• Journal of Trauma and Injury
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• v.21 no.2
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• pp.71-77
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• 2008

Purpose: The Glasgow Coma Scale (GCS), though it is widely used for triage, has been criticized as being unnecessarily complex. Recently, a 3-point Simplified Motor Score (SMS, defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for triage after traumatic brain injury when compared with the GCS as the criterion standard. The purpose of this study was to validate the SMS. Methods: We analyzed the patients who visited Kyungpook National University Hospital emergency center after traumatic brain injury from 2006 January to 2006 June. The test performance of the GCS, its motor component, and SMS relative to three clinically relevant traumatic brain injury outcomes (abnormal brain CT scans, Abbreviated Injury Scale $(AIS){\geq}4$, and mortality) were evaluated with areas under the receiver operating characteristic curves (AUCs). Results: Of 504 patients included in the analysis, 25.6% had an abnormal brain CT scans, 13.1% had $AIS{\geq}4$, and 5.0% died. The AUCs for the GCS, its motor component, and SMS with respect to the abnormal CT scans were 0.776, 0.715, and 0.716, and respectively, those for $AIS{\geq}4$ and mortality, were 0.969, 0.973, and 0.968, and 0.931, 0.909, and 0.909, respectively. Conclusion: The 3-point SMS demonstrated similar test performance when compared with the 15-point GCS score and its motor component for triage after traumatic brain injury in our populations.

• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.190-194
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• 2014

Objective : Post-traumatic stress disorder (PTSD) is a group of diseases that are observed in patients who had experienced a serious trauma or accident. However, some experienced it even after only a mild traumatic brain injury (TBI), and they are easily ignored due to the relatively favorable course of mild TBI. Herein, the authors investigated the incidence of PTSD in mild TBI using brief neuropsychological screening test (PTSD checklist, PCL). Methods : This study was conducted on patients with mild TBI (Glasgow coma scale ${\geq}13$) who were admitted from January 2012 to December 2012. As for PCL, it was done on patients who showed no difficulties in communication upon admission and agreed to participate in this study. By using sum of PCL, the patients were divided into high-risk group and low-risk group. PTSD was diagnosed as the three major symptoms of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth-edifion. Results : A total of 314 TBI patients were admitted and 71 of them met the criteria and were included in this study. The mean age was 52.9 years-old (range : 15--94). The mean PCL score was 28.8 (range : 17--68), and 10 patients were classified as high-risk group. During follow-up, 2 patients (2.7%) of high risk group, were confirmed as PTSD and there was no patient who was suspected of PTSD in the low-risk group (p=0.017). Conclusion : PTSD is observed 2.8% in mild TBI. Although PTSD after mild TBI is rare, PCL could be considered as a useful tool for screening of PTSD after mild TBI.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.804-813
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• 2019

The purpose of this study was to evaluate the effect of Korean medicine in a patient with cognitive impairment, emotional disturbance, and sleep disturbance due to a diffuse axonal injury associated with a traumatic brain injury. The patient was treated with herbal medicine and acupuncture. The treatment effects were evaluated using the Korean version of the Mini-Mental State Examination (MMSE-K) and the Global Detraction Scale (GDS), and by observing clinical symptoms. Improvements in the total scores of MMSE-K and GDS were observed after the Korean medicine treatments; the MMSE-K score increased from 13 to 23 and the GDS score decreased from 5 to 4. The emotional and sleep disturbances were also reduced. These case report findings suggest that Korean medicine may be effective for treating symptoms of diffuse axonal injury in patients with traumatic brain injury.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1272-1280
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• 2018

Introduction: The aim of this study is to report the effect of Ling-Gui-Gan-Zao-Tang (LGGZT) effectively improves anxiety disorder following traumatic brain injury (TBI). Case Presentation: 50-year-old female with traumatic brain injury after falling down from golf cart. After injury, symptoms like anxiety disorder, diarrhea, dizziness, headache were occurred. She took medications like antidepressants, antianxiety drugs and antipsychotic agent, but symptoms deteriorated consistently. After being prescribed LGGZT, patients' symptoms were significantly improved. Result of Impact Event Scale-Revised (IES-R-K) was changed from 24 to 5 and Beck Anxiety Inventory (BAI) was changed from 21 to 3. Also, side effects were not observed during the treatment period. Conclusion: LGGZT can be considered as an effective treatment for anxiety disorder following traumatic brain injury.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.448-454
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• 2018

Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.166-173
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• 2018

Purpose: Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients. Methods: This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient's blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week. Results: A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ${\geq}15$). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups. Conclusions: MIF may be considered as a predictive factor for sepsis in trauma patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.31 no.1
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• pp.38-49
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• 2021

Objectives: This study was conducted to analyze the impact of safety/health managers' experience of trauma case on their post traumatic stress disorder and the mediation effects of job stress and the moderated mediation effects of social support. Method: Using a structured questionnaire, data were collected from 241 workplace safety/health managers with experience in trauma case. The collected data were analyzed using SPSS(IBM. Ver.26.0) and verified through SPSS PROCESS Macro (Ver. 3.4). Results: The trauma case experience and the job stress, which is a mediation variable, had a statistically significant positive effect on post-traumatic stress disorder, and the job stress had a positive mediation effect in the relationship between the trauma case experience and post-traumatic stress disorder. Social support had a statistically significant negative moderation effect in the relationship between the trauma case experience and job stress; social support had a moderated mediation effect on the indirect effect of a job stress on the post-traumatic effect through a trauma case experience. Conclusion: The above findings suggest that work-related job stress management is important in order to reduce safety/health managers' post-traumatic stress disorder caused by the experience of trauma case, and that social support is essential to reduce the job stress, which can later be used as a basis for further studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.2
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• pp.63-70
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• 2021

Objectives: Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. Methods: A total of 156 mothers with children aged 13-18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. Results: Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). Conclusion: Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

• Journal of Korean Critical Care Nursing
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• v.15 no.2
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• pp.50-63
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• 2022

Purpose : This study aimed to identify intensive care units (ICU) nurses' experience of traumatic events, deliberate rumination, self-disclosure, social support, and post-traumatic growth (PTG), and to explore relationships among the variables. Methods : Participants were 157 nurses who have provided direct patient care for six months or more in ICUs at a university hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVAs, Pearson correlations, and multiple linear regressions using the SPSS/WIN version 23.0. Results : The PTG was found to be significantly associated with deliberate rumination (r=0.36, p<.001), self-disclosure (r=0.39, p<.001), and social support (r=0.54, p<.001). Factors that affect PTG significantly were found in the order of social support (𝛽=0.40, p<.001), self-disclosure (𝛽=0.25, p<.001), and deliberate rumination (𝛽=0.24, p<.001). The final regression model explained 40.1% of the variance of PTG (F=26.33, p<.001). Conclusion : The influencing factors identified in this study on PTG, including social support, self-disclosure, and deliberate rumination should be included in programs to promote PTG for ICU nurses who may experience traumatic events repeatedly.

• Journal of People, Plants, and Environment
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• v.24 no.2
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• pp.137-152
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• 2021

Background and objective: This study was carried out to investigate and analyze the preference for plant fragrance and the psychological effects of a agro-healing activity in 101 firefighters aged 39.71 ± 10.94. Methods: For the psychological evaluation, post-traumatic stress symptoms, Korean occupational stress scale short form (KOSS-SF), emotional intelligence, and job satisfaction were surveyed on the Likert scale. For the preference for plant fragrances, 20 ㎕ of commercially available essential oils from four plant species (Mentha spp., Lavandula spp., Citrus limon, C. sinensis) were absorbed into each test paper and provided to the participants. Results: The rate of post-traumatic stress symptoms was high at 37.6% of the firefighters surveyed.. C. limon fragrance had the highest preference among the four plant fragrances, followed by C. sinensis > Mentha spp. > Lavandula spp. with statistically significant difference (F = 14.256, p < .001). The lower their age, income, and position, and higher the education level, the higher the preference for plant fragrances. And the administrative group had higher preference for plant fragrances than field group. In addition, as a result of examining the correlation between job satisfaction, preference for plant fragrance, post-traumatic stress, emotional intelligence, and job stress for fire-fighters, the higher the job satisfaction, the higher the fragrance preference and emotional intelligence, and the lower the post-traumatic stress and job stress. Conclusion: Therefore, installing a garden using botanical fragrances at workplaces that firefighters can easily access will improve job satisfaction and relieve stress. It can be concluded that applying the fragrance of plants to the healing farming activities at the fire-fighter's workplace can increase the usefulness of the healing activities.