• Journal of Chest Surgery
• /
• v.49 no.4
• /
• pp.232-241
• /
• 2016

Background: Paraplegia is a devastating complication following operations on the thoracoabdominal aorta. We investigated whether histidine-tryptophan-ketoglutarate (HTK) solution could reduce the extent of ischemia/reperfusion (IR) spinal cord injuries in a rat model using a direct delivery method. Methods: Twenty-four Sprague-Dawley male rats were randomly divided into four groups. The sham group (n=6) underwent a sham operation, the IR group (n=6) underwent only an aortic occlusion, the saline infusion group (saline group, n=6) underwent an aortic occlusion and direct infusion of cold saline into the occluded aortic segment, and the HTK infusion group (HTK group, n=6) underwent an aortic occlusion and direct infusion of cold HTK solution into the occluded aortic segment. An IR spinal cord injury was induced by transabdominal clamping of the aorta distally to the left renal artery and proximally to the aortic bifurcation for 60 minutes. A neurological evaluation of locomotor function was performed using the modified Tarlov score after 48 hours of reperfusion. The spinal cord was harvested for histopathological and immunohistochemical examinations. Results: The spinal cord IR model using direct drug delivery in rats was highly reproducible. The Tarlov score was 4.0 in the sham group, $1.17{\pm}0.75$ in the IR group, $1.33{\pm}1.03$ in the saline group, and $2.67{\pm}0.81$ in the HTK group (p=0.04). The histopathological analysis of the HTK group showed reduced neuronal cell death. Conclusion: Direct infusion of cold HTK solution into the occluded aortic segment may reduce the extent of spinal cord injuries in an IR model in rats.

• Korean Journal of Health Education and Promotion
• /
• v.14 no.1
• /
• pp.147-160
• /
• 1997

Nowadays according to the complexity of our daily life due to the development of industry and transportation various kinds of injuries happen. Since 1993 the death rate among 5-14 age children by injuries amount to about 57%. Furthermore, the injury of children can give a direct damage to their own family and it can also bring a serious loss to the country as well as the community where they live in accord with degree of an injury. From this reason, the importance of safety education has been increasing. In this study, it is aimed to clarify the effect of injury preventive behaviors on injury incidence of the 6th grade students in the elementary school. This study is accomplished by the survey sampled from 9 elementary schools in seoul, each of which belong to different district. The survey took for 15 days from the date of september 10th 1996 to september 25th 1996 and the results were as follows; 1. For demographic characteristic, sexual distribution was 48.7% of male students and 47.1% of female students. The required time from home to school was 10-19 minutes(51.8%), and the most way of their going to school is to walk(89.7%). Mothers who graduated from high school were 46.6% and 49.4% of fathers were above university graduated level. The most vocation of mothers was housewife as 56.7%. 2. The results of analysis on the injury rates, 75.8% of children experienced more than one injury and the most was play injury. With regards to sites where injuries happened, the room, the kitchen, and the living room in the house ranked first(38.3%) and then injuries at school such as on the playground, in the classroom, and on the stairs was 34.1%. 3. Considering the rate of injury incidence in accordance with demographic characteristics, male students experienced more injuries than female students(p〈0.05). For the way from home to school, children who went to school by bicycle experienced the most injuries and then on foot, by bus in order of which differences were statistically significant(p〈0.05). 4. From the comparison of parents' safety education practice and the injury incidence, the less often parents practice safety education, the more often children experience injuries(p〈0.05). 5. The results of analysis on the effect of injury preventive behaviors on accidents children who didn't act injury preventive behaviors experienced much more injuries than those who did injury preventive behaviors of which differences were statistically significant(p〈0.01). 6. From the results of analysis of factors effecting on the elementary school children's injuries, children without injury preventive behaviors had more effect on accidents than those who had injury preventive behaviors as odds ratio 2.06(p〈0.01), and the odds ratio of male students compared with female students was 1.47(p〈0.05).

• Journal of Acupuncture Research
• /
• v.29 no.6
• /
• pp.23-34
• /
• 2012

Objectives : This study was performed to define clinical character of peripheral facial nerve injury. Methods : 36 patients was identified with peripheral facial nerve injury among 1128 patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gang-dong between January 2010 and November 2011. We reviewed the medical records including gender, age, cause, symptom, period of treatment, and axonal loss. Results : Most common cause of peripheral facial nerve injury was iatrogenic surgery, followed by direct trauma, neoplastic disorders. Patients with facial nerve injury commonly complain about facial palsy(ipsilateal or bilateral), followed by paresthesia, facial spasm, facial pain, auricular pain. Peripheral facial nerve injury group showed worse electrophysiological pattern and younger onset age compared with Bell's palsy group. Conclusion : This study was designed for 36 patients and further studies are necessary.

• Journal of Korean Academy of Nursing
• /
• v.36 no.4
• /
• pp.621-629
• /
• 2006

Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.3
• /
• pp.277-283
• /
• 1999

This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

• Journal of Oral Medicine and Pain
• /
• v.39 no.4
• /
• pp.133-139
• /
• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• BMB Reports
• /
• v.46 no.1
• /
• pp.47-52
• /
• 2013

Intestinal epithelial cell (IEC) apoptosis induced by hypoxia compromise intestinal epithelium barrier function. Both Akt and Hsp90 have cytoprotective function. However, the specific role of Akt and $Hsp90{\beta}$ in IEC apoptosis induced by hypoxia has not been explored. We confirmed that hypoxia-induced apoptosis was reduced by $Hsp90{\beta}$ overexpression but enhanced by decreasing $Hsp90{\beta}$ expression. $Hsp90{\beta}$ overexpression enhanced BAD phosphorylation and thus reduced mitochondrial release of cytochrome C. Reducing $Hsp90{\beta}$ expression had opposite effects. The protective effect of $Hsp90{\beta}$ against apoptosis was negated by LY294002, an Akt inhibitor. Further study showed that Akt phosphorylation was enhanced by $Hsp90{\beta}$, which was not due to the activation of upstream PI3K and PDK1 but because of stabilization of pAkt via direct interaction between $Hsp90{\beta}$ and pAkt. These results demonstrate that $Hsp90{\beta}$ may play a significant role in protecting IECs from hypoxia-induced apoptosis via stabilizing pAkt to phosphorylate BAD and reduce cytochrome C release.

• Journal of Chest Surgery
• /
• v.40 no.5 s.274
• /
• pp.376-379
• /
• 2007

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair He had no problem after this event. He complained of dyspnea that stalled 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.

• Physical Therapy Rehabilitation Science
• /
• v.2 no.1
• /
• pp.31-38
• /
• 2013

Objective: To determine the efficacy and reliability of measuring direct current microcurrent applied through the skin to determine injury in the underlying tissues. Design: Case control study. Methods: First, microcurrent was measured as decreased blood flow induced hypoxia in healthy subjects. Next, reliability was assessed by measuring over ten days with set variations in pressure and distance between the electrodes. Finally, measurements over sprained ankle were compared to measurements over comparable uninjured areas on the same injured subject. Results: For the blood flow test phase, microcurrent significantly decreased an average of 17% after 5 minutes (p<0.05), remained decreased for 30 seconds, and returned to non-occlusive levels after 2 minutes of normal circulation. The results indicate that the microcurrent decrease was not due to blood flow, and most likely from hypoxic cellular damage. For the reliability phase, the coefficients of variation averaged 10.3% for the shoulder, 14.8% for the low back, and 29.1% for the knee. Changing distance 2.5 cm between the electrodes resulted in insignificant changes. Changes in pressure had some significant effect after an increase in force of 2.6 N, affirming the need for consistent pressure for measurement. For the injury test phase, a significant 69% decrease occurred comparing injured areas to the same area on the uninjured side, and a significant 74% occurred comparing injured and non-injured areas on the same limb. Conclusions: Microcurrent through the skin shows promise as an objective method of assessing a soft tissue injury by detecting damage likely due to hypoxia.

• Archives of Plastic Surgery
• /
• v.47 no.5
• /
• pp.435-443
• /
• 2020

Background The innervated radial artery superficial palmar branch (iRASP) flap was designed to provide consistent innervation by the palmar cutaneous branch of the median nerve (PCMN) to a glabrous skin flap. The iRASP flap is used to achieve coverage of diverse volar defects of digits. However, unexpected anatomical variations can affect flap survival and outcomes. Methods Cases in which patients received iRASP flaps since April 1, 2014 were retrospectively investigated by reviewing the operation notes and intraoperative photographs. The injury type, flap dimensions, arterial and neural anatomy, secondary procedures, and complications were evaluated. Results Twenty-eight cases were reviewed, and no flap failures were observed. The observed anatomical variations were the absence of a direct skin perforator, large-diameter radial artery superficial palmar branch (RASP), and the PCMN not being a single branch. Debulking procedures were performed in 16 cases (57.1%) due to flap bulkiness. Conclusions In some cases, an excessively large RASP artery was observed, even when there was no direct skin perforator from the RASP or variation in the PCMN. These findings should facilitate application of the iRASP flap, as well as any surgical procedures that involve potential damage to the PCMN in the inter-thenar crease region. Additional clinical cases will provide further clarification regarding potential anatomical variations.