Purpose: The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations. Methods: A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis. Results: When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014). Conclusions: Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management.
This study was aimed at investigating the relationship of stress perception and psychopathology with biological variables such as systolic and diastolic blood pressure. serum total cholesterol high density lipoprotein and triglyceride in 50 adult patients with essential hypertension and 50 normotensive individuals. Both of the groups were matched to each other regarding age, sex, the level of education and BMI(body mass index). Stress perception and psychopathology between the two groups were compared using GARS and SCL-90-R scales. Biological variables such as blood pressure(systolic. diastolic), serum total cholesterol, high density lipoprotein and triglyceride were measured in all the subjects. The results were as follows ; 1) Hypertensive patients scored significantly higher than normotensive individuals in stress perception related to unusual happenings, change or no change in routine and overall global area, respectively. 2) Regarding psychopathology, hypertensive patients scored significantly higher than normotensive individuals in depression. hostility and interpersonal sensitivity. respectively. 3) Systolic blood pressure had a significantly positive correlation with scores of stress perception related to sickness and injury, and change or no change in routine, respectively. Diastolic blood pressure had a significantly positive correlation with scores of stress perception related to change or no change in routine. 4) In hypertensive patients. the level of serum total cholesterol had a significantly positive correlation with scores of stress perception related to unusual happenings. However, the level of serum triglyceride had a significantly negative correlation with scores of stress perception related to changes in relationships, sickness or injury, and change or no chang in routine. 5) There were no significant correlations between scores of stress perception and biological factors in the normotensive group. 6) The level of serum triglyceride correlated negatively with phobic anxiety in hypertensive group. whereas it correlated positively with PSDI in normotensive group. In conclusion, these results suggest that hypertensive patients have higher level of stress perception and psychopathology than normal individuals. In hypertensive patients, their stress perception is suggested to be correlated with serum cholesterol.
Objective: The goal of this study was to determine the center of pressure (CoP) complexity pattern in approximate entropy technique between genders at different conditions of running speed. Background: It is conducted to evaluate the complexity pattern of CoP in the increment of running speed to have insights to injury prediction, stability, and auxiliary aids for the foot. Method: Twenty men (age=22.3±1.5 yrs.; height=176.4±5.4 cm; body weight=73.9±8.2 kg) and Twenty women (age=20.8±1.2 yrs.; height=162.8±5.2 cm; body weight=55.0±6.3 kg) with heel strike pattern were recruited for the study. While they were running at 2.22, 3.33, 4.44 m/s speed on a treadmill (instrumented dual belt treadmills, USA) with a force plate, CoP data were collected for the 10 strides. The complexity pattern of the CoP was analyzed using the ApEn technique. Results: The ApEn of the medial-lateral and antero-posterior CoP in the increment of running speed showed significantly difference within genders (p<.05), but there were not statistically significant between genders at all conditions of running speed. Conclusion: Based on the results of this study, CoP complexity pattern in the increment of running speed was limited to be characterized between genders as an indicator to judge the potential injury and stability. Application: In future studies, it is needed to investigate the cause of change for complexity of CoP at various running speed related to this study.
Lee, Sun Jin;Jeong, Jae Shim;Lim, Kyung-Choon;Park, Eun Young;Kim, Hye Youn
Journal of Korean Biological Nursing Science
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v.21
no.1
/
pp.54-61
/
2019
Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.
Purpose: This study was done to investigate the effects of backrest elevation of 0 degree and 30 degrees that minimize the risk of increasing ICP when CVP is measured. Methods: Subjects were sixty-four patients who stayed in the neurosurgical intensive care unit after brain surgery at two university-based hospitals. CVP, blood pressure, heart rate and ICP were measured along with position changes in order of backrest position with primary 30 degrees backrest position, 0 degree backrest position and secondary 30 degrees backrest position. For data analysis, one-group, repeated-measures analysis of variance design was used in SAS program. Results: Backrest elevations from 0 degree to 30 degrees did not alter the CVP without increasing the ICP. Therefore, 30 degrees backrest position is a preventive position without increasing ICP. Conclusion: 30 degrees backrest position might be appropriate for brain injury patients when CVP is measured.
The purposes of this study were to reveal the kinematic and kinetic difference of hard ground soccer shoe, firm ground soccer shoe and soft ground soccer shoe. Soccer players were shoes of varying stud designs with some preferring the bladed studs while others opting for the conventional studded stud. Statistics were used one way-ANOVA and Tukey's Honestly Significant Difference Method. Seven healthy college soccer players were attended a test. All parameters were recorded using the Zebris system. Spatio-temporal variables were no significant difference. Lateral symmetry was statistically significant differences (p<.05). Vertical GRF parameters were no significant difference. Medial midfoot pressure, lateral midfoot pressure and central forefoot pressure were statistically significant differences (p<.05). This study demonstrates that playing surface significantly affects difference soccer shoes during soccer game. Furthermore, epidemiological investigation is warranted to determine the effects of playing surfaces on sport specific injury mechanisms.
Objective : This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods : This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results : Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion : The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.
Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.
Lee, Sang Won;Kim, Sun Hyu;Hong, Eun Seog;Ahn, Ryeok
Journal of Trauma and Injury
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v.25
no.1
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pp.1-6
/
2012
Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.
Park, Sang-June;Kim, Sun-Hyu;Lee, Jong-Hwa;Ahn, Ryeok;Hong, Eun-Seog
Journal of Trauma and Injury
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v.23
no.2
/
pp.57-62
/
2010
Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.
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