• 대한불안의학회지
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• 제10권2호
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• pp.95-102
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• 2014

Objective : Previous research showed that childhood trauma or domestic violence resulted in difficulties in controlling emotion and problem solving and vulnerability to psychiatric disorders. To understand the long term effect of childhood trauma, this study investigated their influences on cognitive processing of anger-evoking event and anger behavior among prisoners. Methods : All data were collected from 198 prisoners off our districts in Korea. After they consented to participate, prison officer distributed a questionnaire that included scales to demographic measure, childhood abuse (emotional abuse, physical abuse, and neglect), cognitive response of anger (attentional focus, suspicion, rumination, and hostile attitude) and behavior of anger (impulsive reaction, verbal aggression, physical confrontation, and indirect expression). For statistical analyses, SPSS 18.0 were used and path coefficients were evaluated from the structural equational modeling using LISREL 8.52. Results : Almost 50% of prisoners of our sample experienced one or more trauma during childhood. Then we tested the long term effect of childhood trauma on anger response by structural equation modeling. As expected, childhood trauma was associated with cognitive processing of anger-evoking event and anger behavior. More specifically, emotional abuse (${\beta}$=0.21, p<0.01) predicted suspicion which in turn associated with impulsive reaction (${\beta}$=0.73, p<0.001) and verbal aggression (${\beta}$=0.87, p<0.001). Emotional abuse (${\beta}$=0.24, p<0.01) also predicted hostile attitude which associated with physical confrontation (${\beta}$=0.80, p<0.001) and indirect expression (${\beta}$=0.80, p<0.001). Interestingly, physical abuse associated directly with impulsive reaction (${\beta}$=0.23, p<0.01) and indirect expression (${\beta}$=0.17, p<0.05). Neglect predicted rumination (${\beta}$=0.15, p <0.05) which associated with indirect expression marginally (${\beta}$=0.11, P<0.10). Conclusion : The results of this study, suggest longitudinal and harmful effect of childhood trauma on difficulties in controlling anger. Especially, it was revealed that childhood abuse related with processing anger evoking events more suspicious and hostile and then various anger-expressing behaviors.

• Journal of Trauma and Injury
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• 제31권1호
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• pp.38-42
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• 2018

A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

• 한국산학기술학회논문지
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• 제15권4호
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• pp.1938-1945
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• 2014

본 연구는 십대 유도 엘리트 청소년의 운동 중 신체적 외상의 정도와 관련 요인을 파악하여 청소년의 신체적 외상 개선프로그램 개발에 기초 자료를 제공하기 위하여 시도되었다. 이를 위해 남자 67명 여자 14명 총 81명을 연구 대상자로 선정하였고 2013년 6월 1일부터 28일까지 설문조사하였다. 자료는 SPSS 16.0 Version으로 빈도 분석, chi-square test. t-test를 이용하여 분석하였다. 조사 항목은 신체적 외상의 경험 여부와 빈도, 부위, 종류, 시기, 원인, 치료 방법과 예방법으로 총 6개 항목이었다. 결과로서 외상 경험은 77(95.1%)명, 외상부위는 무릎 35(70.0%)명, 종류는 타박상 42(54.5%)명, 시기는 여름 54(70.1%)명, 원인은 신체적 충돌 40(51.9%)명, 치료방법과 예방에는 각각 병원이용 46(59.7%)명과 휴식 52(65.0%)명이 가장 높게 나타났다. 이에 청소년의 운동 중 신체적 외상을 보건사회문제로 인식하고, 이를 예방할 수 있는 프로그램 개발을 하는 것은 청소년들의 삶의 질을 향상시킬 수 있을 것이다.

• 근관절건강학회지
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• 제27권2호
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• pp.122-131
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• 2020

Purpose: This study aims to investigate major traumatic events experienced by nurses in regional trauma centers and explore the relationship among their traumatic events experience, perceived stress, and stress coping. Methods: Data were collected from 208 nurses in the trauma emergency room (trauma-bay) and trauma intensive care unit at four regional trauma centers. Results: The mean score of the traumatic events experience was 44.3 out of 76 points. The scores for physical injuries caused by traffic accidents or falls as well as patient care with abnormal behaviors were high. Significantly positive correlations among traumatic events experience, perceived stress, and stress coping were identified. Conclusion: Nurses working in the regional trauma centers experienced many various traumatic events, leading to high levels of stress. This study suggests that it is necessary to establish a regular surveillance system for nurses' traumatic events experience and perceived stress.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.204-207
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• 2014

Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.

• Journal of Trauma and Injury
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• 제30권3호
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• pp.103-106
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• 2017

A traumatic Braun-Sequard syndrome of the cervical spine is reported in a 53-year-old male. The patient recovered spontaneously over several days with surgical intervention. The diagnosis was made on magnetic resonance imaging with physical examination, which also demonstrated subsequent resolution of bone marrow intensity. The etiological factors of spinal Braun-Sequard syndrome are reviewed.

• 대한불안의학회지
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• 제15권1호
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• pp.35-44
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• 2019

Objective : The aim of this study was to investigate the individual and job related factors as risk factors for mental health of firefighters. Methods : The data of 202 fire-fighters was analyzed by using a multinomial logistic regression analysis. All participants completed self-reported questionnaires including demographics (sex, age, work duration), the Childhood Trauma Questionnaire, the Ways of Coping Checklist, the Colleague related traumatic events, the Korean occupational stress scale, the Korean Perceived Stress Scale-10, and the Beck Depression Inventory. Participants were divided into three groups according to the level of stress and depressive symptom scores: Low Stress-Low Depression (LS-LD), High Stress-Low Depression (HS-LD), and High Stress-High Depression (HS-HD). Results : A job related factor-organizational injustice-was a significant factor related to HS-LD, while individual factors such as active coping level and childhood trauma experience and a job related factor-difficult physical environment-were significantly associated with HS-HD. Conclusion : These results imply the need to take both individual and environmental approaches into account when managing the stress and depression of firefighters. More specifically, psycho-education to facilitate active coping strategy and adaptive emotional regulation at the individual level and the improvement of physical work environment of firefighters should be supported.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.52-55
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• 2011

The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

• 대한불안의학회지
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• 제5권2호
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• pp.133-138
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• 2009

Diagnosing post-traumatic stress disorder (PTSD) is challenging for several reasons: a lack of training in trauma assessment for most clinicians, underreporting and avoidance by patients, the overlapping of symptoms, and a high comorbidity with other mental disorders. Thus, a careful evaluation and differential diagnosis are essential for the treatment and management of this population. A concept of posttraumatic reaction in people with narcissistic vulnerability, called Trauma-Associated Narcissistic Symptoms (TANS) had appeared in the literature; this has not been, however, systemically investigated. This study examines three cases of TANS that developed after traumatic events such as traffic accidents and physical assault. TANS may mimic PTSD and can show similar features; however, a careful attention to the context and meaning of symptoms can help the clinicians in differentiating TANS from PTSD. Clinicians working with trauma and compensation evaluators should be on alert for this easily overlooked condition.

• Journal of Trauma and Injury
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• 제26권1호
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• pp.22-25
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• 2013

Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.