• Title/Summary/Keyword: Skin injury

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Toll-like Receptor 5 Agonism Protects Mice from Radiation Pneumonitis and Pulmonary Fibrosis

  • Wang, Zhi-Dong;Qiao, Yu-Lei;Tian, Xi-Feng;Zhang, Xue-Qing;Zhou, Shi-Xiang;Liu, Hai-Xiang;Chen, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4763-4767
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    • 2012
  • Radiation pneumonitis and pulmonary fibrosis are the main complications with radiotherapy for thoracic neoplasms, directly limiting the efficient dose in clinical application and currently there are few medicines that effectively function as radioprotectants. However, a TLR5 agonist, CBLB502, was confirmed to have protective efficacy against hematopoietic and gastrointestinal radiation syndromes in mice and primates. This study points to a new direction for protection against thoracic radiation-induced pulmonary syndromes and skin injury by CBLB502. We utilized the TUNEL assay, pathological analysis and immunohistochemistry to obtain evidence thatCBLB502 could alleviate the occurrence of radiation pneumonitis and pulmonary fibrosis as well as radiation-induced skin injury. It may thus play a promising role in facilitating clinical radiotherapy of thoracic neoplasms.

Transmasseteric Approach for Open Reduction and Internal Fixation of Mandible Subcondylar Fracture (깨물근을 통한 하악골 관절돌기하부골절의 관혈적 정복 및 내고정술)

  • Kim, Hak-Soo;Kim, Seong-Eun
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.161-168
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    • 2010
  • Purpose: Surgical approaches to the condylar neck and subcondyle area can cause some morbidity such as, facial nerve injury, time-consuming nature and external scar etc. So many surgeons hesitate using open reduction and internal fixation for the treatment of subcondylar fractures. We report open reduction and internal fixation of subcondylar fractures in 13 adult patients via transmasseteric approach. Methods: From 2007 to 2009, 13 adults with subcondylar fracture of mandible were treated with open reduction and internal fixation via transmasseteric approach. A preauricular incision was extended downwards in a curvilinear fashion in the cervicomastoid skin crease. Skin flap was elevated above the SMAS layer. Masseter muscle was splitted at the anteroinferior edge of the parotid gland. After the fracture was reduced, fixed with appropriate plates and screws. All operation were performed under general anesthesia. Results: Mean follow-up period was 13.3 months. There were no signs and symptoms of facial nerve injury, difficulty in mouth opening, or malocclusion. Dissection time was roughly within 30 minutes. Conclusion: Transmasseteric open reduction and internal fixation of mandible subcondylar fracture can be performed with excellent visualization, and inconspicuous scar. It also offers swift access to the subcondylar area while substatially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

Long-term follow-up of a severely traumatized leg treated with ipsilateral fracture-united fibular transfer in a patient with amputation of the contralateral leg: a case report

  • Kim, Eon Su;Yang, Chae Eun;Kim, Jiye;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.699-702
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    • 2021
  • Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

A step-by-step intraoperative strategy during one-stage reconstruction of an acute electrical burn injury in the neck for superior surgical outcome in India: a case report

  • Mainak Mallik;Sanjay Kumar Giri;M. Vishnu Swaroop Reddy;Kallol Kumar Das Poddar
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.151-157
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    • 2024
  • Electrical burn injuries can cause more damage than clinical evaluations initially suggest. The energy waves penetrate from the surface to the deepest layers of tissue, causing extensive harm at every level. The neck is a critical area, both functionally and aesthetically. We present a case involving a young male patient with a severe fourth-degree electrical burn on the neck, who underwent a single-stage debridement and reconstructive surgery. The pectoralis major myocutaneous flap is a versatile option for various head and neck reconstructions. However, if the donor site cannot be closed primarily and requires split-thickness skin grafting, it can result in unsightly scars and deformities. For large flap paddles, it is ideal to reconstruct the secondary defect with locoregional flaps. In this case, we successfully reconstructed the donor site's secondary defect using a contralateral internal mammary artery perforator flap, without resorting to any skin grafts. The early postoperative results demonstrated satisfactory cosmesis, patient satisfaction, and functional outcomes.

Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis (원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과)

  • Kim, Weon-Yoo;Ji, Jong-Hun;Kwon, Oh-Soo;Park, Sang-Eun;Kim, Young-Yul;Kil, Ho-Jin;Jeong, Jae-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.94-100
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    • 2012
  • Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

Effect of Frost Injury in Harvest Season and Temperature Condition of Orchard on Storage Characteristics of Persimmon (Diospyros kaki 'Fuyu') Fruit (단감 '부유' 과실의 저장특성에 미치는 수확기 동상해 및 과수원 온도조건의 영향)

  • Kwack, Y.B.;Kim, S.H.;Ahn, K.H.;Lee, C.H.;Kang, S.K.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.23 no.1
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    • pp.67-80
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    • 2021
  • We analyzed the effect of planting site (elevation: high, middle, low) and temperature condition of orchard on the frost injury occurrence and storage characteristics of persimmon (Diospyros kaki cv. 'Fuyu) fruits under an early fall frost at two orchards, Changwon (A) and Changnyeong (B), Gyeongsangnam-do Korea. Also, the fruits picked at Nov. 5 and Nov. 20 were MA stored to investigate the quality and chilling injury of fruits. On 2-way factor analysis, both planting elevation and orchard factor had not a significant effect on fruit characteristics (weight, firmness, soluble solid), while planting elevation factor did on the skin color (hunter 'a')(p<0.05). A fruit skin coloration at orchard A was faster than that at orchard B. At low elevation of orchard B, 2% fruits were frost injured at harvest season. On LDPE film MA storage with the fruits harvested at Nov. 5 and Nov. 20, the fruits at orchard A had higher fruit firmness than those of orchard B during storage. In addition, the 73% (orchard A) and 85%(orchard B) fruits harvested at Nov. 5 showed no chilling injury 80 days after storage. However, At harvest of Nov, 20 (after incidence of frost), only the 14% fruits of orchard B had no the chilling disorder 80 days after storage, even though 76% fruits at orchard A did.

Secondary Analysis on Ventilator-Associated Pneumonia and Pressure Injury

  • Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Kaewprag, Pacharmon
    • International Journal of Advanced Culture Technology
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    • v.6 no.3
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    • pp.211-215
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    • 2018
  • Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

Evaluation of apoptosis after ionizing radiation in feeding and starving rats

  • Lee, Jae-Hyun;Cho, Kyung-Ja;Hong, Seok-Il;Park, Min-Kyung
    • Korean Journal of Veterinary Pathology
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    • v.2 no.1
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    • pp.37-46
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    • 1998
  • It has been known that $\gamma$-irradiation usually induces cell death in regenerating stem cell in normal tissues like skin, intestine and hematopoietic organ. The experiment were carried out to evaluate the early response of radiation injury in radiosensitive and intermediate radiosensitive tissues in feeding and starving rats with the doses of 3.5 and 7.0 Gy. The results of the study showed that the histological phenomenon was apoptosis in the doses of the radiation as the early response of tissue injury. Apoptosis were showed organ-specific and cellular specific responses suggesting that the selection of apoptosis be exactly focused on highly renewal organs and cells. It was interesting that the rats starved for 72 hours prior to irradiation induced less apoptosis in liver than fed rats. As for cellular responses it appeared that apoptotic cells were mostly distributed in ductal or periportal cells in liver of feeding rats unlikely in liver of Starving rots which showed no difference in zonal distribution. In salivary gland apoptotic cells in fed rats were highly induced in intercalating and ductal cell population than in acinar cell population although unlikely in starved rats. This study showed the value of apoptosis using the detection system of TUNEL for evaluating cellular damage after radiation injury and the diminished effect of starvation on cell damage after ionizing irradiation.

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Reconstruction of Forefoot Degloving Injury with Innervated Anterolateral Thigh Free Flap (전외측 대퇴부 감각 유리피판을 이용한 전족부 탈장갑 손상 재건)

  • Cho, Hye-In;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.88-92
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    • 2010
  • The forefoot reconstruction is a challenging field for plastic surgeons. Weight bearing tolerability and stability are important factor of choosing reconstruction methods, but cosmetic aspect has to be considered. 51 year old man visited our clinic with extensive degloving injury on right forefoot by roller. The soft tissue defect started from metatarsal area to the toe tip including nails. We harvested the anterolateral thigh flap and transferred it to the forefoot defect area with nerve coaptation. The flap was successful without skin necrosis or other complications. Secondary flap debulking surgery was performed after ten months from initial operation. Patient was satisfied with functional and cosmetic outcomes. The patient was able to wear shoes and walk with adequate sensory recovery. As there is few report about reconstruction of forefoot soft tissue defects, we report a unique case of the anterolateral thigh innervated free flap reconstruction in degloving injury.

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Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.