• Journal of Trauma and Injury
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• v.24 no.2
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• Experimental and Molecular Medicine
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• v.50 no.12
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• pp.3.1-3.14
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• 2018

Type 1 diabetes mellitus (T1DM) is a pathological condition associated with osteopenia. $WNT/{\beta}$-catenin signaling is implicated in this process. Trabecular and cortical bone respond differently to $WNT/{\beta}$-catenin signaling in healthy mice. We investigated whether this signaling has different effects on trabecular and cortical bone in T1DM. We first established a streptozotocin-induced T1DM mouse model and then constitutively activated ${\beta}$-catenin in osteoblasts in the setting of T1DM (T1-CA). The extent of bone loss was greater in trabecular bone than that in cortical bone in T1DM mice, and this difference was consistent with the reduction in the expression of ${\beta}$-catenin signaling in the two bone compartments. Further experiments demonstrated that in T1DM mice, trabecular bone showed lower levels of insulin-like growth factor-1 receptor (IGF-1R) than the levels in cortical bone, leading to lower $WNT/{\beta}$-catenin signaling activity through the inhibition of the IGF-1R/Akt/glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$) pathway. After ${\beta}$-catenin was activated in T1-CA mice, the bone mass and bone strength increased to substantially greater extents in trabecular bone than those in cortical bone. In addition, the cortical bone of the T1-CA mice displayed an unexpected increase in bone porosity, with increased bone resorption. The downregulated expression of WNT16 might be responsible for these cortical bone changes. In conclusion, we found that although the activation of $WNT/{\beta}$-catenin signaling increased the trabecular bone mass and bone strength in T1DM mice, it also increased the cortical bone porosity, impairing the bone strength. These findings should be considered in the future treatment of T1DM-related osteopenia.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.124-131
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• 2024

Purpose: The aim of this study was to utilize the American College of Surgeons Trauma Quality Improvement Program (TQIP) database to identify risk factors associated with developing acute compartment syndrome (ACS) following lower extremity fractures. Specifically, a nomogram of variables was constructed in order to propose a risk calculator for ACS following lower extremity trauma. Methods: A large retrospective case-control study was conducted using the TQIP database to identify risk factors associated with developing ACS following lower extremity fractures. Multivariable regression was used to identify significant risk factors and subsequently, these variables were implemented in a nomogram to develop a predictive model for developing ACS. Results: Novel risk factors identified include venous thromboembolism prophylaxis type particularly unfractionated heparin (odds ratio [OR], 2.67; 95% confidence interval [CI], 2.33-3.05; P<0.001), blood product transfusions (blood per unit: OR 1.13 [95% CI, 1.09-1.18], P<0.001; platelets per unit: OR 1.16 [95% CI, 1.09-1.24], P<0.001; cryoprecipitate per unit: OR 1.13 [95% CI, 1.04-1.22], P=0.003). Conclusions: This study provides evidence to believe that heparin use and blood product transfusions may be additional risk factors to evaluate when considering methods of risk stratification of lower extremity ACS. We propose a risk calculator using previously elucidated risk factors, as well as the risk factors demonstrated in this study. Our nomogram-based risk calculator is a tool that will aid in screening for high-risk patients for ACS and help in clinical decision-making.

• Journal of Korean Academy of Nursing
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• v.50 no.1
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• pp.26-38
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• 2020

Purpose: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness. Methods: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0. Results: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects. Conclusion: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.

• Korean Journal of Culture and Social Issue
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• v.26 no.2
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• pp.99-119
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• 2020

The purpose of this study was to construct and test a hypothetical model about impact of childhood trauma on Relationship Addiction of Korean adults the multiple mediating effects of rejection sensitivity and internalized shame. A purposive sample of 465 Korean adults was recruited from three provincial areas. The collected data were then analyzed using SPSS 23.0 and AMOS 23.0 programs. For data analysis, descriptive statistics and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. We found no significant direct effect of childhood trauma on relationship addiction, but the effects of childhood trauma on Relationship Addiction were successively multi-mediated by internalized shame and rejection sensitivity (B=.265, p<.01), and single-mediated by internalized shame (B=.496, p<.01). Based on the results of this study, it can be suggested that in order to prevent relationship addiction of adults, it is necessary to first explore whether he has experienced childhood trauma and thereby has not only internalized shame but also rejection sensitivity.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.5-8
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• 2001

Background and Objectives： Complications arising from endotracheal intubation are uncommon but, when they do occur, can be significant. Placement of an endotracheal tube frequently results in trauma to the underlying laryngeal and tracheal tissue, although the trauma is usually reversible. Occasionally, these changes can be of a more permanent nature and result in severe impairment of the airway and/or voice. It is proposed that a common factor-gastroesophageal reflux-might be responsible. This study was performed in order to develop the animal model of LPRD using rats and investigated that LPRD could produce significant damage to larynx especially vocal cords. Materials and Methods : The each four rats were used in the experiment and control study. Each was anesthetized and larynx was exposed and injured in the unilateral aritenoid. Injured site was contact with normal saline(control group) and synthetic gastric juice(experimental group). The larynx was examined after 7days in normal environment. Results : All was survived in the control group and two was survived in the experimental group. In the control group, some inflammation cells was found but in the experimental group, granulation was found. Conclusion : We developed animal model of LPRD using rat and thought LPRD may Play an important role in the development of permanent laryngeal injury.

• Journal of Oriental Neuropsychiatry
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• v.22 no.4
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• pp.77-86
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• 2011

Objectives : These days assaults and other natural and human disasters are increasing. But oriental medical treatment researches in Korea are limited in car accident PTSD patients only. Our object is to explore an oriental medical intervention model for the evidence-based approach to PTSD after diverse trauma including disasters. Methods : Domestic papers for Korean researches are obtained from oriental medical related journals by internet searching. International materials are obtained from PubMed searching and a publication from Department of Veterans' Affairs. After assorting searched articles into RCTs and non-RCTs, we analyzed the articles according to the elapsed time from trauma. Results : We confirmed that acupuncture, CBT, and PMR were effective in acute stage after traumatic event. And EMDR, EFT, and relaxation therapy were effective in chronic stage after traumatic event. Building on the findings, we proposed a model of oriental medicine for Disaster Mental Health. Conclusions : Analyzing previous researches about oriental medicine on PTSD, several interventions were confirmed the effectiveness on specific treatment stage. We could find the possibility of Oriental Medicine as a Disaster Mental Heath and proposed a model of Oriental medicine for Disaster Mental Health.

• Journal of Korean Neurosurgical Society
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• v.57 no.6
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• pp.445-454
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• 2015

Objective : In the present study we analyzed neuroprotective and antiapoptotic effect of the difumarate salt S-15176, as an anti-ischemic, an antioxidant and a stabilizer of mitochondrial membrane in secondary damage following spinal cord injury (SCI) in a rat model. Methods : Three groups were performed with 30 Wistar rats; control (1), trauma (2), and a trauma+S-15176 (10 mg/kg i.p., dimethyl sulfoxide) treatment (3). SCI was performed at the thoracic level using the weight-drop technique. Spinal cord tissues were collected following intracardiac perfusion in 3rd and 7th days of posttrauma. Hematoxylin and eosin staining for histopatology, terminal deoxynucleotidyl transferase dUTP nick end labeling assay for apoptotic cells and immunohistochemistry for proapoptotic cytochrome-c, Bax and caspase 9 were performed to all groups. Functional recovery test were applied to each group in 3rd and 7th days following SCI. Results : In trauma group, edematous regions, diffuse hemorrhage, necrosis, leukocyte infiltration and severe degeneration in motor neurons were observed prominently in gray matter. The number of apoptotic cells was significantly higher (p<0.05) than control group. In the S-15176-treated groups, apoptotic cell number in 3rd and 7th days (p<0.001), also cytochrome-c (p<0.001), Bax (p<0.001) and caspase 9 immunoreactive cells (p<0.001) were significantly decreased in number compared to trauma groups. Hemorrhage and edema in the focal areas were also noticed in gray matter of treatment groups. Results of the locomotor test were significantly increased in treatment group (p<0.05) when compared to trauma groups. Conclusion : We suggest that difumarate salt S-15176 prevents mitochondrial pathways of apoptosis and protects spinal cord from secondary injury and helps to preserve motor function following SCI in rats.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.207-215
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• 2004

A finite element analysis is used in this study to model 6 kinds of electrode by a genetic program in order to evaluate the mechanical effect on the 3D human cochlea model and the behavior of electrode. Human cochlea is modeled by the spiral-approximation method and the shape of scala tympani is extracted from the mid section of the human cochlea. Contact pressure at the tip and the insertion force are found to be highest when the wires stack horizontally. Axial rotation of electrode is minimal comparing with the stimulating current spread. The results indicate that the electrode stiffness is important to minimize the trauma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.2
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• pp.97-107
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• 2019

Objectives: Small animal maxillofacial models, such as non-segmental critical size defects (CSDs) in the rabbit mandible, need to be standardized for use as preclinical models of bone regeneration to mimic clinical conditions such as maxillofacial trauma. The objective of this study is the establishment of a mechanically competent CSD model in the rabbit mandible to allow standardized evaluation of bone regeneration therapies. Materials and Methods: Three sizes of bony defect were generated in the mandibular body of rabbit hemi-mandibles: $12mm{\times}5mm$, $12mm{\times}8mm$, and $15mm{\times}10mm$. The hemi-mandibles were tested to failure in 3-point flexure. The $12mm{\times}5mm$ defect was then chosen for the defect size created in the mandibles of 26 rabbits with or without cautery of the defect margins and bone regeneration was assessed after 6 and 12 weeks. Regenerated bone density and volume were evaluated using radiography, micro-computed tomography, and histology. Results: Flexural strength of the $12mm{\times}5mm$ defect was similar to its contralateral; whereas the $12mm{\times}8mm$ and $15mm{\times}10mm$ groups carried significantly less load than their respective contralaterals (P<0.05). This demonstrated that the $12mm{\times}5mm$ defect did not significantly compromise mandibular mechanical integrity. Significantly less (P<0.05) bone was regenerated at 6 weeks in cauterized defect margins compared to controls without cautery. After 12 weeks, the bone volume of the group with cautery increased to that of the control without cautery after 6 weeks. Conclusion: An empty defect size of $12mm{\times}5mm$ in the rabbit mandibular model maintains sufficient mechanical stability to not require additional stabilization. However, this defect size allows for bone regeneration across the defect. Cautery of the defect only delays regeneration by 6 weeks suggesting that the performance of bone graft materials in mandibular defects of this size should be considered with caution.