• 제목/요약/키워드: Severe injury

검색결과 927건 처리시간 0.025초

Effects of amygdalin on the functional recovery and c-Fos expression in the ventrolateral periaqueductal gray region after sciatic crushed nerve injury in rats

  • Kim, Toung-Wook;Lim, Hyung-Ho;Song, Yun-Kyung;Kim, Sung-Eun;Lee, Jin-Woo;Lee, Myoung-Hwa;Seo, Jin-Hee;Shin, Mal-Soon;Lim, Baek-Vin;Kim, Chang-Ju
    • Advances in Traditional Medicine
    • /
    • 제7권5호
    • /
    • pp.556-563
    • /
    • 2008
  • Peripheral nerve injuries are a commonly encountered clinical problem and often result in a chronic pain and severe functional deficits. The expression of c-Fos is sometimes used as a marker of increased neuronal activity. We have prepared the aqueous extract of amygdalin from Armeniacae semen for pain control. In the present study, we investigated the effects of amygdalin on the recovery rate of the locomotor function and on the expression of c-Fos in the ventrolateral periaqueductal gray (vlPAG) region following sciatic crushed nerve injury in rats. Walking track analysis for the evaluation of functional recovery and immunohistochemistry for the c-Fos expression were used in this study. In the present results, characteristic gait change with dropping of the sciatic function index (SFI) was observed and c-Fos expression in the vlPAG was suppressed following sciatic crushed nerve injury in rats. Amygdalin enhanced SFI value and restored c-Fos expression in the vlPAG to the control value. The present our study indicated that amygdalin activates neurons in the vlPAG, and it facilitates functional recovery following peripheral nerve injury.

골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염 (Acalculous Cholecystitis Following Multiple Trauma with Fractures)

  • 김기훈;경규혁;김진수;김관우;김운원;김지완
    • Journal of Trauma and Injury
    • /
    • 제25권4호
    • /
    • pp.203-208
    • /
    • 2012
  • Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

Validation of guidelines for field triage of injured patients for major trauma in patients of brain and spinal injury

  • Lee, Sung Kgun;Kang, Jeong Ho;Song, Sung Wook
    • Journal of Medicine and Life Science
    • /
    • 제17권1호
    • /
    • pp.7-15
    • /
    • 2020
  • The field triage guidelines have been widely implemented in the Korean trauma system. This study aimed to evaluate and validate whether it is reliable to use the field triage guidelines for predicting severe traumatic brain injury (TBI) and traumatic spinal injury (TSI) patients. This study retrospectively analyzed in-hospital cohort registries of all TBI and TSI patients, who visited the emergency department (ED) of the Jeju National University Hospital from 1 January 2013 to 31 December 2015. The primary outcome was defined as TBI and TSI patients with an injury severity score (ISS)>15. Secondary outcomes were defined as cases in which one or more of the following conditions: in-hospital death, ISS>15, admission to the intensive care unit, emergency surgery. We enrolled 14,889 TBI and TSI patients who visited ED, of which 7,966 (53.5%) were triage positive. The overall sensitivity, specificity and area under the curve (AUC) of the full cumulative field triage guidelines step's model (Step 1+3+4 criteria) for primary outcome were 82.8%, 47.0%, and 0.646, respectively. In the results for secondary outcomes, the specificity did not show a significant difference, but the sensitivity decreased to 66.5% and AUC to 0.568. The results of this study suggest that further optimization of the field triage guidelines is needed to identify high-risk TBI and TSI patients.

포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견 (Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings)

  • 이희천;최을수;조규완;강병택;김주원;유치호;서정향;정동인
    • 한국임상수의학회지
    • /
    • 제27권5호
    • /
    • pp.579-583
    • /
    • 2010
  • 18년 령의 수컷 포메라니언견이 낙상으로 인한 외상성 머리 손상으로 내원하였다. 신체검사 및 신경검사 후 뇌손상이 의심되었다. 두부 방사선 쵤영에서 우측 후두골 부위에 골절로 인한 뼈조각이 관찰되었다. 전산화 단층촬영상에서 두개 내 출혈 소견이 확인되었다. 두부 외상에 대한 처치에도 불구하고 환자는 내원 수 시간 후 폐사하였고 부검을 실시하였다. 육안 검사 상 대뇌 피질의 출혈 소견과 부종이 확인되었으며 이는 전산화 단층 촬영 결과와 일치하였다. 본 증례보고는 개에서 발생한 심한 외상성 뇌손상의 임상적 특성, 전산화 단층촬영 영상적 특징, 부검 소견, 그리고 조직학적 변화를 잘 보여주고 있다.

두부외상 환자에서 전두엽 손상과 신경인지기능 변화에 따른 주관적인 증상 연구 (The Study of the Subjective Symptoms according to Frontal Lobe Damage and Change in Neurocognitive Function in Traumatic Head Injury Patients)

  • 김준원;한덕현;기백석;박두병
    • 대한불안의학회지
    • /
    • 제8권1호
    • /
    • pp.31-40
    • /
    • 2012
  • Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.

Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center

  • Lee, Min A;Lee, Seung Hwan;Choi, Kang Kook;Park, Youngeun;Lee, Gil Jae;Yu, Byungchul
    • Journal of Trauma and Injury
    • /
    • 제34권3호
    • /
    • pp.177-182
    • /
    • 2021
  • Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

Injury trends among foreign and domestic tourists in Jeju from 2008 to 2018

  • Hwang, Ki Sang;Lee, Sung Kgun;Song, Sung Wook;Kim, Woo Jeong;Kang, Young Joon;Kang, Kyeong Won;Park, Hyun Soo;Park, Chang Bae;Kang, Jeong Ho;Bu, Ji Hwan;Ko, Seo Young
    • Journal of Medicine and Life Science
    • /
    • 제19권1호
    • /
    • pp.8-13
    • /
    • 2022
  • Jeju is the largest island in Korea and one of its key tourist attractions. As the number of foreign tourists steadily increases, so does the number of injuries incurred there. Accordingly, this study aimed to describe and compare the characteristics of injuries suffered by foreign tourists versus those of domestic tourists. As a cross-sectional study of a retrospective medical record survey, the study was conducted with reference to the Jeju Injury Surveillance System from the 11-year period of January 2008 to December 2018. The following factors were investigated: demographic data, mechanism of injury, place of occurrence, activity when injured, patient outcome, and mortality. A total of 92,095 injured Jeju Island visitors was recorded during this time, a number that included 88,050 Koreans and 4,045 foreigners. The gender ratio showed similar patterns between the two groups and there were no significant age differences. In both groups, the most common mechanism of injury was collisions/cuts. Also, more foreigners experienced falls than Koreans. Regarding the location, Koreans had the most road accidents, while foreigners were most likely to be injured at outdoor locations, such as seas and rivers. Furthermore, more foreigners experienced severe injuries requiring hospitalization. Notably, this study showed the differences in injury between foreign and Korean tourists visiting Jeju Island and its findings lend support to targeted safety promotion programs.

Sciatic neurotmesis and periostitis ossificans progressiva due to a traumatic/unexpected glass injury: a case report

  • Berkay Yalcinkaya;Hasan Ocak;Ahmet Furkan Colak;Levent Ozcakar
    • Journal of Yeungnam Medical Science
    • /
    • 제41권1호
    • /
    • pp.45-47
    • /
    • 2024
  • Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/ tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

Miniature Schnauzer에서 발생한 장간막 염전 1증례 (Mesenteric torsion in a Miniature Schnauzer)

  • 최지혜;김현욱;김진경;장재영;김준영;윤정희
    • 대한수의학회지
    • /
    • 제48권1호
    • /
    • pp.125-130
    • /
    • 2008
  • Mesenteric torsion was diagnosed in a 2-year-old, spayed female Miniature Schnauzer. The patient was presented with acute depression, vomiting, lethargy and hematochezia. On physical examination, severe dehydration, tachycardia, tachypnea, weak femoral pulse, delayed capillary refill time and pale mucous membrane were found and the dog was in shock. Radiography and ultrasonography revealed intestines distended with gas, ascites and the "C" shaped distended intestine. Medical treatments including fluid therapy, analgesics, antibiotics and lidocaine for reducing reperfusion injury were applied. And then, the mesenteric torsion was definitively diagnosed through exploratory laparotomy and intestinal resection and anastomosis were performed. The dog made an uneventful recovery and was free of clinical sign one week after surgery. Mesenteric torsion is an unusual and life-threatening disease in dogs. It has usually been described in the middle and large breed dogs, especially German Shepherds. However, the mesenteric torsion should be included in the differential diagnostic lists for acute abdomen even in small breed dog. The mortality rate of mesenteric torsion can be reduced through prompt diagnosis, proper preventive therapy for shock and reperfusion injury and emergency surgery.

단체급식 안전관리에 대한 영양사 인식 조사(I) - 사고 현황 및 위해 평가 - (Dietitians' Perceptions of Safety Supervision in Institutional Foodservices (I) - Status of Accidents and Assessment of Hazards -)

  • 박혜란;문혜경
    • 대한영양사협회학술지
    • /
    • 제16권4호
    • /
    • pp.318-331
    • /
    • 2010
  • The objectives of this study were to investigate the status of accidents and to assess hazards in institutional foodservices in the Changwon and Masan areas. A survey was conducted from February 1 to March 31, 2009 using questionnaires, and 142 dietitians participated. The dietitians' perception of accident risks in workplace averaged 3.11 points. Forty-five percent of the respondents responded that accidents had occurred more than once between 2006 and 2008. In addition, 28.2% of the respondents experienced employee absences or turnover due to accidents during Year 2008. 'Musculoskelectal injuries or disorders (65.5%)', 'slips or falls (64.8%)', 'burns (57.7%)', and 'cuts and punctures (48.6%)' were the predominant accidents in foodservice. 'Knives (76 points)', 'steam kettles (41 points)', 'vegetable cutters (34 points)' and 'turn kettles (26 points)' were the equipment with severe accidents, such as burns or cut injuries. Among foodservice processes, 'carpal tunnel syndrome while washing (2.83 points)', 'burned by frying oil (2.64 points)', 'cut by sharp tools (2.55 points)', 'musculoskelectal injury by moving heavy weight food materials (2.41 points)', and 'injury by slipping on wet workplace floors and trenches (2.19 points)' were the most frequently occurring accidents at foodservice sites. To prevent safety accidents, dietitians' perceptions of safety supervision should be improved, and therefore, it is necessary they receive safety education.