Risk factors for abnormal CT findings in preschool children head injuries without neurological deficit

Objective@#This study aimed to apply abnormal computed tomography (CT) findings to help identify clinical and physical characteristics which suggest a traumatic brain injury, in preschool children with mild head injuries but without neurological deficit. @*Methods@#Among the 1,735 preschool children (aged ≤6 years) with head trauma who visited our hospital and underwent CT scans, 1,711 students without severe neurologic deficits were retrospectively assessed via images and electronic records. The relationship between the occurrence of abnormal CT findings and clinical symptoms, physical examination findings, and the conditions of children were assessed using Pearson’s chi-squared test and multivariable logistic regression analysis. @*Results@#Traumatic brain injury with abnormal CT findings were observed in 75 of the 1,711 patients, and the association with brain injury was more prominent among patients who had fallen from a height of ≥1 m, had posttraumatic irritability, or had posttraumatic scalp swelling. @*Conclusion@#Free fall from a height of ≥1 m, posttraumatic irritability, and posttraumatic scalp swelling should be carefully assessed in patients who have suffered a traumatic brain injury and show abnormal CT findings but no neurologic deficits. Regardless of their initial signs, an active test is recommended for children who complain of multiple symptoms. Patients with these risk factors require greater in-depth brain CT examination. Abnormal CT findings are more meaningful in the case of patients with multiple symptoms.

Risk factors for abnormal CT findings in preschool children head injuries without neurological deficit

Objective@#This study aimed to apply abnormal computed tomography (CT) findings to help identify clinical and physical characteristics which suggest a traumatic brain injury, in preschool children with mild head injuries but without neurological deficit. @*Methods@#Among the 1,735 preschool children (aged ≤6 years) with head trauma who visited our hospital and underwent CT scans, 1,711 students without severe neurologic deficits were retrospectively assessed via images and electronic records. The relationship between the occurrence of abnormal CT findings and clinical symptoms, physical examination findings, and the conditions of children were assessed using Pearson’s chi-squared test and multivariable logistic regression analysis. @*Results@#Traumatic brain injury with abnormal CT findings were observed in 75 of the 1,711 patients, and the association with brain injury was more prominent among patients who had fallen from a height of ≥1 m, had posttraumatic irritability, or had posttraumatic scalp swelling. @*Conclusion@#Free fall from a height of ≥1 m, posttraumatic irritability, and posttraumatic scalp swelling should be carefully assessed in patients who have suffered a traumatic brain injury and show abnormal CT findings but no neurologic deficits. Regardless of their initial signs, an active test is recommended for children who complain of multiple symptoms. Patients with these risk factors require greater in-depth brain CT examination. Abnormal CT findings are more meaningful in the case of patients with multiple symptoms.

The Factors that Predict Using Mechanical Ventilation for Patients with Organophosphate Intoxication

PURPOSE: The purpose of this study is to investigate the factors that predict using mechanical ventilation for patients with organophosphate intoxication. METHODS: We retrospectively reviewed the medical records of 111 patients with acute organophosphate intoxication and who were treated in our emergency center from January 2000 to December 2008. We compared the toxicologic characteristics, the laboratory findings and the APACHE II scores between the Mechanical Ventilation group (MV group) and the non-Mechanical Ventilation group (the non MV group). RESULTS: Sixty three patients were in the MV group and 48 patients were in the non MV group. In the MV group, the patients had an older age (p<0.001), a larger amount of ingestion (p<0.001), a lower initial serum cholinesterase level (p=0.003), a higher APACHE II score (p<0.001) and they ingested a more toxic agent (p=0.001). There were no significant differences in gender, the type of visit and the arrival time between the MV group and the non MV group. CONCLUSION: We suggest that the patient's age, the amount of organophosphate ingestion, the toxicity of the agent, the initial serum cholinesterase level and the APACHE II score are important factors to determine if mechanical ventilation will be applied for patients with organophosphate intoxication.

Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients

PURPOSE: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. METHODS: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. RESULTS: One hundred forty six(146) patients underwent whole-body CT. The mean age was 44.6+/-18.9 years. One hundred four (104, 71.2%) were men, and the injury severity score was 14.0+/-10.38. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. CONCLUSION: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

Characteristics and Risk Factors of Bicycle Injury

PURPOSE: The bicycle is a clean and future-oriented means of transportation and bicycle usage is growing. The bicycle has been in the spotlight lately with Europe and North America as the center. The purpose of this study was to establish proper prevention strategies for bicycle injuries. METHODS: In this retrospective study, we analysed 148 bicycle-related injury patients who visited our hospital between Feb 1, 2008 and Jan 31, 2009. Information such as age, gender, injury severity score, injury time, injury place, and other characteristics were collected. Data were analysed using SPSS 12.0K. RESULTS: Among the enrollees, 80.4% were male. Patients over 65 years of age accounted for only 18.2% of the group, but average injury severity score (ISS) of this group was the highest. Injuries occurred frequently between 16:00 and 22:00 in the evening, while the severity was higher between 00:00 and 08:00 in the morning. Most of the injuries developed on the roads, which included local roads, national highways, and alleyways. Injuries on the roads were more severe than those that occurred in other places. CONCLUSION: There have been suggestions for using bicycles safely. Legislation on bicycle helmet use already exists. Also, protective apparatus such as knee pads, wrist guards, and protection vests are recommended for use. Construction of more bike trails will be necessary. Above all, bicycle riders' safety consciousness is the most important part.

Antitumor Effects and Immunomodulating Activities of Phellinus linteus Extract in a CT-26 Cell-Injected Colon Cancer Mouse Model

The antitumor effects of Phellinus linteus extract (Keumsa Linteusan) were investigated in a CT-26 cell-injected colon cancer mouse model. When administered orally (250~1,000 mg/kg body weight), Keumsa Linteusan significantly inhibited the growth of solid colon cancer. The highest dose was highly effective, reducing tumor formation by 26% compared with the control group. The anticomplementary activity of Keumsa Linteusan increased in a dose-dependent manner. Lysosomal enzyme activity of macrophages was increased by 2-fold (100 microg/ml) compared with the control group. Keumsa Linteusan can be regarded as a potent enhancer of the innate immune response, and can be considered as a very promising candidate for antitumor action.