• Title/Summary/Keyword: External injury

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The Relationship Between Type and Size of Scalp Injury and Intracranial Injury Among Patients who Visited the Emergency room due to head Trauma (두부손상으로 응급실에 내원한 환자의 두피손상 양상, 크기와 두개내 손상과의 관련성)

  • Kim, Yong Sung;Lim, Hoon;Cho, Young Soon;Kim, Ho Jung
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.8-13
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    • 2006
  • Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

The Classification and Criterion for Low Back Pain Examined from Reference Books of Yi Xue Ru Men(醫學入門) (『의학입문(醫學入門)』의 인용서적으로 살펴본 요통(腰痛)의 분류와 기준)

  • Jo, Hak-Jin
    • Journal of Korean Medical classics
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    • v.28 no.1
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    • pp.35-53
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    • 2015
  • Objectives : In order to find how reference books of Yi Xue Ru Men reflect the classification and criterion for low back pain(LBP). Methods : From reference books of Yi Xue Ru Men, select the texts on classification and criterion for LBP. Results : According to the causes of LBP, Chao Yuan Fang(巢元方) in Sui Dynasty assorted to 5 types of LBP at the very first. Chen Wu Ze(陳無擇) in Song Dynasty made 7 divisions by external, internal, and non-external, non-internal causes. According to the pulse of LBP, Yan Yong He(嚴用和) first categorized 4 groups, Zhu Zhen Heng(朱震亨) added another 4 groups. Aside from this standard, Zhu(朱震亨) adopted the cause standard. Depending on Yunqi(運氣), Lou Ying(樓英) classified 5 types. But his classification had been not adopted by any TCM books. According to symptom of 6 varieties(六變), Zhang Jie Bin(張介賓) assorted external(表), internal(裏), deficiency(虛), sufficiency(實), cold(寒) and heat(熱), add 2 groups besides them. But his categorization did not reflect Yi Xue Ru Men. Li Chan(李梴), the author of this book chose causes and pulse classification standards that Zhu Zhen Heng had adopt. Conclusions : In the side of classification and criterion for LBP, Li Chan first divided 2 group, external and internal injury. After it he subdivided both groups to 10 subgroup. His classification is similar to Chen(陳無擇)'s, but actually followed the classification for external and internal injury that was invented by Li Dong Yuan(李東垣).

The Treatment for Mandibular Condyle Fracture of Children by a Threaded Kirshcner Wire and External Rubber Traction (Threaded Kirschner Wire와 외부 고무줄 견인을 통한 소아 하악골 관절돌기 골절의 치료)

  • Nam, Doo Hyun;Kwon, Ino;Ahn, Hyung Sik;Kim, Jun Hyuk;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.221-224
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    • 2009
  • Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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The Effect of Herbal-Acupuncture Using Ursi Fel into Zusanli$(ST_{36})$ to Recover Function of Stratum Corneum on Mice Model after Atopic Dermatitis Elicitation (족삼리$(ST_{36})$에 시술한 웅담 약침이 아토피 피부염을 유발한 동물 모델의 각질층 기능회복에 미치는 영향)

  • Park Jung-Hoon;Choi In-Hwa
    • The Journal of Korean Medicine
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    • v.26 no.3 s.63
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    • pp.13-26
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    • 2005
  • Objectives : Applying herbal-acupuncture using Ursi Fet into Zusanli (UZ) on to the atopic dermatitis (AD) in mice to study changes in external dermal formation, change of leukocytes in vasculature, change of lipid formation in stratum corneum and distribution of ceramide. This study was done through forcing an injury to the mice's back skin which damages the lipid protection formation in the stratum corneum. Methods : The AD which was caused intentionally using the external application on the mice's back skin was treated with VB; the change of leukocytes in the vasculature was identified through optima 5.2 and Student's t-test and the results were made into a dermal formation graph. Results : After dispensing UZ into the AD, the dermal injury decreased. The recovery of the lipid protection formation which includes lipid and ceramide in the stratum comeum (for suppressing acute inflammation due to factors such as PKC, $TNF-\alpha,\;IL-1\beta$, which controlled the secretion of the relating inflammatory cytokine) also went on to show a decrease of both angiogenesis and degranulated mast cells. In addition, the decrease of epithelial injury also caused the growth of cells to decrease in the stratum basale and cytoclasis. In the vasculature, the leukocytes were also decreased na this could relate to a decrease in AD. Conclusions : UZ has an effect on AD by suppressing dermal injury through the recovery of the lipid protection formation in the stratum corneum.

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The Efficacy of Sihocheonggan-san (Chaihuqinggan-san) Extract to Improve the Function of Stratum Corneum on Mice Model after Atopic Dermatitis Elicitation. (시호청간산 투여가 아토피 피부염을 유발한 동물모델의 각질층 기능회복에 미치는 영향)

  • Park Min-Chul;Choi In-Hwa
    • The Journal of Korean Medicine
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    • v.25 no.3
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    • pp.137-148
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    • 2004
  • Objectives : To study change of external dermal formation, change of leukocytes in vasculature, change of lipid formation in stratum corneum and distribution of ceramide through administering Sihocheonggan-san (SC) extract on to the control (CON). This study was done through forcing injury to mice's back skin which have lipid protection formation in stratum corneum. Materials and Methods : The CON to which damage was caused intentionally using the external application on the mice's back skin used the SC. The change of leukocytes in vasculature were identified through optima 5.2 and Student's t-test and the results were made into a dermal formation graph. Results : After dispensing SC extract into the CON, dermal injury was decreased. Especially, recover of lipid protection formation, which includes lipid and ceramide in stratum corneum suppressing acute inflammation that some factors are PKC, TNF-α, IL-12B which controlled the secretion of relating inflammatory cytokine, also went onto decrease of angiogenesis, and a decrease of degranulated mast cells was noted. In addition, the decrease of epithelial injury also caused the growth of cells to decrease in stratum basale and cytoclasis. In the vasculature, the leukocytes were also decreased and it could relate to decrease in CON. Conclusions : SC has effect on CON suppressing the dermal injury through recovering of lipid protection formation in stratum corneum.

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A Study on the Time Course Changes of Biogenic Amines in Response to Bite Injury (실험교흔조직에서 생물학적 Amines정량에 의한 수상 후 경과시간 판정에 관한 연구)

  • 김성옥;김종열;김윤수
    • Journal of Oral Medicine and Pain
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    • v.9 no.1
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    • pp.65-75
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    • 1984
  • The present studies, the investigations were undertaken for an attemp to analyze time course change of biogemic amines in respons to bite injury in rats and guinea pigs, and obtained the following results that might be applicable to the forensic medicine and Forensic Odontology. The histamine concentrations measured at rat abdominal skins were decreased during the first 8 hours and recovered to control levels after 12 hours. However the serotonin concentrations were decreased during the first hours and increased during 4-8 hours, and then returned to control levels thereafter. In contrast with these results, both histamine and serotonin concentrations were tended to increase in guinea pig skins, but the concetration of histamine showed maximum rate of increase immediately after injury and those of sertonin showed maximum rate of increase at 30 minutes. The differencd in the response of histamine and serotonine after injury between rats and ginea pigs revealed that there is specials deffrence in the response of biogenic amines with regard to external stimuli. These results suggest that the determinition of biogenic amines in skin lesion of bite marks could be applied to the estimation of the elapsed time after antemortem injury.

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Serious Penetrating Craniocerebral Injury Caused by a Nail Gun

  • Jeon, Yong Hyun;Kim, Dong Min;Kim, Sung Hoon;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.537-539
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    • 2014
  • Penetrating cerebral injuries caused by foreign bodies occur rarely due to the substantial mechanical protection offered by the skull. Throughout most of history, the brain, residing in a "closed box" of bone, has not been vulnerable to external aggression. Recently, we encountered a serious penetrating craniocerebral injury caused by a nail gun. Total excision of the offending nail via emergency craniotomy was performed, but the patient's neurologic status was not improved in spite of aggressive rehabilitative treatment. Here, we report on this troublesome case in light of a review of the relevant literature.

Ligament Injuries of Knee in the Recreational Skiers (스키에 의한 슬관절 인대 손상)

  • Lee Dong Chul;Ko Jin Hyeok;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.37-43
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    • 2003
  • Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

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Surgical Treatment of Radial Nerve Injury (요골 신경 손상의 수술적 치료)

  • Lee, Kwang-Suk;Park, Sang-Won;Wie, Dae-Gon
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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