• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.155-164
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• 2023

Objectives : The aim of this study was to identify the factors affecting ideas of persecution in post-traumatic stress disorder (PTSD) patients who underwent Clinician-Administered PTSD Scale (CAPS) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Methods : We retrospectively reviewed 116 patients who underwent CAPS and MMPI 2 between May 2013 and April 2020 at Veteran Health Service Medical Center. Based on the CAPS score, the patients were divided into the PTSD group (n=63, age: 58.16±17.84) and the trauma exposed without PTSD group (n=53, age: 67.34±12.05). After checking the correlation between Ideas of persecution, CAPS, and MMPI-2 scales, linear regression analysis was performed to identify the risk factors for clinically relevant symptoms. Results : The PTSD group showed significant differences in Schizophrenia, Ideas of persecution, Dysfunctional negative emotions, Aberrant Experiences, Psychoticism, Negative Emotionality/Neuroticism, Anxiety, Depression, and Anger scales compared to the trauma-exposed without PTSD group. When analyzing the correlation between Idea of persecution, CAPS and MMPI-2 scales, there was a strong association with most of the scales in MMPI-2 and Idea of persecution except Disconstraint. Multiple linear regression analysis performed in PTSD group identified that risk factors for Idea of persecution were Dysfunctional negative emotions and Anger scale. Conclusions : The PTSD group had increased idea of persecution compared to the trauma exposed without PTSD group. Dysfunctional negative emotions and anger may be risk factors for idea of persecution in trauma exposed population.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.23-26
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• 2007

관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.184-195
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• 1999

Objectives : As traumatic brain injury(TBI) leaves chronic sequelae in mind and body, the injured patients should rectify the meaning and object that they have pursued in their lives and set up a new purpose in life that they may make the rest of their lives meaningful. This study was designed to investigate the purpose and quality of life levels and the influence of demographic and clinical variables on the levels in the patients with TBI, and to be of some help to their rehabilitation. Methods : In order to assess the purpose in life(PIL) and the quality of life(QOL) levels, Purpose-in-Life Test, Sickness Impact Profile, Quality of Life Index, Head Injury Symptom Ckecklist, and Neurobehavioral Rating Scale were administered to the subjects. The subjects were thirty-two patients with TBI and the same numbered normal controls. The TBI group was composed of 16 to 65 year-aged patients who had received mild or severe TBI at least 12 months before, and the controls were siblings or friends of the patients whose age, sex, and educational level were similar to them. Results : 1) The PIL and QOL levels of the patients with TBI remained significantly lower than that of control group after their symptoms of injury were stabilized(p<.01, p<.01). 2) The mean PIL score of TBI group was $58.8{\pm}23.2$, which was to be regarded as the level of existential vacuum. 3) The PIL level of TBI group was significantly correlated with the QOL level(p <.01). 4) The subgroup with lower PIL level in patients with TBI has significantly higher rate of female than that with higher PIL(p<.05), the PIL level of female patients was significantly lower than that of male patients(p <.05). 5) The significant differences in PIL levels were not found, in which comparison was performed between each pair of subgroups of patients with TBI divided by severity of injury(mild vs severe), marital status(married vs unmarried), and occupational status prior to injury(employed vs unemployed). Conclusion : The PIL of patients with TBI still remained the level of existential vacuum after symptoms of sequelae had been stabilized, The QOL level was also extremely low, and as the PIL level was low the QOL was also low. The demographic and clinical variables except sex did not have influence on the PIL level in brain-injured patients. It is suggested that every patient should admit their mental and physical limitations caused by brain injury and revise their purpose in life for successful rehabilitation.

• The Journal of the Korea Contents Association
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• v.11 no.4
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• pp.253-262
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• 2011

Cognitive-communicative disorders after traumatic brain injury(TBI) and right hemisphere damage(RHD) are different from other neurological disorders in nature. Therefore, it is not desirable to use aphasia tests in evaluating individuals with TBI or RHD. The aim of this study is to review assessment protocols on TBI and RHD, and literature related with them. As a result, it is recommended that individuals with TBI be examined in scope of the cognition including attention, memory, organization, reasoning, as well as the functional communication. Similarly, it is useful to consider high-order language related to various cognitive domains in assessing cognitive-communicative ability after RHD. In conclusion, we need to focus on the overall cognitive-communicative domains in an evaluative process of TBI and RHD. Furthermore, it is necessary to develop multiple items for individuals with cognitivecommunicative disorders for the purpose of differentiating these heterogeneous groups from other neurological disorders such as aphasia, and of making good use of them as a therapeutic manual.

• The Journal of the Korea Contents Association
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• v.13 no.2
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• pp.370-377
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• 2013

Traumatic brain injury(TBI) is a brain damage caused by an external physical force. TBI patients have disturbances of functioning including attention, memory, reasoning,, executive function, and pragmatic language. The aim of this study was to develop the cognitive-pragmatic language ability assessment protocol for traumatic brain injury(CAPTBI) and to evaluate reliability and validity. This study was also conducted to investigate domains that contributed to differentiate between the normal and TBI groups. The CAPTBI data were obtained from 226 normal adults and 62 TBI patients(mean age=$43.95{\pm}11.92$, $46.37{\pm}11.87$, M:F=110:116, 48:14). The CAPTBI had high item internal consistency, test-retest reliability, construct validity, and concurrent validity. The normal group performed significantly better than the TBI group in all domains of the CAPTBI and the separate scores for 9 domains. All 9 domains were found to be significant variables to discriminate between the two groups. The most powerful variable was executive function followed by memory, organization, pragmatic language, problem-solving, attention, orientation, reasoning, and visuoperception in order. The CAPTBI could discriminate between the two groups accurately by 95.5%. This result demonstrated that 97.3% of normal adults and 88.7% of TBI patients could be discriminated by CAPTBI. In conclusion, The CAPTBI is appropriate for evaluating and identifying cognitive-pragmatic language disorders in TBI patients.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.28-36
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• 2001

Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.7.4-8
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• 1982

The common causes of neck closed injuries are automobile accidents and sports troubles; open injuries are gun-shot wounds and stab wounds. Generally, the treatment of wide laryngopharyngeal injuries consists of tracheostomy for adequate airway, simple repair and, later, surgical intervention for chronic laryngeal stenosis and hypopharyngeal reconstruction. Recently, authors experienced a case of extensive communicated wound with large defect on the layngopharyngeal structures and anterior neck skin. This large defect was reconstructed with horizontal cervical skin flap after total laryngectomy.

• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.69-73
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• 1987

외상에 의한 횡경막파열은 신속한 진단이 매우 어렵다. 이는 임상증상 및 일반적인 방사선학적 소견이 특이성이 없고, 많은 다른 외상이 동반되어 임상적으로나 방사선학적으로 진단하기 힘들기 때문이다. 더우기 외상성 청경막파열은 좌측에 비해 우측에서는 매우 드물다. 저자들은 임상경사와 단순 흉부-X선 사진상에서 진단이 어려웠던 우측 외상성 횡경막 파열등 3예에 매해서 간신티그램을 시행하여 몇가지 특징적 소견을 관찰할 수 있었다. 즉 간신티그램 상에서 관찰된 횡경막파열의 특징적인 소견은 1) 청경막 탈출에 의한 간우엽의 융기 2) 융기부 기저부의 예각형성 그리고 3) 횡경막교약에 의한 띠모양의 냉소이었다. 그러나 이들 3가지 소견은 반드시 모두가 나타나지 않을 뿐만 아니라 같은 환자에서도 신티영상의 촬영방향에 따라 나타나는 수도 있고 나타나지 않을 수도 있었다. 그러므로 우측 횡경막내 외상성파열로 인한 간 등의 허니아를 진단하기 위해서는 다각도로 신티영상 촬영을 하여야 할 것이다.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.241-245
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• 2009

Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.