• 한국직업건강간호학회지
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• 제28권2호
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• pp.75-82
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• 2019

Purpose: This study aimed to determine the influence of injury and/or injured area classification on depression in patients with industrial injuries. Methods: The participants comprised438 patients who consented to participate and completed self-reported questionnaires. Data were analyzed using SPSS/WIN version 22.0 for descriptive statistics, $x^2$ test, fisher's exact test, ANOVA, and post-hoc $Scheff{\acute{e}}$ test. A stepwise multiple regression analysis was used to identify factors influencing depression. Results: The results indicated that the effect of disease classification and injured areas on depression were significantly different in patients with industrial injuries. The results further showed that severe depression was significantly higher in cardiovascular patients and patients with an injured area of the head and waist. The most powerful predictor was age (50~59 years), return to work (reemployment), disease classification (cardiovascular), and injured area (head, including vascular disease). Conclusion: This study showed that the most influential variable of depression in patients with industrial injuries were cardiovascular issues, injury areas of the head and waist, being aged 50~59 years, and reemployment. To reduce depression in these patients, it is important to develop and implement a psychiatric rehabilitation program that helps patients to formulate a concrete plan and goal for recovery, enabling patients to actively engage in their rehabilitation.

• 대한핵의학회지
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• 제26권1호
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• pp.26-32
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• 1992

Minimal deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using $^{99m}Tc-HMPAO$ Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months fellowing head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with $^{99m}Tc-HMPAO$ Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using $^{99m}Tc-HMPAO$ Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.125-130
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• 2015

Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

• 한국자동차공학회논문집
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• 제15권2호
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• pp.135-142
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• 2007

MADYMO human model with the detail neck was used to investigate the reaction force of neck and neck injury from rear impact directions. In the validation simulation, head acceleration, thorax acceleration and the global kinematics of the head and neck were correlated well with experimental data. Acceleration data from three 15 km/h low speed car rear impact pendulum tests(rear-end, offset, oblique) were used to simulate the model. In the simulation results, the reaction force on the facet joint and discs in the oblique rear impact were higher than rear-end, offset rear impacts. Further research is still needed in order to neck injury analysis about different crash parameters.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 춘계학술대회
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• pp.327-330
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• 1996

We investigated the possibility of preventing a passenger's whiplash injury by rear-end collision. We sought to prevent the whiplash injury by appling an active headrest system to a passenger A main factor in whiplash injury is the backward, rapid, passive, and negative acceleration of the head. Our results showed that the active headrest system does reduce the backward, rapid, passive, and negative acceleration of the head. As a conclusion, Our active headrest system is a useful equipment to prevent whiplash injury.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.66-69
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• 2008

Traumatic bilateral abducens nerve palsy is rare and is associated with intracranial, skull and cervical spine injuries. We report a case of bilateral abducens nerve palsy in a 40-month-old patient with a skull base fracture. The injury mechanism was associated with direct nerve injury caused by a right petrous bone fracture and indirect injury by frontal impact on the abducens nerve at the point of fixation to the petrous portion and Dorello's canal. The emergency physician should be aware of injuries and the mechanism of abducens nerve palsy in head trauma.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.48-52
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• 2020

Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to tolerate prolonged anesthetic exposure is a driving factor for performing the minimal intervention necessary to facilitate recovery. Herein, we present a case involving the successful immediate reconstructive treatment of a severely head-injured adolescent with a composite scalp defect secondary to trauma. A 14-year-old boy sustained a severe head injury from a motor vehicle accident with a composite scalp defect in the right fronto-parietal region. The frontal lobe was exposed, and the right eye was crushed and devitalized. The patient was deeply unconscious for 3 days, without any significant improvements before reconstructive surgery was proposed due to fear of possible meningitis resulting from the exposure of brain structures. We successfully managed the patient with a fronto-parieto-occipital flap, after which the patient promptly recovered consciousness.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.191-194
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• 2007

Objective : Homeless patients probably have epidemiologic features that are different from those of general population. However, there have been no published articles about clinical characteristics of neurosurgical homeless patients. The authors tried to assess the clinical characteristics and treatment outcome of homeless neurosurgical patients. Methods : We retrospectively reviewed the medical records and radiological films of 76 homeless patients and 72 non-homeless patients following head trauma who were admitted to our neurosurgical department between June 2001 and June 2005. We compared two groups of the patients with the demographics, the clinical and laboratory characteristics. Also, 3D-day mortality was determined according to Glasgow Coma Scale (GCS) score. Results : Age of homeless patients was younger than that of non-homeless patients. Homeless patients had previous craniotomy evidences in skull x-rays more frequently (10.5% vs. 1.4%). Acute subdural hematoma was the most common type of head injury in the two groups. Moderate and severe head injury, based on GCS score on admission was more frequent in homeless patients (64% vs. 39%). Fifty percent of homeless patients underwent operation for traumatic head injury. However, 3D-day mortality according to GCS score was not significantly higher in homeless patients. Conclusion : Most homeless neurological patients were relatively young men. Also, moderate or severe brain injuries were observed more frequently. However, mortality rate of homeless patients in neurosurgical field is not significantly higher in the present study.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.51-53
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• 2014

Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.144-147
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• 2017

Laryngeal neoplasm is the second most common malignancy of the upper aerodigestive tract. About 85% to 95% of laryngeal malignancies are squamous cell carcinoma that arises from the epithelial lining of the larynx. The exact cause of laryngeal neoplasm is unknown, but certain risk factors can affect the chances of developing it. Chronic inflammation is a mutagen factor confirmed in the carcinogenesis of various tumor. Inhalation injuries cause histopathologic damage to laryngeal mucosa and inflammation change. This long term inflammation may leads to the development of dysplasia and malignant transformation. Recently, we experienced a case of malignant transformation of laryngeal mucosa after inhalation injury patient 25 years ago. Herein, we reported this rare case and review the relevant literature.