• Herbal Formula Science
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• v.11 no.2
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• pp.159-171
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• 2003

This study was done to investigate effects of SR, CF and AR to angiogenesis of cerebral tissues, protecting damage of cerebral neurons and activating them in cerebral contusion-induced rats. I observed these conclusions as follows ; 1. Observation of VEGF-immunoreactive cells : Groups of administered AR were not meaningful in increasing VEGF-immunoreactive cells for 3 days and 7 days, groups of administered SR meaningfully increased them to control groups in all groups, and groups of administered CF meaningfully increased them to control groups in all groups, too, interestingly, increased double to control group for 7 days. 2. Observation on cerebral neurons by Cresyl violet stain : Dendrites and axons of groups of administered SR, AR for 3 days were clearly observed to control group. Cerebral neurons of groups of administered CF for 3days and 7 days were increased a little, but were not meaningful. In conclusion, AR will be careful of being used in cerebral contusion. CF and SR were effective to activating cerebral hemokinesis by inducing angiogenesis in trauma of tissue, but weakly to protecting trauma of cerebral neurons and activating them. I think more studies will be done in these facts.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.1
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• pp.7-10
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• 1993

The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.327-336
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• 1977

A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.337-342
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• 1977

A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.411-417
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• 1979

During the period of 4 years from August 1, 1975 to August 1, 1979, authors have experienced 100 cases of multiple rib fractures by nonpenetrating injury at Department of Thoracic Surgery, Paik Foundation Hospital in Seoul, Korea. 1. The ratio of male to female patients with multiple rib fracture was 2.6:1 with male predominance and 84% of the total cases were between 20 and 50 years of age. 2. The most common cause of multiple rib fracture was traffic accident and falls accounted for the next largest group. 3. The most common site of rib fracture was 4th rib to 7th rib level on both hemithorax [52%]. 4. Associated injuries were cerebral contusion in 26%, clavicular fracture in 22%, long bone fracture in 22%, pelvic bone fracture in 10%, and scapular fracture in 8%. 5. Early complications and/or result of the multiple rib fractures were lung contusion in 23 cases, subcutaneous emphysema in 21 cases, hemothorax in 21 cases, hemopneumothorax in 6 cases, and flail chest in 12 cases. 6. The flail chests were managed by strapping the chest with adhesive plaster, external traction of flail segment with towel clip, ventilatory assistance for marginal clinical indications, and in cases of complicated with intrathoracic hemorrhage, wire fixation of flail segment through open thoraco-tomy. 7. The principles of therapy for hemothorax and/or pneumothorax were rapid reexpansion of the lungs by thoracentesis [11%] and closed thoracostomy [22%], but open thoracotomy had to be done on 3 cases because of massive bleeding or intrapleural hematoma and diaphragmatic rupture. 8. The over all mortality was 4% [4 among 100 cases] and the cause of all deaths was head injury.

• International Journal of Contents
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• v.8 no.1
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• pp.74-81
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• 2012

The aim is to investigate the analgesic effect of transcranial direct current stimulation(tDCS) on central neuropathic pain(CNP) in spinal cord contusive rat model. Twenty Sprague-Dawley rats($250{\pm}50$ g, male) were used. Thoracic spinal cord(T10) was contused using New York University(NYU) spinal cord impactor. The animals were randomly assigned to two groups; GroupI: Non-treatment after SCI induction(n=10), GroupII: application of tDCS(0.1 mA, 20 min/time, 2 times/day, 5 days/6week) after SCI induction(n=10). Assess the effect of tDCS using the Basso Beattie Bresnahan(BBB) locomotor rating scales, Touch $test^{TM}$ sensory evaluator(TTSE), Plantar test$^{\circledR}$after contusion at the $2^{nd}$, $3^{rd}$, $4^{th}$, $5^{th}$, $6^{th}$ week and the immunohistochemistric response of c-fos in the thalamus, cerebral cortex after contusion at the $3^{rd}$, $6^{th}$ week after SCI. The scores of BBB scales were significantly different from $3^{rd}$week. TTSE were different significantly over time, but there were no differences at each evaluation times on between-measure time effects. Plantar test were different significantly over time and there were difference at the $4^{th}$, $6^{th}$ week after SCI on between-measure time effects. Also, immunohistochemistric response of c-fos was reduced significantly from $3^{rd}$, $6^{th}$ week after SCI in tDCS group compared with control group in thalamus and cortex. These results identified that tDCS of non-invasive therapeutic method may have beneficial analgesic effect on CNP after SCI with behavioral test and immunohistochemical test.

• Progress in Medical Physics
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• v.14 no.4
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• pp.259-267
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• 2003

In vivo $^1$H magnetic resonance spectroscopy (MRS) at 4.7 T was applied to investigate the cerebral metabolite changes of mice brain before and after experimental brain trauma. In vivo $^1$H MR spectra were acquired from a voxel covering right parietal cortex in normal brain, used as control subjects. After experimental brain trauma using the fluid percussion injury (FPI) method, $^1$H MR spectra were acquired from the same lesion three days after trauma. Metabolite ratios of the injured lesion were compared to those of controls. After trauma, N-acetylaspartate (NAA)/creatine (Cr) ratio, as a neuronal marker was decreased significantly versus controls, indicating neuronal loss. The ratio of NAA/Cr in traumatic brain contusion was 0.90$\pm$0.11, while that in normal control subjects was 1.13$\pm$0.12 (P=0.001). Choline (Cho)/Cr ratio had a tendency to rise in experimental brain contusion (P=0.02). Cho/Cr ratio after trauma was 0.91$\pm$0.17 while that before traumas was 0.76$\pm$0.15. Cho/Cr ratio was increased and this might indicate a inflammatory activity. However, no significant difference of [(glutamate＋glutamine) (Glx)]/Cr was established between experimental traumatic brain injury models and normal controls. Lactate (Lac)/Cr ratio was appeared as a sign of shifted posttraumatic energy metabolism and increased versus controls. These findings strongly suggest that in vivo $^1$H MRS may be a useful modality for clinical evaluation of traumatic contusion and could aid in better understanding the neuropathologic process of traumatic contusion induced by FPI. In the present study, in vivo $^1$H MRS was proved to be a useful non-invasive method for in vivo diagnosis and monitoring of posttraumatic metabolism in models of brain contusion.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.244-250
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• 2010

Objective : Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI. Methods : A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome. Results : Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion ($2.2{\pm}1.2$ days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect ($1.5{\pm}0.9$ days), epilepsy ($2.7{\pm}1.5$ days), cerebrospinal fluid leakage through the scalp incision ($7.0{\pm}4.2$ days), and external cerebral herniation ($5.5{\pm}3.3$ days). Subdural effusion ($10.8{\pm}5.2$ days) and postoperative infection ($9.8{\pm}3.1$ days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at $79.5{\pm}23.6$ and $49.2{\pm}14.1$ days, respectively). Conclusion : A poor GCS score ($\leq$ 8) and an age of $\geq$ 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.124-126
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• 1997

Stellate ganglion block is the most widely practiced procedure in the pain clinics due to its wide range of indications. We experienced a rare case who exhibited severe hematoma in neck following stellate ganglion block. A 58-year-old female patient injured by a traffic accident was admitted to the department of negro surgery for the treatment of cerebral contusion, cervical and lumbar sprain and left arm paresis. Because left sensory neural hearing loss occurred, the patient was referred to the pain clinic for treatment with stellate ganglion block due to her left sensory neural hearing loss. The next day stellate ganglion block was done with a negative aspiration for blood. Three hours later, hematoma in neck was found and the patient complained of pain in the neck and dyspnea. The symptoms and signs of respiratory difficulty were progressively aggravated. The hematoma was removed and ruptured muscular branch of vertebral artery was ligated under surgical exploration. In this case, the needle was apparently in the branch of vertebral artery during or after injection in spite of the negative aspiration for blood. Authors recommend that compression of the injected site over 5 minutes should be necessary to prevent a hematoma formation despite of a negative aspiration for blood.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.310-313
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• 2016

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.