• Safety and Health at Work
• /
• 제7권2호
• /
• pp.120-123
• /
• 2016

Background: To assess in a laboratory setting the ability to stay awake in a sample of workers of an Italian hospital and to investigate the association between that ability and the risk of occupational injury. Methods: Nine workers at the University Hospital of Udine who reported an occupational injury in the study period (cases), and seven noninjured workers (controls) underwent a polysomnography and four 40-minute maintenance of wakefulness tests (MWT). Differences in sleep characteristics and in wakefulness maintenance were assessed using Wilcoxon's rank sums tests and Fisher's exact tests. Results: Controls had greater sleep latency, lower total sleep time, fewer leg movements, and a higher percentage ratio of cycling alternating pattern, were more likely not to fall asleep during the MWT and were less likely to have two or more sleep onsets. Although not all the differences reached statistical significance, cases had lower sleep onset times in Trials 1-3. Conclusion: In the literature, the evidence of an association between MWT results and real life risk of accidents is weak. Our results suggest a relationship between the MWT results and the risk of injury among hospital workers.

• Journal of Korean Neurosurgical Society
• /
• 제60권5호
• /
• pp.584-590
• /
• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• The Korean Journal of Pain
• /
• 제29권3호
• /
• pp.179-184
• /
• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• Nutrition Research and Practice
• /
• 제8권4호
• /
• pp.391-397
• /
• 2014

BACKGROUND/OBJECTIVE: Myocardial cell death due to occlusion of the coronary arteries leads to myocardial infarction, a subset of coronary heart disease (CHD). Dietary fiber is known to be associated with a reduced risk of CHD, the underlying mechanisms of which were suggested to delay the onset of occlusion by ameliorating risk factors. In this study, we tested a hypothesis that a beneficial role of dietary fiber could arise from protection of myocardial cells against ischemic injury, manifested after occlusion of the arteries. MATERIALS/METHODS: Three days after rats were fed apple pectin (AP) (with 10, 40, 100, and 400 mg/kg/day), myocardial ischemic injury was induced by 30 min-ligation of the left anterior descending coronary artery, followed by 3 hr-reperfusion. The area at risk and infarct area were evaluated using Evans blue dye and 2,3,5-triphenyltetrazolium chloride (TTC) staining, respectively. DNA nicks reflecting the extent of myocardial apoptosis were assessed by TUNEL assay. Levels of cleaved caspase-3, Bcl-2, and Bax were assessed by immunohistochemistry. RESULTS: Supplementation of AP (with 100 and 400 mg/kg/day) resulted in significantly attenuated infarct size (IS) (ratio of infarct area to area at risk) by 21.9 and 22.4%, respectively, in the AP-treated group, compared with that in the control group. This attenuation in IS showed correlation with improvement in biomarkers involved in the apoptotic cascades: reduction of apoptotic cells, inhibition of conversion of procaspase-3 to caspase-3, and increase of Bcl-2/Bax ratio, a determinant of cell fate. CONCLUSIONS: The findings indicate that supplementation of AP results in amelioration of myocardial infarction by inhibition of apoptosis. Thus, the current study suggests that intake of dietary fiber reduces the risk of CHD, not only by blocking steps leading to occlusion, but also by protecting against ischemic injury caused by occlusion of the arteries.

• Journal of Korean Neurosurgical Society
• /
• 제45권2호
• /
• pp.90-95
• /
• 2009

Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

• Journal of Trauma and Injury
• /
• 제28권3호
• /
• pp.129-133
• /
• 2015

Purpose: The purpose of this study is to evaluate the surgical outcome of duodenal injuries and to analyze the risk factors related to the leakage after surgical treatment. Methods: A retrospective review of 31 patients with duodenal injuries who managed by surgical treatment was conducted from December 2000 to May 2014. The demographic characteristics, injury mechanism, site of duodenal injury, association of intraabdominal organ injuries, injury severity score (ISS), abdominal abbreviated injury scale (AIS), injury-operation time lag, surgical treatment methods, complications, and mortality were reviewed. Results: Duodenal injury was more common in male. Twenty four (77.4%) patients were injured by blunt trauma. The most common injury site was in the second portion of the duodenum (n=19, 58.6%). Fourteen patients (45.2%) had other associated intraabdominal organ injuries. The mean ISS is $13.6{\pm}9.6$. The mean AIS is $8.9{\pm}6.5$. Eighteen patients (58.1%) were treated by primary closure. The remaining 13 patients underwent various operations, including exploratory laparotomy (n=4), pancreaticoduodenectomy (n=3), pyloric exclusion (n=3), Resection with end-to-end anastomosis (n=2), and duodenojejunostomy (n=1). Most common postoperative complications were intraabdominal abscess (n=9) and renal failure (n=9). Mortality rate was 9.7%. Conclusion: ISS, AIS>10, operative time, pancreaticoduodenectomy, sepsis, and renal failure are significant predictors of a postoperative leak after duodenal injury. Careful management is needed to prevent a potential leak in patient with these findings.

• 대한인간공학회지
• /
• 제35권3호
• /
• pp.155-163
• /
• 2016

Objective: This study aims to draw the characteristics of occupational accidents occurred in cabling work, and assess accident severity based on occupational injury data. Background: Accident factors and accident risk are different by the place of work in cabling work. Field managers require information on accident prevention that can be easily understood by workers. However, there has been a lack of studies that focus on cabling work in Korea. Method: This study classifies 450 injured persons caused in cabling work by process, and analyzes the characteristics of occupational injuries from the aspects of age, work experience and accident type. This study also analyzes accident frequency and severity of injury. Results: Results show that preparing/finishing (33.3%) was the most common type of cabling process in injuries, followed by maintenance (28.4%), routing/income (23.1%) and wiring/installation (15.1%) process. The critical incidents in the level of risk management were falls from height in the routing/incoming process, and falls from height in the maintenance process. And, incidents ranked as 'High' level of risk management were slips and trips, fall from height and vehicle incident in the preparing/finishing process, and fall from height in the wiring/installation process. Conclusion and Application: The relative frequency of accident and its severity by working process serve as important information for accident prevention, and are critical for determining priorities in preventive measures.

• 한국학교ㆍ지역보건교육학회지
• /
• 제13권2호
• /
• pp.107-118
• /
• 2012

Backgrounds: In order to prevent dental injuries that often occur in child and adolescent, it is intended to investigate and assess actual state of the injury development, present epidemiological background, and consider and discuss for preparing preventive means against the injury development. Purpose: It was attempted to understand major features of dental injuries developing in child and adolescent and indentify high risk factors of dental injuries in child and adolescent. Methods: In this study, 523 cases of computerized data collected as disease entities of dental injuries among 1-18 years old patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. Results: It was found that the ratio of dental injuries by genders in child and adolescent was 66.14% of male and 33.86% of female. It was shown also that causes of dental injuries by ages were more in order of falling, bumping, chewing, traffic accident, sports, violence, and crash. In addition places where dental injuries occur by ages were home in less than 5 year old group, park, playground, and play yard in 6-11 year old group, park, playground, and play yard also in 12-14 year old group, and stairs, road, and outdoor places such as mountain climbing, beach, and camping in 15-18 year old group. It was found that time rages when dental injuries in child and adolescent often develop were 15-19 o'clock for falling, 15-19 o'clock for crash, 15-19 o'clock for bumping, 19-03 o'clock for violence, 15-19 o'clock for traffic accident, 15-19 o'clock for sports activity, and 15-19 o'clock for chewing. Conclusion: Background of dental injury inducing factors are very complicated and diversified, so deep study and analysis are required for its prediction. Therefore, it seems necessary to identify risk factors by phases such as before, at, and after accident, establish strategies to reduce injury development, and develop and utilize necessary programs.

• 대한정형외과스포츠의학회지
• /
• 제5권2호
• /
• pp.135-140
• /
• 2006

목적: 시즌이 있는 축구 운동에서 선수들의 가장 부상이 많은 시기와 그 부상의 유형을 알아보고 경기 관련 질환 발생을 미리 예견, 파악하여 적절한 예방책을 제시하고 향후 팀의 운영에 참고 자료를 제시 하고자 한다. 대상 및 방법: 서울의 모 프로 측구 팀(45명)을 대상으로 2005년 1월 15일부터 2005년 11월 9일까지 부상에 대한 통계를 내고, 월별 부상 빈도와 부상 유형을 살펴보았다. 결과: 총 157건의 부상이 발생했고, 훈련에 잠가하지 못할 정도의 부상은 87건 이었다. 월별 심각한 부상 건수는 3월에 16건 (18.4%)으로 가장 높게 나타났으며, 전, 후기 축구시즌인 3, 4, 8, 9월의 부상 건수가 46건으로 전체 부상의 52.9%를 차지하였다. 특히, 시즌 중에는 경기 중 경쟁적인 관계에서 접촉에 의해 족관절 염좌와 타박상으로 결장하는 회수가 많았다. 그리고 대퇴부 근육의 손상에 대한 치료가 적절히 이루어지지 못하여, 재손상의 위험도가 높았다. 결론: 부상이 많은 시즌중에는 선수에게 예방을 위한 교육을 시행함으로 팀의 경기력을 향상시킬 수 있을 것이다.

• Clinical and Experimental Pediatrics
• /
• 제65권4호
• /
• pp.194-200
• /
• 2022

Background: Injury is the leading cause of death or disability in children and adolescents. Rates of deaths from injuries have recently declined, but studies of the occurrence of nonfatal injuries are lacking. Purpose: This study aimed to investigate nonfatal injuries in children and adolescents younger than 20 years based on data from the Korean National Health and Nutrition Survey, 2007-2018. Methods: A questionnaire survey was conducted to determine whether children and adolescents had experienced an injury requiring a hospital visit in the previous year. We investigated each injury's risk factors and characteristics. Results: Of a total of 21,598 children and adolescents, 1,748 (weighted percentage, 8.1%) experienced one or more injuries in the previous year. There was no yearly difference in the proportion of injuries experienced. Among the male subjects, 10.0% had an injury experience; among the female participants, 6.1% had an injury experience (P<0.001). The highest rate was 9.0% in children aged 1-4 years. In multivariate logistic regression analysis, male sex; having an urban residence; having restricted activity due to visual, hearing, or developmental impairment; and attention deficit/hyperactivity disorder were significant risk factors for injury experience. The characteristics of up to 3 injuries per patient were investigated, and 1,951 injuries were analyzed. Falls and slips accounted for 34.9%, collisions for 34.1%, and motor vehicle accidents for 11.3% of the total injuries. Ninety-six percent of injuries were unintentional, 20% caused school absences, and 10% required hospitalization. Conclusion: Among Korean children and adolescents, 8.1% experienced injuries at least once a year with no significant differences in incidence over the past 12 years. Greater attention and effort to prevent injuries are needed.