• 제목/요약/키워드: post-traumatic

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외상 후 스트레스 장애 환자의 혈청 테스토스테론치 (Serum Testosterone Levels in Patients with Post-Traumatic Stress Disorder)

  • 김동수;김해정;방유진;고창민;정문용;강석훈
    • 대한불안의학회지
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    • 제9권2호
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    • pp.106-112
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    • 2013
  • Objective : Several reports have found abnormal levels of androgen in post-traumatic stress disorder (PTSD) patients. This abnormality in androgen is hypothesized to due to chronic psychological stress effects on the hypothalamic-pituitary-gonadal (HPG) system. The present study was conducted to estimate serum testosterone levels in PTSD patients in comparison with normal subjects. Methods : Seventy-five male Korean veterans of the Vietnam War volunteered for the study, of which eleven were excluded because of incomplete psychological assessment. To measure basal serum testosterone, blood samples were collected between 8.00 and 9.30 a.m. The clinician administered PTSD scale (CAPS), the structured clinical interview for DSM-IV (SCID), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Mini International Neuropsychiatric Interview Plus (Korean version of MINI-Plus), CES-K (Korean version of combat exposure scale). Results : The serum testosterone level of PTSD patients ($5.4{\pm}2.5ng/mL$) was higher than that of a control group ($3.1{\pm}1.7ng/mL$, p<0.001). Testosterone levels were significantly correlated with CAPS (r=.38, p<.01), HAM-A (r=.35, p<.01) and HAM-D (r=.28, p<.01) in all subjects. Conclusion : The results of the present study suggest that chronic psychological stress affects the HPG system.

외상 후 스트레스 장애의 위험요인으로서의 사상체질 (Sasang Constitution May Act as a Risk Factor for Post Traumatic Stress Disorder)

  • 김윤영;김태열;박소영;장은수
    • 사상체질의학회지
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    • 제32권1호
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    • pp.22-29
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    • 2020
  • In this study, we suggested indirect evidence of whether Sasang constitution(SC) could be a risk factor for Post-traumatic stress disorder(PTSD) among soldiers who participated in Vietnam war. The number of 199 subjects joined this study. We surveyed SC with KS-15 and PTSD with Korean Version of Impact of Event Scale-Revised questionnaires. A Chi-square test and a one-way ANOVA were performed according to SC type, and multiple logistic regression was used to produce odds ratios(ORs). Significant p was .05. The number(rate) of Taeeumin(TE), Soeumin(SE), and Soyangin(SY) types were 131(65.8%), 33(16.6%), and 35(17.6%) respectively. The score of PTSD in SE type(8.78±8.61) was significantly higher than those of SY(4.00±6.5) and TE types(3.65±6.78)(p=.001, SE>TE, SY, Scheffe). SE type was associated with increased PTSD prevalence compared with TE [OR 4.338; 95% CI 1.525-12.335, p<.01], and it was still associated with increased PTSD prevalence [OR 10.658; 95% CI 1.296-87.661, p<.05] after adjusting for age and weight. This study suggests that SC, particularly the SE type, might be significantly associated with PTSD and could be considered as a risk factor for PTSD.

분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과 (Result of Staged Operation in Ruedi-Allgower Type II and III Open Tibia Pilon Fractures with Severe Comminution)

  • 최귀연;이준영;장현웅;김영욱
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.110-115
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    • 2019
  • Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

Tetramethylpyrazine reverses anxiety-like behaviors in a rat model of post-traumatic stress disorder

  • Lee, Bombi;Shim, Insop;Lee, Hyejung;Hahm, Dae-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • 제22권5호
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    • pp.525-538
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    • 2018
  • Post-traumatic stress disorder (PTSD) is a trauma-induced psychiatric disorder characterized by impaired fear extermination, hyperarousal, and anxiety that may involve the release of monoamines in the fear circuit. The reported pharmacological properties of tetramethylpyrazine (TMP) include anti-cancer, anti-diabetic, anti-atherosclerotic, and neuropsychiatric activities. However, the anxiolytic-like effects of TMP and its mechanism of action in PTSD are unclear. This study measured several anxiety-related behavioral responses to examine the effects of TMP on symptoms of anxiety in rats after single prolonged stress (SPS) exposure by reversing the serotonin (5-HT) and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Rats were given TMP (10, 20, or 40 mg/kg, i.p.) for 14 days after SPS exposure. Administration of TMP significantly reduced grooming behavior, increased the time spent and number of visits to the open arm in the elevated plus maze test, and significantly increased the number of central zone crossings in the open field test. TMP administration significantly reduced the freezing response to contextual fear conditioning and significantly restored the neurochemical abnormalities and the SPS-induced decrease in 5-HT tissue levels in the prefrontal cortex and hippocampus. The increased 5-HT concentration during TMP treatment might be partially attribute to the tryptophan and 5-hydroxyindoleacetic acid mRNA level expression in the hippocampus of rats with PTSD. These findings support a role for reducing the altered serotonergic transmission in rats with PTSD. TMP simultaneously attenuated the HPA axis dysfunction. Therefore, TMP may be useful for developing an agent for treating psychiatric disorders, such those observed in patients with PTSD.

외상 후 지연성으로 발생한 장간막 동정맥루: 증례보고 (Delayed Presentation of a Post-traumatic Mesenteric Arteriovenous Fistula: A Case Report)

  • 조자윤;정희경;김형기;임경훈;천재민;허승;박진영
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.248-251
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    • 2013
  • Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

경부운동훈련이 외상 후 스트레스 장애 환자의 경부통증 수준, 우울 요인에 미치는 영향 (The Impact of The Cervical Exercise Training on Post-traumatic Stress Disorder Patient's Cervical Pain Levels and Depression Factor)

  • 박성두;신영일;김명준
    • 대한정형도수물리치료학회지
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    • 제21권1호
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    • pp.37-42
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    • 2015
  • Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

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Effects of systemic administration of ibuprofen on stress response in a rat model of post-traumatic stress disorder

  • Lee, Bombi;Sur, Bongjun;Yeom, Mijung;Shim, Insop;Lee, Hyejung;Hahm, Dae-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • 제20권4호
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    • pp.357-366
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    • 2016
  • Pro-inflammatory cytokine and brain-derived neurotrophic factor (BDNF) are modulated in post-traumatic stress disorder (PTSD). This study investigated the effects of ibuprofen (IBU) on enhanced anxiety in a rat model of PTSD induced by a single prolonged stress (SPS) procedure. The effects of IBU on inflammation and BDNF modulation in the hippocampus and the mechanisms underlying for anxiolytic action of IBU were also investigated. Male Sprague-Dawley rats were given IBU (20 or 40 mg/kg, i.p., once daily) for 14 days. Daily IBU (40 mg/kg) administration significantly increased the number and duration of open arm visits in the elevated plus maze (EPM) test, reduced the anxiety index in the EPM test, and increased the time spent in the center of an open field after SPS. IBU administration significantly decreased the expression of pro-inflammatory mediators, such as tumor necrosis $factor-{\alpha}$, $interleukin-1{\beta}$, and BDNF, in the hippocampus, as assessed by reverse transcription-polymerase chain reaction analysis and immunohistochemistry. These findings suggest that IBU exerts a therapeutic effect on PTSD that might be at least partially mediated by alleviation of anxiety symptoms due to its anti-inflammatory activity and BDNF expression in the rat brain.

북한이탈주민의 외상후 스트레스장애의 임상적 특성 (Clinical Characteristics of Post-Traumatic Stress Disorder among North Korean Defectors)

  • 이경은;안지현;김다은;문승연;홍진표
    • 대한불안의학회지
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    • 제14권2호
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    • pp.80-87
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    • 2018
  • Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

관상동맥질환자의 외상 후 스트레스장애 증상과 삶의 질 (Post-Traumatic Stress Disorder Symptoms and Quality of Life of Patients with Coronary Artery Disease)

  • 이승아;강지연
    • 중환자간호학회지
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    • 제12권1호
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    • pp.82-93
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    • 2019
  • Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

응급실 근무자의 외상 후 스트레스장애 유병률 및 발생 기여 요인 (The Prevalence of Post-traumatic Stress Disorder Among Emergency Room Workers and Factors Contributing to Its Occurrence)

  • 고동률;김건배;이지환
    • 한국의료질향상학회지
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    • 제27권1호
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    • pp.10-19
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    • 2021
  • Purpose: This study was designed to investigate that the prevalence of Post-traumatic stress disorder (PTSD) and occupational environmental factors that contribute to the developing of PTSD in workers who worked in emergency room in Korea. Methods: This study is a multicenter cross-sectional study that was conducted in three emergency rooms. Data was collected by self-response method through questionnaire. The Impact Event Scale-Revised was used to screen the high-risk group of PTSD. Univariate and multivariate regression analysis was used to identify the factors associated with the developing of high-risk group of PTSD. Results: Total 211 subjects responded to the questionnaire. Of these, 170 subjects experienced psychological trauma event (PTE) in the working environment. And 60 subjects classified as high risk group of PTSD, so a prevalence of high risk group for PTSD was 28.4%. Factors related to the high risk group of PTSD were the frequency of psychological trauma events experienced over the past 1 year and the high score of QIDS-SR16. Conclusion: The prevalence of high risk group for PTSD among emergency room workers in Korea is very high. This may adversely affect the safety of patients, so early screening and intervention are necessary.