• Title/Summary/Keyword: post-traumatic

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Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients (정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구)

  • Park, Jin;Kim, Daeho;Kim, Eunkyung;Kim, Seokhyun;Yun, Mirim
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.35-43
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    • 2018
  • Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

Prophylactic Radiotherapy to Prevent the Recurrence of Heterotopic Ossification after Surgical Intervention of the Elbow (주관절에서 이소성 골형성의 재발방지를 위한 예방적 방사선 치료)

  • Kim, Hak-Jae;Kim, Jin-Ho;Kim, Kyu-Bo;Choi, Ja-Young;Chung, Moon-Sang;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.206-212
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    • 2007
  • Purpose: Heterotopic ossification is a well-known postoperative and post-traumatic complication of the elbow. We reviewed the treatment outcome for the use of low-dose radiation after surgical intervention of the elbow to prevent recurrence of heterotopic ossification (HO). Materials and Methods: Forty-five patients with HO underwent surgical intervention and postoperative radiotherapy of the elbow. The median age of the patients was 29 years ($16{\sim}75$ years), and 27 of the patients were men and 18 were women. The occurrence of HO was mainly due to surgery after fracture (24/45) and traumatic injury (21/45). Limitation of the range of motion (ROM) was the most common symptom of the patients. Thirty-four patients received postoperative radiotherapy with a dose of 8 Gy in 2 fractions; 5 patients received a dose of 10 Gy in 5 fractions and 6 patients received a dose of 7 Gy in 1 fraction. Postoperative radiotherapy was given on the first two postoperative days for most of the patients. Sixteen patients were not given anti-inflammatory medication and 29 patients were given NSAIDs for $1{\sim}8$ months. Results: After a median follow-up period of 18 months (range $6{\sim}72$ months), 41 patients showed clinical improvement and two patients did not show improvement. Assessment of the ROM showed a mean improvement from $0{\sim}135^{\circ}$ to $60{\sim}145^{\circ}$ (p=0.028), and assessment of the functional outcome according to MEPI was from ($15{\sim}95$) to ($80{\sim}100$) (p<0.0001). Two of the 34 patients that were followed-up with radiography had mild radiological recurrence of heterotopic ossification. No complications were observed after the radiotherapy. Conclusion: These results suggested that low-dose radiation administered after surgical intervention is safe and effective to prevent the recurrence of HO in the elbow.

The Differences of Interpersonal Experiences between Multicultural and Korean Children with PTSD Symptoms (심리적 외상 경험 다문화가정 아동과 일반가정 아동이 인식하는 대인관계 특성 비교)

  • Gao, Hong-Yue;Hwang, Mae-Hyang
    • The Korean Journal of Elementary Counseling
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    • v.11 no.2
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    • pp.279-298
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    • 2012
  • The purpose of this study was to explore the different perceptions of relationship with significant others of multicultural children with PTSD symptoms. To select the subjects for this study, Korean version of Greenwald and Rubin's CROPS(Child Report of Post-traumatic Symptoms) was administered to 97 multicultural children and 110 Korean children. Among them 20 multicultural children and 22 Korean children were determined as children with PTSD symptoms. SCT was administrated to 42 children and the content analysis of 42 SCTs was undertaken. The following results are the major findings of this research: a) multicultural children perceived their mothers, fathers, friends, and teachers more negatively than Korean children; b) only 55% of multicultural children had positive self-images while almost Korean children had positive self-images; c) multicultural children expressed psychological trauma from peers in school while Korean children expressed psychological trauma from parents at home. Lastly, we discussed implications of the results, limitations and suggestions for future study.

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Humidifier disinfectant lung injury, how do we approach the issues?

  • Choi, Jihyun Emma;Hong, Sang-Bum;Do, Kyung-Hyun;Kim, Hwa Jung;Chung, Seockhoon;Lee, Eun;Choi, Jihyun;Hong, Soo-Jong
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.19.1-19.7
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    • 2016
  • A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone /methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

The Social Support of the Handicaped in Industrial Accident Compensation Insurance (산업재해 장애인의 사회적 지지에 관한 연구)

  • Lee, Hyun-Joo;Oh, Jin-Joo;Choi, Jeong-Myung;Hyun, Hye-Jin;Yoon, Soon-Nyung
    • Korean Journal of Occupational Health Nursing
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    • v.12 no.1
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    • pp.80-88
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    • 2003
  • Rehabilitation has emerged in recent years as major topic for the handicaped in industrial accident compensation insurance(IACI). Specially social support helps the handicaped adjust themselves psychosocially to handicap. This study was conducted to examine different contents and perceived social support, and provide guidlines for specific and proper rehabilitation for the handicaped of IACI. This study is a descriptive study which were collected through two phases using structured questionnaire. In the first stage, surveys were performed via telephone interviews. In the second stage, surveys were performed via home-visit subjects in the first stage included the handicaped of IACI. Finally data were collected from 338 subjects and analyzes by SPSS/PC+10. The instruments of this study were the perceived social support scale which developed by Lee(1996). These scales in the form of 5-point Likert type, consists of 20 items, including 3 subscales of emotional support, informational support, instrumental support. The mean score of social support was 57.2, emotional support 21.0, informational support 21.2 and instrumental support 15.2. The mean of depression for psychosocial factors is 37.5. Threre were significant differences in total perceived social support; age, job status, handicaped degree in IACI, post-traumatic complication and use of instrument. Emotional support was significant differences; age, number of dependent family, job status, handicaped degree in IACI, use of instrument and depression. Informational support was significant differences; job status, posttraumatic complication, use of instrument and depression. Instrumental support was significant differences; sex, job status, handicaped degree in IACI, use of instrument, and depression. The current system of the Labor Welfare institute is not appropriate for solving health problems of the handicaped in IACI. Therefore, it is necessary to develop the plan which can provide the handicaped in IACI high-quality rehabilitation services, so that they must use those services in the community without being dependent on hospitals. This study proposes home visit nursing services as the way to provide various health services within community for the handicaped in IACI.

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THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS (원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Moon, Won-Kyu;Jung, Young-Soo;Lee, Eui-Wung;Kwon, Ho-Keun;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

The Anxiety, Diabetes-Related Distress and Posttraumatic Growth of Parents Who Have Child with Type 1 Diabetes (1형 당뇨병 자녀를 둔 부모의 불안, 당뇨관련 스트레스 및 외상 후 성장)

  • Kim, Mi Young;Kang, Hyun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.257-268
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    • 2017
  • The purpose of this study was to examine the anxiety, levels of diabetes-related distress, and post-traumatic growth of parents who have children with type 1 diabetes and determine the correlation between the differences and variables based on the general characteristics and disease-related characteristics. This is a descriptive survey research and data collection was conducted from January 4th-29th of 2016 with an online survey in an internet community for type 1 diabetes. Seventy seven individuals were included in the final analysis. Statistical analysis was carried out with a t-test, Mann-Whitney U test, Kruskal-Wallis test, and Pearson correlation coefficient. The study results showed that posttraumatic growth was significantly high (p<.05) under parents with a religion, and that parental anxiety and stress were high with children under 6 years of age (p<.05), with cases of hypoglycemia (p<.05), and with high levels of glycated hemoglobin (p<.05). Anxiety and stress had a positive correlation (r=.684, p<.001), and anxiety and stress exhibited a negative correlation with posttraumatic growth (r=-.401, p<.001; r=-.327, p<.05). This suggests that posttraumatic growth can reduce the negative emotions sufficiently, and that a mediating mechanism is needed that promotes posttraumatic growth while decreasing the level of anxiety and stress.

Repair of Ruptured Papillary Muscle of the Tricuspid Valve as a Cause of Tricuspid Insufficiency Following Blunt Chest Trauma (흉부 둔상후 삼첨판막 폐쇄부전을 유발한 삼첨판막 유두근 파열의 치료)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Lee, Jung-Hoon
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.413-416
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    • 2010
  • A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.

Clinical Outcomes of Anterior Open Reduction and Posterior Percutaneous Screw Fixation for Displaced Talar neck Fractures (전방 정복술 및 경피적 후방 압박나사 내고정술을 이용한 전위성 거골 경부 골절의 치료 결과)

  • Park, Ji-Kang;Kim, Yong-Min;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Cha, Jung-Kwan
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.106-114
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    • 2013
  • Purpose: Posteroanterior screw fixation is biomechanically stronger than anteroposterior screw fixation. However, there are few literature about the correlation between clinical results and more strength by posteroanterior fixation. This study was performed to evaluate the clinical outcomes of the accelerated rehabilitation following anterior open reduction and posterior percutaneous screw fixation for displaced talar neck fractures. Materials and Methods: Eighteen cases were followed up for more than 1 year after posteroanterior fixation using headless compression screw for talar neck fractures. The clinical evaluation was performed according to American Orthopaedic Foot and Ankle Society (AOFAS) score and Hawkins criteria. As radiographic evaluation, the degree of fracture displacement, period to union, and occurrence rate of complications such as avascular necrosis through MRI were measured. Results: The AOFAS score was average 90.4 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the Hawkins criteria. Therefore, 16 cases(88.8%) achieved satisfactory results. The degree of fracture displacement had improved significantly from preoperative average 5.6 mm to 1.2 mm immediate postoperatively, and maintained to 1.1mm at the last follow-up. All cases achieved bone union, and the period to union was average 12.4 weeks. There were 3 cases of avascular necrosis of talar body and 2 cases of post-traumatic arthritis. Conclusion: Anterior open reduction and posterior percutaneous headless screw fixation seems to be an effective surgical method for displaced talar neck fractures, because of the possibility of accurate restoration of articular surface, fixation strength enough to early rehabilitation, and needlessness of hardware removal.

The Effect of Hypothermia on Lung Inducible Nitric Oxide Synthase Gene Expression in Intestinal Ischemia-Reperfusion Injury (장 허혈-재관류에서 폐조직의 Inducible Nitric Oxide Synthase유전자 발현에 대한 저체온증의 효과)

  • Kim, Kyuseok;Lee, Jeong Hun;Suh, Gil Joon;Youn, Yeo Kyu;Kang, Young Joon;Kim, Min A;Cho, Sang-Gi;Shin, Hyo-Keun
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.14-20
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    • 2006
  • Purpose: Although hypothermia has been used in many clinical situations, such as post cardiopulmonary resuscitation, stroke, traumatic brain injury, septic shock, and hemorrhagic shock, the mechanism by which it works has not been clearly elucidated. We aimed to evaluate the effect of hypothermia on the plasma nitric oxide (NO) concentration, lung iNOS expression, and histologic changes in intestinal ischemia-reperfusion (IR). Method: Male Sprague-Dawley rats were randomly divided into the hypothermia group (HT, n=8, $27{\sim}30^{\circ}C$) and the normothermia group (NT, n=8, $36{\sim}37^{\circ}C$). They underwent 30 min of intestinal ischemia by clamping the superior mesenteric artery, which was followed by 1.5 h of reperfusion. They were then sacrificed. The acute lung injury (ALI) score, the plasma NO concentration, and lung iNOS gene expression were measured. Results: Compared with the HT group, the NT group showed severe infiltrations of inflammatrory cells, alveolar hemorrhages, and interstitial hypertrophies in lung tissues. There were significant differences in the ALI scores between the NT and the HT groups ($8.7{\pm}1.5/HPF$ in NT vs $5.8{\pm}1.2/HPF$ in HT, p=0.008). Although the plasma NO concentration was slightly lower in the HT group, there was no significant difference between the two groups ($0.80{\pm}0.24{\mu}mol/L$ in NT vs $0.75{\pm}0.30{\mu}mol/L$ in HT, p=0.917). Lung iNOS gene expression was stronger in the NT group than in the HT group. The band density of the expression of iNOS in lung tissues was significantly increased in the NT group compared to the HT group ($5.54{\pm}2.75$ in NT vs$0.08{\pm}0.52$ in HT, p=0.002). Conclusions: This study showed that hypothermia in intestinal IR reduces inflammatory responses, ALI scores, and iNOS gene expression in lung tissues. There was no significant effect of hypothermia on the plasma NO concentration.