• Title/Summary/Keyword: Trauma Intensity

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Mediating Effect of Meaning of Life Moderated by Trauma Intensity on Deliberate Rumination of the Traumatic Experience and Post-traumatic Growth (외상에 대한 의도적 반추와 외상 후 성장의 관계에서 외상 강도에 의해 조절된 삶의 의미의 매개효과)

  • Ryu, Ji-Hyun;Suh, Kyung-Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.1
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    • pp.535-544
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    • 2022
  • This study identified the relationship between deliberate rumination of adults who experienced traumas and post-traumatic growth, and examined the mediating model of meaning of life moderated by trauma intensity on deliberate rumination and post-traumatic growth. Participants were 318 male and female adults who experienced traumas. The moderated mediating effect was analysed with PROCESS Macro 3.5 Model 7. Results revealed that deliberate rumination of adults who experienced traumas was positively correlated with trauma intensity, meaning of life, and post-traumatic growth, while meaning of life was positively correlated with post-traumatic growth. In a moderated mediating model for post-traumatic growth, there was significant interaction effect of deliberate rumination and trauma intensity; conditionally indirect effect of deliberate rumination was only significant for whose trauma intensity were high. These findings suggest that adults who did deliberate rumination are more likely to experience post-traumatic growth with finding meaning of life. And, the moderating effect suggests that this influence is only with higher levels of trauma intensity. In conclusion, deliberate rumination of severe traumatic event may lead to post-traumatic growth, and it can be helpful to experience the meaning of life in the process.

A Case of Traumatic Cervical Braun-Sequard Syndrome

  • Cho, Dae Hyun;Lee, Seung Hwan;Lee, Jae Gil;Jung, Myung Jae
    • Journal of Trauma and Injury
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    • v.30 no.3
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    • pp.103-106
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    • 2017
  • A traumatic Braun-Sequard syndrome of the cervical spine is reported in a 53-year-old male. The patient recovered spontaneously over several days with surgical intervention. The diagnosis was made on magnetic resonance imaging with physical examination, which also demonstrated subsequent resolution of bone marrow intensity. The etiological factors of spinal Braun-Sequard syndrome are reviewed.

Does Intramedullary Signal Intensity on MRI Affect the Surgical Outcomes of Patients with Ossification of Posterior Longitudinal Ligament?

  • Choi, Jae Hyuk;Shin, Jun Jae;Kim, Tae Hong;Shin, Hyung Shik;Hwang, Yong Soon;Park, Sang Keun
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.121-129
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    • 2014
  • Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

Delayed Post-Traumatic Spinal Cord Infarction with Quadriplegia: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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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.

Daily Functioning in Chronic Pain: Study of Structural Relations with Posttraumatic Stress Disorder Symptoms, Pain Intensity, and Pain Avoidance

  • Cho, Sung-Kun;Heiby, Elaine M.;McCracken, Lance M.;Moon, Dong-Eon;Lee, Jang-Han
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.13-21
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    • 2011
  • Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. Results: The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. Conclusions: Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.

Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report

  • Yusuke Tabata;Shuhei Matsui;Masabumi Miyamoto;Koichiro Omori;Yoichiro Tabata;Tokifumi Majima
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.212-217
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    • 2023
  • We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma

  • Kwon, Woo-Keun;Oh, Jong-Keon;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo-Han
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.38-42
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    • 2018
  • A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

Ischiorectal Block with Bupivacaine for Post Hemorrhoidectomy Pain

  • Rajabi, Mehdi;Hosseinpour, Mehrdad;Jalalvand, Faranak;Afshar, Mohammad;Moosavi, Golamabbas;Behdad, Samin
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.89-93
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    • 2012
  • Background: Hemorrhoid is one of the most common surgical diseases occurring in the anorectal region. In this study, we evaluated the effect of ischiorectal fossa block on alleviating post hemorrhoidectomy pain. Methods: In this study, 90 patients suffering from hemorrhoids were evaluated. They were randomly divided into 3 groups. The first group had no block, the second group an ischiorectal block with placebo (normal saline), and the third group a preemptive ischiorectal block with bupivacaine. Postoperative variables such as pain intensity, pethidine consumption, nausea, and vomiting were compared between the groups. Results: The postoperative pain score in group 1 was $8.5{\pm}1.3$ and $8.1{\pm}0.9$ (P=NS) in group 2. The post operative analgesic demand was $3.1{\pm}1.5$ and $3.3{\pm}1.8$ hours in groups 1 and 2, respectively (P=NS). The post operative pain score and analgesic demand were $4.2{\pm}2.1$ and $9.3{\pm}2.7$ hours, respectively, in group 3 (P < 0.0001). Conclusions: Preemptive ischiorectal block reduces the posthemorrhoidectomy pain and opioid demand.

Acupuncture for Subacute and Chronic Post-thoracotomy Pain in Patients with Traumatic Multiple Rib Fractures: A Study Protocol for a Randomised-controlled, Two-arm, Parallel Design, Pilot Trial

  • Kim, Kun Hyung;Cho, Hyun Min;Lee, Chan Kyu;Seok, JunePill;Kim, Seon Hee;Kim, Jung-Eun;Shin, Yu Kyung;Kim, Min Kyung
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.95-100
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    • 2018
  • Background: The aim of this study is to assess the feasibility of acupuncture treatment for the management of subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures. Methods: A total of 30 participants who have undergone thoracotomy after traumatic multiple rib fractures will be recruited. Participants will be invited and equally randomised into acupuncture plus usual care and usual care alone groups. A computer-generated random number sequence will be used and concealed using opaque, sealed, sequentially numbered envelopes. Twelve sessions of manual and electrical acupuncture performed by Korean medicine doctors will be provided over a span of 3 months to participants allocated to the acupuncture group. Participants in the usual care group will continue pain medication, exercise and physical therapy as required. Study feasibility will be measured based on the proportion of patients who complete the measurement of pain at 12 or 24 weeks after baseline. The clinical outcomes will include; the average pain intensity over the recent week at rest, movement and cough, quality of life, patient's global assessment of recovery, respiratory function measured by the pulmonary function test and use of pain medication at 4, 8, 12 and 24 weeks after enrolment. Adverse events will be recorded for all participants. Written informed consent will be obtained from all participants. The local ethics committee has approved the study. This pilot trial will inform further studies investigating the potential role of acupuncture for subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures.

Reduction of Inflammation and Enhancement of Motility after Pancreatic Islet Derived Stem Cell Transplantation Following Spinal Cord Injury

  • Karaoz, Erdal;Tepekoy, Filiz;Yilmaz, Irem;Subasi, Cansu;Kabatas, Serdar
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.153-165
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    • 2019
  • Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma and accompanied by elevated levels of inflammation indicators. Stem cell-based therapy is promising some valuable strategies for its functional recovery. Nestin-positive progenitor and/or stem cells (SC) isolated from pancreatic islets (PI) show mesenchymal stem cell (MSC) characteristics. For this reason, we aimed to analyze the effects of rat pancreatic islet derived stem cell (rPI-SC) delivery on functional recovery, as well as the levels of inflammation factors following SCI. Methods : rPI-SCs were isolated, cultured and their MSC characteristics were determined through flow cytometry and immunofluorescence analysis. The experimental rat population was divided into three groups : 1) laminectomy & trauma, 2) laminectomy & trauma & phosphate-buffered saline (PBS), and 3) laminectomy+trauma+SCs. Green fluorescent protein (GFP) labelled rPI-SCs were transplanted into the injured rat spinal cord. Their motilities were evaluated with Basso, Beattie and Bresnahan (BBB) Score. After 4-weeks, spinal cord sections were analyzed for GFP labeled SCs and stained for vimentin, $S100{\beta}$, brain derived neurotrophic factor (BDNF), 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase), vascular endothelial growth factor (VEGF) and proinflammatory (interleukin [IL]-6, transforming growth factor $[TGF]-{\beta}$, macrophage inflammatory protein [MIP]-2, myeloperoxidase [MPO]) and anti-inflammatory (IL-1 receptor antagonis) factors. Results : rPI-SCs were revealed to display MSC characteristics and express neural and glial cell markers including BDNF, glial fibrillary acidic protein (GFAP), fibronectin, microtubule associated protein-2a,b (MAP2a,b), ${\beta}3$-tubulin and nestin as well as anti-inflammatory prostaglandin E2 receptor, EP3. The BBB scores showed significant motor recovery in group 3. GFP-labelled cells were localized on the injury site. In addition, decreased proinflammatory factor levels and increased intensity of anti-inflammatory factors were determined. Conclusion : Transplantation of PI-SCs might be an effective strategy to improve functional recovery following spinal cord trauma.