• Title/Summary/Keyword: Trauma exposure

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The Effect of Resilience on Posttraumatic Stress Disorder Symptoms and Comorbid Symptoms in Firefighters (강원지역 소방관에서 외상후 스트레스 증상 및 동반증상에 미치는 리질리언스의 영향)

  • Lee, Hong-Eui;Kang, Suk-Hoon;Ye, Byoung Seok;Choi, Jong-Hyuck
    • Anxiety and mood
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    • v.8 no.2
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    • pp.86-92
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    • 2012
  • Objective : This study investigated the relationship between the resilience and posttraumatic stress symptoms, as well as comorbid symptoms in firefighters. Methods : We collected 764 firefighters, who worked at six fire department stations in Gangwon-do. We investigated the impact of event scale-revised (IES-R), the life events checklists (LEC), Connor-Davidson resilience scale (CD-RISC), Beck depression inventory (BDI), state trait anxiety inventory (STAI) and alcohol use disorder identification test (AUDIT). Full PTSD groups, partial PTSD groups and non-PTSD groups, which were classified by IES-R scores, were compared in the LEC, CD-RISC, BDI, STAI and AUDIT, ; multiple linear regression analyses were done for independent predictors of variables. Results : Of the 764 firefighters, there were significant differences in LEC (p<0.001), CD-RISC (p<0.001), BDI (p<0.001), and AUDIT (p=0.001) among the full PTSD groups, partial PTSD groups and non-PTSD groups. However, STAI did not show significant difference among three groups. In multiple regression analysis, CD-RISC (${\beta}=-0.168$, p<0.001), LEC (${\beta}=0.211$, p<0.001) and AUDIT (${\beta}=0.115$, p=0.001) were significant predictors for IES-R. Conclusion : The results of the present study suggested that resilience might be a protective factor in PTSD and comorbid symptoms of PTSD.

3D Printed Titanium Implant for the Skull Reconstruction: A Preliminary Case Study

  • Choi, Jong-Woo;Ahn, Jae-Sung
    • Journal of International Society for Simulation Surgery
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    • v.1 no.2
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    • pp.99-102
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    • 2014
  • The skull defect can be made after the trauma, oncologic problems or neurosurgery. The skull reconstruction has been the challenging issue in craniofacial fields for a long time. So far the skull reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for skull reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile various types of allogenic and alloplastic materials have been also used. However, skull reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original skull anatomy as possible using the 3D printed titanium implant, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we fabricated Titanium implant to reconstruct three-dimensional orbital structure in advance, using the 3D printer. This prefabricated Titanium-implant was then inserted onto the defected skull and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.

ORTHODONTIC TRACTION OF IMPACED CENTRAL INCISOR WITH DILACERATED ROOT (만곡된 치근을 가진 상악 중절치의 교정적 견인을 이용한 치험례)

  • Kim, Young-Jin;Park, Ho-Won;Lee, Ju-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.437-443
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    • 2005
  • Dilaceration is most common in maxillary central incisor. Impaction by dilacerated tooth cause orthodontic problem such as tilting of adjacent tooth, midline deviation. Dilaceration is caused by trauma, cyst, other origin and tooth shape, degree of root curvature, location in the alveolar bone, ability of spontaneous eruption should be considered whether treat or not. Labially and lingually dilacerated tooth is difficult to spontaneous eruption. Thus, Prosthetic treatment alternative with extraction, auto transplantation, orthodontic traction with surgical exposure is included within the treatment alternative. These cases are about impacted central incisor with dilacerated root. We use closed eruption technique and guide impacted tooth into normal position by orthodontic traction.

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A Case Study of the Effects of Posttraumatic Stress Disorder on Operational Fire Service Personnel Within the Lancashire Fire and Rescue Service

  • Khan, Khalid;Charters, Jonathan;Graham, Tony L.;Nasriani, Hamid R.;Ndlovu, Shephard;Mai, Jianqiang
    • Safety and Health at Work
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    • v.9 no.3
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    • pp.277-289
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    • 2018
  • Background: Lancashire Fire and Rescue Service (LFRS), the subject of this evaluative research document employs 1400 people. 80% of employees are operational firefighters and officers whom operate across a range of duty systems and support functions, providing prevention, protection and emergency response to the communities of Lancashire. Methods: The overarching purpose of this epidemiological study is to assess the prevalence of posttraumatic stress disorder (PTSD) amongst operational LFRS personnel and to analyse the effects upon those who may be suffering from it, whether brought about by a single traumatic event or by repeated exposure to traumatic occurrences over a period of time. A combination of primary and secondary research was carried out. Primary data was collated using two recognised clinical questionnaires and statistical analysis was conducted with the aid of the software package SPSS. Results: The findings and statistical analysis showed that out of the 100 people surveyed, 30% of respondents had signs of probable distress. Of this quota, 4% showed symptoms of PTSD. The study considers how an organisation can recognise and manage PTSD and provides recommendations to assist in better recognising and managing the associated risks. Conclusion: Based upon the findings, the authors conclude that the level of PTSD within LFRS is slightly lower than those found in other studies undertaken within the Fire and Rescue Service sector. The paper provides recommendations for future studies and a series of actions for consideration by LFRS senior management to improve PTSD support services for employees.

Ultrasound-Guided Closed Reduction of Nasal Bone Fracture (초음파를 이용한 비골 골절의 비관혈적 정복술)

  • Yang, Hyung Eun;Park, Eun Soo;Cha, Jang Gyu;Kim, Cheol Han;Kim, Jun Hyuk;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.461-465
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    • 2007
  • Purpose: Nasal bone fracture may be the most common fracture among facial trauma. However, diagnosis and treatment tend to be overlooked while the reduction and maintenance of fragments remain complicated. Thus, the results are plagued with high rate of nasal deformity which leads cosmetic and functional discomfort. We took advantage of the fact that the nasal bone is one of the thinnest facial bone while at the same time being located close to the skin and utilized ultrasound in performing reduction of nasal bone. Methods:This method was performed on 25 patients with nasal bone fracture. The CL 15-7 linear array transducer (10-15MHz) ultrasound which provides a total of 7 views (3 axial views and 4 transverse views) of the elevator under the bony fragments was enough for the surgeon to accurately perform the reduction. Results: In our class, an accurate and precise reduction has been made possible by real time images before, during, and after the procedure with the help of ultrasound while reducing the exposure to radiation. Conclusion: Compared to previous methods, satisfaction of patients has increased in the nasal tip, minimal fracture of the side wall and secondary reduction cases. Therefore, the incorporation of ultrasound in the closed reduction of nasal bone may prove to be a useful method.

Reconstruction of hand using anterolateral thigh fascial free flap (전외측대퇴근막 유리피판술을 이용한 수부의 재건)

  • Kim, Ki Wan;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.571-577
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    • 2009
  • Purpose: The Provision of thin and pliable tissue and the adequate coverage of tendon - gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report will discuss our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand. Methods: Between February 2004 and August 2008, seven patients with full - thickness soft tissue defects of the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma (n=5), scar contracture (n=1) and necrosis due to ischemia (n=1). Flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split - thickness skin graft was performed. Result: All flaps survived completely. The size of the transferred flap ranged from $2{\times}4cm$ to $5{\times}8cm$. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed. Conclusion: The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon - gliding mechanism, minimal bulk, minimal donor site morbidity. The disadvantages of this technique were the need for a skin graft and the muscle herniation of donor site.

Evaluation of the accuracy of mobile cone-beam computed tomography after spinal instrumentation surgery

  • Eom, Ki Seong;Park, Eun Sung;Kim, Dae Won;Park, Jong Tae;Yoon, Kwon-Ha
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.12-18
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    • 2022
  • Purpose: Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7-S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.

A Study on the Necessity of Psychological First Aid for Firefighters (소방공무원의 심리적 응급처치 필요성에 관한 연구)

  • Ju-Hyun Kim;Sang-Hyuk Park
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.5
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    • pp.385-390
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    • 2023
  • The purpose of this study is to study the need for psychological first aid for stress of fire officials. a 1:1 in-depth interview with 10 paramedics to solve the research problem. Through interviews, the policy on the need for psychological first aid to improve the mental health of firefighters was proposed as follows by analyzing the working environment of paramedics, post-traumatic stress experience, and psychological first aid experience. First, fire officials need to be assigned to the site to educate in advance about post-traumatic stress and the resulting physical symptoms before being exposed to traumatic events. Second, fire officials should provide psychological first aid at an appropriate time after exposure to trauma cases. Third, it is necessary to supplement the manpower and institutional devices that will specialize in mental health work. Fourth, for customized professional medical services and psychological support suitable for fire officials, it is necessary to link fire-fighting complex healing centers and national firefighting hospitals.

TRAUMATIC INJURIES TO THE UPPER INCISORS IN PRIMARY AND MIXED DENTITION (유치열과 혼합치열기 어린이의 상악 절치부 외상)

  • Chung, Chu-Hyun;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.290-298
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    • 2004
  • In children, change in lifestyles such as an increase in participation of physical activities has increased the chance of receiving an injury, harming the child and their parents. This study was carried out to give basic information of traumatic injuries to the upper anterior teeth which can be used in prevention of future complications that may arise. From June, 2002 to May, 2003, of the 8,799 children in their primary and mixed dentition visiting Department of Pediatric Dentistry, College of Dentistry, Yonsei University 955 upper anterior teeth(primary 543, permanent 412) of 487 children(male 316, female 171) with traumatic injures to the upper incisors were studied. The results were as follows: 1. Trauma to the primary teeth prevailed at the age of 1-3 and to the permanent teeth at the age of 7. The male to female ratio was 1.85:1. 2. Trauma to the upper incisors for both the primary and permanent teeth occurred in the afternoon. Primary teeth were injured most frequently in the home(44.1%) and the permanent teeth outdoors, in the street(17.5%). 3. Both the primary and permanent teeth were most injured by fall-down injuries(39.8%, 12.9%), and next were collisions(22.2%, 6.0%). For the primary teeth, high fall, traffic accident, violence and sports are next in order, and for the permanent teeth, violence, sorts, traffic accidents were next. 4. Average number of 1.6 primary teeth and 2.8 permanent teeth were injured with the right central incisor most prevailing. 5. Crown fracture without pulpal exposure and subluxation injures were highest in frequency in both the primary and permanent teeth.

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Effect of 4-hexylresorcinol on Blood Coagulation and Healing of Injured Vessel in a Rat Model

  • Park, Yong-Tae;Park, Si-Yeok;Kim, Min-Keun;Kim, Seong-Gon;Park, Young-Wook;Kwon, Kwang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.284-293
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    • 2013
  • Purpose: For reconstruction of craniomaxillofacial defects caused by tumor, trauma, infection etc, free flap transplantation with microvascular surgery is a very useful method. Thrombus formation at the anastomosis site is the major cause of graft failure. 4-Hexylresorcinol (4-HR) is generally known as an antiseptic and antiparasitic agent. This study was conducted in order to evaluate the effect of 4-HR on blood coagulation in vitro. In addition, we investigated thrombus formation and endothelial repair of an injured vessel in an animal model. Methods: In the in vitro experiment, we compared blood coagulation time between the 4-HR treated group and normal blood. Thirty rats were used for in vivo animal experiments. After exposure of the right femoral vein, a micro vessel clamp was placed and the femoral vein was intentionally cut. Microvascular anastomosis was performed on all rats using 10-0 nylon under microscopy. The animals were divided into two groups. In the experimental group (n=15), 4-HR (250 mg/kg) mixed with olive oil (10 mL/kg) was administered per os daily. Animals in the control group (n=15) were given olive oil only. The animals were sacrificed at three days, seven days, and fourteen days after surgery and rat femoral vein samples were taken. Vascular patency and thrombus formation were investigated just before sacrifice. Histologic analysis was performed under a microscope. Results: Results of an in vitro blood coagulation test showed that coagulation time was delayed in the 4-HR treated group. The results obtained from an in vivo 4-HR administered rat model showed that the patency of all experimental groups was better at thirty minutes, seven days, and fourteen days after microvascular anastomosis than that of the control group at seven and fourteen days after anastomosis, and the amount of thrombus in the experimental groups was much less than that of the control group. Endothelial repair was observed in the histologic analysis. Conclusion: Findings of this study demonstrated that blood coagulation was delayed in the vitro 4-HR treated group. In addition, good vascular patency, anti-thrombotic effect, and repair of venous endothelial cells were observed in the vivo 4-HR administered rat group.