• Title/Summary/Keyword: Injury of Bone

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Recurrent Secondary Pneumothorax Caused by Bronchiolitis Obliterans Due to Chronic Graft Versus Host Disease in a Patient with Chronic Myelogenous Leukemia after Allogenic Bone Marrow Transplantation (골수이식 후 만성 이식편대숙주질환으로 발생한 폐쇄성 세기관지염에 의한 이차성 재발성 기흉 1례)

  • Ahn, Chul Min;Hwang, Sang Yun;Byun, Min Kwang;Lee, Jin Hyoung;Chung, Wou Young;Moon, Jin Wook;Park, Moo Suk;Min, Yoo Hong;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Kim, Haeryoung;Kim, Hoguen;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.183-187
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    • 2004
  • Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.

A Literature Review of Exercise Intervention for Fall Prevention in the Elderly (고령자의 낙상예방을 위한 운동처방에 대한 고찰)

  • Kim, Mi-Sook;Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.13 no.1
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    • pp.7-19
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    • 2006
  • Falls are a major sources of death and injury in elderly people. Aged-related changes in the physiological systems which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population. Regular exercise may be one way of preventing falls and fall-related fractures. However, the optimal exercise prescription to prevent falls has not yet been defined. On the literature review of exercise intervention for fall prevention in the elderly, exercise appeared to be a useful tool in fall prevention by improving fall risk factors. The optimum exercise prescription; moderate intensity frequency of 3-4 times per week, duration of 30-60minutes can contribute to decreased hazards and number of fall. Fall prevention protocol should include safety, falling effect, enjoyment, and easiness to follow for older people. Effective exercise programs suggested for fall prevention were such as weight-bearing exercise, resistance exercise, lower muscle strength with elastic band, swiss ball exercise walking, tai chi, and yoga.

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Pars Interarticularis Injections in a Patient with Spondylolysis -A case report- (척추용해증 환자에서 Pars Interarticularis Injections의 치료 경험 -증례 보고-)

  • Park, Sang Cheol;Park, Joon Byum;Kwon, Young Eun;Lee, Jun Hak
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.251-254
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    • 2005
  • Spondylolysis, also known as stress injury of pars interarticularis, is a common cause of back pain in athletes, particularly children and young adults. Repeated minor traumas during flexion and extension of the spine are thought to result in bony failure due to excessive bone resorption. These lesions are common in the low back, with the majority found at the L5 vertebra. In the majority of cases of spondylolysis, non-operative treatments are recommended, such as NSAIDs, physiotherapy and bracing. Only if symptoms do not respond to conservative treatments should surgical intervention be considered. Recently, pars interarticularis injections for diagnostic and therapeutic purposes have been found to allow significant pain relief from spondylolysis for long periods. Here, the case of a 57-year-old man with spondylolysis, who suffered from back pain, which was not relieved by an epidural steroid injection, but in whom pars interarticularis injections of local anesthetic and steroid induced complete transient pain relief, following by moderate long-term relief, is presented.

Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus

  • Kim, Hyun Sik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.532-538
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    • 2020
  • Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

Factors Influencing on Pressure Ulcer Incidence among Older Patients with Hip Fracture in a Hospital (고관절 골절로 입원한 노인 환자의 욕창 발생 위험요인)

  • Lee, Sun Jin;Jeong, Jae Shim;Lim, Kyung-Choon;Park, Eun Young;Kim, Hye Youn
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.54-61
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    • 2019
  • Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

Diabetic Foot and Soft Tissue Necrosis Caused by Moxibustion Burn Injury (뜸치료에 의한 화상으로 발생한 당뇨족 및 연부조직 괴사)

  • Han, Song Hyun;Jo, Dong In;Kim, Cheol Keun;Kim, Soon Heum
    • Journal of the Korean Burn Society
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    • v.23 no.2
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    • pp.60-63
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    • 2020
  • A 72-year-old man with diabetes, who underwent moxibustion, developed a foot wound but did not receive proper treatment. Examination showed a soft tissue defect (6×6 cm) on the dorsal aspect of the right foot with involvement of the first and second toes along with some phalangeal bone loss. The wound was treated with a skin graft and healed without complications. The right calf showed a raw surface (4×3 cm), which underwent epithelialization after conservative treatment. We observed four focal necrotic lesions (1.5×1.5 cm) on the right lower leg and anterior chest, which served as indicators of moxibustion, and debridement and primary closure were performed. Moxibustion is increasingly used as a therapeutic option; however, statistical data describing its adverse effects are limited. Moxibustion significantly increases skin temperature and can cause burn injuries. It is important to prevent moxibustion-induced adverse effects and avoid severe complications, particularly in patients with diabetes.

Simultaneous Maxillo-Mandibular Distraction Osteogenesis in Hemifacial Microsomia: a Case Report (상하악에 동시 다발성 골신장술을 이용한 반안면왜소증의 치험례)

  • Kim, Il-Kyu;Park, Jong-Won;Lee, Eon-Hwa;Yang, Jung-Eun;Chang, Jae-Won;Pyun, Yeong-Hun;Ju, Sang-Hyun;Wang, Boon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.447-453
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    • 2010
  • The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

Natural History of the Calcaneal Avulsion Fracture in Neuropathic Arthropathy in a Young Diabetic Patient (A Case Report) (젊은 당뇨 환자에서 신경병성 관절병증 종골 견열 골절의 자연 경과(1예보고))

  • Ko, Young-Chul;Eun, Il-Soo;Jung, Chul-Young;Kim, Jin-Wan;Choi, Hyeon-Soo;Kim, Ok-Gul
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.230-233
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    • 2008
  • The avulsion fracture of the calcaneal tuberosity is rare injury. Usually, it occurs from indirect trauma in old patients with osteoporosis or in patients with diabetic neuropathy. Especially, the bone and joint damage occurred in active patient with severe sensory loss or arthropathy related to nerve damage regardless of the cause is referred to neuropathic arthropathy. Generally, a patient with nondisplacement or minimally displacement is treated by conservative therapy and a patient with severe displacement is treated by open reduction and internal fixation. We experienced a 33 years-old woman with diabetes mellitus who had the displaced avulsion fracture of the calcaneal tuberosity without significant trauma and did not treat. We report upon this case at the 2 years follow-up.

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Protective effects of remifentanil against H2O2-induced oxidative stress in human osteoblasts

  • Yoon, Ji-Young;Kim, Do-Wan;Kim, Eun-Jung;Park, Bong-Soo;Yoon, Ji-Uk;Kim, Hyung-Joon;Park, Jeong-Hoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.263-271
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    • 2016
  • Background: Bone injury is common in many clinical situations, such as surgery or trauma. During surgery, excessive reactive oxygen species (ROS) production decreases the quality and quantity of osteoblasts. Remifentanil decreases ROS production, reducing oxidative stress and the inflammatory response. We investigated remifentanil's protective effects against $H_2O_2$-induced oxidative stress in osteoblasts. Methods: To investigate the effect of remifentanil on human fetal osteoblast (hFOB) cells, the cells were incubated with 1 ng/ml of remifentanil for 2 h before exposure to $H_2O_2$. For induction of oxidative stress, hFOB cells were then treated with $200{\mu}M$ $H_2O_2$ for 2 h. To evaluate the effect on autophagy, a separate group of cells were incubated with 1 mM 3-methyladenine (3-MA) before treatment with remifentanil and $H_2O_2$. Cell viability and apoptotic cell death were determined via MTT assay and Hoechst staining, respectively. Mineralized matrix formation was visualized using alizarin red S staining. Western blot analysis was used to determine the expression levels of bone-related genes. Results: Cell viability and mineralized matrix formation increased on remifentanil pretreatment before exposure to $H_2O_2$-induced oxidative stress. As determined via western blot analysis, remifentanil pretreatment increased the expression of bone-related genes (Col I, BMP-2, osterix, and $TGF-{\beta}$). However, pretreatment with 3-MA before exposure to remifentanil and $H_2O_2$ inhibited remifentanil's protective effects on hFOB cells during oxidative stress. Conclusions: We showed that remifentanil prevents oxidative damage in hFOB cells via a mechanism that may be highly related to autophagy. Further clinical studies are required to investigate its potential as a therapeutic agent.

Development of $5^{th}$ percentile female finite Element Model for Crashworthiness Simulation - Part II Detail Modeling of Internal Components (충돌 안전도 해석을 위한 $5^{th}$ percentile 성인 여성 유한요소 모델 개발 - Part II 신체 부위 별 상세 모델 개발)

  • 나상진;최형연;이진희
    • Journal of Biomedical Engineering Research
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    • v.25 no.4
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    • pp.283-288
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    • 2004
  • The finite element modeling of small female occupant for crash simulation is presented in this paper subsequently to the part I of articulated rigid body model. The limbs and internal components are additionally modeled by joining them to the articulated rigid body model for predicting the crash injuries such as bone fractures and joint dislocations. The behavioral characteristics of each limbs and internal components were validated against available cadaveric test results. Accordingly, the human model proposed in this paper could be utilized for the investigation of impact injury mechanism and further complement the lacking biofidelity of current crash dummy.