• Title/Summary/Keyword: Mental injury

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The Risk of Cervical Spine Injuries among Submersion Patients in River (강에서 발생한 익수 환자의 경추손상 위험도)

  • Kim, Suk Hwan;Choi, Kyung Ho;Choi, Se Min;Oh, Young Min;Seo, Jin Sook;Lee, Mi Jin;Park, Kyu Nam;Lee, Won Jae
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.47-53
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    • 2006
  • Purpose: Recently, the American Heart Association recommended that routine cervical spine protection in submerged patients was not necessary, except in high-energy injury situations. However, until now, this recommendation has few supportive studies and literatures. This retrospective study was performed to demonstrate the risk of cervical spine injury in patients who had been submerged in a river. Methods: Seventy-nine submerged patients who visited St. Mary's Hospital between January 2000 and December 2005 were included in this retrospective study. We investigated and analyzed the victim's age, sex, activity on submersion, mental status and level of severity at admission, prognosis at discharge, associated injuries, and risk group by using the medical records and cervical spine lateral images. According to the activity on submersion, victims were classified into three groups: high risk, low risk, and unknown risk. The reports of radiologic studies were classified into unstable fracture, stable fracture, sprain, degenerative change, and normal. Results: The patients' mean age was 36.8 yrs, and 54% were males. Of the 79 patients, adult and adolescent populations (80%) were dominant. Jumping from a high bridge (48%) was the most common activity on submersion and accounted for 52% of the high-risk group. The Glasgow coma scale at admission and the cerebral performance scale at discharge showed bimodal patterns. The results of the radiologic studies showed one stable fracture, one suspicious stable fracture, and 18 sprains. The incidence of cervical spine fracture in submerged patients was 2.5% in our study. The incidence of cervical spine injury was higher in the high-risk group than it was in the low-risk group, especially in the jumping-from-high-bridge subgroup; however this observation was not statistically significant. No other factors had any significant effect on the incidence of cervical spine injury. Conclusion: Our study showed that even submerged patients in the high risk group had a low incidence of cervical spine fracture and that the prognosis of a patient did not seem to be influenced by the cervical spine fracture itself.

Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients. (의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?)

  • Mun, You-Ho;Kim, Yun-Jeong;Shin, Soo-Jeong;Park, Dong-Chan;Park, Sin-Ryul;Ryu, Hyun-Wook;Seo, Kang-Suk;Park, Jung-Bae;Chung, Jae-Myung;Bae, Ji-Hye
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

Traumatic Brain Injury in Children under Age 24 Months : Analysis of Demographic Data, Risk Factors, and Outcomes of Post-traumatic Seizure

  • Yoon, Sang-Youl;Choi, Yeon-Ju;Park, Seong-Hyun;Hwang, Jeong-Hyun;Hwang, Sung Kyoo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.584-590
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    • 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.

Child abuse, can we find child abuse? - Role of the pediatrician (아동학대, 찾아낼 수 있는가 - 소아청소년과 의사의 역할)

  • Min, Ki Sik
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1194-1199
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    • 2009
  • Child abuse is defined by a recent act or failure to act that results in death, serious physical or emotional harm, sexual abuse or exploitation, or imminent risk of serious harm; involved a child; and is carried out by a parent or caregiver. This report provides guidance in the clinical approach to the evaluation of suspected physical abuse in children, and role of pediatrician. The medical assessment is outlined with obtaining a medical history, physical examination, and diagnostic testing. A minor form of child abuse which only involves skin injury is most frequently seen by a pediatrician. This kind of child abuse can be followed by more severe forms of child abuse, which have high mortality rates and cause serious physical and mental sequelae to the survivor. Therefore, a pediatrician's role in an early detection and prevention of child abuse is very important.

Massive Rhabdomyolysis Following Cardiopulmonary Bypass

  • Kim, Young Sam;Yoon, Yong Han;Kim, Joung Taek;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.181-184
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    • 2014
  • Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Pharmacologic management for the patient with paresthesia after implant surgery or extraction (임프란트 수술이나 발치 후 지각이상 환자에서의 약물치료)

  • Kim, Seong-Taek;Kim, Il-Young;Gang, Hee-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.2
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    • pp.109-113
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    • 2003
  • The inferior alveolar nerve provides unilateral innervation to the dentition, labial mucosa and skin from about commissure to the mental protuberance. Injury to this nerve resulting in sensory impairment can be a distressing problem to some patients. The causes of this problem include trauma, extraction, implant surgery and any maxillofacial surgery and generally the altered sensation is temporary. The surgical procedure has been the most common treatment for this condition but it has some complications. The antidepressants and anticonvulsants have been effective to the treatment of trigeminal dysesthesia. This case report suggests that the use of antidepressants and anticonvulsants is an alternative method to treat the paresthesia after implant surgery or extraction.

A Review of Recent Acupucture Therapy for Developmental disorder (발달장애 아동의 침치료에 대한 최근 동향 고찰)

  • Moon, Se-Hee;Kim, Jeon-Yun;Kim, Lak-Hiyung;Jang, In-Soo
    • Korean Journal of Acupuncture
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    • v.20 no.3
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    • pp.129-146
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    • 2003
  • Objectives : Developmental disorder include every disorder that obstruct functional developments. For example, Mental Retardation, Autism, Developmental Academic Skill Disorder, Developmental Language Disorder, Cerebral Palsy, Tic Disorder(Tourette's Disorder), Attention Deficit Hyperactivity Disorder, Brain injury etc. Methods : Chinese medical circles study herbs, acupuncture and cooperate Western medicine for treat the Developmental disorder variety. So, we research Chinese and Korean Medical Journal from 1990 to 2003, choose the Acupuncture Therapy. Results : Acupuncture Therapy include head needling, body acupuncture, ear-acupuncture therapy, therapy of point injection. By these ways control brain, the brain's marrow, liver, kidney, heart and treat the developmental disorder effective.

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Jogging and its related sports injuries (건강 달리기와 그와 관련된 스포츠 손상)

  • Kyung Hee-Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.1-9
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    • 2004
  • Running people is exceedingly increasing with the concern about the health. The health is defined as 'a state of complete physical, mental and social well being and not merely the absence of disease or infirmity' by WHO. It is very important to know that which level is one's physical strength and what is adequate quality and quantity of one's exercise. In this paper I would describe about exercise pre-scription, sports walking, and jogging. And sports injuries related running will be described briefly.

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The management of patient attempting suicide in the emergency room (응급실에서 자살 시도자의 치료)

  • Roh, Hyeonjeong;Kang, Youngjoon
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.60-63
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    • 2019
  • The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.

Classical oral manifestations of Dyke-Davidoff-Masson syndrome: a case report with review of the literature

  • Kalaskar, Ritesh;Kalaskar, Ashita Ritesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.4
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    • pp.198-203
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    • 2018
  • Dyke-Davidoff-Masson syndrome is a non-inherited rare condition that presents during childhood and is characterized by seizures, hemiplegia, mental retardation, cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses. The present article highlights a case of a 12-year-old male child with additional clinical findings of $caf{\acute{e}}$-au-late pigmentation and ocular lipodermoid. This is the first case report of DykeDavidoff-Masson syndrome to describe oral manifestations, such as unilateral delayed eruption of teeth, hypoplasia, and taurodontism, which could be unique and characteristic of this condition. Oral health care providers and physicians should be aware of these oral observations as dental referrals could warrant early dental prophylactic care and can be useful in diagnosing the possible time of injury and type of Dyke-Davidoff-Masson syndrome.