• Journal of Trauma and Injury
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• v.20 no.2
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.509-512
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• 2012

Objective : The purpose of this study is to evaluate neuroprotective effect of sacral neuromodulation in rat spinal cord injury (SCI) model in the histological and functional aspects. Methods : Twenty-one female Sprague Dawley rats were randomly divided into 3 groups : the normal control group (CTL, n=7), the SCI with sham stimulation group (SCI, n=7), and the SCI with electrical stimulation (SCI+ES, n=7). Spinal cord was injured by dropping an impactor from 25 mm height. Sacral nerve electrical stimulation was performed by the following protocol : pulse duration, 0.1 ms; frequency, 20 Hz; stimulation time, 30 minutes; and stimulation duration, 4 weeks. Both locomotor function and histological examination were evaluated as scheduled. Results : The number of anterior horn cell was $12.3{\pm}5.7$ cells/high power field (HPF) in the CTL group, $7.8{\pm}4.9$ cells/HPF in the SCI group, and $6.9{\pm}5.5$ cells/HPF in the SCI+ES group, respectively. Both the SCI and the SCI+ES groups showed severe loss of anterior horn cells and myelin fibers compared with the CTL group. Cavitation and demyelinization of the nerve fibers has no significant difference between the SCI group and the SCI+ES group. Cavitation of dorsal column was more evident in only two rats of SCI group than the SCI+ES group. The locomotor function of all rats improved over time but there was no significant difference at any point in time between the SCI and the SCI+ES group. Conclusion : In a rat thoracic spinal cord contusion model, we observed that sacral neuromodulation did not prevent SCI-induced myelin loss and apoptosis.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.170-174
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• 2013

Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

• Journal of the Korean Society for Marine Environment & Energy
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• v.8 no.2
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• pp.78-82
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• 2005

Fishermen have higher risk of occupational injuries and disease due to frequent machine usage and direct contact to live biological materials. Moreover, growing elderly workers makes the susceptibility to occupational injuries and disease higher. This study was performed to investigate the occupational safety and health status among fishermen. The interview was carried out at Jumunjin and Geojin ports which were representative port at North East side of Korea. The structured questionnaire were used to interview the fishermen from AM 6:00 to PM 11:00 and total respondent were 97 workers. The results were followed; 7 fishermen of all respondents experienced occupational injuries during their work, 5 fishermen were needed to admission longer than 4 days. The injury types were contusion(4 persons), fracture(1 persons) and amputation(2 persons). The cause of injury might be the lack of caution and the unstability of working condition. These results suggested the ergonomical evaluation of working condition and proper management. But there was limited concern and studies on the policy on occupational safety and health on fishermen. So, further study was required to establish the sound policy of fishermen's occupational safety and health.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.3
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• pp.19-39
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• 2008

Objectives : It has been reported that CG was effective in decreasing injury to neural tissues. To investigate neural responses in the injured spinal cord, an extract of CG was examined to determine its effect on neural responses in the injured spinal cords of rats. Methods : After CG treatment was applied to the spinal cord of rats given a contusion injury, the re-growth responses of injured neural tissues and corticospinal tract axons was observed by measuring the number of GAP-43, Cdc2, and phospho-Erk1/2 proteins, CST axons, GFAP-stained astrocytes, and Glial scarring in the injured spinal cord. Results : Levels of GAP-43, Cdc2, and phospho-Erk1/2 proteins were found to have increased in the injured spinal cord region. The number of GFAP-stained astrocytes also increased within and around the injury cavity. Glial scarring, which was identified by CSPG immunofluorescence staining, was reduced by CG treatment. Anterograde tracing by Dil dye showed that the elongation of the CST axons in the dorso-medial white matter area was almost completely prevented at the injury site. Collateral sprouting was observed in the spinal cord rostrally close to the injury site, and CG treatment further increased axonal arborization in the corresponding region. In vivo migration of CST axons and astrocytes using an implanted polymer tube system showed more of an increase in enhanced migration of axons and astrocytes in CG-treated group compared to the injury control group. Conclusions : These results suggest that CG activated neural responses - including astrocyte migration - and promotes axonal regenerative activity in the injured spinal cord area.

• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.53-58
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• 2011

Purpose: The purpose of this study was to determine the effect of direct functional magnetic stimulation (FMS) of affected spinal cord on motor recovery following spinal cord injury in rats. Methods: After a contusion injury at the spinal level T9 using an NYU Impactor, functional magnetic stimulation was delivered by a magnetic stimulator through a round prototype coil (7 cm in diameter). Stimulation parameters were set as follows: repetition rate = 50 Hz (stimulus intensity 100% = 0.18 T), stimulation time = 20 min. Functional magnetic stimulation was administered twice a day, 5 days per week for 8 weeks starting 4 days after spinal cord injury. Functional magnetic stimulationwas delivered directly to the affected spinal cord. Outcomes of locomotor performance were assessed by the Basso Beattie Bresnahan (BBB) locomotor rating scale and by an inclined plane test weekly for 8 weeks. Results: In the BBB test, hindlimb motor function in the Functional magnetic stimulation group improved significantly more compared to the control group at 3, 4, 6, 7, and 8 weeks (p<0.05). In the inclined plane test, the angle of the plane in the functional magnetic stimulation group increased significantly more compared to the control group at 4, 5, 7, and 8 weeks (p<0.05). Conclusion: Our results demonstrate that direct Functional magnetic stimulation of the lesional site may have beneficial effects on motor improvement after spinal cord injury.

• The Korean Journal of Pharmacology
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• v.31 no.1 s.57
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• pp.1-9
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• 1995

The slow development of histopathological changes and long period required for stabilization of lesions have suggested that secondary injury processes exacerbate the effect of initial mechanical insult after traumatic spinal cord injury (SCI). The importance of glutamate receptors in the normal functions of spinal cord, in concert with the large body of evidence that points to their involvement in neurotoxicity due to both ischemic and traumatic insults to the CNS, suggested a probable role of glutamate receptors in secondary injury process after traumatic SCI. In order to investigate the involvement of excitatory amino acid in the secondary injury process after SCI, this study examined the effect of dextrorphan, a noncompetitive NMDA receptor antagonist, on the recovery of hindlimb function and the residual tissue at injury site following SCI. Locomotor function was assessed using open field test (21 point scale). At 8 weeks spinal cord tissue was examined using quantitative histopathologic technique. Prior to surgery female Long-Evans rats were adapted to the test environment. Rats received laminectomies (T9/T10), and spinal cord contusions (NYU impactor) were produced by a 10 gm weight dropped 25 mm. DXT (15 or 30 mg/kg, i.p.) or saline was injected 15 min before contusion. Behavioral testing resumed 2 days post-injury and continued twice a week for 8 weeks. No differences between DXT and saline groups were found for hindlimb function and sparing tissue at the lesion site. These results suggest that NMDA receptor might not be involved in secondary injury processes after traumatic SCI.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.86-93
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• 2011

Purpose: The purpose of this study was to analyze the characteristics of the injuries of the national elite Taekwondo players with the best performance in the international championship competition. Materials and Methods: Fifty-two athletes who got the injury in the 2011 Gyeongju World Taekwondo Championship competition were included in this sturdy. 950 members of national team of 146 countries participated in this game, 1,063 matches were performed. We analyzed the characteristics of the injuries such as injury rate by gender, age, weight class, injured region and injury type. Results: Fifty-two athletes of 950 athletes in 1,063 matches got injured and injury rate was 5.47 per 100 participants and 24.47/1,000 athlete-exposures. Injury rate of female athletes was higher than mail, but there was no significant statistical difference (p=0.512). Injury rate of over 30 years old was 17.39 per 100 participants, and injury rate of over 87 kg in male weight class and 68 to 73kg in female weight class were highest than other groups, but there was no significant statistical difference (p=0.838). Overall injury rate of the lower extremity was 13.17/1,000 A-E, higher than upper extremity or head and neck or trunk, but injury rate of the hand was 5.17/1,000 A-E, highest as a specific injured region, followed by the knee, 4.70/1,000 A-E (p=0.714). Injury rate of the sprain was 10.81/1,000 A-E, highest as an injury type, the second most common injury type was the fracture, 5.40/1,000 A-E in men, and was the contusion, 9.63/1,000 A-E in women (p=0.033). As one of the most serious injury, 4 of 8 fractures were occurred in hand. Conclusion: Overall injury rate of the elite Taekwondo players in 2011 Gyeongju World Taekwondo Championship was 5.47 per 100 participants and 24.46 per 1,000 athlete exposures. Although the most common type of injury was the sprain of the knee and ankle, the fractures were more commonly occurred in hand.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1690-1698
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• 2012

As alcohol use is one of the most important risk factors for injuries, this study was intended to clarify and evaluate any relationship between drinking patterns and the incidence rates/specific characteristics of injuries in adult populations, using a widely accepted tool, the Alcohol Use Disorders Identification Test (chronic alcohol drinking behaviors measurement, hereinafter the AUDIT) developed by the World Health Organization to help to assess the behaviors in a more accurate and reliable manner. This study used the data collected from the 2009 Korea National Health and Nutrition Examination Survey (KNHANES), in which 7,511 of 7,893 adult participants aged ${\geq}19$ years answered the questions about injuries, and excluding 104 non-respondents, 6,258 of participants in the questionnaire survey of drinking patterns were finally analyzed. The incidence rates and specific characteristics of injuries as classified by the AUDIT categories (i.e., body regions, types and mechanisms) were assessed and estimated in terms of their relative risk using t-test, ANOVA, and logistic regression. SPSS 19.0 statistical package software was employed for statistical analyses. These analyses indicate that the incidence rates of overall injuries were significantly higher in male respondents than in female respondents. The risks of alcohol use related injuries were 8.3 times higher in male respondents than in female ones. Regarding educational background, high school graduates showed the highest rates in the AUDIT with significant difference from the other groups. The married group and the group of respondents having monthly income estimated at KRW 2.01 to 3 million also showed the highest rates in the AUDIT compared to the other groups, indicating statistically significant difference. Significantly increased in problematic drinkers and those with alcohol dependence, the incidence rate of injuries body regions was 0.0371 in the head/neck, and with respect to the AUDIT and the mechanisms of external causes of injuries, transport accidents ranked first, followed by slippage, others, crash and fall. In regard to the classified types of injuries, it was statistically significant in others (e.g., laceration, contusion, addiction, or penetrating wound). In conclusion, the mechanisms of external causes of injuries as well as injuries attributed to alcohol use are very important, and a strategy is required to reduce such the injuries in the manner of decreasing the frequency of drinking after motivation by professional counsellors.