• Title/Summary/Keyword: Pressure injuries

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Effects of Red Koji-Fermented Bupleuri Radix Extracts on Lipopolysaccharide-Induced Rat Acute Lung Injury (홍국발효 시호(柴胡)가 Lipopolysaccharide로 유발된 급성 폐 손상에 미치는 영향)

  • Seo, Young-ho;Jung, Tae-young;Kim, Jong-dea;Choi, Hae-yun
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.21-44
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    • 2021
  • Objective : This study aimed to assess the preventive effect of Bupleuri Radix aqueous extracts (BR) and red koji-fermented BR (fBR) in lipopolysaccharide (LPS)-induced acute lung injury in a rat model. Methods : Rats were administered 30, 60, or 120 mg/kg/day of fBR for 28 days before LPS treatments. All rats were sacrificed 5 h after LPS treatment (500 ㎍/head, intratracheal instillation). Body weights, lung weights, pulmonary transcapillary albumin transit, arterial gas parameters (pH, partial pressure [Pa] of O2, PaCO2), bronchoalveolar lavage fluid (BALF) protein, lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), total cell numbers, neutrophil/alveolar macrophage ratios, lung malondialdehyde (MDA), and myeloperoxidase (MPO) were measured. In addition, histopathological changes including the luminal surface of alveoli (LSA), thickness of alveolar septum, and number of polymorphonuclear neutrophils (PMNs) were checked. Results : LPS injection led to increases in lung weights, pulmonary transcapillary albumin transit, BALF protein, LDH, TNF-α and IL-1β contents, total cells, neutrophil and alveolar macrophage ratios, lung MDA, MPO, alveolar septum thickness, and PMNs, and decreases in PaCO2 and pH of arterial blood and LSA. However, these LPS-induced acute lung injuries were inhibited by pretreatment of 30, 60, and 120 mg/kg of fBR. The most favorable effects were seen with 30 mg/kg fBR as compared with 60 mg/kg of α-lipoic acid and BR. Conclusions : fBR showed preventive effects on LPS-induced acute lung injury, which resembles acute respiratory distress syndrome. The mechanisms of action were likely via antioxidant and anti-inflammatory means.

A Wearable Glove System for Rehabilitation of Finger Injured Patients (손가락 부상 환자의 재활을 위한 장갑형 웨어러블 시스템)

  • Ji-Hun Seong;Hyun-Jin Choi
    • The Journal of the Korea institute of electronic communication sciences
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    • v.18 no.2
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    • pp.379-386
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    • 2023
  • When patients suffer from finger injuries, their finger joints can become stiff and inflexible due to decreased ability to exercise the finger tendons. This can lead to a loss of strength and difficulty using their hands. To address this, it is important to provide patients with consistent rehabilitation treatment that can help restore finger flexibility and strength simultaneously. In this study, we propose wearable gloves that use FSRs (force sensitive resistors) for finger strength training. The glove is designed to be adjustable using rubber bands and a custom PCB is designed for signal acquisition. For the evaluation of finger strength training, the result was analyzed in four cases. We suggest a vector that represents the center of five finger forces, and the result shows that the vector can indicate the level of force balance.

Design of Polymer Composites for Effective Shockwave Attenuation (충격파 완화 복합재의 설계)

  • Gyeongmin Park;Seungrae Cho;Hyejin Kim;Jaejun Lee
    • Composites Research
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    • v.37 no.1
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    • pp.21-31
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    • 2024
  • This review paper investigates the use of shockwave attenuating materials within composite structures to enhance personnel protection against blast-induced traumatic brain injury (bTBI). This paper also introduces experimental methodologies exploited in the generation and measurement of shockwaves to evaluate the performance of the shock dissipating composites. The generation of shockwaves is elucidated through diverse approaches such as high-energy explosives, shock tubes, lasers, and laser-flyer techniques. Evaluation of shockwave propagation and attenuation involves the utilization of cutting-edge techniques, including piezoelectric, interferometer, electromagnetic induction, and streak camera methods. This paper investigates phase-separated materials, including polyurea and ionic liquids, and provides insight into composite structures in the quest for shockwave pressure attenuation. By synthesizing and analyzing the findings from these experimental approaches, this review aims to contribute valuable insights to the advancement of protective measures against blast-induced traumatic brain injuries.

The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study

  • Myung Jin Jang;Woo Sung Choi;Jung Nam Lee;Won Bin Park
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.106-113
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    • 2024
  • Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

Predictors of massive transfusion protocols activation in patients with trauma in Korea: a systematic review

  • Dongmin Seo;Inhae Heo;Juhong Park;Junsik Kwon;Hye-min Sohn;Kyoungwon Jung
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.97-105
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    • 2024
  • Purpose: Massive transfusion protocols (MTPs) implementation improves clinical outcomes of the patient's resuscitation with hemorrhagic trauma. Various predictive scoring system have been used and studied worldwide to improve clinical decision. However, such research has not yet been studied in Korea. This systematic review aimed to assess the predictors of MTPs activation in patients with trauma in Korea. Methods: The PubMed, Embase, Cochrane Library, Research Information Sharing Service databases, KoreaMed, and KMbase were searched from November 2022. All studies conducted in Korea that utilized predictors of MTPs activation in adult patients with trauma were included. Results: Ten articles were eligible for analysis, and the predictors were assessed. Clinical assessments such as systolic and diastolic blood pressure, shock index (SI), prehospital modified SI, modified early warning system (MEWS) and reverse SI multiplied by the Glasgow Coma Scale (rSIG) were used. Laboratory values such as lactate level, fibrinogen degradation product/fibrinogen ratio, and rotational thromboelastometry (ROTEM) were used. Imaging examinations such as pelvic bleeding score were used as predictors of MTPs activation. Conclusions: Our systematic review identified predictors of MTPs activation in patients with trauma in Korea; predictions were performed using tools that requires clinical assessments, laboratory values or imaging examinations only. Among them, ROTEM, rSIG, MEWS, SI, and lactate level showed good effects for predictions of MTPs activation. The application of predictors for MTP's activation should be individualized based on hospital resource and skill set, also should be performed as a clinical decision supporting tools.

Integrated Effect of Non-Invasive Neuromodulation on Bladder Capacity in Traumatic Spinal Cord Injury Patient: Single Case Report

  • Priyanka Dangi;Narkeesh Arumugam;Dinesh Suman
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.86-94
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    • 2024
  • Objective: To evaluate the changes in bladder capacity and storage through non-invasive neuromodulation by application of repetitive Trans magnetic stimulation (rTMS) and genital nerve stimulation (GNS) in traumatic spinal cord survivors. Design: A Single Case Study. Method: The Patient was registered in trail with the clinical trial registry of India (CTRI/2022/05/042431). The Patient was interposed with rTMS on lumbar area, from T11-L4 vertebrae with 1 Hz and the intensity was 20% below that elicited local paraspinal muscular contraction for 13 minutes. GNS was placed over dorsum of the penis with the cathode at the base and anode 2 cm distally at 20 Hz, 200 microseconds, Continuous and biphasic current was delivered and amplitude of stimulation necessary to elicit the genito-anal reflex. For assessment, Neurological examination was done for peri-anal sensation (PAS), voluntary anal contraction (VAC) and bulbocavernous reflex (BCR), deep anal pressure (DAP), and American Spinal Injury Association Impairment Scale (ASIA scale). Outcome assessment was done using Urodynamics, Spinal Cord Independence Measure Scale Version-III (SCIM-III), American Spinal Injury Association Impairment Score (ASIA Score), Beck's Depression Inventory Scale (BDI). The baseline evaluation was taken on Day 0 and on Day 30. Results: The pre-and post-data were collected through ASIA score, SCIM-III, BDI and Urodynamics test which showed significant improvement in bladder capacity and storage outcomes in the urodynamics study across the span of 4 weeks. Conclusion: rTMS along with GNS showed improvement in bladder capacity & storage, on sensory-motor score, in functional independence of individual after SCI.

The Effect of the Active Release Technique on Balance and Functional Movement in Youth Basketball Players

  • Kwang-Nam Kim;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.1-15
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    • 2024
  • Background: This study was conducted to apply active release techniques to male youth basketball players to help improve physical development and damage prevention and improve performance through improved balance and functional movement. Design: Randomized control trial. Methods: The subjects included 33 youth basketball players who were randomly assigned to the experimental group (n=17) and the control group (n=16). For the experimental group, the active release technique was applied to the hip muscles, calf muscles, posterior thigh muscles based on the distribution of injuries surveyed in youth basketball players in the Korean Basksetball League. The Y-balance test and the functional reach test (FRT) were used to assess balance and the Functional Movement Screen (FMS) was used to assess functional movement. Interventions were conducted twice a week for 4 weeks at 40 minutes per session. The experimental group was the active release technique group, and static stretching, a common exercise therapy technique, and self-myofascial release using a foam roller were applied for 20 minutes. The control group received general exercise therapy and placebo active release technique. The placebo active release technique applies pressure only. results:The experimental group showed a greater improvement in balance, as evidenced by the FRT, compared to the control group, which received general exercise treatment. However, there was no statistically significant difference in improvement between the 2 groups. In the case of the experimental group, the difference in the Y balance test before and after the intervention was larger than that of the control group, but there was no statistically significant difference. Significant improvement was found in functional movement, as evidence by the FMS, for the trunk stability test (p < 0.05), in-line lunge test (p < 0.05), rotational stability test (p < 0.05), total score (p < 0.05). Conclusion: In this study, the active release technique improved the balance and functional movement of young basketball players more than general exercise therapy. The application of the active release technique is therefore expected to assist in physical development, prevent damage, and improve the performance of youth basketball players.

Nonoperative Management of Blunt Liver Trauma (둔상성 간 손상환자의 비수술적 치료)

  • Baik, Jung Ju;Kim, Jung Il;Choi, Seung Ho;Choi, Young Cheol;Jun, Si Youl;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.161-171
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    • 2005
  • Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

The Effect of Jaeumgeonbitang adding Evodiae Fructus Extract on the Cerebral Hemodynamics in Rats (자음건비탕가오수유(滋陰健脾湯加吳茱萸) 추출물이 흰쥐의 뇌혈류역학에 미치는 영향)

  • Kong, Kyunghee;Lee, Eunkyoung;Lee, Giseung;Jeong, Hyunwoo;Chong, Myongsoo
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.155-170
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    • 2015
  • Objective : Jaeumgeonbitang have been used in Korean medicine for many centuries as a therapuetic agent of vertigo. JAE was extract of Jaeumgeonbitang adding Evodiae Fructus. The effects of JAE on the cerebral blood flow and blood pressure is not known. This study was designed to investigate the effects of JAE on the ischemic crebral injuries. Method : We performed to investigate effects of JAE on the changes of regional cerebral blood flow(rCBF) and mean arterial blood pressure (MABP) in normal and ischemic rats, and further to determine the mechanism and cytokines production ($IL-1{\beta}$, $TNF-{\alpha}$, IL-10, $TGF-{\beta}$) of JAE. Results : In normal rats, JAE significantly increased rCBF and significantly decreased MABP in a dose-dependent manner. This result suggested that JAE significantly increased rCBF by dilating pial arterial diameter. Increase of JAE-induced rCBF was significantly inhibited by the pretreatment with indomethacin (1 mg/kg, i.p.), an inhibitor of cyclooxygenase, and was significantly inhibited by methylene blue ($10{\mu}g/kg$, i.p.), an inhibitor of guanylate cyclase. Decrease of JAE-induced MABP was significantly increased by the pretreatment with indomethacin (1 mg/kg, i.p.), an inhibitor of cyclooxygenase. So, these results suggested that the mechanism of JAE was mediated by cyclooxygenase. In ischemic rat, the rCBF was significantly and stably increased by JAE (10 mg/kg, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in Control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after reperfusion, Sample group (JAE 10 mg/kg treated group) was significantly decreased $IL-1{\beta}$ and $TNF-{\alpha}$ production compared with Control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after reperfusion, Sample group was significantly increased IL-10 production compared with Control group. Conclusion : These results suggested that JAE was significantly and stably increased regional cerebral blood flow by inhibited $IL-1{\beta}$ and $TNF-{\alpha}$ production, and increased IL-10 production.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.