• Clinical and Experimental Pediatrics
• /
• 제49권10호
• /
• pp.1019-1025
• /
• 2006

Motor delay, when present, is usually the first concern brought by the parents of children with developmental delay. Cerebral palsy that is the most common motor delay, is a nonspecific, descriptive term pertaining to disordered motor function that is evident in early infancy and is characterized by changes in muscle tone, muscle weakness, involuntary movements, ataxia, or a combination of these abnormalities. A wide range of causative disorders and risk factors have been identified for cerebral palsy, and broadly classified into 5 groups; perinatal brain injury, brain injury related to prematurity, developmental abnormalities, prenatal risk factors, and postnatal brain injury. Delay in attaining developmental milestones is the most distinctive presenting complaint in children with cerebral palsy. A detailed history and thorough physical and neurologic examinations are crucial in the diagnostic process. The clinician should be cautious about diagnostic pronouncement unless the findings are unequivocal. Several serial examinations and history review are necessary. All children with cerebral palsy should undergo a neuroimaging study, preferably MRI, because an abnormality is documented on head MRI(89%) and CT(77%). The high incidence rates for mental retardation, epilepsy, ophthalmologic defects, speech and language disorders and hearing impairment make it imperative that all children with cerebral palsy be screened for mental retardation, ophthalmologic and hearing impairments, and speech and language disorders; nutrition, growth, and swallowing also should be closely monitored.

• Journal of Trauma and Injury
• /
• 제37권1호
• /
• pp.67-73
• /
• 2024

Purpose: Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD Checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Methods: Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Results: Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). Conclusions: The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권4호
• /
• pp.652-672
• /
• 1996

Dysfunction of the inferior alveolar nerve may result from trauma, diseases or iatrogenic injury. The development and refinement of an objective method to evaluate this clinical problem is highly desirable and needed, especially concerning for an increasing medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nerve pathways. The purpose of this study was to characterize the Sensory Evoked Potentials(SEPs) and Somatosensory Evoked Potentials(SSEPs) elicited by electrical stimulation of mental nerve. SEPs and SSEPs were measured and analyzed statistically before and after needle injury on the inferior alveolar nerve of Sprague-Dawalye rats. Measuring SEPs was more sensitive in evaluation of the recovery of sensory function from inferior alveolar nerve injury then measuring SSEPs but we measured SSEPs in the hope of providing a safe, simple and objective test to check oral and facial sensibility, which is acceptable to the patient. We stimulated mental nerve after needle injury on the inferior alveolar nerve and SEPS on the level of mandibular foramen and SSEPs on the level of cerebral cortex were recorded. Threshold, amplitude, and latency of both of SEPs and SSEPs were analyzed. The results were as follows ; 1. Threshold of SEPs and SSEPs were $184{\pm}14{\mu}A$ and $164{\pm}14{\mu}A$ respectively. 2 SEPs were composed of 2 waves, i.e., N1 N2 in which N1 was conducted by II fibers and N2 was conducted by III fibers. 3. SSEPS were composed of 5 waves, of which N1 and N2 shower statistically significant changes(p<0.01, unpaired t-test). 4. SEPs and SSEPs were observed to be abolished immediately after local anesthesia and recovered 30 minutes later. 5. SEPs were abolished immediately after injury. N1 of SSEPs was abolished immediately and amplitued of N2 was decreased($20.7{\pm}12.2%$) immediately after 23G needle injury, but N3, N4 and N5 did not change significantly. Recovery of waveform delayed 30 minutes in SEPs and 45 minutes in SSEPs. 6. The degree of decrease in amplitude of SEPs and SSEPs, after 30G needle injury was smaller than those with 23G. SEPs recorded on the level of mandibular foramen were though to be reliable and useful in the assessment of the function of the inferior alveolar nerve after injury. Amplitude of SSEPs reflected the function and integrity of nerve and measuring them provided a safe, simple and abjective test to check oral and facial sensibility. These results suggest that measuring SEPs and SSEPs are meaningful methods for objective assessment in the diagnosis of nerve injury. N1 and N2 of SSEPs can be useful parameters for the evaluation of the nerve function following a needle injury.

• Journal of Chest Surgery
• /
• 제25권1호
• /
• pp.66-72
• /
• 1992

From March 1986 to March 1991, 29 patients were operated due to cardiac tamponade at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital. Among them, 19cases were traumatic origin and 10 were Non traumatic origin. A] Traumatic cardiac tamponade Out of 19 cases, 12 cases were resulted from penetrating injury and 7 cases from trauma. Average time interval from arrival to operation was 91 minutes[15min.~8.5hr.] in penetrating injury group. On the other hand, average time of in cases of blunt trauma was more than 3hours because of the difficulties in diagnosis. Four deaths occured in 19 cases [mortality rate: 21.1%] 3 in blunt trauma group[42.9%] and 1 in penetrating group[8.3%]. In view of our experience, the prognosis was closely correlated with injury mode, initial vital sign and mental status. There was no close correlation between prognosis and cardiac injury site. B] Non traumatic cardiac tamponade The etiologies were malignancy[4], non-spesific pericarditis[3], tuberculosis[1], pyogenic[1] and cardiomyopathy[1]. All of the cases in which performed tube pericardiostomy were the cases that showed no response to conservative treatment and repeat per-icardiocentesis. There was one posoperative death.

• The Journal of Korean Physical Therapy
• /
• 제11권3호
• /
• pp.159-175
• /
• 1999

The purpose of this study lies in providing the basic materials for wrestlers' control of health and physical strength, the preventive, measure for injury during a practice or a game and the scientific training method for upgrading competitive power in a game. The result of analyzing the occurring tendency and therapeutical actions and attitude of sports injury, taking the 258 wrestlers from a high school, an university and pro-team as the object of study through a questioning sheet are like following. 1. Among every wrestlers' causes of injury, the main cause was a physical collision occupying $\50\%$, and an excessive training occupied $30\%$. on the contrary, the unsatisfied wrestler's cause of injury was a shortage of mental concentration and a burden of weight, occupying each $19\%$ and $17\%$. Therefore in order to prevent the injury, you should take care of especially in time of physical collision in a practice or a grme and prevent an excessive training. 2. The seasion with the most frequent occurrence of injury is the winter$(78\%)$, and in the spring and summer$(5.5\%)$, the frequency of occurrence of injury is very low. In the meantime, considering by occurring time, during a practice$(95\%)$ the injury occurs most frequently and during a game$(5\%)$ occure least frequently. Therefore, in order to reduce the injury, you should warm up sufficiently before the training and the practice and concentrate all of you attention and mind. 3. The injury occurs most highly in the afternoon hours occupying about $80\%$, and a little in the dawn and morning hours but in the contrary rarely in the night. 4. As the wrestler's injury type, the injury on muscles and tendons occupies the most to take $65\%$ of the whole injuries.

• 항공우주정책ㆍ법학회지
• /
• 제22권2호
• /
• pp.53-83
• /
• 2007

The purpose of this paper is to study precedent cases of the Air carrier liability for passengers. The article 17 of Warsaw Convention (also in Montreal Convention article 17-1) provides the Air carrier liability for passengers which is the most essential part of the Air carrier liability. According to these Conventions, 1) the carrier is liable for damage sustained in case of death or bodily injury of a passenger. Precedents and theories have disagreements on whether the damage covers the mental injury as well. 2) The carrier is liable for damage sustained from aviation accident. The definition of 'aviation accident' is becoming problematic. 3) The carrier is liable for damage sustained in case of death or bodily injury of a passenger upon condition only that the accident which caused the death or injury took place on board the aircraft or in the course of any of the operations of embarking or disembarking. The question at issue is the range of the operations of embarking or disembarking. This paper introduces the precedents (also, the model precedents) about the carriers liability for passengers and related cases, so as to help understand the trend of judicial decisions. Furthermore, the cases, once took all of the attention of the international air carriers, concerned with the 'Economy class syndrome' (DVT : Deep Vein Thrombosis) are also presented. Under the new Montreal Convention, the carriers liability for passengers will continue to be the main issue. Thus it is required that academics as well as practical businesses may keep up their studies about this issue.

• Safety and Health at Work
• /
• 제12권4호
• /
• pp.471-478
• /
• 2021

Background: Employment standards (ES) include having a regular payday, regular breaks, the right to paid sick or vacation time, and paid wages. Inadequate ES contribute to the labour market vulnerability of workers; however, they are not typically considered to be risk factors for workplace injury. In a sample of Canadian workers, we examine the risk of injury associated with inadequate ES, independent of, and combined with inadequate workplace protections from workplace hazards. Methods: Data from 2,803 adults working 15 hours or more/week in workplaces with at least five employees were analysed. We explored associations between exposure to workplace hazards with inadequate protections [termed occupational health and safety (OHS) vulnerability] and inadequate ES on workplace injury (physical or mental injury; injury requiring time off). Additive interaction models were used to examine the independent and combined effects of these exposures. Results: Occupational health and safety vulnerability and inadequate ES were independently associated with increased injury outcomes. Adjusted models showed an additive relationship for all injury outcomes between OHS vulnerability and inadequate ES. Statistically significant superadditive relationships were observed for physical injury risk with policy and procedure vulnerability plus inadequate ES [synergy index (S) 1.50, 95% CI: 1.13-2.00] and for overall OHS vulnerability plus inadequate ES (S 1.53, 95% CI: 1.16-2.02), suggesting a combined effect greater than independent effects. Conclusion: Occupational health and safety vulnerability and inadequate ES are independently associated with workplace injury. For certain injury outcomes, the combined effect of OHS vulnerability and inadequate ES is greater than the independent effects of each individual exposure.

• 동의신경정신과학회지
• /
• 제26권3호
• /
• pp.307-318
• /
• 2015

Objectives: This study evaluated the effect of oriental treatments and rehabilitation on a patient with organic mental disorder after head trauma caused by traffic accident. Methods: We treated the patient with acupuncture, herb-medication, oriental psychotherapy, and rehabilitation. MMSE-K, BDI, K-MBI, FIM were evaluated before and after treatment. Results: The results indicated that MMSE-K was maintained at 27 points; BDI was reduced from 16 points to 5 points; K-MBI was increased from 75 points to 99 points; and FIM was increased from 86 points to 115 points. Furthermore, the treatment resulted in reduced mental symptoms and improved work capacity. Conclusions: Oriental medical treatment has potential validity in improving symptoms of organic mental disorder.

• Journal of Trauma and Injury
• /
• 제31권2호
• /
• pp.51-57
• /
• 2018

Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

• 대한한방내과학회지
• /
• 제40권5호
• /
• pp.804-813
• /
• 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.