• Title/Summary/Keyword: Head Injuries

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Mild Traumatic Brain Injury and Subsequent Acute Pulmonary Inflammatory Response

  • Lim, Seung Hyuk;Jung, Harry;Youn, Dong Hyuk;Kim, Tae Yeon;Han, Sung Woo;Kim, Bong Jun;Lee, Jae Jun;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.680-687
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    • 2022
  • Objective : The influence of moderate-to-severe traumatic brain injury (TBI) on acute pulmonary injury is well established, but the association between acute pulmonary injury and mild TBI has not been well studied. Here, we evaluated the histological changes and fluctuations in inflammatory markers in the lungs to determine whether an acute pulmonary inflammatory response occurred after mild TBI. Methods : Mouse models of mild TBI (n=24) were induced via open-head injuries using a stereotaxic impactor. The brain and lungs were examined 6, 24, and 72 hours after injury and compared to sham-operated controls (n=24). Fluoro-Jade B staining and Astra blue and hematoxylin staining were performed to assess cerebral neuronal degeneration and pulmonary histological architecture. Quantitative real-time polymerase chain reaction analysis was done to measure inflammatory cytokines. Results : Increased neuronal degeneration and the mRNA expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, and transforming growth factor (TGF)-β were observed after mild TBI. The IL-6, TNF-α, and TGF-β levels in mice with mild TBI were significantly different compared to those of sham-operated mice 24 hours after injury, and this was more pronounced at 72 hours. Mild TBI induced acute pulmonary interstitial edema with cell infiltration and alveolar morphological changes. In particular, a significant infiltration of mast cells was observed. Among the inflammatory cytokines, TNF-α was significantly increased in the lungs at 6 hours, but there was no significant difference 24 and 72 hours after injury. Conclusion : Mild TBI induced acute pulmonary interstitial inflammation and alveolar structural changes, which are likely to worsen the patient's prognosis.

Revision after Instability Surgery (수술 후 재발한 견관절 불안정증의 치료)

  • Kim, Paul Shinil;Jo, Chris Hyunchul
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.374-382
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    • 2020
  • Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

A Study on Characteristics of Motorcycle Accident among Korean Elderly using Medical Record Information (의무기록 정보를 활용한 노인 오토바이 운수사고의 특성에 관한 연구)

  • Hye-Rang Kim;Moo-Sik Lee;Arma Park;Kwang-Hwan Kim
    • Journal of Digital Convergence
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    • v.21 no.2
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    • pp.17-25
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    • 2023
  • The purpose of this study was to analyze the characteristics of elderly motorcycle accidents according to data from elderly inpatients to prepare prevention measures for the elderly against injury in motorcycle accidents. Chi-squared test, independent sample t-test, and canonical correlation analysis were performed on the Korea Disease Control and Prevention Agency's National Hospital Discharge In-depth Injury Survey data from 2015 to 2019, from which the records of 1,384 elderly inpatients hospitalized because of motorcycle accidents were obtained. intracranial injury(S06) was the most common care and treatment characteristic for both age groups. The most frequent injury site was the head and neck, and the most frequent injury type was a fracture. The above findings show that prevention education and policy formulation at the national level are necessary to identify and manage the factors of elderly motorcycle accidents. This study provides basic data for developing measures and policies to prevent and reduce injuries, making it significant for public health causes.

Diagnosis of split fractures of the mandible in adults

  • Taesik Kim;Sung Gyun Jung;In Pyo Hong;Young Joong Hwang
    • Archives of Craniofacial Surgery
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    • v.24 no.4
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    • pp.167-173
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    • 2023
  • Background: Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians' understanding of mandibular split fractures and offer insights for future research. Methods: This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients' medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. Results: The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. Conclusion: This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.

Surgical Correction of Bilateral Gastrocnemius Muscle Rupture and Its Prognosis in a Korean Native Calf

  • Gyuho Jeong;Younghye Ro;Kyunghyun Min;Woojae Choi;Ilsu Yoon;Hyoeun Noh;Danil Kim
    • Journal of Veterinary Clinics
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    • v.40 no.3
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    • pp.215-220
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    • 2023
  • A 3-month-old Korean native cattle (Hanwoo) calf with difficulty taking normal posture and an inability to rise was referred for a definite diagnosis and active treatment, including surgery. The calf had a history of an accident in which both hind limbs were trapped in a barn structure. After admission, a "rabbit leg" posture was observed, a typical sign of gastrocnemius muscle rupture, and both digits were knuckled downward like they were trying to grip the ground. This was considered to be a result of the superficial digital flexor not rupturing but only the gastrocnemius muscle rupturing. Physical examination revealed laceration of the metatarsus and firmness behind both stifle joints which were presumed to be the sites of gastrocnemius muscle rupture. Skeletal abnormalities, including fractures, were ruled out by radiography. Based on these findings, the patient was diagnosed with bilateral gastrocnemius muscle rupture, and surgery was performed to reconnect the head of the ruptured muscle. Because the rupture occurred perpendicular to the muscle direction, the locking loop technique, a method of suturing severed tendons, was used to reduce the tension. After surgery, the cast was used to prevent further injuries and promote voluntary rehabilitation. Follow-up was completed, with the calf showing normal posture and gait 112 days after surgery. This is the first case report in the Republic of Korea describing the successful diagnosis and treatment of bilateral gastrocnemius muscle rupture in a calf.

Comparison of Lower Extremity Muscle Activity and Knee Joint Load according to Movement Speed Conditions during the Barbell Back Squat (바벨 백 스쿼트 시 운동 속도 조건에 따른 하지근 활성도 및 무릎 관절의 부하량 비교)

  • Moon-Seok Kwon;Jae-Woo Lee
    • Korean Journal of Applied Biomechanics
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    • v.34 no.1
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    • pp.25-33
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    • 2024
  • Objective: The purpose of this study was to compare the lower extremity muscle activity and knee joint load according to movement speed conditions during the barbell back squat. Method: Nine males with resistance training experience participated in this study. Participants performed the barbell back squat in three conditions (Standard, Fast, and Slow) differing movement speed. During the barbell back squat, muscle activity of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris long head (BFL), semitendinosus (ST), gluteus maximus (GM), gastrocnemius (GCN), and tibialis anterior (TA) was collected using an 8 channel wireless EMG system. The peak flexion angle of the lower extremity joints and the peak resultant joint force in each direction of the knee joint were calculated using eight motion capture cameras and ground reaction force plates. This study was to used the Friedman test and the Wilcoxon signed rank test, to compare lower extremity muscle activity and peak resultant joint force at knee joint according to movement speed conditions during the barbell back squat, and the statistical significance level was set at .01. Results: In the downward phase of the barbell back squat, the RF and TA showed the higher muscle activity in the fast condition, and in the upward phase, RF, VL, VM, BFL, ST, GM, and TA showed the higher muscle activity in the fast condition. As a results, analyzing of the load on the knee joint, in the downward phase, and in the upward phase, the higher peak compressive force of the knee joint was showed in the fast condition. Conclusion: The barbell back squat with fast movement speed was more effective due to increased muscle activity of lower extremity, but one must be careful of knee joint injuries because the load on the knee joint may increase during the barbell back squat with fast movement speed.

The influence of wearing helmet and cervical spine injury in skiers and snowboarders (스키와 스노우 보드에서 헬멧의 착용이 경추부 손상에 미치는 영향)

  • Kim, Sung Hun;Kim, Tae Kyun;Chun, Keun Churl;Hwang, Jae Sun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.94-99
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    • 2011
  • Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

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The Effects of Chest Injury in the Early Deaths of Trauma Patients (외상에 의한 초기 사망에서 흉부손상에 대한 고찰)

  • Lee Dong Hoon;Cho Dai Yun;Kim Chan Woong;Sohn Dong Suep
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.127-133
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    • 2006
  • Background: In the studies of the distribution of time to death in trauma patients, the early deaths within several hours after injury were a large component of total trauma deaths. Due to the development of trauma system, overall mortality of trauma was decreased, but trauma is still the major cause of deaths. Material and Method: From January 1994 to December 2003, trauma patients who had been admitted and had expired at tertiary hospital were enrolled. There was a total of 400 cases, a retrospective study was done to determine the distribution of trauma mortality according to the part of the body that were severely injured part and compared the difference between early deaths within 6 hours and late deaths after 6 hours. We also analysed the risk factors of early deaths due to trauma. Result: In severe injury to the head and abdomen, the distribution of mortality was bimodal. But, in severe chest injuries, the distribution was log-shape and most early deaths were almost of trauma related. The average of GCS were 5.86$\pm$4.15 for the early deaths and 8.24$\pm$5.02 for the late deaths (p < 0.05). The AIS of thorax were 2.66$\pm$1.87 for the early deaths and 1.55$\pm$1.76 for late deaths. The risk factors for early mortality were non-EMS transportation (odds ratio 3.474), high AIS (odds ratio 1.491) and GCS (odds ratio 0.859). Conclusion: In trauma patients, the causes of early mortality were severe brain injury and massive hemorrhage. Also severe chest injuries were the major cause of the early deaths in truama. Early diagnosis of chest injury can frequently be missed in the acute trauma setting. Therefore, high index of suspicion, a careful examination, and aggressive surgical treatment are important in multiple trauma patients.

Cerebrolysin Attenuates Astrocyte Activation Following Repetitive Mild Traumatic Brain Injury: Implications for Chronic Traumatic Encephalopathy (만성외상성뇌병증과 관련된 반복적 경도 외상성뇌손상(rmTBI)모델에서 cerebrolysin의 별아교 세포활성 억제효과)

  • Kang, Hyun Bae;Kim, GiHun;Kim, HyunJoong;Han, Sa Rang;Chae, Dong Jin;Song, Hee-Jung;Kim, Dong Woon
    • Journal of Life Science
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    • v.23 no.9
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    • pp.1096-1103
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    • 2013
  • Chronic traumatic encephalopathy (CTE), which is common in athletes, is a progressive neurodegenerative disease and a long-term consequence of repetitive closed head injuries. CTE is regarded as a chronic brain syndrome due to the effects of repetitive traumatic brain injury (TBI). Because neurotrophic factors are neuroprotective in models of brain and spinal cord injuries, we examined the effects of cerebrolysin, a mixture of various neurotrophic factors, on brain pathology in a mouse model of repetitive mild TBI (rmTBI), which is a good model of CTE. Five groups were created and treated as follows: groups 1 and 2: rmTBI for 4 weeks following cerebrolysin injection for 4 weeks; groups 3 and 4: rmTBI for 8 weeks with or without cerebrolysin injection for 4 weeks; group 5: control. We found that p-tau expression was increased in the pyramidal layer of the cortex and hippocampus, particularly the CA3 region, but not in the CA1 region and the dentate gyrus (DG). Intra-tail vein administration of cerebrolysin ($10{\mu}l$ of 1 mg/ml) after/during rmTBI treatment reduced p-tau expression in both the cortex and hippocampus. Histological analysis revealed mild astrocyte activation (increased expression of glial fibrillary acidic protein (GFAP)) but not microglia activation (ionized calcium binding adaptor molecule 1 (iba-1) expression) and peripheral macrophage infiltration (CD45). Additionally, administration of cerebrolysin after rmTBI resulted in reduced astrocyte activation. These observations in rmTBI demonstrated that cerebrolysin treatment reduces phosphorylation of tau and astrocyte activation, attenuates brain pathology, and mitigates function deficits in TBI. Taken together, our observations suggest that cerebrolysin has potential therapeutic value in CTE.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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