• Journal of Trauma and Injury
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• v.37 no.2
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• pp.166-169
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• 2024

Stab wounds, particularly those affecting multiple body regions, present considerable challenges in trauma care. This report describes a case of sustained self-inflicted stab injuries to the abdomen and thighs of a 23-year-old male patient. Although the patient's vital signs were stable and bleeding was minimal from thigh wounds without overt signs of vascular injury, the patient experienced a sudden, profound hemorrhage from the right thigh, leading to cardiac arrest. Successful resuscitation was followed by surgical repair of a right superficial femoral arterial injury accompanying a resuscitative endovascular balloon of the aorta. Subsequent lower extremity computed tomography angiography revealed no additional vascular abnormalities. The patient was discharged in stable condition on the 12th postoperative day. This case underscores the unpredictability of stab wound trajectories and the potential for hidden vascular injuries, even in the absence of immediate life-threatening signs. It also emphasizes the critical role of advanced imaging modalities, such as computed tomography angiography, in identifying concealed injuries, and the importance of strategic intraoperative techniques, including resuscitative endovascular balloon occlusion of the aorta, in achieving favorable patient outcomes.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.971-977
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• 1999

Background: Immunologic and inflammatory responses of cardiopulmonary bypass(CPB) influence postoperative mortality and morbidity with multiple organ injury. It has been reported that ischemia/reperfusion induced-myocardial injury during CPB is causative of release of inflammatory cytokines such as interleukin-6(IL-6) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$). The purpose of this study was to detect the time course of the activated cytokine and troponin-T(TnT), and to examine the correlation between such parameters during CPB. Material and Method: The serial samples were collected from arterial blood via radial arterial catheter in 23 patients who are underwent open heart surgery (OHS) with CPB, the IL-6, TNF-$\alpha$ and TnT were checked. Result: \circled1 IL-6, TNF$\alpha$- and TnT concentration increased significantly during CPB with a peaking level of CPB-off (p 0.05). \circled2 IL-6 had highly positive correlation with aortic cross clamping time and total bypass time(r=0.80, 0.78; p 0.05, respectively). \circled3 There was no correlation among IL-6, TNF-$\alpha$ and TnT. Conclusion: In conclusion, these data showed that elevated production of serum IL-6 during CPB was attributable to ischemia/reperfusion induced-myocardial damage. IL-6 will become a new and sensitive biological marker in assessment of myocardial damage during OHS with CPB. However, further studies will be needed to apply IL-6 in more patient population.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.100-107
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• 2008

Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was $37.70{\pm}19.78years$ with 36.6% of the patients being under 30 years fo age. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs.

• Journal of Trauma and Injury
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• v.32 no.2
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• pp.101-106
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• 2019

Purpose: The purpose of this study was to determine the essential factors for prompt arrangement of angio-embolization in patients with pelvic ring fractures. Methods: A total of 62 patients with pelvic ring fractures who underwent angio-embolization in Dankook University Hospital from March 2013 to June 2018 were retrospectively reviewed. There were 38 men and 24 women with a mean age of 59.8 years. The types of pelvic ring fractures were categorized according to the Tile classification. Patient variables included sex, initial hemoglobin concentration, initial systolic blood pressure, transfused packed red blood cells within 24 hours, Injury Severity Score (ISS), mortality rate, length of hospital stay, and time to angio-embolization. Results: The most common pelvic fracture pattern was Tile type B (n=34, 54.8%). The mean ISS was $27.3{\pm}10.9$ with 50% having an $ISS{\geq}25$. The mean time to angio-embolization from arrival was $173.6{\pm}89minutes$. Type B ($180.1{\pm}72.3minutes$) and type C fractures ($174.7{\pm}91.3minutes$) required more time to angio-embolization than type A fractures ($156.6{\pm}123minutes$). True arterial bleeding was identified in types A (35.7%), B (64.7%), and C (71.4%). Conclusions: It is important to save time to reach the angio-embolization room in treating patients with pelvic bone fractures. Trauma surgeons need to consider prompt arrangement of angio-embolization when encountering Tile type B or C pelvic fractures due to the high risk of true arterial bleeding.

• Journal of Ginseng Research
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• v.46 no.5
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• pp.683-689
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• 2022

Background: Since ginsenosides exert an anti-thrombotic activity, blood flow-improving effects of DK-MGAR101, an extract of mountain ginseng adventitious roots (MGAR) containing various ginsenosides, were investigated in comparison with an extract of Korean Red Ginseng (ERG). Methods: In Sprague-Dawley rats orally administered with DK-MGAR101 or ERG, oxidative carotid arterial thrombosis was induced with FeCl₃ (35%), and their blood flow and occlusion time were measured. To elucidate underlying mechanisms, the cytoprotective activities on rat aortic endothelial cells (RAOECs) exposed to hydrogen peroxide (H₂O₂) were confirmed. In addition, the inhibitory activities of DK-MGAR101 and ERG on agonist-induced platelet aggregation, thromboxane B₂ production, and ATP granule release from stimulated platelets as well as blood coagulation were analyzed. Results: DK-MGAR101 containing high concentrations of Rb1, Rg1, Rg3, Rg5, and Rk1 ginsenosides (55.07 mg/g) was more effective than ERG (ginsenosides 8.45 mg/g) in protecting RAOECs against H₂O₂ cytotoxicity. DK-MGAR101 was superior to ERG not only in suppressing platelet aggregation, thromboxane B₂ production, and granule release, but also in delaying blood coagulation, FeCl₃-induced arterial occlusion, and thrombus formation. Conclusions: The results indicate that DK-MGAR101 prevents blood vessel occlusion by suppressing platelet aggregation, thrombosis, and blood coagulation, in addition to endothelial cell injury.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.874-885
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• 2012

In the present study, the possibility of whether the pharmacological effects of Scutellariae Radix Aqueous Extracts(SR) were favorably changed by report that lipopolysaccharide(LPS)-induced rat acute lung injury was treated with Red-Koji(Monascus purpureus 12002) fermentation. Three different dosages of Red-Koji fermented SR extract(fSR), 125, 250 and 500 mg/kg were orally administered once a day for 28 days before LPS(Escherichia coli 0111:B4) treatments, and then 5 hours after LPS treatment(500 ${\mu}g$/head, intra trachea instillation), all rats were sacrificed. Changes in the body weights, lung weights, pulmonary transcapillary albumin transit, arterial gas parameters(pH, $PaO_2$ and $PaCO_2$) bronchoalveolar lavage fluid(BALF) protein, lactate dehydrogenase(LDH) and proinflammatory cytokine tumor necrosis factor-${\alpha}$(TNF-${\alpha}$), interleukin-$1{\beta}$(IL-$1{\beta}$) contents, total cell numbers, neutrophil and alveolar macrophage ratios, lung malondialdehyde(MDA), myeloperoxidase(MPO), proinflammatory cytokine TNF-${\alpha}$ and IL-$1{\beta}$ contents were observed with histopathology of the lung, changes on luminal surface of alveolus(LSA), thickness of alveolar septum, number of polymorphonuclear neutrophils(PMNs). As results of LPS-injection, dramatical increases in lung weights, pulmonary transcapillary albumin transit increases in $PaCO_2$, decreases in pH of arterial blood and $PaO_2$, increases of BALF protein, LDH, TNF-${\alpha}$ and IL-$1{\beta}$ contents, total cells, neutrophil and alveolar macrophage ratios, lung MDA, MPO, TNF-${\alpha}$ and IL-$1{\beta}$ contents increases were detected with decreases in LSA and increases of alveolar septum and PMNs numbers, respectively as compared with intact control. Especially fSR 125 mg/kg showed quite similar favorable effects on the LPS-induced acute lung injuries as compared with 60 mg/kg of ${\alpha}$-lipoic acid and 250 mg/kg of SR. The results suggest that over 125 mg/kg of fSR extracts showed favorable effects on the LPS-induced acute lung injury mediated by their antioxidant and anti-inflammatory effects. Moreover, increases of the pharmacological effects of SR on LPS-induced acute lung injury were observed by Red-Koji fermentation in this study, at least 2-fold higher.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.963-966
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• 1995

Ischemia reperfusion injury occurs in various diseases. The role of oxygen free radicals in IR injury of the lung has been spotlighted and many studies have been performed. In this study, we tried to prepare a stable rat lung model for IR injury, focusing on surrounding conditions as hilar stripped left lung, clamped left pulmonary artery and bronchus,and declamped after determined period was passed, and right main pulmonary aretery was clamped. Arterial blood gas analyes were performed at 1, 10, 20, 30, minutes after reperfusion. Before clamping, PaO2 was 95 to 120 mmHg in all animals. There were six groups; Group I : temperature 15o C, and 120 minutes clamping, Group II: 20 oC, and 120 minutes clamping, Group III : 25 oC, and 120 minutes clamping, Group IV : 15oC, 90 minutes clamping, Group V : 20 oC, 90 minutes clamping,Group VI: 20 oC, 75 minutes clamping. Each groups contained 10 Sprague Dayley rats. The humidity was maintained 100 % as circulation imerged isotonic Hartmann`s solution of the pleural cavity. In group IV, V, and VI, PaO2 decreased significantly in all animals immediately after reperfusion, but 43 % survived till 10 minutes after reperfusion, it was 74.0$\pm$5.7, 73.3$\pm$10.8,and 88.2$\pm$17.7 mmHg. Pulmonary edema was observed histologically in 2/10 animals in group IV, 6/10 in group V , 3/10 in group VI, 9/10 in group I, and the other lungs showed all edema. We established a stable model by setting ischemic time,and temperature, between 75 to 90 minutes,15 to 20o C, and isotemperature Hartmann`s solution immersion of the pleural cavity.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.10-16
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• 2006

We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.1
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• pp.55-64
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• 2011

The object of this study was to observe the effects of Scutellariae Radix (SR) aqueous extracts on lipopolysaccharide (LPS)-induced rat acute lung injury. Five different dosages of SR extracts were orally administered once a day for 28 days before LPS treatments, and then 5 hours after lipopolysaccharide treatment, all rats were sacrificed. 8 groups, each of 16 rats per group were used in the present study. Changes on the body weights, lung weights, pulmonary transcapillary albumin transit, arterial gas parameters (pH, $PaO_2$ and $PaCO_2$) bronchoalveolar lavage fluid (BALF) protein, lactate dehydrogenase (LDH) and proinflammatory cytokines tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-1${\beta}$ (IL-1${\beta}$) contents, total cell numbers, neutrophil and alveolar macrophage ratios, lung malondialdehyde (MDA), myeloperoxidase (MPO), proinflammatory cytokine TNF-${\alpha}$ and IL-1${\beta}$ contents were observed with histopathology of the lung, changes on luminal surface of alveolus (LSA), thickness of alveolar septum, number of polymorphonuclear neutrophils (PMNs). The results were compared with a potent antioxidant ${\alpha}$-lipoic acid, 60 mg/kg, in which the effects on LPS-induced acute lung injury were already confirmed. The results obtained in this study suggest that over 125 mg/kg of SR extracts showed favorable effects on the LPS-induced acute lung injury, and 250 mg/kg of SR extracts resembling acute respiratory distress syndrome mediated by their antioxidant and anti-inflammatory effects and .as similar to ${\alpha}$-lipoic acid in the present study. Therefore, it is expected that SR will be showed favorable effects on the acute respiratory distress syndrome.

• Journal of Trauma and Injury
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• v.25 no.1
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• pp.1-6
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• 2012

Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.