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Article ; Online: Validation of the 35-mm rule in traumatic pneumothorax in an Asian population.

Nho, Woo Young

2024 Volume 136, Issue 1, Page(s) 60–66

Abstract: Objectives: Thoracic injury crucially threatens human health. Recent studies have suggested using computed tomography (CT) to observe traumatic pneumothorax (PTX). However, cross-ethnic validation is required to overcome potential barriers for the ... ...

Abstract	Objectives: Thoracic injury crucially threatens human health. Recent studies have suggested using computed tomography (CT) to observe traumatic pneumothorax (PTX). However, cross-ethnic validation is required to overcome potential barriers for the global application of this method. This study aimed to validate the 35-mm rule in traumatic PTX in a Korean population. Methods: Data from the institutional registry were analyzed, and chest CT images were reviewed. Factors for observation failure were evaluated via logistic regression analysis, and a receiver-operating curve was created to calculate the optimal cutoff value. Results: In total, 286 participants were included in this study. The average PTX size was 8.2 (3.2-26.5) mm, and 210 of 213 (95.3%) initially observed patients with a PTX size of ≤35 mm successfully completed the safety observation. Multivariate regression analysis revealed that a PTX size of >35 mm is associated with observation failure and suggested a cutoff of 24.5 mm. Conclusion: Most patients with traumatic PTX of ≤35 mm on CT had undergone successful 4-h observation without thoracostomy. Additionally, PTX of >35 mm was an independent risk factor for observation failure. Considering the lower optimal cutoff value and high failure rates observed in this study, the current guidelines need modifications.
MeSH term(s)	Humans ; Pneumothorax/etiology ; Pneumothorax/complications ; Thoracic Injuries/complications ; Thoracic Injuries/diagnostic imaging ; Thoracostomy/adverse effects ; Thoracostomy/methods ; Tomography, X-Ray Computed ; Retrospective Studies
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	410138-8
ISSN	1941-9260 ; 0032-5481
ISSN (online)	1941-9260
ISSN	0032-5481
DOI	10.1080/00325481.2024.2313449
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Article ; Online: Bacterial cerebritis with broad-scale cranial defect caused by self-trepanation.

Nho, Woo Young

The American journal of the medical sciences

2024

Language	English
Publishing date	2024-03-28
Publishing country	United States
Document type	Letter
ZDB-ID	82078-7
ISSN	1538-2990 ; 0002-9629
ISSN (online)	1538-2990
ISSN	0002-9629
DOI	10.1016/j.amjms.2024.03.018
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Article ; Online: Abdominal compartment syndrome caused by severe acute gastric distension in a patient with COVID-19: A case report.

Park, Ki Bum / Nho, Woo Young

Medicine

2023 Volume 102, Issue 28, Page(s) e34326

Abstract: Rationale: The clinical manifestation of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to critical. The gastrointestinal (GI) tract is involved in the early stages of the disease and is recognized as an important entry site for the virus. ...

Abstract	Rationale: The clinical manifestation of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to critical. The gastrointestinal (GI) tract is involved in the early stages of the disease and is recognized as an important entry site for the virus. Consequently, GI manifestations are common in patients with COVID-19; however, the GI presentation of COVID-19 in relation to bowel dilatation has rarely been reported. Here, we report a case of acute severe gastric distension resulting in aortic compression and abdominal compartment syndrome (ACS) in a patient with COVID-19. Patient concerns: A 72-year-old male presented to the emergency department (ED) with severe abdominal distension. The patient had been confirmed to have COVID-19 5 days prior to the visit. Diagnoses: Computed tomography revealed critical abdominal distension with severe gastric dilatation, accompanied by compression of the abdominal aorta and distal thrombosis formation. Interventions: Intravenous fluid resuscitation and support with inotropic agents were initiated immediately, and a large amount of gastric content was evacuated via a nasogastric (NG) tube. Outcome: Finally, the patient was discharged after 12 days of admission without obvious complications. Lessons: ACS is critical, which can be caused by a severe degree of acute gastric distension (AGD). Evacuation of the intraluminal contents is the most efficient management strategy. Prognosis is poor, and most previous studies of the transition from AGD to ACS have reported unfavorable outcomes.
MeSH term(s)	Male ; Humans ; Aged ; Intra-Abdominal Hypertension/etiology ; COVID-19/complications ; Gastric Dilatation/complications ; Abdomen ; Aorta, Abdominal ; Acute Disease
Language	English
Publishing date	2023-06-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000034326
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Article ; Online: Gastric perforation after polyurethane foam ingestion.

Park, Ki Bum / Nho, Woo Young / Yu, Byunghyuk / Park, Jungbae

Clinical toxicology (Philadelphia, Pa.)

2024 Volume 62, Issue 3, Page(s) 197–199

Abstract: Introduction: Acute intoxication rarely produces conditions that require urgent surgical care.: Case summary: A 45-year-old man presented to the emergency department with severe abdominal pain after the deliberate ingestion of 200 cm: Images: ... ...

Abstract	Introduction: Acute intoxication rarely produces conditions that require urgent surgical care. Case summary: A 45-year-old man presented to the emergency department with severe abdominal pain after the deliberate ingestion of 200 cm Images: Computed tomography revealed foreign material occupying the entire gastric chamber, as well as diffuse gastric perforation. Conclusions: Life-threatening gastric perforation can occur after polyurethane foam ingestion. Clinical/medical toxicologists and emergency physicians need to be aware of the highly expandable nature of this agent.
MeSH term(s)	Humans ; Polyurethanes ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Stomach/injuries ; Foreign Bodies/surgery ; Foreign Bodies/complications ; Abdominal Pain/etiology ; Isocyanates ; Suicide, Attempted
Chemical Substances	Polyurethanes ; polyurethane foam (9009-54-5) ; Isocyanates ; 4,4'-diphenylmethane diisocyanate (B0LO6BBS8C)
Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	204476-6
ISSN	1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
ISSN (online)	1556-9519
ISSN	0009-9309 ; 0731-3810 ; 1556-3650
DOI	10.1080/15563650.2024.2330632
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Article: Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department.

Sakong, Dal / Choe, Michael Sung Pil / Nho, Woo Young / Park, Chang Won

Clinical and experimental emergency medicine

2023 Volume 10, Issue 1, Page(s) 84–91

Abstract: Objective: Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time ... ...

Abstract	Objective: Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time between symptom onset and surgery and the perioperative severity of AGD during the COVID-19 pandemic compared to before the era of COVID-19. Methods: This retrospective, single-center cohort study included patients who presented to the ED with suspected AGD and who underwent emergency cholecystectomy. We designed a before-after comparative study, and the intervention was the COVID-19 outbreak. The 6-month period after the COVID-19 outbreak was defined as the post-COVID group, whereas the pre-COVID group consisted of the same period in the previous year. The primary outcome was the time from symptoms to surgery. We evaluated the time intervals between symptom onset and ED arrival and between ED arrival and surgery. The secondary outcomes were preoperative and postoperative severity indexes. Results: A total of 316 patients was analyzed. The post-COVID group showed longer duration from symptom onset to ED arrival (34.0 hours vs. 15.0 hours, P<0.001) and longer time interval from ED arrival to surgery (16.2 hours vs. 10.2 hours, P<0.001) than the pre-COVID group. The overall time interval between symptom onset to surgery was longer in the post-COVID group than the pre-COVID group (71.5 hours vs. 33.5 hours, P<0.001). The post-COVID group showed higher preoperative Simplified Acute Physiology Score II scores than the pre-COVID group (20.1 vs. 18.2, P=0.045). The proportion of moderate or severe disease increased in the post-COVID group (78% vs. 65%, P=0.017). The durations of hospital stay (7.0 days vs. 5.0 days, P<0.001) and intensive care unit stay (27.1 hours vs. 10.8 hours, P=0.008) were longer in the post-COVID group than in the pre-COVID group. Conclusion: During the pandemic, the time interval between symptom onset to surgery was significantly increased among patients with AGD. Concomitantly, higher preoperative severity indexes and longer hospital stay were reported with a delay in emergency surgery.
Language	English
Publishing date	2023-01-09
Publishing country	Korea (South)
Document type	Journal Article
ISSN	2383-4625
ISSN	2383-4625
DOI	10.15441/ceem.22.239
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Article ; Online: Emergency contraceptive provision in the emergency department and risk analysis for delayed utilization in South Korea.

Choi, Yoon Jung / Lee, Soo Hyung / Yi, Jeongsik / Nho, Woo Young

Medicine

2023 Volume 102, Issue 47, Page(s) e36195

Abstract: In certain nations, the emergency department (ED) has been designated as the primary center to provide emergency contraception (EC). However, analyses of ED visits for EC are limited. Moreover, ED-based research that focuses on time is limited to only a ... ...

Abstract	In certain nations, the emergency department (ED) has been designated as the primary center to provide emergency contraception (EC). However, analyses of ED visits for EC are limited. Moreover, ED-based research that focuses on time is limited to only a few surveys. The aims of this study were to examine the characteristics of ED visitors for EC and the interval between the coitus and arrival at the ED, and to analyze the factors associated with delays in visiting the ED. This retrospective cohort study involved patients at 2 urban tertiary academic hospitals in South Korea. All patients who presented to the ED for EC between January 2019 and December 2021 were analyzed. The median age of the participants was 26 years. The most common variables were age of 20 to 29 years (42.0%), evening visits (34.9%), weekends or public holidays (62.6%), single status (89.2%), and visits after contraceptive failure (79.1%). The mean time interval was 7.49 hours, and 77.4% of all patients visited the ED within 12 hours. Patients who received public sex education presented earlier (P < .001). ED visits after nonconsensual sexual incidents represented significantly delayed presentations (P < .001). Regression analysis revealed that both the lack of public education and the occurrence of nonconsensual coitus were associated with incident-to-ED visit intervals of >12 hours. Most patients received emergency contraceptive pill (ECP) within the recommended timeframe. In particular, nationwide school-based public sex education positively affected early ECP access. In contrast, ECP provision was delayed for patients who experienced nonconsensual coitus. Strategies for timely ECP access should account for possible concerns about stigmatization and privacy.
MeSH term(s)	Female ; Humans ; Adult ; Young Adult ; Contraceptives, Postcoital ; Retrospective Studies ; Emergency Service, Hospital ; Republic of Korea ; Risk Assessment
Chemical Substances	Contraceptives, Postcoital
Language	English
Publishing date	2023-11-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000036195
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Article: A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study.

Nho, Woo Young / Kim, Jong Kun / Kee, Se Kook

Annals of translational medicine

2021 Volume 9, Issue 18, Page(s) 1399

Abstract: Background: Acute gallbladder disease (AGD) is frequent in the emergency department (ED), and usually requires surgical intervention. Gallbladder torsion (GT) is a rare entity among patients with AGD. There are sparse reviews of GT's clinical ... ...

Abstract	Background: Acute gallbladder disease (AGD) is frequent in the emergency department (ED), and usually requires surgical intervention. Gallbladder torsion (GT) is a rare entity among patients with AGD. There are sparse reviews of GT's clinical characteristics, and there is no comparative study between them in the same patient cohort. Therefore, we report the case series of GT, and compare the statistical differences between GT and non-GT with AGD. Methods: We collected retrospective data from patients who visited ED with AGD and underwent emergency cholecystectomy between January 2005 and December 2020. We combined consecutive case series of GT and compared them with non-GT gallbladder disease. Results: Six GT cases were diagnosed over the study duration. Five were female (83%) and the average age was 77.8 years. All patients presented with abdominal pain, and the median duration of pain was two days. Only two cases were suspected for GT pre-operatively (33%). One patient underwent laparotomy, and the others underwent laparoscopic cholecystectomy with a mean operation time of 59 min. The torsion direction was of the same proportion in both directions; five (83%) were rotated completely. The mean length of hospital stay was 9.3 d and outcomes were favorable in most GT cases. In the comparative study between GT and non-GT, age was higher in the GT group (P=0.048), and duration or severity of pain showed no statistical difference (P=0.528; P=0.637, respectively). Body temperature was higher in the non-GT group without statistical significance (P=0.074). Gallstones were present in 68.8% of the non-GT group, which is significantly higher than that of the GT group (P=0.036). Conclusions: Six exceptional GT cases were managed successfully. The overall characteristics of each GT case demonstrated similar with previous reviews. Our comparative analysis showed that age, pulse rate, serum creatinine level, and gallstone presence showed statistical differences. Contrary to the traditional knowledge of GT, some distinct features like sex, duration or severity of pain, and fever showed no significant differences within AGD in our research.
Language	English
Publishing date	2021-10-18
Publishing country	China
Document type	Journal Article
ZDB-ID	2893931-1
ISSN	2305-5847 ; 2305-5839
ISSN (online)	2305-5847
ISSN	2305-5839
DOI	10.21037/atm-21-2399
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Article ; Online: Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study.

Cho, Sung Hoon / Nho, Woo Young / Lee, Dong Eun / Ahn, Jae Yun / Kim, Joon-Woo / Lim, Kyoung Hoon / Ryoo, Hyun Wook / Kim, Jong Kun

BMC emergency medicine

2024 Volume 24, Issue 1, Page(s) 53

Abstract: Background: Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the ... ...

Abstract	Background: Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the effects of the coronavirus disease 2019 (COVID-19) pandemic on IHT among patients with major trauma was lacking. Method: This retrospective cohort study was conducted in an urban trauma center (TC) of a tertiary academic affiliated hospital in Daegu, Korea. The COVID-19 period was defined as from February 1, 2020 to January 31, 2021, whereas the pre-COVID-19 period was defined as the same duration of preceding span. Clinical data collected in each period were compared. We hypothesized that the COVID-19 pandemic negatively impacted IHT. Results: A total of 2,100 individual patients were included for analysis. During the pandemic, the total number of IHTs decreased from 1,317 to 783 (- 40.5%). Patients were younger (median age, 63 [45-77] vs. 61[44-74] years, p = 0.038), and occupational injury was significantly higher during the pandemic (11.6% vs. 15.7%, p = 0.025). The trauma team activation (TTA) ratio was higher during the pandemic both on major trauma (57.3% vs. 69.6%, p = 0.006) and the total patient cohort (22.2% vs. 30.5%, p < 0.001). In the COVID-19 period, duration from incidence to the TC was longer (218 [158-480] vs. 263[180-674] minutes, p = 0.021), and secondary transfer was lower (2.5% vs. 0.0%, p = 0.025). Conclusion: We observed that the total number of IHTs to the TC was reduced during the COVID-19 pandemic. Overall, TTA was more frequent, particularly among patients with major trauma. Patients with severe injury experienced longer duration from incident to the TC and lesser secondary transfer from the TC during the COVID-19 pandemic.
MeSH term(s)	Humans ; Middle Aged ; Pandemics ; Retrospective Studies ; Patient Transfer ; COVID-19/epidemiology ; Trauma Centers ; Republic of Korea/epidemiology
Language	English
Publishing date	2024-04-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2050431-7
ISSN	1471-227X ; 1471-227X
ISSN (online)	1471-227X
ISSN	1471-227X
DOI	10.1186/s12873-024-00963-6
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Article: Epsilon Wave Masked by ST-Segment Elevation After Cardioversion From Sustained Ventricular Tachycardia: An Exceptional Manifestation of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.

Kim, Shinwoo / Lee, Ju Hwan / Nho, Woo Young / Kim, Hyoungouk

The Journal of emergency medicine

2022 Volume 62, Issue 2, Page(s) 254–259

Abstract: Background: Early recognition and management of ventricular dysrhythmia (VD) are among the top priorities in the medical field, and are very important in cases of suspected acute coronary syndrome (ACS). Here we present a case of ventricular tachycardia ...

Abstract	Background: Early recognition and management of ventricular dysrhythmia (VD) are among the top priorities in the medical field, and are very important in cases of suspected acute coronary syndrome (ACS). Here we present a case of ventricular tachycardia (VT), which should be considered in ACS. Case report: A 59-year-old man with unstable vital signs visited the emergency department (ED) after a syncopal episode associated with chest discomfort. Initial electrocardiography (ECG) revealed wide complex tachycardia, which was considered monomorphic VT. After successful cardioversion, ST-segment elevation was observed on subsequent ECG with reciprocal ST-segment depression. Immediate pharmacological treatment and coronary angiography were performed because of suspected acute myocardial infarction; however, normal coronary arteries were observed. On subsequent ECG analysis, a small blip at the end of the QRS complex termed an epsilon wave, which is a characteristic finding in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), was detected in the V1 lead. A borderline diagnosis of ARVD/C was made based solely on ECG findings, and the definite diagnosis was confirmed using echocardiography. An implantable cardioverter-defibrillator was inserted soon after, and the patient reported no further events. Why Should an Emergency Physician be Aware of This?: ARVD/C is a critical disease entity that is commonly associated with life-threatening VA. However, presentations of ARVD/C resembling ACS are exceptionally rare. Accordingly, accurate diagnosis of ARVD/C in ED settings is clinically challenging. A high clinical suspicion is required to identify ARVD/C and avoid further life-threatening episodes.
MeSH term(s)	Arrhythmogenic Right Ventricular Dysplasia/complications ; Arrhythmogenic Right Ventricular Dysplasia/diagnosis ; Arrhythmogenic Right Ventricular Dysplasia/therapy ; Defibrillators, Implantable/adverse effects ; Electric Countershock ; Electrocardiography ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/therapy
Language	English
Publishing date	2022-01-17
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2021.10.033
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Article: Torsion of suprahepatic gall bladder.

Nho, Woo Young / Kim, Jae Oh / Nam, Soon Young / Kee, Se Kook

Journal of minimal access surgery

2021 Volume 17, Issue 3, Page(s) 382–384

Abstract: Suprahepatic gall bladder is rare, and torsion of the ectopic gall bladder is extremely rare. We report a patient of acute suprahepatic cholecystitis with torsion. A 69-year-old Korean male was admitted to our hospital for sudden-onset, severe epigastric ...

Abstract	Suprahepatic gall bladder is rare, and torsion of the ectopic gall bladder is extremely rare. We report a patient of acute suprahepatic cholecystitis with torsion. A 69-year-old Korean male was admitted to our hospital for sudden-onset, severe epigastric pain. Abdominal computed tomography and ultrasonography showed a distended gall bladder with diffuse wall thickening and scanty pericholecystic fluid, which was located in ectopic suprahepatic position, accompanied by S4 hypotrophy of the liver without gallstones. Emergency laparoscopic cholecystectomy was performed, and intraoperative findings revealed a distended and ischaemic gall bladder that was located in the suprahepatic position and had twisted along the cystic duct and artery pedicle in a clockwise manner. Detorsion was done and the gall bladder was resected. Unfortunately, the pre-operative diagnosis of gall bladder torsion was missed, and a definite diagnosis was made at the time of surgery. The patient was discharged on the 4
Language	English
Publishing date	2021-05-27
Publishing country	India
Document type	Journal Article
ZDB-ID	2186884-0
ISSN	1998-3921 ; 0972-9941
ISSN (online)	1998-3921
ISSN	0972-9941
DOI	10.4103/jmas.JMAS_171_20
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