• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.649-656
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• 2020

Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

• Korean Journal of Ecology and Environment
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• v.36 no.1 s.102
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• pp.29-37
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• 2003

Benthic macro-invertebrates were seasonally collected in the Onchen Stream in Pusan, from July 2001 to March 2002. Generally 4 phylum 5 class 10 order 19 family 23 species were observed in the study sites. Ephemeroptera, Plecoptera and various species appeared in headwater stream while Oligochaeta and Chironomidae were dominated in downstream sites. Community abundance patterns, especially the dominant taxa, Oligochaeta and Chironomidae, appeared to be different depending upon the sampling months. Oligochaeta was usually observed in July, December and March while Chironomidae was appeared in September. The biological indices, TBI(Trent Biotic Index), BS (Biotic Score), BMWP (Biological Monitoring Working Party)were calculated with the appeared communities of the sampling sites through the survey months. TBI showed 1 to 8, BMWP was 1 to 93 and CBI appeared 9 to 387 in the different sites. The biological indices decreased from headstream to downstream sites, We implemented the unsupervised Kohonen network for patterning of community abundance of the sampling sites. The patterning map by the Kohonen network was well represented community abundance of the sampling sites. Also, we conducted RTRN (Real Time Recurrent Neural Network) for predicting of the biological indices in the different sites. The results appeared that the predicting values by RTRN were well matched field data (correlation coefficient of TBI, BMWP and CBI were 0.957, 0.979 and 0.967, respectively).

• Radiation Oncology Journal
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• v.17 no.2
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• pp.146-150
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• 1999

Myasthenia gravis (MG) is relatively rare ouuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150$\~$180 cGy consisting of 10 cGy per fraction, three times a week, for 5~e weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4$\~$6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy.

• Journal of Korean Neurosurgical Society
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• v.38 no.3
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• pp.215-220
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• 2005

Objective : Many researchers believe that the hypothermia shows neuro-protective effect on brain injury. To understand the molecular mechanism of the hypothermic treatment, this study investigated its effects on the expression of cell death or survival related proteins such as p53, Bcl-2 and Bax in the rat traumatic brain injury[TBI] model. Methods : Twenty rats [Spraque Dawley, $200{\sim}250g$] were subjected to the brain injury of moderate severity [$2.4{\sim}2.6atm$] using the fluid percussion injury device and five rats were received only same surgery as controls. During 30minutes after the brain injury, the hypothermia group was maintained the body temperature around $34^{\circ}C$ while the control group were maintained that of $36^{\circ}C$. Five rats in each group were sacrificed 12h or 24h after brain injury and their brain sections was analyzed for physical damages by H-E stains and the extent of apoptosis by TUNEL assay and immunohistochemical stains. The tissue damage after TBI was mainly observed in the ipsilateral cortex and partly in the hippocampus. Results : Apoptosis was observed by TUNEL assay and the Bax protein was detected in both sample which harvested 12h and 24h after TBI. In the hypothermia treatment group, tissue damage and apoptosis were reduced in HE stains and TUNEL assay. In hypothermia treatment group rat shows more expression of the Bcl-2 protein and shows less expression of the Bax protein, at both 12h and 24h after TBI. Conclusion : These results show that the hypothermia treatment is an effective treatment after TBI, by reducing the apoptotic process. Therefore, it could be suggested that hypothermia has a high therapeutic value for treating tissue damages after TBI.

• Journal of Korean Neurosurgical Society
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• v.66 no.5
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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.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.6-11
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• 2003

목적 : 전신방사선조사(TBI)시 균등한 선량을 조사할 목적으로 사용되는 각 신체부위별 보상체(compensator) 두께의 결정은 열형광선량계(TLD)를 이용하여 표면선량(surface dose)을 측정하고, 심부선량(depth dose)으로 환산하는 방법을 주로 이용한다. 그러나 이와 같은 방법은 골(bone) 조직에 대한 선량감쇠(dose attenuation)의 영향이 고려되지 않아 신체중심부에서의 정확한 심부선량을 알 수가 없다. 이에 본 연구

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.2
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• pp.165-171
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• 2020

Ischemic and traumatic brain injuries are the major acute central nervous system disorders that need to be adequately diagnosed and treated. To find biomarkers for these acute brain injuries, plasma levels of some specialized pro-resolving mediators (SPMs, i.e., lipoxin A4 [LXA4], resolvin [Rv] E1, RvE2, RvD1 and RvD2), CD59 and interleukin (IL)-6 were measured at 0, 6, 24, 72, and 168 h after global cerebral ischemic (GCI) and traumatic brain injuries (TBI) in rats. Plasma LXA4 levels tended to increase at 24 and 72 h after GCI. Plasma RvE1, RvE2, RvD1, and RvD2 levels showed a biphasic response to GCI; a significant decrease at 6 h with a return to the levels of the sham group at 24 h, and again a decrease at 72 h. Plasma CD59 levels increased at 6 and 24 h post-GCI, and returned to basal levels at 72 h post-GCI. For TBI, plasma LXA4 levels tended to decrease, while RvE1, RvE2, RvD1, and RvD2 showed barely significant changes. Plasma IL-6 levels were significantly increased after GCI and TBI, but with different time courses. These results show that plasma LXA4, RvE1, RvE2, RvD1, RvD2, and CD59 levels display differential responses to GCI and TBI, and need to be evaluated for their usefulness as biomarkers.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.631-639
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• 2020

Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

• The Korean Journal of Health Service Management
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• v.4 no.2
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• pp.63-72
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• 2010

The present study purposed to prevent oral diseases and to improve oral health in children. For this purpose, we selected 70 cases who are 5~7 years old preschoolers at the kindergarten affiliated to G College in Gyeongsangbukdo, and analyzed the general patterns of oral care and the relation of the patterns with dental plaque and deciduous dental caries in the children. Specifically, we conducted oral examination and applied pit and fissure sealant according to the eruption of deciduous molar and first molar. In addition, we executed the 1st and 2nd tooth brushing instruction (TBI), and surveyed S-OHI and PHP twice. Excluding 14 preschoolers who did not appear in the 2nd survey, we performed the study with 56 preschoolers and drew conclusions as follows. 1. The number of decayed or missed or filled teeth among deciduous teeth was 3 or more in 42.9% of female children, and 46.4% of male children, so male children showed a slightly higher rate. 2. The degree of dental plaque formation was $1.64{\pm}1.22$ among the surveyed children. 3. The oral health index was lower after TBI than before in all the children (P<.001). 4. Change in the oral health index was particularly larger in 7 year old female children (p<.005). 5. The patient hygiene performance index was lower after TBI than before in both the buccal surface and lingual surface of the children (p<.005). 6. The patient hygiene performance index was lower after TBI than before in all of male children's teeth except the right maxillary first deciduous molar (p<.001).

• Korean Journal of Biological Psychiatry
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• v.9 no.2
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• pp.120-128
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• 2002

Objectives:The purpose of this study was to develop a cognitive rehabilitation program and to investigate the effect of the program that restores the deficiency of memory, which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients. Methods:Sixteen TBI patients participated in this study. The inclusion criteria were : 1) aged 18 to 60 ; 2) higher than IQ 80 ; 3) lower than MMSE-K 25 and K-MAS(Korean version of Memory Assessment Scale) 85. We administered our program to an experimental group(N=8) in order to improve attention and memory for 4 weeks(total 12 section). Our program was not administrated to a control group(N=8) for 4 weeks. After administrating this program, we measured MMSE-K and K-MAS for the experimental and control groups. Results:The findings of the study were as follows. 1) the experimental group showed significant improvement on MMSE-K score in comparison with baseline, but the control group did not. 2) the experimental group showed significant improvement on K-MAS score in comparison with baseline, but the control group did not. In particular, among the three subscales of K-MAS, only verbal memory scale revealed significant improvement, while visual and short-term memory scales revealed no differences. Conclusion:Our cognitive rehabilitation program improves cognitive state and memory, particulary verbal memory, for TBI patients. These results imply that our program aids in rehabilitation of basic cognition such as memory which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients.