Journal of Trauma and Injury

Seung Hwan Lee

9 Articles

A Case of Traumatic Cervical Braun-Sequard Syndrome: Dae Hyun Cho, Seung Hwan Lee, Jae Gil Lee, Myung Jae Jung; J Trauma Inj. 2017;30(3):103-106. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.103

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Abstract PDF: A traumatic Braun-Sequard syndrome of the cervical spine is reported in a 53-year-old male. The patient recovered spontaneously over several days with surgical intervention. The diagnosis was made on magnetic resonance imaging with physical examination, which also demonstrated subsequent resolution of bone marrow intensity. The etiological factors of spinal Braun-Sequard syndrome are reviewed.; Summary

Management of Perirectal Laceration without Fecal Diversion: A Case Report: Dae Hyun Cho, Seung Hwan Lee, Myung Jae Jung, Jae Gil Lee; J Trauma Inj. 2017;30(2):55-58. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.55

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Abstract PDF: Clinical research on multiple lacerations of perineum or buttock is sparse and rare so limited to case reports. But a missed rectal injury combined bladder or vessel can have devastating consequence. Although it is generally known that it should be treated accompanying with diverting ileostomy or colostomy, the aim of this case is announce the possibility of management of perectal injury without diversion.; Summary

Prevalences of Incidental Findings in Trauma Patients by Abdominal and Pelvic Computed Tomography: Jin Young Lee, Myung Jae Jung, Jae Gil Lee, Seung Hwan Lee; J Trauma Inj. 2016;29(3):61-67. Published online September 30, 2016; DOI: https://doi.org/10.20408/jti.2016.29.3.61

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2 Citations

Abstract PDF

PURPOSE
Abdominal and pelvic computed tomography (APCT) is frequently used as a diagnostic tool in trauma patients. However, trauma unrelated, incidental findings are frequently encountered. The aim of this study was to determine the prevalences of incidental findings on APCT scans in trauma patients.
METHODS
The archived records of 801 trauma patients treated from January 2013 to December 2015 were reviewed retrospectively. Six hundred and forty of these patients underwent contrast enhanced APCT in an emergency department and were included in this study, and 205 (32.1%) of these patients had incidental findings. These findings were divided into two categories: category I, meaning a radiological benign finding not requiring further evaluation or follow- up, and category II, requiring further evaluation and follow-up.
RESULTS
One hundred and sixty (24.8%) patients were allocated to category I and 45 (7.2%) to category II. The most frequent incidental findings were discovered in kidneys (34.6%), followed by liver (28.8%), and gallbladder (15.6%). The most frequent finding in category I was a benign cyst (60.1%), followed by a simple stone (15.6%), and hemangioma (11.9%). Adenomyomatosis of the gallbladder (17.8%) was the most common lesion in category II, followed by atypical mass (15.6%), complicated stone (15.6%) and cystic neoplasm (15.6%).
CONCLUSION
The prevalence of an incidental finding on APCT scans was 32.1%. Although category II lesions were not common in trauma patients, these findings should be communicated to patients, and when necessary referred to a primary care physician. Systems are required for producing appropriate discharge summaries and informing patients about the implications of incidental findings.

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Incidental Cancer Diagnoses in Trauma Patients: A Case–Control Study Evaluating Long-term Outcomes
Nathaniel Bell, Amanda Arrington, Swann Arp Adams, Mark Jones, Joseph V. Sakran, Ambar Mehta, Jan M. Eberth
Journal of Surgical Research.2019; 242: 304. CrossRef
Filling the void: a low-cost, high-yield approach to addressing incidental findings in trauma patients
Nicholas Sich, Andrew Rogers, Danelle Bertozzi, Praveen Sabapathi, Waed Alswealmeen, Philip Lim, Jonathan Sternlieb, Laura Gartner, James Yuschak, Orlando Kirton, Ryan Shadis
Surgery.2018; 163(4): 657. CrossRef

Relation between Blood Alcohol Concentration and Clinical Parameters in Trauma Patients: Tae Hwa Hong, Ji Young Jang, Seung Hwan Lee, Hyung Won Kim, Hong Jin Shim, Jae Gil Lee; J Trauma Inj. 2015;28(4):256-261. Published online December 31, 2015; DOI: https://doi.org/10.20408/jti.2015.28.4.256

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Abstract PDF: PURPOSE
The aim of this study was to evaluate the effects of blood alcohol concentration (BAC) on the clinical parameters in trauma patients.
METHODS
From January 2011 to March 2013, the records of a total of 102 trauma patients with BAC data were analyzed retrospectively. The revised trauma score (RTS), injury severity score (ISS), presence of shock, use of mechanical ventilation and blood transfusion, length of hospital stay, and mortality were collected. Patients were divided into four groups in accordance with the level of BAC: group A (<100 mg/dL), B (100~200 mg/dL), C (200~250 mg/dL), and D (>250 mg/dL). Patients were also divided into two groups depending on the presence of the shock, and gender, ISS, BAC, and presence of active bleeding were compared between these two groups.
RESULTS
No statistically significant differences in the ISS, RTS, presence of active bleeding, use of mechanical ventilation, and mortality were noted between groups A to D. However, the presence of shock was significantly higher in group D. After patients with severe chest injuries had been excluded, mechanical ventilation was found to have been applied more frequently in the higher BAC groups (C and D). A logistic regression analysis of these factors showed that extremely high BAC (>250 mg/dL) was an independent indicator of shock.
CONCLUSION
High BAC is a predicator of shock and the need for mechanical ventilation in patients with trauma, regardless of injury severity. Alcohol intoxication leads to an overestimate of the clinical condition and aggressive management for trauma patients. Thus, a guideline for the diagnosis and treatment of patients intoxicated with alcohol is necessary.; Summary

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center: Hyung Won Kim, Tae Hwa Hong, Seung Hwan Lee, Myung Jae Jung, Jae Gil Lee; J Trauma Inj. 2015;28(4):241-247. Published online December 31, 2015; DOI: https://doi.org/10.20408/jti.2015.28.4.241

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Abstract PDF

PURPOSE
To evaluate the influence of how the trauma care system is applied on the management of trauma patients.
METHODS
We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups.
RESULTS
The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the posttrauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group.
CONCLUSION
Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

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Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital
Kyoung Hwan Kim, Sung Ho Han, Soon-Ho Chon, Joongsuck Kim, Oh Sang Kwon, Min Koo Lee, Hohyoung Lee
Journal of Trauma and Injury.2019; 32(1): 1. CrossRef
Characteristics and Outcomes of Trauma Patients via Emergency Medical Services
Dae Hyun Cho, Jae Gil Lee
Journal of Trauma and Injury.2017; 30(4): 120. CrossRef
Analysis of Abdominal Trauma Patients Using National Emergency Department Information System
In-Gyu Song, Jin Suk Lee, Sung Won Jung, Jong-Min Park, Han Deok Yoon, Jung Tak Rhee, Sun Worl Kim, Borami Lim, So Ra Kim, Il-Young Jung
Journal of Trauma and Injury.2016; 29(4): 116. CrossRef

A Case of Cardiac Laceration due to Anterior Thoracic Stab Injury: Won Gi Woo, Ji Young Jang, Seung Hwan Lee, Chang Young Lee, Jae Gil Lee; J Trauma Inj. 2014;27(3):71-74.

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Abstract PDF: Among chest trauma patients, cardiac laceration is a rare, but severe, condition requiring prompt management. Depending on the patient's hemodynamic status, early detection rate of a cardiac laceration may or may not be occur. If a possibility of cardiac laceration exists, an emergent thoracotomy should be performed. Furthermore, patients who experience a cardiac laceration also experience different kinds of complications. Therefore, close follow-up and monitoring are required. Herein, we report a 41-year-old man with a left atrium and a left ventricle laceration caused by a thoracic stab injury.; Summary

The Choice of Management in Patients with Splenic Blunt Trauma: A Single Center Study: Ji Young Jang, Seung Hwan Lee, Jae Gil Lee; J Trauma Inj. 2013;26(4):280-285.

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Abstract PDF: PURPOSE
Nowadays, non-operative management increases in patients with blunt splenic injury due to development of diagnostic and interventional technique. The purpose of this study is to evaluate the management in patients with blunt splenic injury and effect of clinical state such as shock on the choice of management.
METHODS
From April 2007 to July 2013, we retrospectively reviewed the medical charts of fifty patients who had splenic injury after blunt trauma. The demographic characteristics, American Association for the Surgery of Trauma (AAST) grade of splenic injury, management method (emergency operation, angiographic embolization or observation) and clinical outcome were analyzed.
RESULTS
The mean age was 41.5+/-21.4 years and male was 44(88%). Twenty patients(40%) were in shock condition initially and five patients(10%) underwent emergency operation due to hemodynamic instability. Emergency angiographic embolization was performed in 20 patients(40%) and 25 patients were managed conservatively. When patients were divided into shock group (SG) and non-shock group (NSG), Patients in SG had significantly higher serum lactate level and base deficit than NSG (lactate; 4.5+/-3.4 mmol/L, base deficit; 5.8+/-4.4 mmol/L vs 1.9+/-1.4 mmol/L, 2.8+/-2.5 mmol/L, p=0.007, p=0.013). There was no significant difference of AAST grade and contrast blush rate in abdomen CT between two groups. Among 45 patients with non-operative management, four patients(8.9%) got delayed angiographic embolization and 3 patient died from companied organ injury.
CONCLUSION
Non-operative management can be acceptable management option in patients with splenic blunt trauma under intensive hemodynamic monitoring.; Summary

Transfer Patterns of Multiple Trauma Patients in University Hospital after Acute Phase Management: Jong Min Lee, Ji Young Jang, Seung Hwan Lee, Jae Gil Lee; J Trauma Inj. 2013;26(4):261-265.

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Abstract PDF: PURPOSE
The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type.
METHODS
Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review.
RESULTS
The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038).
CONCLUSION
An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.; Summary

Management of Traumatic Pancreas Injury in Korea: Literature Review: Seung Hwan Lee, Ji Young Jang, Hongjin Shim, Jae Gil Lee; J Trauma Inj. 2013;26(3):207-213.

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Abstract PDF: PURPOSE
Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population.
METHODS
Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes.
RESULTS
Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies( 23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock.
CONCLUSION
In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.; Summary

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