• Title/Summary/Keyword: 손상중증도

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Quantitative Analysis of Electrophysiological Characteristics of CIDP and CMT Type 1: Sensory Nerve Research (CIDP와 CMT 1형의 전기생리학적 특성에 대한 정량 분석: 감각신경연구)

  • Kang, Ji-Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.151-157
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

Management of Patients with Rib Fractures: Analysis of the Risk Factors Affecting the Outcome (늑골골절 환자 치료: 결과에 영향을 주는 위험인자 분석)

  • Kim, Han-Yong;Kim, Myoung-Young
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.285-291
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    • 2010
  • Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

Protective Effects of Trimetazidine in a Rabbit Model of Transient Spinal Cord Ischemia (허혈성 척수 손상의 동물실험모델에서 Trimetazidine의 척수 보호효과)

  • 장운하;최주원;김미혜;오태윤;한진수;김종성;이수윤
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.255-260
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    • 2002
  • Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. Material and Method: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n= 17); TMZ group(Group 2, n= 16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. Result: The average motor function score was significantly higher in the TMZ group(3.20 $\pm$ 0.77 vs 1.13 $\pm$ 1.25 at 2 hours, 3.50 $\pm$ 0.76 vs 1.45 $\pm$ 1.57 at 24 hours, and 3.91 $\pm$ 0.30 vs 1.86 $\pm$ 1.86 at 48 hours after operation; p value$\leq$0.05). Histologic observations were correlated with the motor scores. Conclusion: The results suggested that trimetazidine reduced spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery:

Clinical Characteristics of Patients with Traumatic Diaphragm Injury and Comparison of Scoring Systems as Predictors (외상성 횡격막 손상환자의 임상적 고찰과 예후 예측 인자의 유용성 비교)

  • Lee Sang Jin;Jung Jin Hee;Sohn Dong Suep;Cho Dai Yun
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.56-62
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    • 2005
  • Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

Influences of Injury Severity and Age on Severe Anxiety in Posttraumatic Stress Disorder Patients with no Previous History of Psychiatric Disorders (정신건강의학과 치료 과거력이 없는 외상후 스트레스 장애 환자에서 나이와 손상 심각도가 중증 불안에 미치는 영향)

  • Park, Woon Yeong;Park, Sang Hag;Kim, Sang Hoon;Kim, Seung Gon;Park, Jung In;Choo, Il Han
    • Anxiety and mood
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    • v.9 no.1
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    • pp.54-60
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    • 2013
  • Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

Effects of Y-Balance Test Difference of the Ankle Dorsi-flexion Range of Motion in K3 Soccer Players

  • Gyu-Ho Choi;Jin-Wook Lee
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.11
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    • pp.161-168
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    • 2023
  • The purpose of this study was to determine the relationship with the Y-Balance Test, which evaluates dynamic balance ability according to the ankle joint dorsiflexion range of motion in a non-weight bearing posture. This study involved 27 male soccer players who regularly participate in the K3 League with more than 10 years of soccer experience. The Pearson Rank Correlation Coefficient was used to verify the relationship between ankle joint dorsiflexion and dynamic balance ability. The results of this study showed significant differences in PLRD (P<.05) and CS (P<.01) in the HADR group. A significant correlation between ankle joint dorsi-flexion range of motion and severity was found only in PMRD, PLRD, and CS. Therefore, a decrease in ankle joint dorsi-flexion is associated with a decrease in balance ability. In order to prevent injuries in soccer players, it is believed that regular evaluation of ankle joint range of motion as well as training to improve knee and hip joint strength and proprioception are necessary.

Analysis of Ambulance Traffic Accident During Driving (국내 구급차량의 운행 중 사고 분석에 관한 조사 연구)

  • Shin, Dong-min;Yoon, Byung-gil;Han, Yong-taek
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.130-137
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    • 2016
  • The purpose of this study is to investigate the circumstances surrounding collisions involving ambulances with an aim to improving the safe operation of emergency services. Collisions are relatively common within paramedic emergency services. We analyzed the time, injury site, and any other specific factors of 908 collisions occurring within four cities. Within our study 29.6% of paramedics have been involved in accidents while responding to an emergency call, with the main cause of the accident being signal violation (35.7%), and is the other party's negligence (22.2%). 92.1% of these accidents occurred while the emergency lights were being operated. XX% of accidents took place in the afternoon, while xx% took place within the hours of xx:xx and xx:xx, during which time there is generally lower levels of traffic, which can cause severe brain and neck damage of 14.4% but the other part is 62.1%. (Ed note; this is not clear at all. 14.4% of collisions resulted in severe head and neck injuries, while 23.5% of collisions resulted in no injury. According to the respondents, defensive driving (xx%), observance of traffic laws (xx%), safe driving habits (xx%)to paramedics were the most critical factors in evading collision. Signal passes were identified as the most common cause of collision (70.1%). Although the majority of collisions occurred while the emergency lights were operational, the damage can cause severe damage at the time of accident occurred.

Urethroperineal Fistula Associated with a Severe Ulcerative Dermatosis in a Puppy (자견에서 발생한 중증의 궤양성 피부증과 관련된 요도회음누관증)

  • Choi, Ho-Jung;Lee, Young-Won;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.101-103
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    • 2009
  • 40-day-old mixed male puppy was presented with a 10-day history of tenesmus and extensive ulcerative lesion of perineum. At physical examination, the dog was voiding mainly from an orifice in the perineal fistula. On fistulogram, a urethroperineal fistula was diagnosed. The dog was treated by wet dressing for wound management and antibiotics for 4weeks. Subsequently, the patient improved and no complication or recurrence was presented.

Influencing factors of the severity of occupational fall injury (직업손상과 관련된 추락환자의 중증도에 영향을 미치는 요인)

  • Ju, Jeong-Mi;Tak, Yang-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.113-125
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    • 2016
  • Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

Comparative study of geographic differences of severe trauma mortality in Korea (한국의 중증외상 사망률의 지역적 차이에 대한 비교 연구)

  • Jeong, Tae-Wook;Jo, Ji-Yeon;Kim, Seong-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.37-48
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    • 2021
  • Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.