• Physical Therapy Korea
• /
• v.3 no.1
• /
• pp.57-64
• /
• 1996

Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.

• Childhood Kidney Diseases
• /
• v.19 no.2
• /
• pp.71-78
• /
• 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 Korean Neurosurgical Society
• /
• v.40 no.6
• /
• pp.450-454
• /
• 2006

The incidence of vertebral artery injury during the anterior approach to the cervical spine is rare, but potentially lethal. The authors describe two cases of vertebral artery injury during anterior cervical decompression surgery. In the first case, infection was the cause of the vertebral artery injury. During aggressive irrigation and pus drainage, massive bleeding was encountered, and intraoperative direct packing with hemostatic agents provided effective control of hemorrhage. Ten days after surgery, sudden neck swelling and mental deterioration occurred because of rebleeding from a pseudoaneurysm. In the second case, the vertebral artery was injured during decompression of cervical spondylosis while drilling the neural foramen. After intraoperative control of bleeding, the patient was referred to our hospital, and a pseudoaneurysm was detected by angiography four days after surgery. Both pseudoaneurysms were successfully occluded by an endovascular technique without any neurological sequelae. Urgent vertebral angiography, following intraoperative control of bleeding by hemostatic compression in cases of vertebral artery injury during anterior cervical decompression, should be performed to avoid life-threatening complications. Prompt recognition of pseudoaneurysm is mandatory, and endovascular treatment can be life saving.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.8
• /
• pp.1050-1054
• /
• 2000

Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.10 no.1
• /
• pp.13-19
• /
• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.15 no.4
• /
• pp.239-247
• /
• 2015

Recently, various research studies on frontal collision and rear-ender which occur more frequently compared to others are underway as the public interest on them is growing. This study analyzes scientifically the relationship between effective impact speed and injury incidence for vehicle crash accident reconstruction and presents a relevant model formula. Because real vehicle experiments have certain limitations such as possible injuries, this study efforts to collect and analyze as many materials as possible to substitute real vehicle experiments, including data from various collision tests and human experiments. As a result, this study present a threshold in which head-on collisions and rear impacts do not cause injuries under 7 km/h of effective impact speed, and suggests a model formula showing that injury extent is linearly proportional to effective impact speed through collision speed and amount of plastic deformation. In conclusion, a model formula for estimating effective impact speed and injury incidence newly proposed in this study is expected to be used as a minimum standard of judgment in disputes on the injury extent of passenger in head-on collisions and rear impacts. Furthermore its availability in terms of technological analysis in legal arguments is expected to be very high if this study will be enhanced by referring to scientific analyses of various real accidents so as to apply it in various types of collision accidents.

• Journal of Trauma and Injury
• /
• v.24 no.2
• /
• pp.61-67
• /
• 2011

Purpose: Lawn trimmers are widely used to cut the weeds around graves in South Korea, but they can cause ocular injury. We investigate at the emergency room the incidence and the clinical features of ocular trauma induced by lawn trimmers. Methods:The authors analyzed 106 patients who visited Konyang University Hospital's emergency room from March 1, 2007, to October 31, 2011, because of ocular trauma caused by a lawn trimmer. Patients were sorted into two groups, severe ocular injury and mild ocular injury. Results: Over a 5-year period, 106 patients with ocular trauma caused by a lawn trimmer underwent clinical study. Most of the patient (103 patients) were males, and the average age of the patients was $51.75{\pm}11.66$ years. The incidence of ocular trauma peaked in the sixth decade of life. Most injuries occurred between July and September. Severe ocular injury developed in 46.2% of all patients. As age increased, so did the severity of the ocular injury. The impacting object was a small stone in 43.4% of all patients. Nobody wore protective gear. The most common diagnosis were corneal abrasion, followed by intraocular foreign body, corneal laceration, and sclera laceration. Fifty-four patients were followed up, and thirty-six patients of them had severe injury. The most common complication was a traumatic cataract. Conclusion: Ocular trauma induced by a lawn trimmer is more severe than general ocular trauma. We suggest that everyone using a lawn trimmer should wear protective gear and follow safety guidelines.

• Journal of Chest Surgery
• /
• v.18 no.2
• /
• pp.352-359
• /
• 1985

A clinical evaluation was performed on 811 cases of chest trauma who were admitted and treated at the department of thoracic & cardiovascular surgery, Catholic Medical College, during the past 19 years from Jan. 1966 to Dec. 1984. 1. The overall incidence rate of male to female was 3:1. 2. The common age groups were 4th, 5th, and 3rd decades. 3. The most common cause of chest trauma was stab in penetrating wound and traffic accidents in non penetrating wound. 4. The most common injury from non penetrating chest trauma was rib fracture [81.3%], and the incidence rate of flail chest was 14.5% of all cases of rib fractures. 5. The incidence rate of hemo-pneumothorax was 50.4% in non penetrating wounds, and 55.2% in penetrating wounds. 6. The most common method of surgical treatment was CTD [33.5%], and open thoracotomy was performed in 67 cases [8.3%]. 7, The overall mortality was 3.3% [27 cases], and common causes of the death were shock and respiratory insufficiency.

• 대한예방의학회:학술대회논문집
• /
• 1995.10a
• /
• pp.137-138
• /
• 1995

• Journal of Trauma and Injury
• /
• v.25 no.4
• /
• pp.271-274
• /
• 2012

Duodenal perforation has a high incidence of complications and mortality if not detected and treated early. Delayed diagnosis of duodenal perforation is frequent because patients rarely complain of any symptoms. We report a case of duodenal perforation that appeared after trauma and was cured by using conservative treatment.