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Young Hoon Yoon 8 Articles
Frequency of Post-Concussion Syndrome in Korean Patients with Minor Head Injury
Ji Young Lee, Young Hoon Yoon, Roger J Lewis, Juliana Tolles
J Trauma Inj. 2017;30(2):41-46.   Published online June 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.2.41
  • 1,969 View
  • 19 Download
AbstractAbstract PDF
PURPOSE
To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury.
METHODS
We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care.
RESULTS
Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury.
CONCLUSION
The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.
Summary
Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography
Ji Min Park, Young Hoon Yoon, Timothy Horeczko, Amy Hideko Kaji, Roger J Lewis
J Trauma Inj. 2017;30(2):25-32.   Published online June 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.2.25
  • 2,122 View
  • 19 Download
  • 2 Citations
AbstractAbstract PDF
PURPOSE
The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED).
METHODS
We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003?2004 and 2013?2014.
RESULTS
In patients with gastrointestinal perforation, time from ED arrival to CT was shorter (111.4±66.2 min vs. 199.0±97.5 min, p=0.001) but time to surgical consultation was longer (135.1±78.8 vs. 77.9±123.7, p=0.006) in 2013?2014 than in 2003?2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups.
CONCLUSION
With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.
Summary

Citations

Citations to this article as recorded by  
  • A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation
    Ga-Young Lee, Chan-Ran Park, Jung-hyo Cho, Chang-gue Son, Nam-hun Lee
    Journal of Korean Medicine.2022; 43(3): 195.     CrossRef
  • GASTROİNTESTİNAL PERFORASYON TANISINDA KULLANILAN GÖRÜNTÜLEME YÖNTEMLERİ VE GÖRÜNTÜLEME BULGULARI
    Mehtap ILGAR, Tuna ŞAHİN
    Cukurova Anestezi ve Cerrahi Bilimler Dergisi.2022; 5(2): 199.     CrossRef
Efficacy of Nefopam Analgesia for Trauma Patients in the Emergency Department
Tae Youn Lim, Jung Youn Kim, Sung Hyuk Choi, Young Hoon Yoon
J Trauma Inj. 2017;30(1):1-5.   Published online March 31, 2017
DOI: https://doi.org/10.20408/jti.2017.30.1.1
  • 2,785 View
  • 52 Download
AbstractAbstract PDF
PURPOSE
Nefopam is a centrally acting non-narcotic analgesic that has mostly been used for postoperative pain. We examined the efficacy of nefopam analgesia (alone and in combination with ketorolac) for trauma patients in the emergency department.
METHODS
We performed a retrospective chart review to select trauma patients who received nefopam at the emergency department of Korea University Medical Center Guro Hospital between January 2012 and December 2012. Patients younger than 15 years were excluded. The primary outcome measure was change of pain score (numeric rating scale) from baseline (before medication) to 30 min after medication. The secondary outcome measure was requirement for additional analgesia (pethidine).
RESULTS
Records of 1465 trauma patients who received analgesics in the emergency department from January 2012 to December 2012 were examined. Patients were classified into five groups according to initial analgesic: nefopam (n=112), ketorolac (n=867), pethidine (n=365), nefopam+ketorolac (92), and nefopam+pethidine (22). There were no significant differences in pain score reductions among the five groups. Twenty-two patients in the nefopam group, 141 in the ketorolac group, and 29 in the nefopam+ketorolac group required rescue analgesia with pethidine; these rates were not significantly different.
CONCLUSION
The efficacy of nefopam analgesia for trauma patients in the emergency department is comparable to that of more commonly used agents, including ketorolac and pethidine.
Summary
Characteristics of Injured Pregnant Women by the Traffic Accidents
Duk Hwan Kim, Young Duck Cho, Jung Youn Kim, Young Hoon Yoon, Sung Woo Lee, Sung Woo Moon, Sung Hyuk Choi
J Trauma Inj. 2012;25(4):132-138.
  • 1,074 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents.
METHODS
From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records.
RESULTS
The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence.
CONCLUSION
When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.
Summary
Predictive Factors for MDCT as a Primary Survey in Traumatic Cervical Spine Injury
Guen E Pak, Chul Han, Young Duck Cho, Jung Youn Kim, Young Hoon Yoon, Sung Woo Lee, Sung Woo Moon, Sung Hyuk Choi
J Korean Soc Traumatol. 2011;24(1):18-24.
  • 1,070 View
  • 2 Download
AbstractAbstract PDF
PURPOSE
Missing cervical pathology after injury may lead to disability and influence long-term survival. Controversies continue to evolve concerning the initial screening methods used to predict cervical spine injury. Through a retrospective chart review, we attempted to analyze and propose factors predictive of cervical trauma.
METHODS
Of all the patients who had visited the Emergency Department of Korea University, from January 2009 to December 2009, a retrospective review of the clinical records of the 217 patients who had undergone cervical spine computed tomography was done. We investigated whether we could predict the need for cervical spine computed tomography shortly after presentation in trauma patients by comparing the group with fractures and group without fractures and by finding risk factors showing significant differences between the two groups that might be used as guides in decision making.
RESULTS
Of the 217 subjects who underwent cervical spine computed tomography scans, 33 were identified with fractures of the cervical spine while 184 were not. The most common mechanisms of trauma, in order, for those with fractures were falls, followed by traffic accidents. We found that the injury severity score, multiple injuries, a high-energy injury mechanism, neurologic deficit, and pain and tenderness of the cervical spine showed statistically significant differences between the two groups.
CONCLUSION
Fractures of the cervical spine that are not observed with simple radiography occur with a relatively high frequency in trauma patients. Consideration should be given to the risk factors for cervical spine fracture, and if pertinent, cervical spine computed tomography should be performed with speed for early diagnosis of cervical spine fractures.
Summary
Early Traumatic Deaths
Seung Won Paik, Chul Han, Yun Sik Hong, Sung Hyuk Choi, Sung Woo Lee, Sung Woo Moon, Young Hoon Yoon, Woo Sung Yu, Duk Hwan Kim
J Korean Soc Traumatol. 2010;23(2):75-82.
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AbstractAbstract PDF
PURPOSE
In Korea, trauma is the 3rd most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have.
METHODS
The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score).
RESULTS
A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate.
CONCLUSION
One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.
Summary
Clinical Evaluation of Abdominal Stab Wound Patients in the ED
Jong Hak Park, Jung Youn Kim, Jun Hyun Shin, Young Hoon Yoon, Han Jin Cho, Sung Woo Moon, Sung Hyuk Choi, Sung Woo Lee, Yun Sik Hong
J Korean Soc Traumatol. 2010;23(1):21-28.
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  • 6 Download
AbstractAbstract PDF
PURPOSE
In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received non-therapeutic surgery and conservative treatment.
METHODS
This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed.
RESULTS
The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%.
CONCLUSION
In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of non-therapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.
Summary
Impact of Initial Helical Abdominal Computed Tomography on the Diagnosis of Hollow Viscus Injury and Blunt Abdominal Traumare
Young Duck Cho, Yun Sik Hong, Sung Woo Lee, Sung Hyuk Choi, Young Hoon Yoon, Sung Ik Lim, Ik Jin Jang, Seung Won Baek
J Korean Soc Traumatol. 2008;21(1):28-35.
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  • 3 Download
AbstractAbstract PDF
PURPOSE
This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients.
METHODS
This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed.
RESULTS
Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group.
CONCLUSION
Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.
Summary

J Trauma Inj : Journal of Trauma and Injury