• Title/Summary/Keyword: INJURY

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Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

  • Lee, Hak-Jae;Sun, Hyun-Woo;Lee, Jae-Seok;Choi, Nak-Joon;Jung, Yoon-Joong;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.51-57
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    • 2018
  • Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

School Safety Education Factors Predicting Injury Prevalence Among Korean Adolescence (학교의 안전교육 관련 특성이 청소년의 사고발생 예측에 미치는 영향)

  • 이명선;박경옥
    • Korean Journal of Health Education and Promotion
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    • v.21 no.2
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    • pp.147-165
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    • 2004
  • Injury is a leading cause of death in the children and adolescent populations. In particular, more than 80% of unintentional injury was related to risk-taking behaviors involved in diverse accidents around school and home. Therefore, educational approaches should be provided for children and adolescent populations, and schools are the essential and appropriate sites to conduct safety education. This study was conducted to identify injury prevalence and safety education at schools among middle and high school students in Korea. About 1,034 middle and high students in 28 schools participated in a self-administered survey. The target schools were selected from the stratified random sampling method throughout schools of seven metropolitan cities in Korea. The questionnaires were delivered to the vice-principals by ground mailing service and the vice-principals administered survey data collection. The questionnaire asked about safety education provided in schools, injury experience in the last year, needs for injury prevention class in school, and demographics. All survey responses were entered into SPSS worksheet. Multivariate analysis of variance (MANOVA) and descriptive discriminant analysis (DDA) were used in statistical analysis with SPSS software 11.1. Multivariate analysis of variance was conducted as a preliminary analysis of DDA. According to the result of multivariate analysis of variance, gender (man), grade (poor), living with both parents, and displaying injury prevention messages on school news board were significantly different between the injured student group and the uninjured student group (p= .00). These four factors also had significant effects on students' injury experience in DDA, although correlation of the four factors with injury experience was weak overall based on their canonical function coefficients. All structure coefficients of the four factors were greater than .30, which means the four factors have discriminant effects on injury prevalence. The sizes of the discriminant effects, in order, were largly from gender, grade, living with both parents, and safety message display on school news boards.

The Clinical Effects of Heating-conduction Acupuncture Therapy with General Acupuncture Therapy for Lateral Ligament Injury Induced by Ankle Sprain Grade II (전열침(傳熱鍼)과 일반 침의 병행치료가 발목 염좌로 인한 외측인대 2도 손상에 미치는 임상적 효과)

  • Jahng, Sun-Jeong;Jang, Hyo-Kil;Heo, Dong-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.191-203
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    • 2011
  • Objectives: The purpose of this study is to investigate the clinical effects of heating-conduction therapy on lateral ligament injury induced by ankle sprain grade II. Methods: The 67 outpatients who were diagnosed as ankle sprain grade II were performed heating-conduction acupuncture therapy on lateral ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied pretreatment and after 1st, 2nd treatment. Results: 1. The pain threshold and VAS score after 1st and 2nd treatment with an isolated injury of the anterior talofibular ligament showed statistically significant improvement compared with pretreatment. 2. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular and the calcaneofibular ligament showed statistically significant improvement compared with pretreatment. 3. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament showed statistically significant improvement compared with pretreatment. 4. After 1st and 2nd treatment on the posterior talofibular ligament and after 2nd treatment on the anterior taofibular and calcaneofibular ligament with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament the pain threshold showed statistically significant improvement compared with pretreatment. 5. Between isolated injury and combined injury of lateral ligament, the difference in pain threshold and VAS score was not statistically significant. Conclusions: Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with an isolated injury and combined injury of lateral ligament induced by ankle sprain grade II.

Iatrogenic Ureteral Injury: When and How to Treat? (의인성 요관손상: 언제, 어떻게 치료할 것인가?)

  • Seo, Kang Il;Lee, Jong Bouk
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.8-14
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    • 2008
  • Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.

Latissimus Dorsi Transfer in Brachial Plexus Injury for the Elbow Flexion (상완 신경총 손상후 주관절 근력 회복을 위한 광배근 전이술)

  • Han, Chung-Soo;Chung, Duke-Whan;Soh, Jae-Ho
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.35-40
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    • 1998
  • The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

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Investigation of Injury Types and Frequency of Bearded Dragons According to Stocking Density (사육밀도에 따른 턱수염 도마뱀(Bearded dragon)의 부상 형태와 빈도 조사)

  • Jeon, Seung-Yeop
    • Journal of Environmental Science International
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    • v.31 no.4
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    • pp.369-372
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    • 2022
  • This study was conducted to determine the injury type and frequency of bearded dragons during single and group breeding according to stocking density, for 16 weeks. A total of 14 bearded dragons compromising three groups were selected for this study. Six and four bearded dragons bred in a cage of 45 cm × 45 cm × 45 cm were designed as group A and B, respectively. Group C was made of four partitions (20 cm × 20 cm × 20 cm) of equal size in the kennel, and the dragons, four in number, were reared alone. Injury type criteria were given 1 score each in 6 stages. Most of the injury types in group A were primary tail cutting, which was 1 point, depending on the score, except for 4 scores. The injury type of group A varied, that is 1, 2, 3, and 5 scores, and the pattern lasted for 2 to 9 weeks. After 10 weeks, the dragons showed no response to injury type, except 4 scores at 11 weeks and 2 scores at 14 weeks with a frequency of one, respectively. The representative injury types of the group B were primary tail cutting, which was 1 point, and the scores of the injury type from 2 to 11 weeks were the highest; the frequency of occurrence at 1 and 2 scores was 5 times and 3 times, respectively, and the frequency of occurrence at 3 scores was twice. In addition, 5 scores were found to have the lowest frequency of occurrence. Solitary breeding showed no response to the type of injury for 16 weeks. Consequently, single breeding with an appropriate stocking density did not affect stress, and it could be expected a positive aspect for pet welfare.

유치에 대한 Traumatic Injury의 처치

  • Han, Se-Hyeon
    • The Journal of the Korean dental association
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    • v.22 no.5 s.180
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    • pp.383-385
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    • 1984
  • 생활양식의 변화에 따라 유치 및 유영구치에 대한 traumatic injury가 크게 증가하고 있으며 이는 어린이나 보호자에게 심리적으로 커다란 영향을 미칠 수 있는 것이다. 어린이의 신체중 구강주위에 가장 많은 injury를 받는 것으로 나타나고 있고 하악전치 보다는 상악전치가, 여자 보다는 남자가 더욱 많은 injury를 받는 것으로 알려져 있으며 유전치에 대한 injury가 가장 많은 시기는 걷는 것, 달리는 것을 처음 재우게 되는 1½~2½세 사이이다. 물론 같은 어린이가 수회의 injury를 받을 수 있으며 특히 조심성이 없거나 가정이 파괴된 상태의 어린이에 있어 사고 위험이 높은 것으로 나타나고 있다. 일단 injury가 발생하면 가능한 한 빨리 치료가 이루어져야 하는데 유치는 계승치 맹출에 의하여 정상적인 치근 흡수현상을 나타내고 발육중인 유영구치는 치근이 미완성된 상태이므로 성숙된 영구치와는 처치방법이 다르며 때 고려해야 할 사항으로, ① management of child, ② degree of root resorption (degree of permanent tooth development), ③ space problems, ④ degree of parental concern, ⑤habits, ⑥ speech, ⑦ esthetics등이 있다.

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Intraoperative Diagnosis of a Pericardial Injury Associated with Multiple Diaphragmatic Ruptures in a Patient with Abdominal Blunt Trauma

  • Kim, Do Wan;Jeong, In Seok;Na, Kook Joo;Song, Sang Yun;Lee, Kyo Seon;Kang, Seung Ku
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.180-183
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    • 2016
  • A diaphragmatic injury is uncommon, but occurs more frequently with injury to other organs. Particularly, a diaphragmatic accompanied by a pericardial injury is very rare. The authors report a case of incidentally detecting a pericardial injury during surgery for a diaphragmatic injury due to abdominal blunt trauma.

Stent Graft Repair of Penetrated Injury of the Common Carotid Artery

  • Kim, Soon Jin;Ryu, Sang Woo;Chekar, Jaykey;Kim, Yong Tae;Seo, Bo Ra
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.172-175
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    • 2016
  • Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

  • Chen, Po-Chuan;Tsai, Shih-Hung;Chen, Yu-Long;Liao, Wen-I
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.293-295
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    • 2014
  • Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompressive craniectomy, but permanent neurological damage occurred. This is the first case of profound PTCI following a low-energy penetrating craniocerebral nail injury and reminds clinicians of possibility this rare dreadful complication for care of head-injured patients.