• Clinical Pain
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• v.20 no.2
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• pp.127-130
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• 2021

Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

• Safety and Health at Work
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• v.10 no.2
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• pp.172-179
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• 2019

Background: Workers exposed to hazards without adequate protections are at greater risk of injury and illness. Supervisor activities have also been associated with injury risk. We examined the interplay between supervisor safety support and occupational health and safety (OHS) vulnerability on workplace injury and illness. Methods: A survey was administered to 2,390 workers employed for more than 15 hrs/week in workplaces with at least five employees who had a direct supervisor. We examined the combined effects of hazard exposure with inadequate protection (OHS vulnerability) and supervisor support on workplace injury and illness, using additive interactions in log-binomial regression models. Results: OHS vulnerability and lack of supervisor support independently increased the likelihood of physical injuries at work. Crude and adjusted models showed that the risk of physical injury was at least 3.5 times higher among those experiencing both OHS vulnerability and a lack of supervisor support than individuals without OHS vulnerability and with a supportive direct supervisor. Workers who experienced vulnerability were at less risk if they had a supervisor who was supportive. Conclusion: In workplaces where workers experience one or more types of OHS vulnerability, having a supportive supervisor may play an important role in reducing the risk of injury and protecting workers.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.363-366
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• 2010

Vertebral artery (VA) injury is a rare and serious complication of cervical spine surgery; this is due to difficulty in controlling hemorrhage, which can result in severe hypotension and cardiac arrest, and uncertain neurologic consequences. The authors report an extremely rare case of a 56-year-old woman who underwent direct surgical repair by end-to-end anatomosis of an unanticipated VA injury during C2 pedicle screwing. Postoperatively, the patient showed no neurological deterioration and computed tomography angiography of the VA demonstrated normal blood flow. Although direct occlusion of an injured VA by surgical ligation or endovascular embolization has been used for management of an unanticipated VA injury during surgery, these methods may be associated with significant morbidity and mortality. However, despite its technical demand, microvascular primary repair can restore normal blood flow and minimizes the risk of immediate or delayed ischemic complications. Here we report an iatrogenic VA injury during C2 pedicle screwing, which was successfully treated by end-to-end anastomosis.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.304-306
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• 2021

Objectives: We report on a patient who showed mild bradykinesia due to injury of the corticofugal tract (CFT) from the secondary motor area following direct head trauma, which was demonstrated on diffusion tensor tractography (DTT). Case summary: A 58-year-old male patient underwent conservative management for subarachnoid hemorrhages caused by direct head trauma resulting from a fall from six-meter height at the department of neurosurgery of a local hospital. His Glasgow Coma Scale score was 3. He developed mildly slow movements following the head trauma and visited the rehabilitation department of a university hospital at ten weeks after the fall. The patient exhibited mild bradykinesia during walking and arm movements with mild weakness in all four extremities (G/G^-). Results: On ten-week DTT, narrowing of the right CFT from the supplementary motor area (SMA-CFT), and partial tearing of the left SMA-CFT, left CFTs from the dorsal premotor cortex (dPMC-CFT) and both corticospinal tracts (CSTs) at the subcortical white matter were observed. Conclusion: This case demonstrated abnormalities in both CSTs (partial tearing at the subcortical white matter and narrowing), both SMA-CFTs (narrowing and partial tearing) and left dPMC-CFT. We believe our findings suggest the necessity of assessment of the CFTs from the secondary motor area for patients with unexplained bradykinesia following direct head trauma.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.162-169
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• 2021

Purpose: For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods: We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients' characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results: The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions: If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.71-78
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• 2015

The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.

• Journal of muscle and joint health
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• v.16 no.1
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• pp.66-79
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• 2009

Purpose: The purpose of this study was to analyze the relationship between rehabilitation motive and social support perceived by spinal cord injury patients. Method: Data were collected by the questionnaires from 83 patients with spinal cord injury in a hospital. It was analyzed using descriptive statistics, t-test, ANOVA and Peason's correlation coefficients. Result: The social support score was 3.51 of 5 in average. The connectedness of subordinate portion was the highest as 3.57. The rehabilitation motive was 2.93 of maximum 4.00 in average. Among sub-dimensions of the rehabilitation motive, the mean score of change oriented motivation was 3.27 as the highest. The higher the direct support, the higher the indirect support(r=.663, p=.000). The higher the rehabilitation motive, the higher the direct(r=.282, p=.010) and indirect support(r=.397, p=.000). Conclusion: According to this study, the social support had the significant relationship with the rehabilitation motive. The social support was the key factor to enhance the rehabilitation motive psychologically. Finally, there is a need to develop the nursing intervention improve the social support for the spinal cord injury patients.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• Safety and Health at Work
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• v.1 no.2
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• pp.107-111
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• 2010

This paper provided a brief summary of the current strategic goals, activities, and impacts of the NIOSH (National Institute for Occupational Safety and Health) occupational injury research program. Three primary drivers (injury database, stakeholder input, and staff capacity) were used to define NIOSH research focuses to maximize relevance and impact of the NIOSH injury-prevention-research program. Injury data, strategic goals, program activities, and research impacts were presented with a focus on prevention of four leading causes of workplace injury and death in the US: motor vehicle incidents, falls, workplace violence, and machine and industrial vehicle incidents. This paper showcased selected priority goals, activities, and impacts of the NIOSH injury prevention program. The NIOSH contribution to the overall decrease in fatalities and injuries is reinforced by decreases in specific goal areas. There were also many intermediate outcomes that are on a direct path to preventing injuries, such as new safety regulations and standards, safer technology and products, and improved worker safety training. The outcomes serve as an excellent foundation to stimulate further research and worldwide partnership to address global workplace injury problems.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.13-18
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• 2004

In most patients with facial palsy after temporal bone injury, temporal bone High Resolution CT revealed direct or indirect facial nerve canal involvement, and in complete palsy severe degeneration groups, there were direct findings in most cases. Author believe that meticulous analysis and symptom correlation of the fracture patterns seen in facial canal injury in patients with traumatic facial nerve palsy is helpful for treatment planning and prognosis.