• 동의생리병리학회지
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• 제23권5호
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• pp.1080-1086
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• 2009

This study was designed to investigate the effects of Gastrodiae Elata Pharmacopuncure at GB20 on motor control and cognitive dysfunction recovery after mild traumatic brain injury in rats. Rats were divided into three groups; (1) no treatment after traumatic brain injury(experiment I), (2) Treatment with NPA after traumatic brain injury(experiment II), (3) Treatment with GEP after traumatic brain injury(experiment III). In our study, we carried out behavioral test(Rotarod, Morris water maze) and immunohistochemistry study of the change BDNF in the hippocampus(pre, $7^{th}$, $14^{th}$ day). In Rotarod test(motor control function) was significantly increased in the experimental group III as compared with experimental group I, II on $7^{th}$(p<0.01) and $14^{th}$ day(p<0.001). In Morris water maze test(cognitive function) was significantly decreased in the experimental group III as compared with experimental group I, II on $14^{th}$ day(p<0.001). In immunohistochemistric response of BDNF in the hippocampus, the experimental group III was more immune response than the other groups on $14^{th}$ day. These results imply that Gastrodiae Elata Pharmacopuncure at GB20 can play a role in facilitating recovery of motor control and cognitive function after mild traumatic brain injury in rats.

• 디지털융복합연구
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• 제16권7호
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• pp.511-516
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• 2018

외상성 뇌손상 환자에게 일반적인 형태의 짧은 엄지보조기(thumb splint)와 헬스장갑을 수정하여 만든 장갑형 보조기를 적용하여 손기능과 기능적 과제 수행에서의 효과를 알아보고자 하였다. 대상자는 외상성 뇌손상 1인을 대상으로 하였고 개별실험연구 방법 중 동시중재교차 연구설계를 적용하였다. 짧은 엄지보조기와 맞춤 제작한 장갑형 보조기를 이용한 중재의 결과는 보조기를 적용하지 않은 손과 비교하였을 때 즉각적인 손기능의 향상이 있었으며 두 가지 보조기 중에서는 장갑형 보조기를 사용하였을 때 기능적 과제에서 더 유용하였다. 외상성 뇌손상 환자가 가지는 손기능 장애의 작업치료중재로써의 보조기가 효과적임을 확인할 수 있었고 개인별 특성에 맞춘 보조기 적용의 필요성을 확인할 수 있었다. 앞으로 유사한 대상자들에 대한 다양한 상태에서의 보조기 적용에 대한 연구가 필요하다.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.138-143
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• 2007

Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

• 대한치과의사협회지
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• 제22권5호통권180호
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• pp.383-385
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• 1984

생활양식의 변화에 따라 유치 및 유영구치에 대한 traumatic injury가 크게 증가하고 있으며 이는 어린이나 보호자에게 심리적으로 커다란 영향을 미칠 수 있는 것이다. 어린이의 신체중 구강주위에 가장 많은 injury를 받는 것으로 나타나고 있고 하악전치 보다는 상악전치가, 여자 보다는 남자가 더욱 많은 injury를 받는 것으로 알려져 있으며 유전치에 대한 injury가 가장 많은 시기는 걷는 것, 달리는 것을 처음 재우게 되는 1½~2½세 사이이다. 물론 같은 어린이가 수회의 injury를 받을 수 있으며 특히 조심성이 없거나 가정이 파괴된 상태의 어린이에 있어 사고 위험이 높은 것으로 나타나고 있다. 일단 injury가 발생하면 가능한 한 빨리 치료가 이루어져야 하는데 유치는 계승치 맹출에 의하여 정상적인 치근 흡수현상을 나타내고 발육중인 유영구치는 치근이 미완성된 상태이므로 성숙된 영구치와는 처치방법이 다르며 때 고려해야 할 사항으로, ① management of child, ② degree of root resorption (degree of permanent tooth development), ③ space problems, ④ degree of parental concern, ⑤habits, ⑥ speech, ⑦ esthetics등이 있다.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.21-27
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• 2006

Purpose: The liver is one of the most commonly injured organs by blunt or penetrating abdominal trauma. Patients with liver injury can be treated by using nonoperative or operative management. The aim of this study was to study patients with traumatic liver injury who were treated by using operative management. Methods: Ninety-eight patients with traumatic liver injury underwent surgical treatment from January 1995 to December 2004 at Soonchunhyang University Cheonan hospital. Medical records were reviewed retrospectively, and demographic, clinical, operative, and postoperative datas were collected and analyzed. Results: Among the patients with operative management, the peak incidence was in the third and the fourth decades. The male-to-female ratio was 1.9:1. The most frequent injury mechanism was blunt trauma (85.7%). Abdominal computed tomography was the diagnostic modality used most frequently. Severe liver injury above Grade III was seen in 80.6% of all patients, and long bone fracture was the most common combined injury. Patients were managed by using various techniques, including simple closure, liver resection, and perihepatic packing. Pulmonary complications were the most common postoperative complications (35.7%). the overall mortality rate was 17.3%. Between the survival group and the expired group, the amount of transfusion for the expired group was statistically more than that for the survival group. Conclusion: Operative management is an effective treatment modality for hemodynamically unstable patients with severe traumatic liver injury. The amount of transfusion is a significant prognostic factor for survival.

• 한국임상수의학회지
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• 제27권6호
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• pp.718-722
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• 2010

전북지역에서 야생 멧돼지 사냥 시 발생한 응급 외상성 질환을 치료하기 위하여 내원한 사냥견 100마리를 외상의 정도에 따라 분류 하였다. 분류는 응급 외상성 질환의 경향과 정도를 부상의 원인, 부상 부위의 숫자와 위치, 부상의 중등도, 치사율과 같은 의료 기록들을 통하여 정보를 수집하였고 이를 토대로 후향성 조사를 실시 하였다. 사냥견 100마리의 환자에서 136개 (71마리의 단일 응급 외상성 질환과 29마리에서 복합 응급 외상성 질환)의 응급 외상성 질환이 발견되었다. 응급 외상성 질환의 원인으로는 야생 멧돼지 공격에 의한 응급 외상이 92마리, 오발로 인한 응급 외상이 7마리 그리고 덫에 의한 응급 외상이 1마리로 조사 되었다. 흉부는 응급 외상 질환이 가장 잘 발생하는 부위이며, 부상심각점수(ISS)는 2단계로 판단되었다. 치사율은 9% 였으며 사망에 이르게 된 증례는 모두 흉강에 외상을 입고 있었다. 야생 멧돼지 사냥 시에 발생하는 응급 외상성 질환은 사냥물을 공격할 때 대부분 발생하는 것으로 특히 가장 흔한 부위는 흉부였으며 이것은 임상 수의사가 흔히 접하는 일반적인 응급 질환들과는 매우 다른 특징을 나타내고 있었다. 본 연구를 통하여 야생 멧돼지 사냥견에서 응급 외상성 질환의 치료 경과, 발생 형태, 예후, 치사율 등 임상 응급 진료에 필요한 정보들을 알 수 있었다.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.8-13
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• 2006

Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.24-30
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• 2012

Objective : This study was conducted to assess the clinical significance of traumatic brain stem injury (TBSI) reflected on Glasgow Coma Score (GCS) and Glasgow Outcome Score (GOS) by various clinical variables. Methods : A total of 136 TBSI patients were selected out of 2695 head-injured patients. All initial computerized tomography and/or magnetic resonance imaging studies were retrospectively analyzed according to demographic- and injury variables which result in GCS and GOS. Results : In univariate analysis, mode of injury showed a significant effect on combined injury (p<0.001), as were the cases with skull fracture on radiologic finding (p<0.000). The GCS showed a various correlation with radiologic finding (p<0.000), mode of injury (p<0.002), but less favorably with impact site (p<0.052), age (p<0.054) and skull fracture (p<0.057), in order of statistical significances. However, only GOS showed a definite correlation to radiologic finding (p<0.000). In multivariate analysis, the individual variables to enhance an unfavorable effect on GCS were radiologic finding [odds ratio (OR) 7.327, 95% confidence interval (CI)], mode of injury (OR; 4.499, 95% CI) and age (OR; 3.141, 95% CI). Those which influence an unfavorable effect on GOS were radiologic finding (OR; 25.420, 95% CI) and age (OR; 2.674, 95% CI). Conclusion : In evaluation of TBSI on outcome, the variables such as radiological finding, mode of injury, and age were revealed as three important ones to have an unfavorable effect on early stage outcome expressed as GCS. However, mode of injury was shown not to have an unfavorable effect on late stage outcome as GOS. Among all unfavorable variables, radiological finding was confirmed as the only powerful prognostic variable both on GCS and GOS.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.242-247
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• 2009

Purpose: Trauma is an important cause of death in children. In particular, the liver is the second most commonly organ injured by blunt abdominal trauma. Treatment of patients with liver injury is has changed, and non-operative treatment is the major treatment method at present. In this study, we reviewed traumatic liver injury in pediatric patients. Methods: Seventy-seven patients younger than 16 years of age with traumatic liver injury were assessed for 10 years from July 1999 to June 2009 at Wonju Christian hospital. Records of the patients were reviewed retrospectively. Demographic and clinical data were analyzed. Results: The median age was 6 years, and the male-to-female ratio was 1.2 : 1. The most common injury grade was grade I. The majority of injuries were caused by was traffic accidents, and the second most common cause of injuries was falls. Twenty-four patients had liver injuries alone, and the most common accopaning injury was a lung injury. The average hospital stay was 20.7 days, and the average ICU stay was 4.8 days. Four patients died (5.2%). There were 6 patients with under 10 points on the Glasgow coma scale (GCS). Among these patients, three died. All mortality cases had over 16 points on the Injury Severity Score (ISS). Two patients were treated surgically, one of whom died. Of the 75 patients with non-operative management, three died due to associated injuries. Conclusion: Most pediatric patients with liver injury have good results with non-operative management. Associated injuries and hemodynamic instability are predictive of patient outcome, and those with isolated liver injuries can be successfully managed non-operatively.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.125-129
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• 2007

Purpose: The liver is one of the most commonly injured organs in abdominal trauma. Surgery has played a major role in treating traumatic liver injury. Recently, it was reported that conservative treatment could be the first-line management for hemodynamically stable patients without combined intraabdominal surgical problems. The aim of this study was to examine the prognostic factors in traumatic liver injury. Methods: The medical records of 41 patients who were treated for traumatic liver injury at Seoul National University Bundang Hospital from March 2003 to October 2007 were retrospectively reviewed. Results: Among the 41 patients, 34 cases (82.9%) were managed nonsurgically, and 7 cases (17.1%) were managed surgically. Out of the 5 (12.2%) mortalities, 2 were encountered in those who underwent surgery, and 3 were encountered in those who were treated nonsurgically. Univariate analysis showed that the initial systolic blood pressure, the initial hemoglobin level, and the grade of liver injury were significant prognostic factors for survival. Multivariate analysis indicated that initial low systolic blood pressure was the only independent risk factor. Conclusion: Patients with unstable vital signs initially have a poor prognosis. Aggressive management might be helpful for improving the survival rate in these patients.