• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.448-454
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• 2018

Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.176-178
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• 2009

Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.400-402
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• 2005

Herniation of the kidney through a traumatic diaphragmatic rupture in itself is rare. However, complete avulsion of the renal pedicle implies not only a more rare event, but also a surgical emergency. We report a case of a patient with complete avulsion of renal vessels and ureter of an intrathoracic kidney herniated through a diaphragmatic rupture caused by blunt trauma. Prompt diagnosis with a computer tomographic scan and immediate surgery saved the patient's life.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.14-19
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• 2006

The patient with a posttraumatic stiffness frequently has a history of prolonged immobilization after a traumatic event. Adhesions in the extraarticular humeroscapular motion interface may be present independently or in combination with intraarticular capsular contractures. A through history and physical examination usually reveal the cause and anatomic location of stiffness. Passive stretching exercise program is effective as a first line treatment, but manipulation under anesthesia is usually not effective because of potential complication such as fracture, tendon rupture and neurologic injury. The humeroscapular motion interface adhesion can be released either open or arthroscopically. The combined technique coupled with an aggressive rehabilitation program can provide more effective motion restoration and pain relief.

• Korean Journal of Comparative Education
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• v.27 no.1
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• pp.1-28
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• 2017

In this study, the school crisis response system and intervention are examined in the U.S. by reviewing Crisis Response Team(CRT) to give a direction for establishing and improving the school crisis response system in Korea. To do this, a literature review has been conducted focusing on domestic and foreign literature on the school - based crisis response system about the U.S. and Korea. The characteristics of the school-based CRT in the U.S. are as follows. First, in the U.S., the organizational structure and financial support for school - based crisis response has been stated by law so that the roles and responsibilities of region, district, school have been clearly defined. Second, in the event of a school crisis, the school have been shared the role of professional crisis response according to the Incident Command System and coordinates communication smoothly between each area of society through cooperation with CRT. Third, CRT prevents burnout by showing flexibility in team composition so that CRT members are not tired or overwhelmed by a crisis event, and focuses on strengthening the crisis capability of the school itself through cooperation between the school and CRT. Fourth, the school-based CRT in the U.S. conducts a step by step crisis intervention from prevention to prolonged post management. Based on these results, implications for the establishment and improvement of school-based crisis response system in Korea are discussed.

• Anxiety and mood
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• v.14 no.2
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• pp.71-79
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• 2018

Objective : Several earlier studies have reported similar symptoms in patients with posttraumatic stress disorder (PTSD) who have been repeatedly exposed to relevant media after disasters and trauma. This study aimed to examine the effects of indirect trauma experience through media rather than direct traumatic events on an individual's social life. Methods : Five hundred and fifty-four individuals participated in our online, self-reported questionnaire survey. All subjects were asked to complete a demographic questionnaire, Posttraumatic Diagnostic Scale, Beck Depression Inventory, the Impact of Event Scale-Revised, State-Trait Anxiety Inventory, Korean version of Alcohol Use Disorder Identification Test, Patient Health Questionnaire-15, Suicidal Behaviors Questionnaire-Revised. Participants were assessed in regards to their experience of violent media exposure within the past three months. Results : Data from our study indicates that the group exposed to violent media had significantly higher perceived stress, physical symptoms, insomnia, and suicide ideation in comparison to the control group. Among the major symptoms of PTSD, the proportion of intrusion symptoms was relatively high in the media exposed group. Conclusion : This suggests that indirect trauma caused by media exposure could cause post-traumatic stress symptoms. The PTSD caused by indirect trauma may have slight differences from the PTSD caused by direct trauma. Therefore, it is necessary to understand, prevent, and control the adverse effects of media.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• Journal of Korean Biological Nursing Science
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• v.24 no.1
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• pp.1-16
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• 2022

Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

• Journal of English Language & Literature
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• v.56 no.6
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• pp.1311-1337
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• 2010

This paper deals with one of the hottest debates in the history of the Association for Asian American Studies (AAAS) since its inception in the late 1960s. In 1998 at Hawai'i, the AAAS awarded Lois-Ann Yamanaka its Fiction Award for her novel Blu's Hanging, only to have this award protested. The point at issue was the inappropriate representation of Filipino American characters called "Human Rats" in the novel. This event divided the association into two groups: one criticizing the novel for the problematic portrayal of Filipinos in colonial Hawai'i, and the other defending it from the criticism in the name of aesthetic freedom. Such a "crisis of representation" in Asian American identity reflects on the ways in which local Hawaiians are positioned in the complicate power dynamic between oppositional Hawaiian identity and cosmopolitan diasporic identity within the larger framework of Asian American pan-ethnic identity. The controversial event triggered the eruption of Asian Americans' anxiety over the identity-bounded nation of Asian America where intra-racial classism and conflict have been at play, which are primary themes of Blu's Hanging. This paper shows how Yamanaka's Blu's Hanging becomes so disturbing a work to prevent the hegemonic formality of Asian America identity from being fully dogmatic. Ultimately, it contradicts the political unconscious of the reading public and unmasked its false consciousness by engendering a "free subjective intervention" in the ideological reality of colonial Hawai'i.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3821-3824
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• 2012

Aim: SNPs of ERCC1 and ERCC2 genes have been found to be associated with response to platinum therapy in different clinical settings. In the current study, we investigated the relationship of SNPs in ERCC1 and ERCC2 to cisplain response and survival in osteosarcoma patients. Methods: 267 consecutive patients diagnosed with osteosarcoma between January 2003 to January 2005 were followed up until the end of January 2010. ERCC1 Asn118Asn, ERCC1 Gln504Lys, ERCC2 Asp312Asn and ERCC2 Lys751Gln polymorphisms were detected based upon the Sequenom MassARRAY platform.Results: For ERCC1 Asn118Asn, the variant genotype T/T was strongly significantly associated with a higher event free survival when compared with the wild-type C/C, with an adjusted OR (95% CI) of 0.39 (0.14-0.95). ERCC2 751 A/A genotype showed increased event free survival of osteosarcoma (HR=0.44; 95%CI=0.10-0.87). However, we did not find significant association of ERCC1 Gln504Lys and ERCC2 Asp312Asn polymorphisms with prognosis of osteosarcoma. Conclusions: We first report associations of four SNPs, ERCC1 Asn118Asn, ERCC1 Gln504Lys, ERCC2 Asp312Asn and ERCC2 Lys751Gln, with risk of death from osteosarcoma in a Chinese population, indicating ERCC1 118T/T and ERCC2 A/A may be used as surrogate markers for clinical outcome of osteosarcoma treatmetn with cisplain.