• 대한영상의학회지
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• 제84권4호
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• pp.809-823
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• 2023

외상(trauma)이란 신체 외부에서 작용한 힘에 의한 여러 해부학적, 병태생리학적 변화를 수반하는 신체 손상을 의미한다. 외상 환자는 우리 사회가 고도로 발달해 감에 따라 그 수도 따라 증가하고 있다. 치료 및 진단기술의 발전과 보급의 증가로 외상의학의 중요성은 점점 커지고 있으며 그 수요 역시 증가하고 있다. 그중 특히 흉부 및 흉부의 대혈관의 손상은 환자의 생명을 위협하고 그 후유증 역시 심각한 경우가 많아 진단 및 치료 방법의 중요성이 점차 증가하고 있는 추세이다. 흉부 및 흉부의 대혈관의 외상이 발생하였을 경우 그 사고 수상 기전 및 관련된 해부학적 손상 기전에 따라서 다양한 정도의 신체 손상이 발생한다. 주요한 손상으로는 흉부의 동맥에서 발생하는 출혈이 있으며, 이는 혈역학적 불안정과 응고장애 등을 동반하여 환자의 생명을 위협하게 된다. 이러한 손상은 즉각적인 진단과 빠른 치료적 접근이 예후를 증진하는데 도움을 주는 경우가 많다. 이러한 환자의 치료로는 환자의 상태에 따라서 수술적 접근 방법과 중재적 시술로 접근하는 방법이 있다. 이 중 중재적 시술은 그 편리성과 신속성 및 높은 치료 효과로 인해 점차 각광받고 있으며, 전 세계적으로 보다 많은 외상의료기관에서 점차 시행되고 있다. 대표적인 흉부 외상 환자의 인터벤션 치료로는 비대동맥성 손상의 경우 색전술(embolization)이 있으며, 대동맥의 경우 thoracic endovascular aortic repair (TEVAR)가 있다. 이러한 시술들은 수술적 치료 방법에 비하여 내과적 혹은 외과적 부작용이 적고, 수술적 방법보다 신속하게 시행할 수 있는 점 등 보다 많은 장점을 가지고 있으며 외상 환자의 치료성적 향상에 기여하고 있다.

• Journal of Chest Surgery
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• 제52권5호
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Journal of Ginseng Research
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• 제33권4호
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• pp.268-277
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• 2009

Ginsenosides are among the most well-known traditional herbal medicines frequently used for the treatment of cardiovascular symptoms in South Korea. The anti-ischemic effects of compound K (CK), a metabolite of ginsenoside Rb1, on ischemia-induced isolated rat hearts were investigated through the analyses of the changes in the hemodynamics (blood pressure, aortic flow, coronary flow, and cardiac output) and the measurement of the infarct region. The subjects in this study were divided into four groups: the normal control, the CK-alone group, the ischemia-induced group without any treatment, and the ischemia-induced group treated with CK. No significant differences in perfusion pressure, aortic flow, coronary flow, and cardiac output were found between the groups before ischemia was induced. The oxygen and buffer supply was stopped for 30 min to induce ischemia 60 min after reperfusion in the isolated rat hearts, and the CK was administered 5 min before ischemia induction. The CK treatment significantly prevented decreases in perfusion pressure, aortic flow, coronary flow, and cardiac output under ischemic conditions. In addition, the hemodynamics (except for the heart rate) of the group treated with CK significantly recovered 60 min after reperfusion, unlike in the control group. CK significantly limited the infarct. These results suggest that CK treatment has distinct anti-ischemic effects in an exvivo model of an ischemia-reperfusion-induced rat heart.

• BMB Reports
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• 제47권7호
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• pp.388-392
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• 2014

Berberine, a type of isoquinoline alkaloid isolated from Chinese medicinal herbs, has been reported to have various pharmacological activities. Studies have demonstrated that berberine has beneficial effects on vascular remodeling and alleviates restenosis after vascular injury. However, its mechanism of action on vascular smooth muscle cell migration is not fully understood. We therefore investigated the effect of berberine on human aortic smooth muscle cell (HASMC) migration. Boyden chamber assay was performed to show that berberine inhibited HASMC migration dose-dependently. Real-time PCR and Western blotting analyses showed that levels of matrix metalloproteinase (MMP)-2, MMP-9, and urokinase-type plasminogen activator (u-PA) were reduced by berberine at both the mRNA and protein levels. Western blotting assay further confirmed that activities of c-Fos, c-Jun, and NF-${\kappa}B$ were significantly attenuated. These results suggest that berberine effectively inhibited HASMC migration, possibly by down-regulating MMP-2, MMP-9, and u-PA; and interrupting AP-1 and NF-${\kappa}B$ mediated signaling pathways.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.136.2-137
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• 2003

It was previously reported that luteolin, a flavone compound, displayed the potent anti-oxidant and anti-inflammatory effects, which have also been successful in reducing vascular smooth muscle cells(VSMCs) proliferation after arterial injury. Proliferation of VSMCs plays an important role in development of astherosclerosis. In this study, a possible anti-proliferative effect and its mechanism on rat aortic VSMCs by luteolin was investigated. (omitted)

• Journal of Chest Surgery
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• 제24권3호
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• pp.287-291
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• 1991

Intra-aortic balloon pump [IABP] was applied to 12 patients between July, 1987, and September, 1990. The 12 patients included 8 who were assisted with IABP intraoperatively; 4 patients used IABP postoperatively. 8 patients could not be withdrawn from cardiopulmonary bypass [CPB], but 6 of them [75%] were able to separate from CPB with IABP. They all were withdrawn from the balloon. Four [50%] of them are hospital survivors, and alive at the time of this report. 4 additional patients were assisted with IABP, postoperatively. 2 of them [50Yo] were withdrawn from the balloon but died. The overall survival and balloon weaning rates are 33.3% [4/12] % 66.7% [8/12], respectively. IABP was most effective when applied early to patients who had transient and reversible injury to the myocardium.

• Journal of Chest Surgery
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• 제32권9호
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• pp.844-846
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• 1999

이물질(foreign body)의 만성적인 자극은 혈관에 지연성 손상을 가져올 수 있다. 척추 측후만증을 교정하고 자 약 14개월 전에 흉추에 CD 금속강과 나사못(Cotrel-Dubousset rods and screws)을 장치했던 환자에서 CD 나사못의 만성적인 자극으로 흉벽의 박동성 혈종을 합병한 가성 대동맥류가 발생하였다. 이 환자에서 가성 대동맥류가 발생한 하행대동맥 부위를 절제하고 인조혈관 대치술로 치료하였기에 보고한다.

• Journal of Chest Surgery
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• 제57권1호
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• pp.96-98
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• 2024

The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

• Journal of Chest Surgery
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• 제40권8호
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• pp.558-563
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• 2007

배경: 외상성 대동맥 파열은 사망률이 매우 높은 치명적인 손상이며, 환자의 경과는 동반된 손상과 밀접한 관계가 있다. 따라서 적절한 수술 시기와 치료 방침을 결정하는 것이 중요하다. 대상 및 방법: 겸자 봉합술로 수술한 15명의 외상성 흉부 하행 대동맥 파열 환자를 대상으로 동반 손상 여부, 수술 후 경과 등을 후향적으로 분석하였다. 결과: 사망률은 6.68% (1예)로 환자는 수술 중 사망하였으며, 지연 혈복강으로 인한 것으로 생각한다. 평균 수술 시간 및 대동맥 겸자 시간은 $231{\pm}53.1$분, $13.1{\pm}5.3$분이었다. 1예에서 수술 후 10일째, 장 폐쇄 증상을 호소하여 시행한 복부 전산화 단층 촬영에서 기계적 장 폐쇄가 발견되어 구획 절제술을 시행하였다. 결론: 외상성 대동맥 파열은 여러 방법으로 수술할 수 있지만, 그중 겸자 봉합술은 비교적 안전하고 효과적인 방법이라고 생각한다.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.