• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.582-591
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• 2018

Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.

• Korean Journal of Applied Biomechanics
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• v.26 no.4
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• pp.369-375
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• 2016

Objective: The purpose of this study was to investigate the possibility of injuries and the types of movement related to damage by body parts, and to prepare for prevention of injuries and development of a training program. Method: For this study, the experiment was conducted according to levels of 60 percentages (ST) and 85 percentages (MA) and 10 subjects from the Korean elite national weightlifting team were included. Furthermore, we analyzed joint moment and muscle activation pattern with three-dimensional video analysis. Ground reaction force and EMG analyses were performed to measure the factors related to injuries and motion. Results: Knee reinjuries such as anterior cruciate ligament damage caused by deterioration of the control ability for the forward movement function of the tibia based on the movement of the biceps femoris when the rectus femoris is activated with the powerful last-pull movement. In particular, athletes with previous or current injuries should perceive a careful contiguity of the ratio of the biceps femoris to the rectus femoris. This shows that athletes can exert five times greater force than the injury threshold in contrast to the inversion moment of the ankle, which is actively performed for a powerful last pull motion and is positively considered in terms of intentional motion. It is activated by excessive adduction and internal rotation moment to avoid excessive abduction and external rotation of the knee at lockout motion. It is an injury risk to muscles and ligaments, causing large adduction moment and internal rotation moment at the knee. Adduction moment in the elbow joint increased to higher than the injury threshold at ST (60% level) in the lockout phase. Hence, all athletes are indicated to be at a high risk of injury of the elbow adductor muscle. Lockout motion is similar to the "high five" posture, and repetitive training in this motion increases the likelihood of injuries because of occurrence of strong internal rotation and adduction of the shoulder. Training volume of lockout motion has to be considered when developing a training program. Conclusion: The important factors related to injury at snatch include B/R rate, muscles to activate the adduction moment and internal rotation moment at the elbow joint in the lockout phase, and muscles to activate the internal rotation moment at the shoulder joint in the lockout phase.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.24-33
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• 2023

Purpose : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484-0.579). The sensitivity was 56.6% (45.5-67.7%) and the specificity was 69.7% (66.0-73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p < .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

• Korean Journal of Health Education and Promotion
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• v.11 no.2
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• pp.18-32
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• 1994

The purpose of this study was to analyze the effectiveness of injury prevention education on elementary school students. We are selected two elementary school in Tejeon, one was intervention school, the other was control school. Surveys were completed before the begining of the interventions in February in 1994 and again after their completion in July 1994. Intervention group was 284 students in pre-test and 218 students in post-test. And control group was 253 students in pre-test and 208 students in post-test. The results of this study was followed. 1. In the general characteristics of subjects studied, sex, mother education, father education, economic status, number of household, and traffic environment were not significant difference between intervention and control group(p>0.05). 2. The contents of injury prevention education that subjects wished to learn, were not significant difference between intervention and control group(p>0.05). Also the mothods of that were significant difference between intervention and control group in pre-test(p<0.05) but not in post-test(p>0.05). 3. Education in knowledge, attitude and practice of injury prevention was slightly effectiveness. Change in attitude of injury prevention was higher than in knowledge and attitude of that we guess that they require a lot of education in the pedestrian prevention. 4. Reative risk between intervention and control group in injury incidence was 1.53 in hospital-care students, and 1.43 in home-care children. Also relative risk of total injury incidence was 1.38, therefore we knew that injury incidence after education was reduced. 5. In the analysis of injury causes, pedestrain injury was remarkably reduced at hospital-care students in two group. At home-care students, two groups were high proportion in play injury. 6. In the analysis of injury places, intervention group was high proportion at near-the house in pre-test(35.4%) and at school in post-test(36.4%). And control group was high at inside-the house in pre-test(31.5%) and at near-the house in post-test(28.2%).

• Journal of Trauma and Injury
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• v.33 no.2
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• pp.88-95
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• 2020

Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.142-150
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• 2010

Purpose: In this study, patients in whom two computed tomography (CT) scans had been obtained within 24 hours of injury were analyzed to determine the incidence, risk factors and clinical significance of a progressive intracerebral hematoma (PIH). Methods: Participants were 182 patients with a traumatic intracerebral hematoma and contusion who underwent a repeat CT scan within 24 hours of injury. Univarite and multivariate statistics were used to define growth (volume increase) and to examine the relationship between the risk factors and hemorrhage expansion. Results: Fifty-four percent of the patients experienced progression in the size of the lesion in the initial 24 hours postinjury. A PIH was independently associated with worsened Glasgow coma scale (GCS) score (2.99, 1.04~8.60), the presence of subarachnoid hemorrhage (6.29, 2.48~16.00), the presence of a subdural hematoma (6.18, 2.13~17.98), the presence of an epidural hematoma (5.73, 1.18~27.76), and the presence of a basal cistern effacement (10.93, 1.19~99.57). Conclusion: For patients undergoing scanning within 2 hours of injury, the rate of PIH approaches 61%. Early repeated CT scanning is indicated in patients with a nonsurgically-treated hemorrhage revealed on the first CT scan. Worsened GCS score, significant hematoma growth and effacement of the basal cisterns on the initial CT scan are powerful predictors of which patients will require surgery. These findings should be important factors in understanding and managing of PIH.

• Korean Journal of Child Studies
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• v.31 no.2
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• pp.169-182
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• 2010

This study sought to compare beliefs regarding injury, accidents, and prevention behaviors between mothers and teachers in childcare centers. The subjects were 252 mothers whose children were aged between 1 and 4 years old and 264 teachers in childcare centers. The data were analyzed using t-tests, ANOVA, and partial correlation. Our results were as follows; 1) Mothers believed that by experiencing minor injuries young children would learn to recognize risk and develop their abilities to endure pain. Mothers engaged in prevention behaviors in accidents less when compared to teachers in childcare centers. 2) Mothers and teachers in childcare centers whose ages were below 30-years-old and whose education levels were below high school tended to believe young children would learn to recognize risk through accidents, and they engaged in prevention behaviors in accidents less. 3) There was a negative correlation between injury beliefs and prevention behaviors in accidents.

• Transactions of the Korean Society of Automotive Engineers
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• v.11 no.6
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• pp.108-117
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• 2003

Development of advanced restraint system challenges both restraint and automobile manufacturers to come up with proper airbag design to reduce occupant out-of-position related injury. The important component of the advanced restraint system is the multi stage inflator. The multi stage inflator can independently control two or more airbag inflation stages to maximize occupant protection. The objective of this research is to develop relationship between airbag inflation characteristics, the occupant positions and the airbag design variables. The tests are conducted using five kinds of inflators, two kinds of airbag cushion folding methods and two kinds of tear lines. In the case of inflator, the out-of-position tests are performed with a traditional inflator, a depowered inflator and a dual stage inflator. And the efficiency and injury mechanism are evaluated by analyzing the injury pulses and values. Using this relationship, airbag design guideline is established for airbag aggressivity thresholds and the risk of injury is identified according to occupant positions.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.33 no.8
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• pp.799-806
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• 2009

Thoracic injury from restraint loading is the principle causative factor of death, which was shown to be particularly significant for older drivers. To characterize thoracic response to belt loading of older drivers, detailed finite element models of the adult and aged thorax were developed. The geometry of the 50th percentile adult male was chosen for the adult FE model. The thoracic FE model was validated against data obtained from results of PMHS pendulum impact tests. The quantified patterns of age-related shape and well-established material changes were applied to the adult model to develop the aged model. Belt force and chest deflection were applied to the developed two types of models. Rib and clavicle fracture risk obviously increased in the aged model. This finding showed that larger rib angle and reduced material properties of the ribcage produced more higher risk of injury in the older driver.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.154-157
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• 2021

Tracheobronchial injury (TBI) is an uncommon but potentially fatal event. Iatrogenic lesions during bronchoscopy, endotracheal intubation, or thoracic surgery are considered the most common causes of TBI. When TBI is detected during surgery, concomitant surgical treatment is recommended. Herein we present a case of successful robotic primary repair of iatrogenic tracheal and left bronchial branch tears during a robot-assisted hybrid 3-stage esophagectomy after neoadjuvant chemoradiotherapy. A robotic approach can facilitate the repair of this injury while reducing both the potential risk of conversion to open surgery and the associated increased risk of postoperative respiratory complications.