• Safety and Health at Work
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• v.15 no.1
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• pp.66-72
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• 2024

Background: This study examines the relationship between functional disability and work ability in workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data were collected during the first medical examination using anamnestic and clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the high school degree, 45.6% married. Results: WAI and ODI reported a negative and fair correlation (r = -0.454; p = .000). Workers with acute LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms. White collars without depressive symptoms reported higher work ability - even in chronic disability conditions-than those with depressive symptoms. Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study's findings highlight the importance of using a multidisciplinary approach to manage and prevent disability due to LBP.

• Investigative Magnetic Resonance Imaging
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• v.22 no.1
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• pp.10-17
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• 2018

Purpose: To evaluate interpretation errors involving spine MRIs by residents in their second to fourth year of training, classified as minor, intermediate and major discrepancies, as well as the types of commonly discordant lesions with or without clinical significance. Materials and Methods: A staff radiologist evaluated both preliminary and final reports of 582 spine MRIs performed in the emergency room from March 2011 to February 2013, involving (1) the incidence of report discrepancy, classified as minor if there was sufficient description of the main MR findings without ancillary or incidental lesions not influencing the main diagnosis, treatment, or patients' clinical course; intermediate if the correct diagnosis was made with insufficient or inadequate explanation, potentially influencing treatment or clinical course; and major if the discrepancy affected the main diagnosis; and (2) the common causes of discrepancy. We analyzed the differences in the incidence of discrepancy with respect to the training years of residents, age and sex of patients. Results: Interpretation discrepancy occurred in 229 of the 582 cases (229/582, 39.3%), including 146 minor (146/582, 25.1%), 40 intermediate (40/582, 6.9%), and 43 major cases (43/582, 7.4%). The common causes of major discrepancy were: over-diagnosis of fracture (n = 10), missed cord lesion (n = 9), missed signal abnormalities associated with diffuse marrow (n = 5), and failure to provide differential diagnosis of focal abnormal marrow signal intensity (n = 5). No significant difference was found in the incidence of minor, intermediate, and major discrepancies according to the levels of residency, patients' age or sex. Conclusion: A 7.4% rate of major discrepancies was found in preliminary reporting of emergency MRIs of spine interpreted by radiology residents, probably related to a relative lack of clinical experience, indicating the need for additional training, especially involving spine trauma, spinal cord and bone marrow lesions.

• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.262-272
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• 2018

Background: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. Methods: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. Results: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. Conclusion: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.923-935
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• 2021

Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.736-741
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• 2008

Background: Pneumonia continues to be the most common major infection in trauma patients. Despite the advances in prevention, diagnosis, and treatment for pneumonia, it remains a major cause of morbidity and mortality. The aim of this retrospective study is to identify the risk factors and clinical features of ventilator-associated pneumonia among chest trauma patients. Material and Method: The study population consisted of 78 mechanically ventilated patients admitted to the ICU of Chonnam National University Hospital between January, 2001, and December, 2006. The patients were divided into two groups: those with pneumonia (Group I) and without pneumonia (Group II). Clinical predictors of the occurrence and mortality for ventilator associated pneumonia were analyzed. Result: There were 57 men and 21 women, with a mean age of $48.3{\pm}19.9$ years. Almost half of the patients, 48.7% (38 of 78), had pneumonia. The mortality rate was 21.0% (8 of 38) in Group I and 2.5% (1 of 40) in Group II. The predictors of ventilator-associated pneumonia were the duration of mechanical ventilation (17.4 days vs 6.5 days, p<0.001), the mean stay in the ICU (21.7 days vs 9.7 days, p<0.001), the use of inotropics due to hemodynamic instability (63.1% vs 25.0%, p=0.001), and the serum level of CRP ($11.3{\pm}7.8$ vs $6.4{\pm}7.3$, p=0.006). Conclusion: Posttraumatic ventilator-associated pneumonia was significantly related with the duration of mechanical ventilation, the mean stay in ICU, and the use of inotropics due to hemodynamic instability. The serum level of CRP at admission was higher in the pneumonia group. Morbidity and mortality can be reduced by early identification of predictive factors for developing pneumonia in chest trauma patients.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.437-454
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• 1998

Osteopotosis is a disease characterized by reduced amount of bone mass leading to enhanced bone flagility. The number of patients with osteoporotic vertebral fracture is increasing and it is one of the leading causes of morbidity in the elderly and postmenopausal women. It is a condition in which bone mass decrease, causing bones to be more susceptible to fracture. A trivial trauma can easily cause one or more bones to break in a person with severe osteoporosis. So it is a major health problem. Pysicians and patients are concerned with the optimum approach to the treatment and prevention of osteoporosis. Until a recent date, many oriental medicine studies were performed to find the preventive and curative efficacy on the osteoporosis, which is differ from therapeutics of Western-medicine. The proper use of Herb-med and role of Accupuncture are issues that have generated major research efforts. This study was carried out to investigate evaluation of clinical and experimental study on the osteoporosis. So, these are to be mentioned in this paper.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.58-64
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• 2003

Cancer is a life crisis which inflicts major psychological and physical trauma upon the victim. Most of the cancer patients suffer from major depression, profound frustration, and impaired social adjustment. Therefore suicidal ideation and suicidal attempt are also becoming a serious threat to cancer patients and their families. Hospice is patient-centered, and accepts the inevitability of 'death' while simultaneously being life-affirming. Even though there is no chance of physical cure, there is much scope for psychosocial and spiritual healing. Most of cancer patients who commit suicide suffer hem many mental problems. Hospice specialists must play an important role in evaluating and managing emotional or behavioral problems associated with suicidal ideatior and are also are expected to serve as informed commentators regarding suicide. It is crucial that hospice specialists define their role and develop clinical skills to intervene in suicidal event effectively. A systematic approach to suicidal cancer patients is a essential, and there is need for specific training for all hospice professionals. In this case report, the author introduced knowledge and clinical guidelines for a desirable approach to suicidal cancer patient.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.322-328
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• 1993

The trauma has been known as a major etiologic factor in temporomadibular joint disorders. The endotracheal intubation is suspected as one of the traumatic factor to temporomandibular disorder. But there are few reports about the amount of mouth opening during endotracheal intubation and temporomandibular joint disorder after endotracheal intubation. The authors studied the effects of endotracheal intubation to temporomandibular joint with 70 patients given surgical operation through general anesthesia. The results were as follows. 1. The mean amount of mouth opening for entire patients during endotracheal intubation was 26.3mm (s, d : 2.6), for oral intubation group 25.9mm(s, d : 3.2), for nasal intubation group 26.6mm(s, d : 1.9). There was no difference between two group stastically. (p<0.05) 2. 1 week later endotracheal intubation, the maximum mouth opening increased 1.5mm for entire patients, 1.5mm for oral intubation group, 1.6mm for nasal intubation group than behare endotracheal intubation. 3. Five patients complained the discomforts around temporomandibular joint after endotracheal intubation. The amount of mouth opening during endotracheal intubation was within physiologic range. It seemed that $45^{\circ}$ upward endoscopic lifting for exposure of glottis gave trauma to temporomandibular joint.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.308-313
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• 2001

The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin $E_2(PGE_2)$ concentration was measured in 11 joints. Leukotriene $B_4(LTB_4)$ concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean $PGE_2$ concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.204-209
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• 2010

Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).