• 가정∙방문간호학회지
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• 제8권1호
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• pp.25-37
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• 2001

Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

• The Journal of Korean Physical Therapy
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• 제17권1호
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• pp.108-122
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• 2005

The gait training strategy in very important things for central nervous system(CNS) injury patients. There are many method and strategy for regaining of the gait who had CNS injury. A human being has central pattern generator(CPG) is spinal CPG for locomotion. It is a neural network which make the cyclical patterns and rhythmical activities for walking. Sensory input from loading and hip position is essential for CPG stimulation that makes the central neural rhythm and pattern generating structure. From sensory input, the proprioceptive information facilitate proximal muscles that controlled in voluntarily from cortical level and visual and / or acoustical information facilitate distal muscles that controlled voluntarily from subcortical level. Gait training method can classify that is functional level and structural level. Functional level includ level surface gait, going up and down the stair. It is important to facilitate a guide tempo in order to activate the central pattern generators. During the functional test or functional activities, can point out the poor period in gait that have to be facilitate in structural level. There are many access methods with patient position and potentiality. The methods are using of rhythmic initiation, replication and combination of isotonic with standing position. Clinically using it on weight transfer onto the stance leg, loading response, loading response and pre-swing, terminal stance, up and downwards stairs.

• BMB Reports
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• 제31권2호
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• pp.183-188
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• 1998

2-chloroethylethyl sulfide (CEES) is an alkylating agent that readily reacts with a wide variety of biological molecules causing metabolic abnormality. The mechanism of cell death during CEES injury is poorly understood. We have examined the effect of exposure of thymocytes with various concentrations of CEES to determine the pattern of cell death in thymocytes injury induced by CEES. In the present study, we show that two patterns of cell death occurred by either one of two mechanisms: apoptosis and necrosis. Exposure to low level of CEES (100 ${\mu}M$) for 5 h caused an induction of apoptosis on thymocytes, as identified by the following criteria: DNA fragmentation visualized by the characteristic "ladder" pattern was observed upon agarose gel electrophoresis and morphological features were revealed by microscopical observations. In contrast, exposure to high levels of CEES (500 ${\mu}M$) induce necrotic features such as cell lysis. Thus, depending on the concentrations, CEES can result in either apoptotic or necrotic cell damage. Our findings suggest that thymocytes which are not killed directly, but merely injured by low levels of CEES, are able to activate an internally-programmed cell death mechanism, whereas thymocytes receiving severe damages apparently can not.

• 대한정형외과스포츠의학회지
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• 제9권1호
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• pp.22-27
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• 2010

도시화, 사회 경제적 발달로 인하여 많은 사람들이 달리기 운동을 즐기고 있다. 달리기는 단순한 운동이지만 반복적인 동작을 하기 때문에 관절에 특이적인 손상이 발생될 수가 있다. 달리기 운동 손상의 원인은 급성기의 손상보다는 만성적인 과사용 증후군으로 인한 것이 대부분이다. 또한 달리기를 할 때 흔히 동반되는 손상은 전방 슬관절 통증, 장경 인대 증후군, 피로 골절, 족저 근막염, 아킬레스 건염, 후방 경골 인대 증후군 등이 있다. 달리기 운동 손상의 가장 흔한 부위는 무릎 관절이다. 이에 저자들은 문헌 고찰을 하여, 달리기 운동 손상 중에서 무릎에서 발생하는 손상의 종류, 원인, 예방, 재활적인 치료 등을 중심으로 알아보고자 한다.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.18-23
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• 2009

Purpose: In this study, we retrospectively investigated the medical records of patients with facial fractures and suspected cranial injuries in order to determine if there was any relationship between various facial fracture patterns and cranial injuries. Methods: Medical records were reviewed to identify patients diagnosed with facial fractures who underwent cranial computed tomography (CT) scans. Records were reviewed for gender, age, injury mechanism, facial fracture pattern, and presence or absence of cranial injuries. Facial fracture patterns were classified as isolated fractures (tripod, zygomatic arch, maxilla, orbit, and mandible), combined fractures, or total fractures. Cranial injuries included skull fractures, traumatic subarachnoid hemorrhages, subdural hemorrhages, epidural hemorrhages, and contusional hemorrhages. All cranial injuries were established by using cranial CT scans, and these kinds of cranial injuries were defined radiologically-proven cranial injuries (RPCIs). We evaluated the relationship between each pattern of facial fractures and the incidence of RPCIs. Results: Of 132 eligible patients with facial fractures who underwent cranial CT scans, a total of 27 (20.5%) patients had RPCIs associated with facial fractures. Falls and slips were the most common causes of the fractures (31.8%), followed by assaults and motor vehicle accidents (MVAs). One hundred one (76.5%) patients had isolated facial fractures, and 31 (23.5%) patients had combined facial fractures. Fractures were found most commonly in the orbital and maxillary bones. Patients with isolated maxillary fractures had a lower incidence of RPCIs than those with total mandibular fractures. RPCIs frequently accompanied combined facial fractures. Conclusion: Combined facial fractures had a significant positive correlation with RPCIs. This means that facial fractures caused by stronger or multidirectional external force are likely to be accompanied by cranial injuries.

• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.73-77
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• 2018

Purpose: The prefrontal lobe, supplementary motor area, cerebellum, and basal ganglia are activated during gait. In addition, gait is controlled by nerves, such as the corticospinal tract (CST) and corticoreticular pathway (CRP). In this study, the presence of an injury to the CST and CRP was identified by diffusion tensor imaging and the characteristics of the gait pattern were investigated according to inferior cerebral artery infarction. Methods: One patient and six control subjects of a similar age participated. A 69-year-old female patient had an injury to the left basal ganglia, insular gyrus, corona radiata, dorsolateral prefrontal cortex, and postcentral gyrus due to an inferior cerebral artery infarction. Diffusion tensor imaging (DTI) data was acquired 4 weeks after the stroke. The kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 4 weeks DTI, the CST and CRP in the affected hemisphere did not show injury to the affected and unaffected hemisphere. Gait analysis showed that the cadence of spatio-temporal parameter was decreased significantly in the patient. The angle of the knee joint was decreased significantly in the affected and unaffected sides compared to the control group. Conclusion: The results of diffusion tensor imaging showed that although the patient was evaluated to be capable of an independent gait, the quality and quantity of gait might be reduced. This study could help better understand the gait ability analysis of stroke patients and the abnormal gait pattern of patients with a brain injury.

• Journal of Chest Surgery
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• 제54권1호
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• pp.59-64
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• 2021

Background: Diaphragmatic injuries following blunt or penetrating thoraco-abdominal trauma are rare, but can be life-threatening. Rib fractures are the most common associated injury in patients with a traumatic diaphragmatic injury (TDI). We hypothesized that the pattern of rib fracture injuries could dictate the likelihood of acute TDIs. Methods: A retrospective study was carried out between April 2014 and October 2018 to analyze patients with TDIs and rib fractures at a major trauma center in London, United Kingdom. Results: Over the study period, 1,560 patients had rib fractures, of whom 14 had associated diaphragmatic injuries. Left-sided diaphragmatic injuries were found in 8 patients (57%). A significant proportion of the rib fractures were located posterolaterally (44.9%). The highest frequency of fractures was found in ribs 5-10, which accounted for 74% of all the fractures. Ten patients underwent surgery, of whom 7 were diagnosed with a diaphragmatic injury intraoperatively after video-assisted thoracoscopic surgery assessment of the pleural cavity. Two patients died due to severe injuries of other organs and the remaining 2 patients were managed conservatively. Conclusion: Our series of patients demonstrates a relationship between significant rib fractures and diaphragmatic injuries in trauma patients, and the diagnostic difficulties in identifying the condition. We found that the location of the rib fractures and the pattern of injury in patients with TDIs were much lower and posterolateral in the chest wall without a preference for laterality. We suggest using a thoracoscope in patients undergoing chest wall surgery post-trauma to aid in diagnosing this condition.

• 대한한의학회지
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• 제36권3호
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• pp.111-125
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• 2015

Objectives: The purpose of this study was to analyze the current cases of oriental medical injury relief data from Korea Consumer Agency (KCA), and to report the current change of oriental medical disputes pattern. Methods: Oriental medical injury relief cases processed by KCA from January 2010 to February 2015 were collected and analyzed. Results: 149 Oriental medical injury relief cases from KCA were analyzed for the study. The highest number that had been relieved was 43 in 2014. In monthly status, 18 case in September was The highest. According to the record, the bigger city had the bigger amount of relief cases which was 53(Seoul), 43(Gyeng-gi), 11(Busan) and so on. In age categories, 30s had the highest number of injury relief cases. The injury relief cases of package program had been rapidly increasing since 2013. Cancellation was the dominant claims cause of package program and consumer required the refund of prepayment. Breast augmentation was the majority treatment type of injury relief cases of package program. Average prepayment of package program was \3,166,085. Conclusions: This study finded that the major cause of oriental medical dispute was changed from side effect of clinical treatment to patient's satisfaction of medical service.

• The Korean Journal of Physiology and Pharmacology
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• 제19권5호
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• pp.461-465
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• 2015

Microglia, the resident macrophages in the central nervous system, can rapidly respond to pathological insults. Toll-like receptor 2 (TLR2) is a pattern recognition receptor that plays a fundamental role in pathogen recognition and activation of innate immunity. Although many previous studies have suggested that TLR2 contributes to microglial activation and subsequent pathogenesis following brain tissue injury, it is still unclear whether TLR2 has a role in microglia dynamics in the resting state or in immediate-early reaction to the injury in vivo. By using in vivo two-photon microscopy imaging and $Cx3cr1^{GFP/+}$ mouse line, we first monitored the motility of microglial processes (i.e. the rate of extension and retraction) in the somatosensory cortex of living TLR2-KO and WT mice; Microglial processes in TLR2-KO mice show the similar motility to that of WT mice. We further found that microglia rapidly extend their processes to the site of local tissue injury induced by a two-photon laser ablation and that such microglial response to the brain injury was similar between WT and TLR2-KO mice. These results indicate that there are no differences in the behavior of microglial processes between TLR2-KO mice and WT mice when microglia is in the resting state or encounters local injury. Thus, TLR2 might not be essential for immediate-early microglial response to brain tissue injury in vivo.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.128-135
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• 2008

Purpose: As the care of surgical patients becomes increasingly complex and catheter-based techniques are more frequently applied, the pattern of iatrogenic vascular injuries may be increasing. Major vascular injuries can jeopardize a patient's life or limb survival. The purpose of this study was to examine the current etiology and prognosis for iatrogenic vascular injuries. Methods: We reviewed medical records of 29 cases of iatrogenic vascular injury that were treated Seoul National University Bundang Hospital between October 2003 and October 2008. We studied clinical variables including demographics, cause of injury, clinical presentations, management and prognosis. Results: The mean age was 60.8 years (range: 25-86), and the male to female ratio was 1.9 : 1. The causes of injuries were operation related complication in 18 cases (62.1%), endovascular intervention and diagnostic angiography in 11 cases (37.9%). The types of vascular injury were partial severance in 14 cases, pseudoaneurysm in 8, arteriovenous fistula (AVF) in 3, thrombosis in 2, complete severance in 2. Especially, device related complication including percutaneous closing device were occurred in 9 and the others came from inadvertent physician's procedure. Primary repair were done in 12 cases, end-to-end anastomosis in 5, interposition graft in 4, ligation in 2, patch angioplasty in 1, peudoaneurysm excision and arteriorrhaphy in 1, hematoma evacuation in 1, and endovascular repair in 3. There were 2 cases of mortality, one of them due to hemorrhagic shock and the other due to septic shock. Conclusion: Proper selection of treatment modalities should be important to have better outcome according to the type of injury as well as anatomical location. Each physician should be familiar to new device as well as patient's topographical feature. Immediate referral to vascular specialist is also essential to reduce morbidity.