• Korean Journal of Biological Psychiatry
• /
• v.8 no.1
• /
• pp.156-161
• /
• 2001

We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.

• Korean Journal of Biological Psychiatry
• /
• v.7 no.1
• /
• pp.46-54
• /
• 2000

Traumatic brain injury(TBI) is generally considered to be a risk factor for psychiatric disorders, especially depression and anxiety disorder. Despite the anxiety disorders are frequent sequelae after traumatic brain injury, the patients have not been payed medical attention and treated by doctors properly. The factors of precipitating and sustaining the anxiety disorders after TBI are brain injury itself, and the patient's or caregiver's response to the disability after TBI. To diagnose and treat them effectively, the knowledge about the mechanisms of and symptoms after TBI have to be needed. Psychiatrist should be a supportive and good listener to the patients who are complaining anxiety symptoms and differentiate whether the psychiatric symptoms are due to TBI or not. Because the TBI patients are very sensitive to drug side effects, doctors have to be familiar with the side effects as well as the mechanisms of action of the common psychotropics.

• Journal of Trauma and Injury
• /
• v.19 no.1
• /
• pp.8-13
• /
• 2006

Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

• Journal of Trauma and Injury
• /
• v.20 no.2
• /
• pp.138-143
• /
• 2007

Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.2
• /
• pp.255-260
• /
• 2021

Objective : We aimed to investigate the presence of brachial plexus injury (BPI) in traumatic brain injury (TBI) patients and to draw attention to BPI, which can be overlooked by physicians in TBI patients. Methods : The study was designed retrospectively by examining the files of 58 patients with moderate to severe TBI to investigate coexistence of TBI and BPI. Results : BPI was detected in six of 58 TBI patients (10.3%). BPI was detected after an average 116 days from the initial injury. Three patients had lower trunk BPI and three patients had panplexopathy. Conclusion : Diagnosis of BPI in patients with TBI is delayed in the acute period of injury. The clinicians should keep in mind that BPIs may occur and remain undiagnosed in patients with TBI.

• Journal of Korean Neurosurgical Society
• /
• v.65 no.2
• /
• pp.196-203
• /
• 2022

Objective : To perform a comparative analysis of therapeutic effects associated with two different shapes of ceria nanoparticles, ceria nanorods (Ceria NRs) and ceria nanospheres (Ceria NSs), in an in vitro model of traumatic brain injury (TBI). Methods : In vitro TBI was induced using six-well confluent plates by manually scratching with a sterile pipette tip in a 6×6-square grid. The cells were then incubated and classified into cells with scratch injury without nanoparticles and cells with scratch injury, which were treated separately with 1.16 mM of Ceria NSs and Ceria NRs. Antioxidant activities and anti-inflammatory effects were analyzed. Results : Ceria NRs and Ceria NSs significantly reduced the level of reactive oxygen species compared with the control group of SH-SY5Y cells treated with Dulbecco's phosphate-buffered saline. The mRNA expression of superoxide dismutases was also reduced in nanoparticle-treated SH-SY5Y cells, but apparently the degree of mRNA expression decrease was not dependent on the nanoparticle shape. Exposure to ceria nanoparticles also decreased the cyclooxygenase-2 expression, especially prominent in Ceria NR-treated group than that in Ceria NS-treated group. Conclusion : Ceria nanoparticles exhibit antioxidant and anti-inflammatory effects in TBI models in vitro. Ceria NRs had better anti-inflammatory effect than Ceria NSs, but showed similar antioxidant activity.

• Applied Microscopy
• /
• v.48 no.4
• /
• pp.102-109
• /
• 2018

Multiple synaptic boutons (MSBs) have been reported to be synapse with two or more postsynaptic terminals in one presynaptic terminal. These MSBs are known to be increased by various brain stimuli. In the motor cortex, increased number of MSB was observed in both acrobat training (AC) model and traumatic brain injury (TBI) model. Interestingly one is a physiological stimuli and the other is pathological insult. The purpose of this study is to compare the connectivity of MSBs between AC model and TBI model in the cerebral motor cortex, based on the hypothesis that the connectivity of MSBs might be different according to the models. The motor cortex was dissected from perfused brain of each experimental animal, the samples were prepared for routine transmission electron microscopy. The 60~70 serial sections were mounted on the one-hole grid and MSB was analyzed. The 3-dimensional analysis revealed that 94% of MSBs found in AC model synapse two postsynaptic spines from same dendrite. But, 28% MSBs from TBI models synapse two postsynaptic spines from different dendrite. This imply that the MSBs observed in motor cortex of AC model and TBI model might have different circuits for the processing the information.

• Advances in biomechanics and applications
• /
• v.1 no.4
• /
• pp.253-267
• /
• 2014

The human head is identified as the body region most frequently involved in life-threatening injuries. Extensive research based on experimental, analytical and numerical methods has sought to quantify the response of the human head to blunt impact in an attempt to explain the likely injury process. Blunt head impact arising from vehicular collisions, sporting injuries, and falls leads to relative motion between the brain and skull and an increase in contact and shear stresses in the meningeal region, thereby leading to traumatic brain injuries. In this paper the properties and material modeling of the subarachnoid space (SAS) as it relates to Traumatic Brain Injuries (TBI) is investigated. This was accomplished using a simplified local model and a validated 3D finite element model. First the material modeling of the trabeculae in the Subarachnoid Space (SAS) was investigated and validated, then the validated material property was used in a 3D head model. In addition, the strain in the brain due to an impact was investigated. From this work it was determined that the material property of the SAS is approximately E = 1150 Pa and that the strain in the brain, and thus the severity of TBI, is proportional to the applied impact velocity and is approximately a quadratic function. This study reveals that the choice of material behavior and properties of the SAS are significant factors in determining the strain in the brain and therefore the understanding of different types of head/brain injuries.

• Journal of Trauma and Injury
• /
• v.22 no.2
• /
• pp.134-141
• /
• 2009

Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

• The Journal of Korean society of community based occupational therapy
• /
• v.2 no.1
• /
• pp.13-23
• /
• 2012

Objective : The purpose of this study was to provide evidence for effectiveness of community-based rehabilitation methods and results after traumatic brain injury through systematic review. Methods : The materials of the research were collected by retrieving research items in the areas of "community-based rehabilitation" and "traumatic brain injury" from the data base of Ovid and PubMed. Among the collected materials, 7 research results are suggested concerning the effectiveness of rehabilitation in community-based after traumatic brain injury in terms of subjects, measurement tools, cure methods and results. Results : Characteristics of subjects were diverse in numbers of subject, age, level of impairment and duration of disease. Research designs were all experimental studies and the most outcome parameters of community-based rehabilitation was occupational performance(27.7%). Cure methods were used occupational therapy programs concerning rehabilitation programs, cognitive therapy, cognitive behavioral therapy and home based occupational therapy. Conclusion : The results implied that community-based rehabilitation is effective on occupational performance, participation, prevention, and occupational justice, partially effective on adaptation, health and wellness, and non effective on the role competence. It is suggested the future research need to be done to develop intervention programs and studies in every types.