• The Korean Journal of Physiology
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• v.29 no.2
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• pp.291-299
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• 1995

Lateral giant (LG)-mediated escape response of crayfish is sensitized by natural traumatic events. Such sensitization has previously been shown to be associated with increased transmission between primary afferents and sensory interneurons at the cholinergic synapse of LG escape reflex circuit. In the present study, it was firstly investigated as to whether transmission is also altered at other synapses of the LG-escape reflex circuit by traumatic shock-induced sensitization. Evidence that traumatic shock also directly affects the excitability of lateral giants is now provided by the finding that traumatic shock produces a significant reduction of the time needed for LG to recruit its contralateral homologue, which is defined as commissural delay. Octopamine, a naturally occurring neuromodulator in the crayfish nerve cord, has also been shown to enhance transmission at the cholinergic synapse between primary afferents and sensory interneurons, and has been conjectured to mediate sensitization. Like traumatic shock, $octopamine\;(10^{-5}-5{\times}10^{-4}\;M)$ also enhanced the efficacy of commissural transmission between lateral giants, as indicated by a significant reduction of commissural delay. This effect was blocked by an octopamine antagonist phentolamine, suggesting a specific action of octopamine on the octopamine receptor present on LGs. These observations suggest that both traumatic shocks and octopamine may cause a rather broad alteration in the excitability of the crayfish nervous system that contributes to the sensitization of the LG escape response.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.108-116
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• 2023

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as an adjunct to resuscitation of patients with traumatic shock. However, the effectiveness of REBOA is still debated because of inconsistent indications across centers and the lack of medical records. The purpose of this study was to investigate the effectiveness and feasibility of REBOA by analyzing clinical results from a single center. Methods: This study included 96 patients who underwent REBOA between August 2016 and September 2021 at a regional trauma center according to the center's treatment algorithm for traumatic shock. Medical records, including the time of the decision to conduct the REBOA procedure, time of operation, type of aortic occlusion, and clinical outcomes, were collected prospectively and analyzed retrospectively. Patients were classified by REBOA protocol (group 1, 2, or 3) and survival status (survivor or non-survivor) for analysis. Results: The overall success rate of the procedure was 97.9%, and the survival rate was 32.6%. In survivors, blood pressure was higher than in non-survivors both before the REBOA procedure (p=0.002) and after aortic occlusion (p=0.03). The total aortic occlusion time was significantly shorter (p=0.001) and the proportion of partial aortic occlusion was significantly higher (p=0.014) among the survivors. The non-survivors had more acidosis (p<0.001) and higher lactate concentrations (p<0.001) than the survivors. Conclusion: REBOA may be a feasible bridge therapy for resuscitation of patients with traumatic shock. Prompt and accurate decision-making to perform REBOA followed by damage control surgery could improve survival rates and clinical outcomes.

• Clinical Pain
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• v.19 no.1
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• pp.28-31
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• 2020

The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5~6 to 0~1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.791-797
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• 1993

We evaluated forty cases of traumatic diaphragmatic ruptures that we have experienced from Mar. 1976 to Mar. 1992. Thirty patients were male and 10 were female[M:F=3:1]. The age distribution was ranged from 2 to 76 years with the mean age of 35 years. The traumatic diaphragmatic ruptures were due to blunt trauma in 26 cases[traffic accident 20, fall down 4, others 2] and penetrating trauma in 14 cases[stab wound 13, gun shot 1]. In the blunt trauma, 21 of 26 cases were diagnosed within 24 hours after injury and all cases except one in penetrating trauma were diagnosed within 24 hours. In the blunt trauma, the rupture site was located in the left in 20 cases and in the right in 6 cases. In the penetrating trauma, the rupture site was located in the left in 10 cases and in the right in 4 cases. The repair of 40 cases were performed with thoracic approach in 19 cases, thoracoabdominal approach in 17 cases and abdominal approach in 4 cases. The postoperative mortality was 7.5 %[3/40]. The causes of death were septic shock[1], acute renal failure[1] and hypovolemic shock[1].

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.8
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• pp.3815-3823
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• 2013

The purpose of this study was to closely examine the influence of field-shock experience and post traumatic stress perceived by fire officials upon somatic symptoms and coping methods. A survey was carried out targeting 362 male and female fire officials who are working at fire safety centers where are located in Gangwon-do Province. The collected data were used SPSS 19.0 and AMOS 19.0 for Windows. It carried out frequency analysis, factor analysis for validity and reliability, Cronbach's ${\alpha}$ analysis, descriptive statistics and correlation. For hypothesis verification, an analysis was carried out by using structural equation modeling. All the statistical analyses were set for the significant level in p<.05. The results are as follows. First, the perceived field-shock stress was indicated to have influence upon post traumatic stress. Second, the perceived field-shock stress was indicated to have influence upon somatic symptom. Third, the perceived field-shock stress was indicated to have influence upon a coping method. Fourth, the post traumatic stress was indicated to have influence upon somatic symptom. Fifth, the post traumatic stress was indicated to have influence upon a coping method. Sixthly, the somatic symptom was indicated to have influence upon a method of coping with stress.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.119-125
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• 2021

Purpose: The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings. Methods: We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016. Results: The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group. Conclusions: This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.

• 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.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.162-169
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• 2020

Purpose: There is increasing evidence in the literature regarding resuscitative endovascular balloon occlusion of the aorta (REBOA) globally, but few cases have been reported in Korea. We aimed to describe our experience of successful Zone III REBOA and to discuss its algorithm, techniques, and related complications. Methods: We reviewed consecutive cases who survived from hypovolemic shock after Zone III REBOA placement for 4 years. We reviewed patients' baseline characteristics, physiological status, procedural data, and outcomes. Results: REBOA was performed in 44 patients during the study period, including 10 patients (22.7%) who underwent Zone III REBOA, of whom seven (70%) survived. Only one patient was injured by a penetrating mechanism and survived after cardiopulmonary resuscitation. All patients underwent interventions to stop bleeding immediately after REBOA placement. Conclusions: This case series suggests that Zone III REBOA is a safe and feasible procedure that could be applied to traumatic shock patients with normal FAST findings who receive a chest X-ray examination at the initial resuscitation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2225-2233
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• 2013

This study was designed to identify the extent of incident shock who are in high risk of post traumatic shock stress, and analyze the related factors that affect the extent of incident shock. The subjects are 415 rescue workers from Seoul Metropolitan Fire & Disaster Headquarters, who are in high frequency of fire outbreaks and rescue mobilization. With a reliability of Cronbach's ${\alpha}$=.975, the results show invasion, avoidance, sleep disorder and emotional paralysis, dissociative symptom, hyper arousal as foremost causes respectively. Moreover, the results imply that the extent of incident shock was higher in people with more age or being married. Also, from the occupational perspective, the number of years as fire fighters, as rescue workers, mobilization and experiences at work in proportion to incident shocks has risen exponentially. It is notable that the groups who alleviate stress by consuming liquors had higher extent of incident shock. In conclusion, to deal with groups in high risk, management system and prevention care programs for incident shocks need to be introduced immediately and put into effect.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.90-98
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• 2004

Traumatic brain injury is an insult to the brain caused by an external physical force, that may product a diminished or altered state of consciousness, which results in impairment of cognitive abilities or physical function. The purposes of this study were to overview injury mechanism and neural plasticity of traumatic brain injury. Injury mecanism includes exitotoxicity, production free radical, inflammation and apoptosis. Furthermore traumatic brain injury has protective mechanisms includes production of neural growth factor, heat shock protein, anti-inflammatory cytokines.