- Relation between Serum S100beta and Severity and Prognosis in Traumatic Brain Injury
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Oh Hyun Kim, Kang Hyun Lee, Kap Jun Yoon, Kyung Hye Park, Yong Su Jang, Hyun Kim, Sung Oh Hwang
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J Korean Soc Traumatol. 2007;20(2):138-143.
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 Abstract
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- PURPOSE
S100beta, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. S100beta, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S100beta, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum S100beta, and neurologic outcome, and severity in traumatic brain injury.
METHODS
From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for S100beta, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS).
RESULTS
Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum S100beta, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups (0.74+/-50 microgram/L vs 7.62+/-6.53 microgram/L P=0.002). A negative correlation existed between serum S100beta, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum S100beta, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlations between serum S100beta, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of S100beta. was 7.62 beta partial differential/L (SD=+/-6.53) in the expired patients, 1.15 microgram/L in the mildly disable patient, and 0.727 microgram/L (SD=+/-0.73) in the recovered patients. These differences are statistically significant (p<0.001).
CONCLUSION
In traumatic brain injury, a higher level of serum concentration of S100beta, has a poor prognosis for neurologic outcome.
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Summary
- The Characteristics of Spinal Injury in Skiing and Snowboarding Injuries
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Yong Sung Cha, Kang Hyun Lee, Sun Hyu Kim, Yong Su Jang, Hyun Kim, Tae Yong Shin, Sung Oh Hwang
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J Korean Soc Traumatol. 2007;20(1):33-39.
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Abstract
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- PURPOSE
Few studies have been done for spinal injuries after skiing and snowboarding accidents. Assuming that the riding patterns of skiing and snowboarding were different, we analyzed the differences between the mechanisms, diagnoses and levels of spinal injuries caused by them. The purpose of this study was to gain a better understanding of spinal hazards associated with skiing and snowboarding in order to educate skiers and snowboarders.
METHODS
We conducted a prospective study of 96 patients who had sustained spinal injuries as a result of skiing and snowboarding accidents from January 2003 to March 2006. We used a questionnaire, radiological studies, history taking, and physical examinations. We analyzed the mechanism of injury, the level of spinal injury, the severity of spinal injury, and the Abbreviated Injury Scale scores (AIS score). We used the t-test and the chi-square test.
RESULTS
The skiing and the snowboarding injury group included in 96 patients. The skiing injury group included 30 patients (31.2%), and the snowboarding injury group included the remaining 66 patients (69.8%). The primary mechanism of injury in skiing was collisions and in snowboarding was slip downs (p=0.508). The primary level of spinal injury in skiing and snowboarding was at the L-spine level (p=0.547). The most common athlete ability of the injured person was at the intermediate level (p=0.954). The injured were most commonly at the beginner or the intermediate level (p=0.302). The primary diagnosis of spinal injury in skiing and snowboarding was back spain (p=0.686). The AIS scores did not differed between the two groups (p=0.986).
CONCLUSION
The most common spinal injury after skiing and snowboarding accidents was back sprain. There was no difference in the severity of spinal injury between skiing and snowboarding accidents.
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Summary
- Comparisons of Fracture Types and Pelvic Angiographic Findings in Hemodynamically Unstable Pelvic Bone Fracture
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Kwon Il Lee, Kang Hyun Lee, Sung Chan Kang, Sung Min Park, Yong Su Jang, Tae Yong Shin, Sung Oh Hwang, Hyun Kim
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J Korean Soc Traumatol. 2007;20(1):26-32.
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Abstract
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- PURPOSE
Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings.
METHODS
We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings.
RESULTS
In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: +/-20.1). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery.
CONCLUSION
The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.
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