• Title/Summary/Keyword: 손상 기전

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The Protective Effect of Prostaglandin E1 Against Ischemia-reperfusion Injury of Musculocutaneous Flaps (백서 복직근피판에 있어 허혈-재혈류 손상에 미치는 Prostaglandin E1의 예방효과)

  • Hong, Joon Pio;Chung, Yoon Kyu;Chung, Soon-Hee
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.190-198
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    • 2000
  • 본 연구는 백서 복직근피판에 있어 허혈-재혈류 손상에 미치는 prostaglandin E1(PGE-1)의 예방효과를 분석 실험하였으며, 그 기전으로 내피세포의 intercellular adhesion molecule-1(ICAM-1)이 down regulation 됨을 확인하였다. 기존의 PGE-1은 혈관 확장 및 혈소판 응고 저하 등의 기전으로 피판 이식술 후 주로 사용하였으나, 허혈-재혈류 손상 시에 PGE-1 역할에 대한 연구는 잘 알려진바 없다. 허혈-재혈류 손상에 대한 기전은 현재 여러 가설로 설명되고 있으나, 최근 내피 세포와 백혈구의 역할이 주목을 받고 있다. 장시간 허혈 상태의 피판은 재혈류시 백혈구가 내피세포에 접착함으로써 직간접적인 경로로 독소를 생성하며, 결국 내피세포 및 주변조직의 괴사로 이어진다. 본 연구는 면역조직학 염색을 통한 내피세포의 ICAM-1 발현 억제와 그로 인한 백혈구의 내피세포 접착 억제를 그 기전으로 볼 수 있었으며, PGE-1을 술 중 투여함으로써 피판의 생존율을 향상시킬 수 있었다.

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The Relationship between Bone Bruise in MR-Imaging and the Degrees of Acute Anterior Cruciate Ligament Injury (급성 전방십자인대 손상 시 자기공명영상에서 나타나는 골멍과 전방십자인대 손상 정도의 관계)

  • Jeong, Hwa-Jae;Shin, Hun-Kyu;Ko, Chun-Suk;Kim, Jang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.17-25
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    • 2012
  • Purpose: The aim of this retrospective study was to evaluate the relationship between appearance and size of bone bruise and severity of anterior cruciate ligament (ACL) injury with magnetic resonance imaging (MRI), furthermore, to identify the mechanism of ACL injury by analyzing the footprint of bone bruise. Materials and Methods: Sixty-five subjects who was taken an MRI within 6 weeks after acute ACL injury were studied. All MRI showed ACL injury and associated bone bruises. Bone bruises were analyzed using Costa-Paz classification based on appearance and location and also scored using Kornaat bone bruise grading system based on size and location. The severity of the ACL injury was graded using a 4-point system (ie, grade 0-3) with oblique coronal MRI. Results: There was statistically significant correlation between Costa-Paz classification of bone bruises in lateral femoral condyle and grade of ACL injury. There were more type 2 lesions in partial tear group (grade 1, 2), however, type 3 lesions of Costa-Paz classification in complete tear group (P=0.037). Significant positive correlations were observed between Kornaat total bone bruise score and grade of ACL injury (P=0.014). Most common ACL injury mechanism was pivot shift injury. Other mechanisms were clip valgus injury, phantom foot injury, and hyperextension injury. Conclusion: It is highly suggested that appearance and size of bone bruise is related to severity of ACL injury after acute ACL injury. The foot print of bone bruise provides valuable clues to identify ACL injury mechanism.

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Comparison of the Injury Mechanism, Pattern and Initial Management Approach for Orthopedic Injuries According to the Injury Severity in Moderate-to-Severe Injured Patients (중등도 이상의 손상 환자에서 손상 중증도에 따른 정형외과적 손상에 대한 수상기전, 손상유형, 초기 치료적 접근의 비교)

  • Lee, Eui-Sup;Sohn, Hoon-Sang;Kim, Younghwan;Shon, Min Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.383-396
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    • 2020
  • Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.

Conservative Treatment of the Knee Injury and Pain (슬관절 손상과 동통의 보존적 치료)

  • Bin Seoung-I1;Nam Tae-Seok;Ahn Ji-Hyun;Jung Kwang-Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.107-110
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    • 2004
  • Treatment of knee injury and pain consists of conservative and surgical treatment. Although conservative treatment is suffice in many cases, surgical treatment is performed which is not necessary. Therefore, thorough knowledge of injury mechanism and selection of treatment modalities are required. Injury mechanism and conservative treatment of knee injury patients will be discussed.

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Mechanism of Injury in the Anterior Cruciate Ligament Tears Sustained in Participation in Soccer (축구 손상에 의한 전방 십자인대 파열 환자의 수상 기전)

  • Cho, Kwang-Hyun;Park, Young-Eun;Choi, Nam-Hong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.33-36
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    • 2008
  • Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.

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Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury (스포츠 손상과 비스포츠 손상에 의한 상부 관절와 순 전후방(SLAP) 병변의 비교)

  • Lee, Kwang-Won;Lee, Seung-Hun;Yang, Dong-Hyun;Kam, Byoung-Sup;Choy, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.175-182
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    • 2007
  • Purpose: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a non-sports-induced injury. Materials and Methods: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. Results: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). Conclusion: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.

Presumptive Role of Neutrophilic Oxidative Stress in Oxygen-induced Acute Lung Injury in Rats (흰쥐에서 고농도 산소 흡입에 의한 급성 폐손상 시 호중구성 산화성 스트레스의 역할)

  • Moon, Yongsuck;Kim, Jihye;Lee, Young Man
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.464-470
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    • 2008
  • Background: This study examined the role of neutrophilc oxidative stress in an $O_2-induced$ acute lung injury (ALI). Methods: For 48 h, experimental rats were exposed to pure oxygen (normobaric hyperoxia) in a plastic cage. Forty-eight hours after $O_2$ breathing, the rats were sacrificed and the parameters for ALI associated with neutrophilic oxidative stress were assessed Results: Normobaric pure oxygen induced ALI, which was quite similar to ARDS. The $O_2-induced$ neutrophilic oxidative stress was identified by confirming of the increase in lung myeloperoxidase, BAL neutrophils, malondialdehyde (MDA), cytosolic phospholipase $A_2$ ($cPLA_2$) activity in the lung, histological changes and BAL cytospin morphology. Conclusion: In part, ALI-caused by oxygen is affected by neutrophils especially by the generation of free radicals.

Analysis of the Characteristics of Young-old and Old-old Injured Patients in Korea: Focusing on 2021 Discharge Injury Statistics (2004~2021) (우리나라 전·후기 노인 손상환자 특성분석: 2021 퇴원손상통계(2004~2021년) 자료를 중심으로)

  • Jongsuk LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.257-264
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    • 2024
  • This study analyzed data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) (2004~2021) and found that for the young-old with disabilities, the location of injury was roads and main roads, the activity at the time of injury was daily life, the mechanism of injury was falling and the type of transportation accident was collision with passenger cars. In the old-old, the characteristics by type of injury were fractures, the intentionality of the injury was unintentional, the place of injury was residence, the activity at the time of injury was daily life, the mechanism of injury was falling and the type of transportation accident was pedestrian. In conclusion, the old-old were more likely to suffer injuries at home and in daily life than the young-old with disabilities, and old-old injured patients were more active than the old-old, resulting in higher falls and transportation accidents and older seniors were more likely to have pedestrian accidents. Based on the information collected from the young-old and old-old, it is believed that efforts to prevent damage that consider the characteristics of the elderly are necessary.

Neuroimaging of Traumatic Brain Injury (외상성 뇌손상의 영상진단)

  • Choi, Woo Suk
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.169-176
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    • 1995
  • 두부 외상은 많은 발생율과 사망율을 차지하고 있으며, 건강한 생활을 위해 큰 관심을 갖게 되었다. 신경방사선영상은 외상성 뇌손상 환자들의 진단과 치료에 필수적인 방법이다. 뇌손상의 기본 기전, 병리, 그리고 영상 소견을 이해 하는 것은 매우 중요하다. 1970년대에 Glasgow coma scale의 형상과 전산화단층촬영(CT)의 발달은 임상의사들이 두부외상에 대한 평가와 환자들의 경과를 예상하는데 극적인 변화를 주었다. 최근 자기공명영상(MRI)의 발달로 외상성 뇌손상의 형태를 더욱 이해 하게 되었고, 두부 외상의 발견율이 높아지게 되었다.

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