang Young Lee, Min Koo Lee
J Trauma Inj. 2012;25(4):291-295.
  • 1,330 View
  • 9 Download
AbstractAbstract PDF
Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.
Summary
Early Surgical Stabilization of Ribs for Severe Multiple Rib Fractures
Jung Joo Hwang, Young Jin Kim, Han Young Ryu, Hyun Min Cho
J Korean Soc Traumatol. 2011;24(1):12-17.
  • 1,134 View
  • 20 Download
AbstractAbstract PDF
PURPOSE
A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments.
METHODS
From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment.
RESULTS
The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality.
CONCLUSION
In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.
Summary
Clinical Aanalysis of Airway Trauma
Hyun Min Cho, Young Jin Kim, Han Young Ryu, Jung Joo Hwang
J Korean Soc Traumatol. 2011;24(1):7-11.
  • 985 View
  • 2 Download
AbstractAbstract PDF
PURPOSE
Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients.
METHODS
A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009.
RESULTS
Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient).
CONCLUSION
Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.
Summary

J Trauma Inj : Journal of Trauma and Injury