- Balloon Angioplasty for Budd-Chiari Syndrome Resulting from Primary Repair of an Inferior Vena Cava Injury
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Joohyun Sim, Je Hwan Won, Kyoungwon Jung, Cook John Lee, Young Hwan Kim
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J Trauma Inj. 2014;27(4):196-200.
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 Abstract
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- Budd-Chiari syndrome is an uncommon condition characterized by hepatic outflow obstruction. Direct suture of the injured Inferior vena cava in a patient with blunt hepatic trauma also may cause an equivalent condition. However, early diagnosis is possible with common symptoms and radiologic evaluation. Moreover, a transluminal approach with balloon angioplasty could prevent long-term complications of Budd-Chiari syndrome without repeated abdominal surgery.
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Summary
- Outcomes for Employment of a Trauma Clinical Nurse Specialist in the Treatment of Trauma Patients
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Yooun Joong Jung, Young Hwan Kim, Tae Hyun Kim, Min Ae Keum, Dae Sung Ma, Kyu Hyouck Kyoung, Jung Jae Kim, Suk Kyung Hong
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J Trauma Inj. 2012;25(4):254-260.
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Abstract
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- PURPOSE
Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients.
METHODS
Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared.
RESULTS
To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05).
CONCLUSION
The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.
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Summary
- Medical Expenses for Trauma According to the Type of Medical Insurance
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Heeseung Park, Yooun Joong Jung, Young Hwan Kim, Tae Hyun Kim, Min Ae Km, Kyu Hyouck Kyoung, Jung Jae Kim, Suk Kyung Hong
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J Trauma Inj. 2012;25(4):178-187.
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Abstract
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- PURPOSE
In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system.
METHODS
From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged.
RESULTS
Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge.
CONCLUSION
We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.
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Summary
- Abdominal Organ Injuries with Chyloperitoneum after Blunt Tauma: A Case Report
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Young Hwan Kim, Yooun Joong Jung, Suk Kyung Hong
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J Korean Soc Traumatol. 2012;25(3):105-108.
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Abstract
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- Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There's still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta.
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Summary
- The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Treatment of Traumatic Pancreas Injury
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Min young Jeong, Young hwan Kim, Kyu hyouck Kyoung, Sung Koo Lee, Suk kyung Hong
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J Korean Soc Traumatol. 2011;24(2):136-142.
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Abstract
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- PURPOSE
Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury.
METHODS
We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed.
RESULTS
A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation.
CONCLUSION
Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.
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