Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.
Kim, Yun-Bae;Hur, Gyeung-Haeng;Sungho Shin;Yeon, Gyu-Baek;Park, Seung-Ju;Kang, Jong-Koo
Toxicological Research
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v.16
no.3
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pp.187-193
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2000
The antidotal, anticonvulsant and neuroprotective effects of physostigmine and procyclidine. the combinational prophylactics for organophosphate poisoning, were evaluated in rats. In comparison with a low protective effect (1.6 fold) of atropine (15 mg/kg) and 2-pralidoxime (30 mg/kg), the traditional antidotes regimen, a marked protection ratio of 7.3 fold was achieved by combinational pretreatment with physostigmine (0.05 mg/kg) and procyclidine (10 mg/kg), which was superior to that (3.5 fold) with pyri-dostigmine (0.1 mg/kg) and atropine (15 mg/kg). Rats exposed to a high dose (10 mg/kg. 2 X $LD_{50}$) of diisopropylfluorophosphate showed severe epileptiform seizures on electroencephalography, resulting in necrotic and apoptotic brain injuries in discrete brain regions under histopathological and TUNEL immuno-histochemical examinations in 24 hr. Such seizures and excitotoxic brain injuries were fully prevented by pretreatment with physostigmine (0.05 mg/kg) and procyclidine (10 mg/kg). in contrast to a negligible effect of pyridostigmine (0.1 mg/kg) and atropine (15 mg/kg). Taken together, it is proposed that the prophylactics composed of physostigmine and procyclidine could be a promising regimen for the prevention of lethality, seizures and brain injuries induced by organophosphate poisoning.
Kang, Sung Chan;Lee, Kang Hyun;Choi, Han Joo;Park, Kyung Hye;Kim, Sang Chul;Kim, Hyun;Hwang, Sung Oh
Journal of Trauma and Injury
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v.21
no.1
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pp.53-58
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2008
Purpose: Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries. Methods: One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders. Results: Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was $26.7{\pm}10.0$, and that of the snowboarders was $26.7{\pm}6.2$. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was $4.5{\pm}2.1$ and that of the snowboarder group was $5.9{\pm}5.0$ (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%). Conclusion: The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.
Objectives The purpose of this study is to report the clinical effects of oriental medical treatment on developmental disorder induced by traumatic brain injuries. Methods The patients were treated with herb medicine, acupunctures, moxibustions, and negative pressures, and then evaluated by manual muscle tests, gross motor function measurements, sequenced language scales for infants. Results The patient's manual muscle power, motility, cognition, speech were significantly improved after six weeks of oriental medical treatment. Conclusions This study showed that oriental medical treatments were effective on developmental disorder induced by traumatic brain injuries. However, further clinical studies were needed.
Stroke is a leading cause of long-term disability in ischemic survivors who are suffering from motor, cognitive, and memory impairment. Previously, we have reported suppressing LPA5 activity with its specific antagonist can attenuate acute brain injuries after ischemic stroke. However, it is unclear whether suppressing LPA5 activity can also attenuate chronic brain injuries after ischemic stroke. Here, we explored whether effects of LPA5 antagonist, TCLPA5, could persist a longer time after brain ischemic stroke using a mouse model challenged with tMCAO. TCLPA5 was administered to mice every day for 3 days, starting from the time immediately after reperfusion. TCLPA5 administration improved neurological function up to 21 days after tMCAO challenge. It also reduced brain tissue loss and cell apoptosis in mice at 21 days after tMCAO challenge. Such long-term neuroprotection of TCLPA5 was associated with enhanced neurogenesis and angiogenesis in post-ischemic brain, along with upregulated expression levels of vascular endothelial growth factor. Collectively, results of the current study indicates that suppressing LPA5 activity can provide long-term neuroprotection to mice with brain ischemic stroke.
Park, Sung-Jun;Hur, Jin-Woo;Kwon, Ki-Young;Rhee, Jong-Joo;Lee, Jong-Won;Lee, Hyun-Koo
Journal of Korean Neurosurgical Society
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v.46
no.3
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pp.205-209
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2009
Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.
It is imperative to analyse brain injuries directly in real time, so as to find effective therapeutic compounds to protect brain injuries by stress. We established a system which could elucidate the real time $Ca^{2+}$ dynamics in an organotypic cultured hippocampal slice by the insults of artificial stress hormone, dexamethasone. The real time $Ca^{2+}$ dynamics could continuously be detected in cornus ammonis 3 (CA3) of the organotypic hippocampus for 8 hours under confocal microscopy. When dexamethasone concentration was increased, the $Ca^{2+}$ was also increased in a dose dependent manner at $1{\sim}100{\mu}M$ concentrations. Moreover, when the organotypic cultured hippocampal slice was treated with a glutamate receptor antagonist together with dexamethasone, the real time $Ca^{2+}$ dynamics were decreased. Furthermore, we confirmed by PI uptake study that glutamate receptor antagonist reduced the hippocampal tissue damage caused by dexamethasone treatment. Therefore, our new calcium ion dynamics system in organotypic cultured hippocampal slice after dexamethasone treatment could provide real time analysis method for investigation of brain injuries by stress.
Purpose: The recent increase in electric scooter (e-scooter) use has been accompanied by an increase in injuries from e-scooter-related accidents. Studies have reported that most such injuries are minor, and physicians may therefore underestimate the severity of such injuries. This study investigated the types and severity of injuries caused by isolated e-scooter accidents (i.e., those that did not involve colliding with other cars or falling from heights). Methods: This prospective observational study was conducted from May to December 2021 at Dankook University Hospital tertiary medical center. The demographic data of patients injured in isolated e-scooter-related accidents were collected. All injuries were categorized by body part. Results: Fifty eligible patients visited our emergency department during the study period. Of these, 76% were categorized as nonemergency, and 62% were discharged after initial evaluation and treatment at the emergency department. Another 10% were admitted to the intensive care unit (ICU) and 18% to the ward, with nine patients receiving at least one operation. The average hospital stays were 2.4 days in the ICU and 9 days in the ward. One death occurred due to traumatic brain injury (overall mortality rate, 2%). Multiple fractures of the left third through ninth ribs combined with lung laceration and fractures of T12 and L4 were noted. Conclusions: Various types and severities of injuries can occur in isolated e-scooter accidents. While most such injuries are minor, some will require ICU admission or surgery, and deaths can occur. Physicians should not underestimate the severity of such injuries.
The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient's condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.
190 cases of the thoracic injuries experienced at the department of chest surgery, Chungnam National University Hospital, for 5 years from Jan. 1976 till Dec 1980, were analysed. The results are as follows; 1. The incidence rate of male to female was 5.1:1. The common age groups were 3rd, 4th and 5th decades, and the most common age group in the penetrating injury was 3rd decade. 2. The most common mode of the nonpenetrating injuries was a traffic accident [63.0%], and the most commonly used tool in the penetrating injuries is a knife [66.7%]. 3. The most common nonpenetrating injury was rib fracture [73.9%], and the common fracture sites were 5th, 6th, 7th and 8th ribs [especially, 7th rib]. The incidence rate of flail chest was 15% of the cases of the rib fractures. 4. The common associated injuries of the nonpenetrating were long bone fracture [18.3%], brain contusion [15.9%], and clavicle fracture etc.. 5. The common method of surgical treatment were closed thoracostomy [46.7%], thoracentesis, and open thoracotomy [7.4%] etc.. 6. The overall mortality was 2.8%. [Nonpenetrating; 0.8%, Penetrating; 6.3%]
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