• Title/Summary/Keyword: Severe injury

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Frequency and Pattern of Traffic Accidents in Different Atmospheric Phenomena (기상(氣象)에 따른 교통사고(交通事故) 발생양상(發生樣相)과 빈도(頻度))

  • Kim, Doo-Hie;Lee, Jung-Mi
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.1 s.29
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    • pp.98-105
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    • 1990
  • In order to fine out the relationship between traffic accidents and atmospheric phenomena, we have analyzed 2,562 cases, one tenth of the total traffic accidents occurred in Taegu city for a year in 1988. The meteorological elements observed by Taegu Weather Bureau were used. It was divided into two largy categories : the patterns of accident as human injuries and destructions of car. When the accidents were overlapped in each other, it was considered as human injury. Human injuries were subdivided into three parts : death, severe wound and slight in, when more then two cases were overlapped, we choiced severe damage. The average number of daily traffic accidents including human injuries were lowest in winter of four seasons. The accident patterns in accordance with the seasons showed statistically significant difference. The frequency was the highest as 3.3 cases in an hour at $25.1-30.0^{\circ}C$ of atmospheric temperature, the rate of human injury showed the increase by the increased temperature. But there were not significant. Also it was the highest as 3.7 cases in less than 31% of humidity and the rate of human injury as the highest at 41-50%, but not significant. And it was the increasing tendency as wind speed increase, and the rate of human injury was the highest at 6.1-7.0 m/sec, but it was not significant. In relation to precipitation, and visibility, were the highest as 5.4 cases at 5.1-10.0 mm of rainfall, the rate of human injury was increased by the increased precipitation and showed statistically significant. And it was highest within 6 Km of visibility, but the rate of the human injury was the lowest within same distance, and also showed significance. The accidents were higher with snow on the road, but the rate of human injury was comparatively lower, but no significance.

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Hypoxia-inducible factor: role in cell survival in superoxide dismutase overexpressing mice after neonatal hypoxia-ischemia

  • Jeon, Ga Won;Sheldon, R. Ann;Ferriero, Donna M.
    • Clinical and Experimental Pediatrics
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    • v.62 no.12
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    • pp.444-449
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    • 2019
  • Background: Sixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies. Purpose: HIF-1α deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the role of HIF-2α in HI is not well characterized. Copper-zinc superoxide dismutase (SOD)1 overexpression is not beneficial in neonatal HI. The expression of HIF-1α and HIF-2α was measured in SOD1 overexpressing mice and compared to wild-type littermates to see if alteration in expression explains this lack of benefit. Methods: On postnatal day 9, C57Bl/6 mice were subjected to HI, and protein expression was measured by western blotting in the ipsilateral cortex of wild-type and SOD1 overexpressing mice to quantify HIF-1α and HIF-2α. Spectrin expression was also measured to characterize the mechanism of cell death. Results: HIF-1α protein expression did not significantly change after HI injury in the SOD1 overexpressing or wild-type mouse cortex. However, HIF-2α protein expression increased 30 minutes after HI injury in the wild-type and SOD1 overexpressing mouse cortex and decreased to baseline value at 24 hours after HI injury. Spectrin 145/150 expression did not significantly change after HI injury in the SOD1 overexpressing or wild-type mouse cortex. However, spectrin 120 expression increased in both wild-type and SOD1 overexpressing mouse at 4 hours after HI, which decreased by 24 hours, indicating a greater role of apoptotic cell death. Conclusion: HIF-1α and HIF-2α may promote cell survival in neonatal HI in a cell-specific and regional fashion. Our findings suggest that early HIF-2α upregulation precedes apoptotic cell death and limits necrotic cell death. However, the influence of SOD was not clarified; it remains an intriguing factor in neonatal HI.

Multiple Intraabdominal Solid Organ Injuries after Blunt Trauma (외상후 복부 다발성 고형장기 손상)

  • Park, Hyung Do;Kim, Sun Hyu;Lee, Jong Hwa;Hong, Jung Seok;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.193-198
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    • 2009
  • Purpose: This study evaluated the characteristics and the prognosis of multiple intraabdominal solid organ injuries, including those to the liver, spleen, and kidney, after blunt trauma. Methods: From January 2001 to March 2009, 39 patients with multiple intraabdominal solid organ injuries, which had been confirmed by contrast-enhanced computed tomography after blunt trauma, were included in this retrospective study. The injury severity score (ISS), abbreviated injury scale (AIS), revised trauma score (RTS), American Association for the Surgery of Trauma (AAST) injury grade of solid organs, initial hemodynamic status, blood gas analysis, blood transfusion, and the mortality were the main outcome measurements. Results: Injured groups were classified into liver/kidney (n=17), liver/spleen (n=4), spleen/kidney (n=13), and liver/kidney/spleen (n=5) groups. Patients were older in the liver/kidney group than in the liver/kidney/spleen group (43 vs 18 years, p=0.023). The initial systolic blood pressures tended to be lower in the liver/kidney group than in the other groups (84 vs 105, 112, and 114 mmHg, p=0.087). The amounts of 24-hour packed RBC transfusion were 32 units in the liver/kidney group and 4 units in the liver/kidney/spleen group, but the difference was not statistically significant. Differences were found in neither the RTS, ISS, and AIS for head, chest, abdominal, and pelvic injuries nor the AAST injury grade for solid organ, but injuries to the chest were more severe in the liver/spleen group than in the spleen/kidney group (AIS 4.0 vs 2.8, p=0.028). Conservative treatment was the most frequent applied treatment in all groups. There were 6 mortalities : 3 due to hypovolemia, 2 to sepsis, and 1 to brain injury. Mortalities occurred only in the liver/kidney group. Conclusion: Patients who had intraabdominal solid organ injuries of the liver and the kidney simultaneously, tended to be transfused more at an early time after trauma, to have lower initial systolic blood pressures, and to have a higher mortality.

Effect of Aspirin on the Acute Lung Injury Induced by Intestinal Ischemia/Reperfusion. (장의 허혈-재관류로 유도된 급성 폐손상에서 아스피린의 작용)

  • Park, Yoon-Yub
    • Journal of Life Science
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    • v.19 no.6
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    • pp.818-824
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    • 2009
  • The mechanisms responsible for ischemia/reperfusion (I/R) injury have direct or indirect relevance to clinical lung injury after severe shock, cardiopulmonary bypass, and transplantation. This study investigated the effects of aspirin on intestinal I/R-induced acute lung injury (ALI) in rats. Lipopolysaccharide (LPS) induced cyclooxygenase-2 (COX-2) expression in A549 and RAW264.7 cells. RAW264.7 macrophages had shown greater expression of COX-2 than A549 cells. In addition, the NADPH oxidase inhibitor apocynin and p38 MAPK inhibitor SB203580 attenuated LPS-stimulated COX-2 expression. To induce ALI, intestinal ischemia was performed for 60 min prior to the 4 hr reperfusion by clamping the superior mesenteric artery in Sprague-Dawley rats. In order to test and compare the effect of non-specific COX inhibitor aspirin with the effect of mepacrine, a well known phospholipase$A_{2}$ inhibitor, rats were divided into 4 groups: Sham, I/R, Mepa+I/R (mepacrine, 60 mg/kg, i.p.), ASA+I/R (aspirin, 10 mg/kg, i.p.). In the present investigation, myeloperoxidase activities in the lung and intestinal tissues were increased by I/R. These changes were reduced by single pretreatment of mepacrine (60 mg/kg, i.p.) or aspirin (10 mg/kg, i.p.) 30 min before I/R. Structural studies demonstrated that the tissue injuries in the lung and intestine after I/R were also attenuated by the pretreatment of mepacrine or aspirin. These results suggest that I/R-induced ALI is mediated, in part, by the activation of COX. In addition, pretreatment of aspirin might be helpful for the prevention of ALI in ARDS-prone patients. In addition, the p38 MAPK inhibitor and apocynin also might be helpful to ALI through the inhibition of COX-2 expression.

Prevention of Alpine Ski Injuries (알파인 스키 부상의 예방)

  • Eun Seung-Pyo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.109-114
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    • 2002
  • The types of Alpine ski injuries have changed through the years in relationship to the development of skiing equipment. Modern skis, boots and bindings are better at protecting the tibia, which previously was almost as commonly injured as the knee. Since the 1980s, severe knee sprains, most of them involving the anterior cruciate ligament have tripled while injuries of the lower extremity below the knee diminished significantly. However, recent studies show no further improvements in either lower leg fractures or increase in the rates of ACL sprains has occurred. The use of carving skis presents an increased risk for sustaining isolated ACL injuries in more skilled skiers and less skilled skiers are more likely to sustain an ankle fracture than skiers using conventional skis. To restore the trend of diminishing lower leg injury rates, efforts will be needed to motivate skiers to have their equipment serviced by ski shop professionals following ASTM (American Society for Testing and Material) standard procedures. As of now, there are no boots, bindings or skis on the market designed to protect skiers from the ACL injury. The only method proven to reduce ACL injury Is a training program based on recognizing the circumstances that lead to ACL injury in skiing and to avoid these events.

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Characteristics of Head Injuries After Skiing and Snowboarding Accident (스키와 스노보드 사고에서 두부손상의 특징)

  • Kang, Sung Chan;Lee, Kang Hyun;Choi, Han Joo;Park, Kyung Hye;Kim, Sang Chul;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.53-58
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    • 2008
  • Purpose: Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries. Methods: One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders. Results: Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was $26.7{\pm}10.0$, and that of the snowboarders was $26.7{\pm}6.2$. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was $4.5{\pm}2.1$ and that of the snowboarder group was $5.9{\pm}5.0$ (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%). Conclusion: The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.

Incidences of Lower Extremity Injuries in Korea (국내 하지손상의 발생현황에 대한 분석)

  • Kim, Chang Sun;Choi, Hyuk Joong;Kim, Jai Yong;Shin, Sang Do;Koh, Sang Baek;Lee, Kug Jong;Im, Tai Ho
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.36-45
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    • 2008
  • Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

Development of a Rabbit Iliac Arterial Stenosis Model Using a Controlled Cholesterol Diet and Pullover Balloon Injury (콜레스테롤 식이 및 내막 손상을 통한 토끼 장골동맥 협착 전임상 모델 개발)

  • Hooney D. Min;Chong-ho Lee;Jae Hwan Lee;Kun Yung Kim;Chang Jin Yoon;Minuk Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.372-380
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    • 2024
  • Purpose This study aimed to develop a rabbit iliac stenosis model and evaluate the effects of different mechanical injury techniques on the degree of arterial stenosis. Materials and Methods Eighteen rabbits were divided into three groups: cholesterol-fed with pullover balloon injury (group A; n = 6), cholesterol-fed with localized balloon dilatation (group B; n = 6), and chow-diet with pullover balloon injury (group C; n = 6). After baseline angiography, the left iliac arteries of all rabbits were injured with a 3 × 10 mm noncompliant balloon using either a wide pullover technique (groups A and C) or a localized balloon dilatation technique (group B). A nine-week follow-up angiography was performed, and the angiographic late lumen loss and percentage of stenosis were compared. Results Group A exhibited the most severe late lumen loss (A vs. B, 0.67 ± 0.13 vs. 0.04 ± 0.13 mm, p < 0.0001; A vs. C, 0.67 ± 0.13 vs. 0.26 ± 0.29 mm, p < 0.05; stenosis percentage 32.02% ± 6.54%). In contrast, group B showed a minimal percentage of stenosis (1.75% ± 6.55%). Conclusion Pullover-balloon injury can lead to significant iliac artery stenosis in rabbits with controlled hypercholesterolemia. This model may be useful for elucidating the pathogenesis of atherosclerosis and for evaluating the efficacy of novel therapeutic interventions.

A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.406-408
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    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

Surgical Treatment of a Life-Threatening Large Retropharyngeal Hematoma after Minor Trauma : Two Case Reports and a Literature Review

  • Park, Jin Hoon;Jeong, Eui-Kyun;Kang, Dong-Ho;Jeon, Sang Ryong
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.304-307
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    • 2015
  • Only a few cases of anterior longitudinal ligament (ALL) injury related with retropharyngeal hematoma without fracture have previously been reported. The treatment of choice for retropharyngeal hematoma is generally considered to be conservative care, but we believe that early surgery of this pathology would be better in certain situations. Here, we describe two cases with life-threatening large retropharyngeal hematomas related with ALL injuries and operated on at an early stage. Two previously healthy patients visited the emergency room with neck pain and dyspnea after falling. Serious neck swelling was observed and lateral neck X-ray showed severe widening of the prevertebral space. Due to dyspnea progression, emergency endotracheal intubation was performed. Although there was no primary cause of the retropharyngeal hematoma on preoperative examination, ALL tearing was intraoperatively confirmed during early surgery. The in-hospital evolutions of the patients were favorable after surgery. We should bear in mind the possibility of ALL injury and perform early surgery where possible given the earlier convalescence and good prognosis.