• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.55-64
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• 2024

Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

• Journal of Korean Society of Transportation
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• v.28 no.5
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• pp.17-29
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• 2010

The main objective of this study is to consider the necessity of introducing owner expenses in estimating the cost of traffic accidents, as is done in some advanced countries. It is known as "owner cost" in the U.S, "enterprise project price" in Japan, and "human cost" in the U.K. To achieve this, the seriousness and present state of post-traumatic stress disorder (PTSD) of traffic accident offenders, which is generally not observed when traffic accidents occur, are evaluated; countermeasures reflecting personal characteristics are prepared according to degree of affliction. The results could be summarized as follows. First, the present condition and seriousness of PTSD from traffic accidents that has been estimated only within the accidents offenders are evaluated through a survey. Second, a distinction analysis model is developed. 'Insomnia caused by accidents' and 'mental daunting in accident situations or similar ones during driving' are chosen as the variables of the discriminant. Third, as a result of the construction of an Ordered Probit Model to comprehend the seriousness of PTSD, the variables turns out in the order of 'seriousness of the most damaged victim, 'nightmare about the accident', 'insomnia experience', 'mental daunting during driving', 'gender', and 'major driving area'. Finally, the cures reflecting characteristics of gender and region are suggested, which are preferred for degree of seriousness of PTSD. The analysis shows that the method to minimize the damage, such as decline of work efficiency, by moving ahead the rehabilitation of the offenders would be suggested and this could minimize the direct and indirect damages that could happen to business owners for whom the drivers work.

• Journal of Internet of Things and Convergence
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• v.8 no.5
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• pp.63-70
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• 2022

This study is a study that collects and analyzes data through An autoethnographyon as one of method of qualitative research, through which researcher have experienced firsthand in the process of developmenting and counseling there a new concept professional mental health mobile service platform as a mental health social welfare expert. The results of this study are as follows.First, there are people in Korea who are directly exposed to mental health issues and need to receive professional medical services, but there are also quite a few members of the public who have a desire for general mental health services, although the level of therapeutic intervention is not required. Second, considering the characteristics of modern society and especially in the pandemic situation of infectious diseases such as COVID-19, more and more people are preferring various mental health service platforms using mobile devices. Third, all generations complain of mental health issues such as family problems, stress, interpersonal relationships, and occupations, and other mental health problems such as self-harm and suicide accidents are frequently mentioned in connection with mental disorders such as depression, anxiety disorder, addiction, and post-traumatic stress disorder. Fourth, youngth s were exposed to various mental health-related issues, and above all, they were complaining of serious mental health problems such as self-harm and suicide accidents. Fifth, in delivering professional mental health services, mental health experts with the ability also to provide professional services online through mobile devices are needed as well offline. Finally, based on the results of this study, policy and practical suggestions related to the provision of mental health services in the future, and directions for follow-up studies were suggested.

• Anxiety and mood
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• v.5 no.2
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• pp.125-132
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• 2009

Objective : This study examined psychiatric characteristics of wounded persons of Daegu subway fire accident occurring in February 2003 after six years. Methods : 103 wounded persons completed psychometric measures at 2 months and 6 years after the accident. Changes of psychiatric symptoms were compared and factors affecting post-traumatic stress disorder (PTSD) seriousness were examined. Results : In Minnesota Multiphasic Personality Inventory, the scores of Psychopathic Deviate (Pd), Masculinity/ Femininity (Mf), Social Introversion (Si) scales were significantly changed over time. The scores of Symptoms Checklist-90-Revision subscales were mostly decreased over time, however, paranoid ideation (PAR) subsclae scores were not significantly changed over time. In all of the State-Trait Anxiety Inventory (STAI)-State, Beck Depression Inventory, Impact of Event Scale, and PTSD Checklist-Civilian, mean scores at 6 years after the accident were significantly lower than those at 2 months after the accident. However, STAI-Trait score was not significantly changed over time. Total seriousness of PTSD was found to be affected by quality of sleep. Conclusions : Psychiatric symptoms of subjects were largely improved over time, but distrust and doubt of others were continued. In addition, the wounded persons suffered from sleep problems. Therefore, early and continuous interventions of public institutions and public health specialists are needed for the wounded persons with chronic psychiatric disorders.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.18-23
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• 2009

지난 50여년간 국가유공자 및 제대군인의 보상은 전쟁 및 군복무중 발생한 상이처로 인해 장애를 입은 자를 중심으로 보상해 왔으며, 군 복무 중 발생한 질병의 보상에 대해서는 아직까지 심도 있게 논의된바 없다. 우선 한국의 군복무와 관련한 질병 보상과 관련한 본격적인 논의에 앞서 중요하게 고려되야 할 부분은 우리보다 100여년 이상 앞서 연구해 왔고 지금까지도 활발히 진행중인 미국의 질병 보상 제도와 질병 인정범위에 대해 분석해볼 필요성이 제기된다. 미국의 군복무와 관련한 질병에 관한 최초 보상의 역사는 1800년대로 군복무와 관련한 질병에 관한 대표적인 최초의 보상 질환은 PTSD(Post Traumatic Stress Disorder)의 초기 형태인 향수병(nostalgia)으로 이 질환이 군복무와 연관된 질환으로 인정받은 최초 질병이었다. 미국의 경우 미국의 군복무와 관련된 질환은 직접질환과 추정 질환으로 분류되는데 먼저 군복무 직접 질환의 경우 질병 보상이 되는 대표적 질환은 고혈압, 당뇨, 빈혈, 동맥경화증, 관절염, 심장염, 간질, 신장염, 정신병, 활동성 결핵, 위궤양 등 거의 모든 질환이 포함되어 있다. 특히, 정신병 흡연과 음주에 의한 질환 자살도 남에게 피해를 주지 않은 경우는 대부분 보상이 된다. 이상 살펴본 바와 같이 선진국에 비해 한국의 군복무와 관련한 질병보상 범위와 너무도 상이한데 국가유공자예우에 관한 법률 시행령 제 14조에 의거 1급부터 7급까지 등급판정을 부여하는데 이는 대부분 외상에 의한 절단, 관통상, 신체 기능상실자를 위주로 보상을 하고 있어 외상과의 합병증이 없는 질병에 대한 보상은 실질적으로 거의 인정을 받지 못하고 있는 실정이다. 끝으로 군복무와 관련한 질병 보상과 의료, 복지증진을 위한 종합적인 발전 방안을 몇가지 제언코자 한다. 첫째, 제대군인 질병연구센타 설립. 둘째, 정신질환, 외상후 스트레스장애군(PTSD), 진행성 질환 무상의료 지원 및 연금지급 셋째, 고엽제 2세환자의 역학조사가 필요하다.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.454-462
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• 2016

Purpose: Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The purpose of this study was to identify the level of PTG and its correlates in Korean patients with breast cancer. Methods: A sample of 120 participants was recruited from outpatients, who had successfully completed primary treatment of breast cancer at a university hospital., Data were collected from June to December, 2014 using Posttraumatic Growth Inventory, Illness Intrusiveness Rating Scale, Cancer Coping Questionnaire, Revised Life Orientation Test and The Multidimensional Scale of Perceived Social Support. Results: Total score for the PTG was $79.18{\pm}17.54$ in patients surviving breast cancer. Bivariate analyses indicated that PTG was positively associated with having a religion, perceived social support, greater optimism, cancer coping, and illness intrusiveness. Results of the regression analysis showed that cancer coping (${\beta}=.29$, p=.001), optimism (${\beta}=0.28$, p=.001) and illness intrusiveness (${\beta}=0.17$, p=.037) were statistically significant in patients' PTG. Conclusion: The research findings show that the variables of cancer coping, optimism and illness intrusiveness significantly explain PTG and these psychological variables can be used to provide improvement in PTG for patients with breast cancer.

• Korean Journal of Culture and Social Issue
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• v.28 no.2
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• pp.187-217
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• 2022

The aim of this study is to examine the psychometric properties of the Korean version of the Post-traumatic Stress Disorder Checklist for DSM-5(PCL-5). For this purpose, online surveys were conducted for two times with a one year interval using the data from 1,077 Korean adults at time 1, and 563 Korean adults at time 2. First, from the result of the confirmatory factor analysis, comparing the model fit of the 1, 4, 6, and 7-factor model, the 4, 6, and 7-factor model showed a acceptable fit, and the best fit was seen in the order of the 7, 6, 4-factor model. Second, the internal consistency, omega coefficient, construct validity, average variance extracted, and test-retest reliability results were all satisfactory.. Third, a correlation analysis with the K-PC-PTSD-5 and the sub-factors of BSI-18 was conducted to check the validity of the Korean Version of PCL-5. As a result, a positive correlation was seen with both K-PC-PTSD-5 and BSI-18. Fourth, a hierarchical multiple regression was performed to examine whether the Korean Version of PCL-5 predicts future PTSD, depression, anxiety, and somatization. As a result, the Korean Version of PCL-5 measured at time 1 significantly predicted PTSD, depression, anxiety, and somatization symptoms at time 2. Fifth, by analyzing the ROC curve, the discriminant power of PCL-5 for screening PTSD symptom groups was confirmed, and the best cut-off score was suggested. As a result of the longitudinal validation of Korean version of PCL-5, it was found that this scale is a reliable and valid measure for Korean adults. By looking into the predictive validity of the scale, it was found that the Korean version of PCL-5 can predict not only PTSD symptoms but also PTSD-related symptoms such as depression, anxiety, and somatization. Also, this study differs from previous validation studies measuring PTSD symptoms in that it suggested a cut-off score to help differentiate PTSD symptom groups.

• Anxiety and mood
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• v.14 no.1
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• pp.44-52
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• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.676-687
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• 2020

Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.