• Journal of Trauma and Injury
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• 제35권3호
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• pp.168-172
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• 2022

Purpose: The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries. Methods: In this retrospective study, open neck injury patients who were admitted to the Trauma Center of Daejeon Eulji Medical Center, Eulji University between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality. Results: Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale. Conclusions: Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.79-85
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• 2010

Purpose: Many trials for new therapeutic approaches such as stem cell-based transplantation have been conducted to improve the repair and regeneration of injured cord tissue and to restore functions following spinal cord injury (SCI) in animals and humans. Adipose tissue-derived stromal cells (ATSCs) have multi-lineage potential to differentiate into cells with neuron-like morphology. Most studies of stem cell transplantation therapy after SCI are focused on cellular regeneration and restoration of motor function, but not on unwanted effects after transplantation such as neuropathic pain. This study was focused on whether transplantation of ATSCs could facilitate or attenuate hindpaw pain responses to heat, cold and mechanical stimulation, as well as on improvement of locomotor function in a rat with SCI. Methods: A spinal cord injury rat model was produced using an NYU impactor by dropping a 10 g rod from a height of 25 mm on to the T9 segment. Human ATSCs (hATSCs; approximately $5{\times}10^5$ cells) or DMEM were injected into the perilesional area 9 days after the SCI. After transplantation, hindpaw withdrawal responses to heat, cold and mechanical allodynia were measured over 7 weeks. Motor recovery on the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and on the inclined plane test were also evaluated. Results: The present study demonstrated that increased hindpaw withdrawal responses to cold allodynia was observed in both groups after transplantation, but the development of cold-induced allodynia in the hATSC transplantation group was significantly larger than in the control group. The difference between the two groups in locomotor functional improvement after SCI was also significant. Conclusion: Careful consideration not only of optimal functional benefits but also of unintended side effects such as neuropathic pain is necessary before stem cell transplantation therapy after SCI.

• 재활간호학회지
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• 제2권2호
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• pp.176-183
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• 1999

Sexual life is one of the most important things for the quality of living, which nobody can ignore. Especially, spinal cord injury is one of the most typical disabilities, which can cause abrupt changes of sexuality. Hence, sexual adjustment and its subordinate problems have to be dealt with among various problems caused by spinal cord injury. The purpose of this study was to comparative sexual interest and adjustment between the married and the unmarried people with SCI. A total of 134 persons who were registered members of SCI organization and admitted rehabilitation unit between February and June 1999 were included in the study. The sample consisted of 69 unmarried and 64 married people with SCI. Participants answered the 15 items concerning sexual interest, sexual adjustment. The results are as follows: 1) The mean score of sexual interest for the unmarried was 16.4. From seven topics related to sexuality, the greatest interest was to cope emotionally with changes in sexual functioning. For the married, mean score of sexual interest was 13.8 and the greatest interest was to help a partner cope emotionally with limitation on sexual dysfunction. There were significant difference sexual interest between two groups (t=3.75, p= .00). 2) Each mean score for sexual adjustment in the married and the unmarried was 20.0, 19.6. There were no significance difference sexual interest between two groups (t=.24, p= .811). However, there was a statistically significant difference of sexual interest. 3) Sexual interests and adjustments are not correlated in case of the unmarried that have r score= .224, while they are corrlated in case of the married that have r= .398. Because the average age of the SCI becomes lower and lower, sexual rehabilitation programs should be given the unmarried as well as the married with SCI. In conclusion, the spinal injured's major concerns about their sexual life are different between the married and the unmarried-the unmarried are interested in practical problems such as methods and techniques to achieve sexual satisfaction and their fertility, while the married give priority to considerations about their spouse. Paying attention to different sexual interest according to marital status, we should make two different sexual rehabilitation programs for each group. One program including support groups with their sposes for the married, the other program to give a chance t o solve problems of sexuality for the unmarried with SCI.

• 대한한의학회지
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• 제29권5호
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• pp.14-28
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• 2008

Objective : This study was carried out to understand effects of ginseng(hearinafter ; GS, Panax Ginseng) extract on regeneration responses on injured sciatic nerves in rats. Methods :Using white mouse, we damaged sciatic nerve & central nerve, and then applied GS to the lesion. Then we observed regeneration of axon and non-neuron. Results : 1. NF-200 protein immunostaining for the visualization of axons showed more distal elongation of sciatic nerve axons in GS-treated group than saline-treated control 3 and 7 days after crush injury. 2. GAP-43 protein was increased in the injured sciatic nerve and further increased by GS treatment. Enhanced GAP-43 protein signals were also observed in DRG prepared from the rats given nerve injury and GS treatment. 3. GS treatment in vivo induced enhanced neurite outgrowth in preconditioned DRG sensory neurons. In vitro treatment of GS on sensory neurons from intact DRG also caused increased neurite outgrowth. 4. Phospho-Erk1/2 protein levels were higher in the injured nerve treated with GS than saline. Phospho-Erk1/2 protein signals were mostly found in the axons in the injured nerve. 5. NGF and Cdc2 protein levels showed slight increases in the injured nerves of GS-treated group compared to saline-treated group. 6. The number of Schwann cell population was significantly increased by GS treatment in the injured sciatic nerve. GS treatment with cultured Schwann cells increased proliferation and Cdc2 protein signals. 7. GS pretreatment into the injured spinal cord generated increased astrocyte proliferation and oligodendrocytes in culture. In vitro treatment of GS resulted in more differentiated pericytoplasmic processes compared with saline treatment. 8. More arborization around the injury cavity and the occurrence at the caudal region of CST axons were observed in GS-treated group than in saline-treated group. Conclusion :GS extract may have the growth-promoting activity on regenerating axons in both peripheral and central nervous systems.

• 재활간호학회지
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• 제3권1호
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• pp.27-42
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• 2000

The purpose of this study was to identify the degree of sexual adjustment and quality of life in married men with spinal cord injuries and to furnish primary data to sexuality rehabilitation nursing practice which can lead to ideal sexual life and quality of life those men with SCI. Seventy married men with SCI were conveniently sampled in Kwangju, Suncheon, Mokpo and Seoul for responding the questionnaire, which was based on this research. With the research scale, SIS (Sexual interest and satisfaction) by Siosteen et al.(1990) and SB(Sexual behaviour) by Kreuter et al.(1996) were used for the measurement of sexual adjustment. And, for measuring quality of life was used SCI QL-23(Spinal cord injury of life-23) scale by Lundqvist et al.(1997). Data were collected from January 20 to March 20, 1999, using a structured questionnaire. A hundred volumes of questionnaire were used. and 85 volumes were collected, 70 volumes were used as research data after excluding 15 volumes unsuitable to data analysis. The obtain data were analysed using percentage, t-test, ANOVA, Duncan test, and Pearson's correlation by SAS PC+ program. The results were as follows: 1. The mean score of sexual interest and satisfaction of the subjects was 8.42. out of 18. The ways of their sexual behavior after spinal cord injuries were embracing and caressing (62.9%), kissing(58.6%), caressing breast with hands (55.7%), caressing breast with hands (52.9%), caressing genitals with hands (37.2%), caressing genitals with mouth(30.0%) and sexual intercourse (18.6%). The mean score of quality of life was 52.53 out of 100. 2. Age(F=3.24, p=.045) and caregiver (F=4.02, p=.022)were major variables which reveals significant differences in terms for sexual interest and satisfaction. The later results on Duncan's test showed that subjects who were in their 30s or 40s were significant higher than subjects whose age were in their 50s in their sexual interest and satisfaction. Also subjects with their spouse's care or mother's care were higher than those with other's care. 3. Subjects with incomplete paraplegia were higher than those with the complete paraplegia in sexual interest and satisfaction (F=3.01, p=.036). 4. Variables that showed the significant differences in the quality of life were education(t=2.860, p=.007) and period of marriage(t=2.125, p=.037). and occupational status(t=-2.161, p=.034). High school graduates, those who married before spinal cord injuries and those who didn't have occupation were higher than the other subjects. 5. Variables that revealed significant differences in the quality of life were time passage after spinal cord injuries(F=8.72, p=.001) and injured level of spinal cord(F=3.32, p=.042). Duncan's test showed that subjects who had lived for less than 4 years were higher those with time passage of 5-9 years and 10 years. Also subjects with lumbar injuries were higher than those with thoracic injuries in terms of quality of life. 6. There was negatively correlated between sexual interest and satisfaction and quality of life(r=-.256, p<.05). As a result of these findings sexuality rehabilitation for individuals with SCI was very important issue for their quality of life. Thus, registered nurses who care clients with SCI should activily participate in the client's sexual needs. Also, various sexual behaviors as well as sexual intercourse should be encouraged for the sexual adjustment of client's with SCI.

• The Korean Journal of Pain
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• 제11권1호
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• pp.23-29
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• 1998

Background: The present study was conducted to investigate effects of microinjection of bicuculline, GABA-A receptor antagonist, into the brain stem nuclei on the dorsal horn neuron responsiveness in rats with an experimental peripheral neuropathy. Methods: An experimental neuropathy was induced by a unilateral ligation of L5~L6 spinal nerves of rats. After 2~3 weeks after the surgery, single-unit recording was made from wide dynamic range (WDR) neurons in the spinal cord dorsal horn. Results: Responses of WDR neurons to both noxious and innocuous mechanical stimuli applied to the somatic receptive fields were enhanced on the nerve injured side. These enhanced responsiveness of WDR neurons were suppressed by microinjection of bicuculline into periaqueductal gray(PAG) or nucleus reticularis gigantocellularis(Gi). A similar suppression was also observed when morphine was microinjected into PAG or Gi. Suppressive action by Gi-bicuculline was reversed by naloxonazine, ${\mu}$-opioid receptor antagonist, microinjected into PAG whereas PAG-bicuculline induced suppression was not affected by naloxonazine injection into Gi. Gi-bicuculline induced suppression were reversed by a transection of dorsolateral funiculus(DLF) of the spinal cord. Conclusions: The results suggest that endogenous opioids, via acting on GABAergic interneurons in PAG and Gi, may be involved in the control of neuropathic pain by activating the descending inhibitory pathways that project to the spinal dorsal horn through DLF to inhibit the responsiveness of WDR neurons.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.151-156
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• 2013

Purpose: Traumatic cervical SCI is frequently accompanied by dural tear and the resulting cerebrospinal fluid (CSF) leak after surgery can be troublesome and delay rehabilitation with increasing morbidity. This study evaluated the incidence of intraoperative CSF leaks in patients with traumatic cervical spinal cord injury (SCI) who underwent anterior cervical surgery and described the reliable management of CSF leaks during the perioperative period. Methods: A retrospective study of medical records and radiological images was done on patients with CSF leaks after cervical spine trauma. Results: Seven patients(13.2%) were identified with CSF leaks during the intraoperative period. All patients were severely injured and showed structural abnormalities on the initial magnetic resonance image (MRI) of the cervical spine. Intraoperatively, no primary repair of dural tear was attempted because of a wide, rough defect size. Therefore, fibrin glue was applied to the operated site in all cases. Although a wound drainage was inserted, it was stopped within the first 24 hours after the operation. No lumbar drainage was performed. Postoperatively, the patients should kept their heads in an elevated position and early ambulation and rehabilitation were encouraged. None of the patients developed complications related to CSF leaks during admission. Conclusion: The incidence of CSF leaks after surgery for cervical spinal trauma is relatively higher than that of cervical spinal stenosis. Therefore, one should expect the possibility of a dural tear and have a simple and effective management protocol for CSF leaks in trauma cases established.

• 한국운동역학회지
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• 제18권4호
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• pp.151-159
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• 2008

본 연구는 2008 베이징 장애인 올림픽에 참가하는 국가대표 휠체어 탁구 선수들 중 대표적인 절단장애 선수와 척수장애 선수의 스트로크를 대상으로 운동학적 비교분석을 실시하였다. 실재와 같은 경기상황을 설정하여 모든 경기 상황에서의 스트로크를 수집하였다. 그중 대표적인 포핸드 스트로크 세 개의 동작과 백핸드 스트로크 세 개의 동작을 추출하였다. 9대의 적외선 카메라를 이용하여 수집한 자료는 LabVIEW7.0 그래픽 프로그램을 이용한 운동학적 분석에 의하여 각운동으로 나타내었다. 그 결과 척수장애 선수의 포핸드 스트로크에서는 몸통의 회전이 하위분절인 어깨의 회전과 팔꿈치의 굴곡신전과 거의 동시에 이루어지고 있었다. 백핸드 스트로크는 몸통의 회전, 어깨의 굴곡-신전, 그리고 팔꿈치의 굴곡-신전이 날아오는 공의 연장선상에서 일정한 형태로 정렬되어 있었고 공을 치기위한 백스윙은 어깨의 회전을 이용해 만들고 있었다. 절단장애 선수의 포핸드 스트로크는 팔의 외측회전으로 백스윙과 내측회전으로 만들어지는 회전을 이용하여 스트로크 하고 있었다. 백핸드 스트로크는 어깨의 회전과 허리의 회전에 있어 내측회전이 백스윙을 만들고 백스윙 후 공을 향한 큰 폭의 외측회전으로 임팩트를 이루고 있었다.

• Preventive Nutrition and Food Science
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• 제8권1호
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• pp.24-28
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• 2003

There is evidence to suggest that cranberry juice supplements improve the health of the urinary tract by inhibiting the binding of fimbriated uropathogenic E. coli to the bladder mucosa. In patients with neurogenic bladders, urinary tract infections (UTI) are particularly common and often poorly managed by antibiotic treatment. A double-blind, randomized, placebo-controlled trial was undertaken on 29 geriatric and spinal cord injured patients with dysfunctional bladders. They received three times daily at mealtimes a 4 oz bottle of cranberry juice (Ocean Spray Cranberries, USA) or a specially prepared synthetic placebo drink. Two episodes of UTI arose in week one of cranberry intake and none thereafter, compared to four episodes of UTI in 4 placebo patients in weeks four, six and 10. Mean bacterial adhesion counts on bladder cells of the patients rose during the first month of treatment in 71 % of the placebo patients compared to only 31 % of cranberry patients (p < 0.001). The difference persisted to some extent for the second and third months. Bacterial adhesion levels correlated with culture findings (higher adhesion and higher viable counts in urine) (p < 0.001), positive leukocyte nitrite tests (136$\pm$131 bacteria per cell versus 52$\pm$86 in negative tests) (p < 0.001), and higher white blood cell counts (> 10) per high power field (126$\pm$125 versus 48$\pm$85 bacteria per cell) (p<0.001). E. coli was the most frequently isolated organism (40% samples) followed by K. pneumoniae (17%) and a number of other uropathogens. Group B Streptococci, and coagulase negative Staphylococcus were recovered from urine in 4 samples but were not associated with any red blood cell presence. The daily intake of cranberry juice, in amounts which are not detrimental to long term compliance, appeared to have a role in reducing the risk of bladder colonization and infection in a highly susceptible patient population.

• The Journal of Korean Physical Therapy
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• 제18권2호
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• pp.59-65
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• 2006

목적: 전침과 경피신경전기자극이 근육 손상에 미치는 차이와 효과에 대하여 알아보기 위하여 이 실험을 시행하였다. 방법: 8-10주령의 건강한 S-D계 흰쥐 18마리(250-300g)가 이 실험에 사용되었으며 각 실험은 수술을 통하여 장지신근을 30초간 수술용 겸좌로 압좌한 후 무작위로 세 그룹으로 나누었다. 아무런 처치를 하지 않은 그룹을 대조군(Con), TENS 적용 그룹을 실험군-1(Ex-1), 전참 적용군을 실험군-2(Ex-2)으로 정하여 전기 자극을 반도 2Hz, 강도 1mA, 통전시간 15분 씩 7일간 적용한 후 각 그룹에서 2마리씩 1, 3, 7일에 희생하여 척수의 요수부위를 적출하여 이를 NT-3 항체 처리하여 염색하였다. 결과: 실험군-1, 2는 대조군에 비하여 조금 더 많은 NT-3가 발현됨을 관찰 할 수 있었지만, 각 실험군 간의 큰 차이는 발견하지 못하였다. 결론: TENS와 전침적용의 분자수준에서의 큰 차이점은 없다고 사료된다.