• 제목/요약/키워드: Acute isolated injury

검색결과 43건 처리시간 0.029초

Fatal Traumatic Subarachnoid Hemorrhage due to Acute Rebleeding of a Pseudoaneurysm Arising from the Distal Basilar Artery

  • Kim, Byung Chul;Lee, Jae Il;Cho, Won Ho;Nam, Kyoung Hyup
    • Journal of Korean Neurosurgical Society
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    • 제56권5호
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    • pp.428-430
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    • 2014
  • Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

거골의 골연골 병변 (Osteochondral Lesions of the Talus)

  • 이근배
    • 대한족부족관절학회지
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    • 제16권1호
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    • pp.9-18
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    • 2012
  • Osteochondral lesions of the talus are isolated cartilage and/or bone lesions that are known cause of chronic ankle pain. They can occur as the result of a single acute ankle injury or from repetitive loading of the talus. Technical development in radiologic imaging and ankle arthroscopy have improved diagnostic capabilities for detecting osteochondral lesions. Characteristics which are important in assessing an osteochondral lesions include: the size, the type (chondral, subchondral, cystic), the stability, the displacement, the location, and the containment of lesion. Nonoperative treatment involving period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions in select pediatric and adolescent patients. Operative treatment is recommended for unstable lesions or failed conservative management. Marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autograft or allograft, autologous chondrocyte implantation, are frequently employed. The purpose of this article is to review the historical background, etiology, classification systems, diagnostic strategies, and to describe a systematic approach to management of osteochondral lesions of the talus.

Cardioprotective effect of ginsenoside Rb1 via regulating metabolomics profiling and AMP-activated protein kinase-dependent mitophagy

  • Hu, Jingui;Zhang, Ling;Fu, Fei;Lai, Qiong;Zhang, Lu;Liu, Tao;Yu, Boyang;Kou, Junping;Li, Fang
    • Journal of Ginseng Research
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    • 제46권2호
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    • pp.255-265
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    • 2022
  • Background: Ginsenoside Rb1, a bioactive component isolated from the Panax ginseng, acts as a remedy to prevent myocardial injury. However, it is obscure whether the cardioprotective functions of Rb1 are related to the regulation of endogenous metabolites, and its potential molecular mechanism still needs further clarification, especially from a comprehensive metabolomics profiling perspective. Methods: The mice model of acute myocardial ischemia (AMI) and oxygen glucose deprivation (OGD)-induced cardiomyocytes injury were applied to explore the protective effect and mechanism of Rb1. Meanwhile, the comprehensive metabolomics profiling was conducted by high-performance liquid chromatography and quadrupole time-of-flight mass spectrometry (HPLC-Q/TOF-MS) and a tandem liquid chromatography and mass spectrometry (LC-MS). Results: Rb1 treatment profoundly reduced the infarct size and attenuated myocardial injury. The metabolic network map of 65 differential endogenous metabolites was constructed and provided a new inspiration for the treatment of AMI by Rb1, which was mainly associated with mitophagy. In vivo and in vitro experiments, Rb1 was found to improve mitochondrial morphology, mitochondrial function and promote mitophagy. Interestingly, the mitophagy inhibitor partly attenuated the cardioprotective effect of Rb1. Additionally, Rb1 markedly facilitated the phosphorylation of AMP-activated protein kinase α (AMPKα), and AMPK inhibition partially weakened the role of Rb1 in promoting mitophagy. Conclusions: Ginsenoside Rb1 protects acute myocardial ischemia injury through promoting mitophagy via AMPKα phosphorylation, which might lay the foundation for the further application of Rb1 in cardiovascular diseases.

The Impact of Surgical versus Transcatheter Aortic Valve Replacement on Postprocedural Acute Kidney Injury in Patients with Chronic Kidney Disease

  • Eun Chae, Kim;Sue Hyun, Kim;Yeiwon, Lee;Suk Ho, Sohn;Jae Woong, Choi;Jeehoon, Kang;Jung Kyu, Han;Kyung Hwan, Kim;Hyo-Soo, Kim;Ho Young, Hwang
    • Journal of Chest Surgery
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    • 제55권6호
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    • pp.435-441
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    • 2022
  • Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

Effects of Larval Extracts from P. brevitarsis seulensison Cytokine and Diagnostic Marker in Carbon Tetrachloride-Administered SD Rats

  • Lee, Ji-Sook;Kwon, Ohseok;Hwang, Seock-Yeon;Yun, Chi-Young
    • 대한임상검사과학회지
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    • 제43권3호
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    • pp.113-119
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    • 2011
  • This study was designed to determine the effects of larval extracts from Protaetia brevitarsis seulensis shade dried larva from Korea and China on liver tissues of hepatic injury groups. The experimental groups are divided into five groups; Normal, carbon tetrachloride single injection ($CCl_4$), Pb-CHI ($CCl_4$ + P. brevitarsis shade dried larva from China), Pb-KOR ($CCl_4$ + P. brevitarsis shade dried larva from Korea) and SIL ($CCl_4$ + 0.35% silymarin) groups. Sprague Dawley rats were oral injected with $CCl_4$ at a dose l mg/kg (20% in corn oil) for induction of liver damage for 4 weeks. Each experimental group was fed with a dose 50 mg/kg of larval extracts based on medicinal preparations from 3 weeks to 4 weeks after $CCl_4$ treatment. At the end of 4 weeks, we evaluated the serum levels of glutamate-oxaloacetate transaminase (GOT), glutamate-pyruvate transferase (GPT), alkaline phosphatase (ALP) and blood urea nitrogen (BUN) in serum and the cytokine levels of tumor necrosis factor-${\alpha}$) (TNF-${\alpha}$) and transforming growth factor-${\beta}$ (TGF-${\beta}$) in the cells isolated from spleen and liver. The histological analysis was also conducted. The $CCl_4$ injection reduced body weight, induced congestion of middle lobe and hepatocytic degeneration, resulting in disintegration of hepatic cords, and increased biochemical markers of blood related to hepatic injury. On the other hand, the Pb-CHI and Pb-KOR group decreased the levels of biochemical markers in blood and cytokine levels in spleen and liver. Especially, the Pb-KOR group facilitated the recovery of biochemical values of blood related to hepatic injury, hepatic lesions and fibrosis. Taken together, larval extract from P. brevitarsis might prevent acute hepatotoxicity and enhance the recovery of liver fibrosis and cirrhosis induced by $CCl_4$, and the ingredients could be a promising candidate for the prevention and treatment of hepatic disorders.

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Platelet-activating Factor에 의한 급성폐손상에서 호중구성 산화성 스트레스에 관여하는 Cytosolic Phospholipase A2 활성도의 변화 (Cytosolic Phospholipase A2 Activity in Neutrophilic Oxidative Stress of Platelet-activating Factor-induced Acute Lung Injury)

  • 권영식;현대성;이영만
    • Tuberculosis and Respiratory Diseases
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    • 제63권6호
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    • pp.497-506
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    • 2007
  • 연구배경: 급성호흡곤란증후군의 병인론에 관여하는 PAF의 역할이 다양하고 중요하므로 본 연구에서는 PAF의 또 다른 작용의 가능성, 즉 $cPLA_2$의 활성화(retrograde activation of $cPLA_2$ by PAF)의 가능성을 검사하고자 하였다. 즉, $cPLA_2$의 활성화에 따른 염증성 지질분자의 생성이 산소기의 생성과정을 증폭시키고 이 때 생성된 PAF가 역으로 $cPLA_2$를 활성화시키는지를 확인하기 위하여 본 연구는 고안되었다. 방 법: 흰쥐에서 급성폐손상을 유도하기 위하여 $5{\mu}g$의 PAF를 0.5 ml의 0.25% bovine serum albumin 용액과 혼합한 뒤 기도 내로 직접 분무하거나 0.5 ml의 4.5 mM의 과산화수소를 기도 내로 분무하였다. 대조군의 경우는 0.5 ml의 생리적 식염수를 기도 내로 분무하였다. 5 시간 후에 단백누출지수 측정, 폐장의 MPO 활성도 측정, 폐포 세척액 내의 호중구 산정, CINC 측정, NBT 및 cytochrome-c 환원검사를 시행하였다. 또한 폐장 및 호중구에 서의 $cPLA_2$ 활성도의 측정 및 광학현미경과 전자현미경을 이용하여 형태학적 관찰을 시행하였다. 결 과: PAF투여 후 단백누출지수, MPO, BAL내의 호중 구의 수 및 CINC의 농도가 대조군에 비하여 유의하게 증가하였다. NBT및 cytochrome-c환원검사의 결과 PAF는 호중구의 respiratory burst를 현저히 증가시키고, 분리된 사람의 호중구에서도 산소기의 생성을 현저히 증가시켰 다. 동시에 PAF는 분리된 호중구 및 폐장의 $cPLA_2$의 활성도도 증가 시켰다. 폐장 내로 투여한 과산화수소는 폐장의 $cPLA_2$활성도를 대조군에 비하여 현저히 증가시켰다. 결 론: $cPLA_2$의 활성화에 따라 생성된 PAF는 호중구의 산소기 생성을 증가시켜 폐장 내의 산화성스트레스를 유발하고 동시에 이때 생성된 산화기는 $cPLA_2$를 활성화시키며 PAF 또한 $cPLA_2$의 활성도를 증가시켜 PAF가 급성호흡 곤란증후군의 병인론에 관여하는 것으로 생각된다.

허혈/재관류 손상연구를 위한 체외 신장 재관류 모델 (A model of Isolated Renal Hemoperfusion)

  • 남현숙;우흥명
    • 한국임상수의학회지
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    • 제26권5호
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    • pp.441-444
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    • 2009
  • 허혈/재관류 손상은 장기이식 분야에서 해결해야 할 주요 문제점으로 알려져 있다. 본 연구에서는 대퇴 동,정맥 부위에서 기존의 혈관 문합법 대신 맥관 connector를 이용하여 간단하면서 효과적인 체외 재관류 모델을 개발하였기에 소개하고자 한다. 개발된 모델이 허혈/재관류 손상연구에 효과적인지 알아보기 위해 혈액 동력학적 평가와 신장의 재관류 후 손상 양상을 분석하였다. 기존의 재관류 모델에서 사용되는 문합 부위인 복강 대동맥의 혈압과 본 연구에서 재관류 부위로 활용된 대퇴동맥의 혈압은 유의적 차이가 없었다. 허혈 손상 후 재관류 효과를 알아보기 위해 미니돼지에서 적출한 신장을 HTK 용액에 24, 48시간 동안 각각 저온보관 후 대퇴부에 이식하여 재관류 한 결과, 신장의 재관류까지 수술시간은 평균 $7.0{\pm}1.1$분 소요되었으며, 3시간 재관류 후 재관류 손상 정도는 저온보관시간에 따라 증가되는 것이 확인되었다. 이는 개발된 모델이 맥관 문합 없이 간단한 관류방법이면서도 기존의 복잡한 수술에 의한 재관류 방법과 유사한 손상 모델을 만들 수 있는 효과적인 허혈/재관류 동물모델이라는 것을 의미한다. 따라서 본 연구에서 개발한 신장 재관류 모델은 초기 허혈/재관류 손상 연구와 장기이식에서 이식면역연구에 효과적인 모델이라 사료된다.

산소기에 의한 급성 폐손상에서 폐모세혈관압의 역할에 관한 연구 (The Role of Pulmonary Capillary Pressure in the Oxygen Free Radical-Induced Acute Lung Injury)

  • 유철규;김영환;한성구;심영수;김건열;한용철
    • Tuberculosis and Respiratory Diseases
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    • 제39권6호
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    • pp.474-483
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    • 1992
  • 연구배경 : 급성 폐손상은 원인에 상관없이 병태생리학적으로 폐동맥압의 증가와 폐부종을 특징으로 하는데 산소기를 포함한 여러 종류의 염증매개성 물질들이 급성 폐손상의 발병기전에 관여할 것으로 생각되고 있다. 그러나 산소기에 의한 급성 폐손상에서 폐모세혈관압의 변화는 확실하게 알려져 있지 않다. 또한 폐부종의 형성에는 폐포-모세혈관투과성과 함께 폐모세혈관과 폐포사이의 수압차도 중요한 역할을 하는 것으로 알려져 있으나 산소기에 의한 급성 폐손상에서 폐포모세혈관압의 역할에 관해서는 별로 알려져 있지 않은 실정이다. 방법 : Sprague-Dawley 백서를 정상 대조군(n=5), xanthine/xanthine oxidase 처치군(n=7), catalase 전치치군(n=5), papaverine 전처치군(n=7)과 indomethacin 전처치군(n=5)으로 나누어 격리순환폐모델에서 시간경과 따른 폐동맥압, 폐모세혈관압을 측정하고 폐의 무게 변화를 관찰하여 폐부종의 지표로 사용하였다. 폐모세혈관압은 micropuncture에 의한 방법과 일치도가 높은 것으로 알려져 있는 double occlusion법을 이용하였다. 즉, 폐동맥으로의 관류와 좌심방으로부터의 관류를 동시에 2초간 차단하여 폐동맥압과 좌심방압이 비슷한 압력에서 평형상태를 유지할 때의 압력을 폐모세혈관압으로 사용하였다. 결과 : 1) 폐동맥압과 폐모세혈관압은 각각 xanthine/xanthine oxidase 처치군에서 대조군에 비해 유의하게 높았다. 이들은 catalase와 papaverine 전처치로 각각 유의하게 완화되었으나 indomethacin 전처치로는 유의하게 완화되지 않았다. 2) xanthine/xanthine oxidase 처치군에서 관찰된 폐부종은 catalase 천처치와 papaverine 전처치로 유의하게 완화되었으나 indomethacin 전처치로는 완화되지 않았다. 결론 : 격리순환폐모델에서 산소기에 의한 백서의 급성 폐손상시 폐모세혈관압이 증가하고 이는 폐포-모세혈관투과성이 증가된 상태하에서 폐부종을 악화시키며 산소기에 의한 폐모세혈관압의 증가와 폐부종에 cyclooxygenase 대사물은 큰 역할을 하지 않을 것으로 생각된다.

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Effect of Zinc-enriched Yeast FF-10 Strain on the Alcoholic Hepatotoxicity in Alcohol Feeding Rats

  • Cha, Jae-Young;Heo, Jin-Sun;Cho, Young-Su
    • Food Science and Biotechnology
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    • 제17권6호
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    • pp.1207-1213
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    • 2008
  • The possible protective effects of highly zinc-containing yeast Saccharomyces cerevisiae, FF-10 strain, isolated from tropical fruit rambutan on acute alcoholic liver injury in rats were evaluated. Zinc concentration in this strain was 30.6mg%. The activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and $\gamma$-glutamyl transpeptidase ($\gamma$-GTP) were highly increased when alcohol was treated, relative to the normal rats. Also, a highly significant increase in the blood alcohol and acetaldehyde levels by alcohol treatment was observed. Administration of FF-10 strain markedly prevented alcohol-induced elevation of the activities of serum ALT, AST, and $\gamma$-GTP, and the levels of blood alcohol and acetaldehyde, and these reduced levels reached to that of normal rats. As compared with alcohol treated control rats, the FF-10 strain supplementation showed highly decreased the triglyceride concentration in serum. Alcohol treatment induced the marked accumulation of small lipid droplets, hepatocytes necrosis, and inflammation, but FF-10 strain administration attenuated to alcohol-induced accumulation of small lipid droplets and hepatocyte necrosis in the liver. Therefore, the current finding suggests that zinc-enriched yeast FF-10 strain isolated from tropical fruit rambutan may have protective effect against alcohol-induced hepatotoxicity.