• Journal of Trauma and Injury
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• 제34권4호
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• pp.279-283
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• 2021

Traumatic spinal cord infarction is a rare condition that causes serious paralysis. The regulation of spinal cord blood flow in injured spinal cords remains unknown. Spinal cord infarction or ischemia has been reported after cardiovascular interventions, scoliosis correction, or profound hypotension. In this case, a 52-year-old man revisited the emergency center with motor and sensory abnormalities in all four extremities 56 hours after a motor vehicle collision. Despite the clinical presentation and imaging examination, there were no specific findings on the patient's first visit to the trauma center. Cervical spine computed tomography angiography showed a narrow vertebral artery, and diffusion-weighted imaging revealed spinal cord infarction from C3 to C5 with high signal intensity. It should be kept in mind that delayed-onset spinal cord infarction may occur in minor or major trauma patients as a result of head and neck injuries.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.593-598
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• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

• Research in Community and Public Health Nursing
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• 제30권2호
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• pp.217-225
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• 2019

Purpose: The purpose of this study is to assess socio-demographic, disaster-related, physical health-related, psychological, and social factors that may adversely affect disaster victims' QoL (Quality of Life). Methods: A cross sectional study was designed by using the secondary data. From the 3rd Disaster Victims Panel Survey (2012~2017), a total of 1,659 data were analyzed by using descriptive statistics including frequency, percentage, t-test, ANOVA, and multivariate linear regression. Results: Older people with lower health status lacking financial resources prior to a disaster were more at risk of low levels of QoL. Lower levels of perceived health status, resilience, and QoL were reported by disaster exposed individuals, while their depression was higher than the depression in the control group of disaster unexposed ones. Resilience, social and material supports were positively associated with QoL whereas depression and PTSD (Post-Traumatic Stress Disorders) were negatively associated. Conclusion: These findings suggest that psychological symptoms and loss due to disasters can have adverse impacts on the QoL of disaster victims in accordance with their prior socio-demographic background. They also indicate that targeted post-disaster community nursing intervention should be considered a means of increased social support as well as physical and mental health care for disaster victims.

• Journal of Korean Academy of Nursing
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• 제51권3호
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• pp.334-346
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• 2021

Purpose: The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. Methods: The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients' needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. Conclusion: The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.244-250
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• 2010

Objective : Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI. Methods : A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome. Results : Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion ($2.2{\pm}1.2$ days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect ($1.5{\pm}0.9$ days), epilepsy ($2.7{\pm}1.5$ days), cerebrospinal fluid leakage through the scalp incision ($7.0{\pm}4.2$ days), and external cerebral herniation ($5.5{\pm}3.3$ days). Subdural effusion ($10.8{\pm}5.2$ days) and postoperative infection ($9.8{\pm}3.1$ days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at $79.5{\pm}23.6$ and $49.2{\pm}14.1$ days, respectively). Conclusion : A poor GCS score ($\leq$ 8) and an age of $\geq$ 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.

• Journal of Chest Surgery
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• 제36권8호
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• pp.590-594
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• 2003

Vascular injury has been increased with popular outside activities. However there are only a few studies for vascular trauma. We intended to find out the relationships between the vascular trauma and its prognosis. Material and Method: Forty-four patients were diagnosed and operated on for vascular injury in the Gyeongsang National University Hospital from 1992. to 1999. We reviewed their chart and analysed their data retrospectively. We studied to causes, treatments, and prognoses of traumatic vascular injury. Result: The transfer time between accident place and emergency department was mean 3,5 hour, and the operation preparing time was 8.8 hours. Five cases required amputation of extremity. All amputation cases were combined with communited bony fractures. Thirty-eight cases had combined other injuries, and almost combined injuries were muscular and neurological damages, Conclusion: The optimal treatment plan for vascular trauma was prompt diagnosis and quick management. It may decrease amputation rate and post-traumatic complications. Therefore we must be carefully evaluated the multiple traumatic patients for early diagnosis of vascular injury and operate quickly in emergency status.

• Journal of Korean Medicine Rehabilitation
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• 제29권4호
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• pp.73-79
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• 2019

Objectives The purpose of this study is to provide Korean version of mild traumatic brain injury assessment tool. Methods The original version of acute concussion evaluation (ACE) was translated into Korean, and it was then back-translated into English without any prior knowledge of ACE. Finally, the pre-final version of Korean version of acute concussion evaluation (K-ACE) was derived. 49 Korean patients who had been diagnosed with mild traumatic brain injury participated in the study and completed K-ACE. Overall, 44 data were used to analyze findings. Validity of the study was assessed based on Concurrent validity. Reliability was also evaluated using Cronbach's ${\alpha}$ and the intraclass correlation coefficient. Results The Cronbach's ${\alpha}$ value for each item presented a proper level of internal consistency with results of 0.711 to 0.893 in two evaluations, respectively. The intraclass correlation coefficient of the retest reliability was marked as 0.892 (95% CI 0.840~0.933). Concurrent validity demonstrated positive correlations between K-ACE and Korean version of postconcussional syndrome questionnaire. Conclusions The K-ACE is concluded as a valid and reliable tool for measuring mild traumatic brain injury and post-concussion symptoms. Upon completion of the follow-up study, the K-ACE will be well-utilized by both clinicians and researchers.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.543-551
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• 2023

Objective : This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods : This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results : Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion : The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.

• Fire Science and Engineering
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• 제33권6호
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• pp.132-141
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• 2019

This study was conducted to investigate the effects of a forest therapy program on post-traumatic stress disorder (PTSD) and mood states of fire fighters. A total of 293 participants completed two psychological questionnaires before and after the program was conducted: the Post Traumatic Stress Disorder Checklist (PCL) and the Profile of Mood States (POMS). Data were analyzed with paired t-test and ANCOVA using SPSS 24.0. The PTSD results showed a significant decrease from 11.38 ± 12.58 points before the program to 6.91 ± 10.50 points after the program. Results of the POMS questionnaire revealed an increase in positive factors and a decrease in negative factors, with a significant overall decrease in POMS results from 8.58 ± 18.47 points before the program to -0.63 ± 15.83 points after the program. As a result of analyzing the differences in stress reduction effects according to the amount of sleep participants had, PTSD showed improvement at 6-8 hours of sleep. These results are expected to be utilized as a basis for stress management and relief in fire fighters.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.35-41
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• 2015

Purpose: This study was conducted to examine how patients' coping style and social support affect post-traumatic stress disorder (PTSD) in breast cancer patients who are treated with chemotherapy. Methods: The sample consisted of 134 outpatients who received breast cancer treatments at the cancer clinic of a university hospital. The collected data were analyzed by frequency, percentage, t-test, ANOVA, ${\chi}^2$-test, Pearson correlation coefficients using SPSS for Windows, version 18.0. Results: Among total, 26.9% of patients were classified into a high-risk PTSD group. In the high-risk group, a positive correlation was found between active and passive coping styles and between social support and active coping styles. Conclusion: In this study, the stronger the social support was, the more active the coping style was for high-risk PTSD patients with breast cancer. Considering the fact that cancer requires life-long self-management, strong social support could improve patients' healthcare capability. Furthermore, solid social support could effectively reduce the stress level and improve the quality of life for breast cancer patients in the high-risk PTSD group.