• 제목/요약/키워드: Vessel injury

검색결과 128건 처리시간 0.029초

하지에서의 역행성 지방근막 피판술: 유리피판술을 대치할 수 있는가? (Reversed Adipofascial Flap in Lower Leg: Can It Replace the Free Flap?)

  • 이영진;안희창;최승석;황원중
    • Archives of Plastic Surgery
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    • 제32권1호
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    • pp.100-104
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    • 2005
  • A soft tissue defect of the lower leg or foot presents a challenging problem. Reconstructive surgeon should be armed at all points of wound site, tendon and bone exposure, injury of major vessel and so on in the lower limb. We reconstructed the defects of lower legs and feet of 25 patients between February, 1997 and December, 2003. Applying reversed adipofascial flap with skin graft on a soft tissue defect of the lower leg or foot is challenging. We did a comparative study of 25 reversed adipofascial flaps with 51 free flaps. All 25 cases of reverse adpofascial flap reconstruction were successful except for a partial loss of skin graft in 3 occasions. The reversed adipofascial flap had a merit of a short operation time and hositalization, a high success rate and minimum complications. Besides major vessels in the lower leg are better preserved and donor morbidity is minimal. However, the flap is unmerited in reconstructing a hug hallowed defect and in the leg with poor blood circulation and once previous surgery. The operators may consider the feasible substitution of reversed adipofascial flap for free flap before applying in the lower leg.

가변성 폐동맥 협착기구의 실험적 연구 (Experimental Study of Adjustable Pulmonary Artery Banding Device)

  • 홍유선;박영환
    • Journal of Chest Surgery
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    • 제30권8호
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    • pp.747-751
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    • 1997
  • 폐동맥협착을 시행한 환아에서 수술직후 변화하는 혈역학에 대응하기 위하여 피하조직에 위치시켜 쉽게 조절할 수 있는 기구를 개발하였다. stainless steel wire를 이용하여 스프링을 만든후 이것의 표면을 PTFE로 덮은 형태로 제작하였으며 스프링 내부로 wire를 통과시켜 이것을 올가미 형식으로 죄는 방법으로 협착을 할 수 있게 하였으며 협착의 정도를 피하조직으로 통하는 투명한 tube에 1mm간격으로 표시하여 알수 있게 하였다. 6마리의 개의 하행대동맥에 협착을 시행하였다. 수술후 1,2일째에도 이완과 협착을 효과적으로 유도 할수 있었으며 3개월후 어느정도의 혈관손상은 있었으나 큰 협병증 없이 유지함을 보였다. 비록 실험적인 연구이지만 인체에 삽입할수 있는 재료로 쉽게 기구제작이 가능하며 앞으로 피하를 열고 조절가능한 폐동맥협착술에 이용할 수 있으리라 생각된다.

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교통사고후유증(交通事故後遺症)(편타성(偏墮性) 손상(損傷))에 대한 침구치료(鍼灸治療)의 접근(接近) (A Study on Acupuncture Treatment for Disorders following Whiplash Injuries)

  • 김민아;박용진
    • Journal of Acupuncture Research
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    • 제17권3호
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    • pp.75-86
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    • 2000
  • Objectives : This study is to applied effectively to the acupuncture treatment for disorders following whiplash injuries. Methods : This study suggests five various ways and principtes of treating disorders following whiplash injuries by means of acupuncture. First principle is that acupuncture treatment is carried out on acupoint far from cervical spine at acute stage, on the other hand, Extraordinary Vessel and other acupuncture treatment such as five element acupuncture treatment is applied at chronic stage in order to control balance disoders due to cervical pathology. Second is acupuncture treatment will be performed in group of three part of Meridian System-Yangmyung, Taeyang, Soyang-according to cervical kinetic, its characteristic and location of pain. Third is acupuncture treatment could be performed on basis of theory of Eohyel-disorders and disturbance of blood circulation. Fourth is to decrease tension of SCM muscle, because disorders following whiplash injuries has much association to injury of CM muscle and is simillar to tension syndroms of SCM muscle. fifth is taping therapy could control and decrease disorders following whiplash injuries based on spiral balance taping theory. Conclusions : These results suggest that acupuncture treatment for disorders following whiplash injuries will significally decrease pain and control syndrom caused by cervical disorder.

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Use of the cross-leg distally based sural artery flap for the reconstruction of complex lower extremity defects

  • Liang, Weihao;Tan, Bien Keem
    • Archives of Plastic Surgery
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    • 제46권3호
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    • pp.255-261
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    • 2019
  • Cross-leg flaps are a useful reconstructive option for complex lower limb defects when free flaps cannot be performed owing to vessel damage. We describe the use of the extended distally based sural artery flap in a cross-leg fashion for lower extremity coverage in three patients. To maximise the viability of these extended flaps, a delay was performed by raising them in a bipedicled fashion before gradual division of the tip over 5 to 7 days for cross-leg transfer. Rigid coupling of the lower limbs with external fixators was critical in preventing flap avulsion and to promote neovascular takeover. The pedicle was gradually divided over the ensuing 7 to 14 days before full flap inset and removal of the external fixators. In all three patients, the flaps survived with no complications and successful coverage of the critical defect was achieved. One patient developed a grade 2 pressure injury on his heel that resolved with conservative dressings. The donor sites and external fixator pin wounds healed well, with no functional morbidity. The cross-leg extended distally based sural artery flap is a reliable reconstructive option in challenging scenarios. Adequate flap delay, manoeuvres to reduce congestion, and postoperative rigid immobilization are key to a successful outcome.

Preventive effects of sea cucumber (Apostichopus japonicus) ethanol extract on palmitate-induced vascular injury in vivo

  • Zhang, Chunying;Cha, Seon-Heui
    • Fisheries and Aquatic Sciences
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    • 제25권2호
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    • pp.90-100
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    • 2022
  • Cardiovascular diseases (CVDs) have posed serious public health problems, accounting for nearly 30% of mortality worldwide and their incidence is still increasing. Therefore, new treatment resources are necessary to prevent or manage the ever-increasing population of patients with CVDs. Sea cucumber is well known for its medical and health benefit effects, but it is not well known what/how effect it has on vascular disease. In the present study, we examined the protect effect of sea cucumber, Apostichopus japonicus 80% ethanol extract (AJE) on zebrafish embryo with the stimulation of free fatty acid, palmitate (PA). In vivo study showed that AJE can attenuate PA-induced toxicity through relieving the rapid heartbeat, increasing the survival rate and reducing the malformation in both wild type and Tg (fli1a:eGFP) transgenic zebrafish lines. Additionally, compare with PA treated embryos, the yolk sac area, body length, axial vascular segment (AVS) and intersegmental vessel (ISV) of the co-treatment group of AJE and PA were comparable to the control group. Moreover, AJE lowered the expression of inducible nitric oxide synthase (iNOS), nitric oxide (NO) and inflammation-related genes induced by PA, and inhibited PA-induced vascular development disorders. Our data preliminarily verify that AJE could be a candidate resource for the prevention or therapy of CVDs.

Inhibitory effects of artemether on collagen-induced platelet aggregation via regulation of phosphoprotein inducing PI3K/Akt and MAPK

  • Lee, Dong-Ha
    • Journal of Applied Biological Chemistry
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    • 제65권3호
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    • pp.167-172
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    • 2022
  • Pathophysiological reaction of platelets in the blood vessel is an indispensable part of thrombosis and cardiovascular disease, which is the most common cause of death in the world. In this study, we performed in vitro assays to evaluate antiplatelet activity of artemether in human platelets and attempted to identify the mechanism responsible for protein phosphorylation. Artemether is a derivative of artemisinin, known as an active ingredient of Artemisia annua, which has been reported to be effective in treating malaria, and is known to function through antioxidant and metabolic enzyme inhibition. However, the role of artemether in platelet activation and aggregation and the mechanism of action of artemether in collagen-induced human platelets are not known until now. In this study, the effect of artesunate on collagen-induced human platelet aggregation was confirmed and the mechanism of action of artemether was clarified. Artemether inhibited the phosphorylation of PI3K/Akt and Mitogen-activated protein kinases, which are phosphoproteins that are known to act in the signal transduction process when platelets are activated. In addition, artemether decreased TXA2 production and decreased granule secretion in platelets such as ATP and serotonin release. As a result, artemether strongly inhibited platelet aggregation induced by collagen, a strong aggregation inducer secreted from vascular endothelial cells, with an IC50 of 157.92 μM. These results suggest that artemether has value as an effective antithrombotic agent for inhibiting the activation and aggregation of human platelets through vascular injury.

Rehabilitation of an Amur Leopard Cat (Prionailurus bengalensis) with Complex Injury by a Road Accident

  • Sungryong Kim;Sungin Lee;Ok-Joo Lim;Ki-Jeong Na;Dong-Hyuk Jeong
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.411-416
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    • 2022
  • A 2.2 kg adult female Amur leopard cat (Prionailurus bengalensis) injured in a road accident was rescued. Severe abrasions on the left chin were washed daily with an antiseptic and silver sulfadiazine ointment was applied. Corneal edema of the oculus sinister (OS) was treated with ofloxacin and 5% sodium chloride eye drops. The skin wounds gradually improved, but the eye condition did not improve and the lens was also found to be detached. In addition, on the 6th day of hospitalization, melena was observed. On radiographic examination, foreign bodies in the stomach and a fracture of the sternum were confirmed. Subsequently, endoscopic removal of foreign bodies and enucleation of the OS using an electrothermal vessel sealer were performed sequentially over several days. However, corrective surgery of the fractured sternum was not carried out because a natural union of the fracture had occurred, which was found to be fairly stable. The patient completely recovered on the 83rd day and was successfully released into the wild on the 97th day, after two weeks of adaptation training in a natural environment. This report describes the rehabilitation of a wild Amur leopard cat injured in a road accident through a series of diagnostic and treatment steps until its eventual return to the wild and highlights some improvements needed in the process.

우상지(右上肢) 단마비(單痲痺)가 주증(主症)인 풍비 환자의 만금탕가미방(萬金湯加味方) 투여 호전 1례 (Case Report of Hemiplegia after apoplexy in a Patient with Monoplegia on Right upper Extremity Treated with Herbal Prescription)

  • 정병주;우성호;김병철;김용호;서호석;황규동;장하정;남효익;김회영;김진원
    • 대한한방내과학회지
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    • 제27권1호
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    • pp.288-293
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    • 2006
  • Background : Monoplegia is the paralysis of a limb. It is commonly caused by an injury to the cerebral cortex, and rarely caused by injury to the internal capsule, brain stem, or spinal cord. Most problems with cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. Objectives : This study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment of monoplegia on an upper extremity to test the validity of acupuncture and herbal treatment for it. Methods : By using Digital Infrared Thermographic Imaging(DITI), thermal differences$({\Delta}T)$ of acupoints on the upper extremity in a patient with monoplegia on the right upper extremity were measured after an attack of the disease. By giving Mangeum-tang(萬金湯) and treating the patient with acupuncture. the temperature changes of the upper extremity were examined through DITI and improvement was observed. Results : Compared with the left arm which suffered no such injury, the right recovered about 80% of sensation, and the grade of monoplegia improved from Grade O to Grade V. Also, the temperatures of right palmar-dorsal hand and the region of Weiguan(外關, Waiguan, TE5) were $1^{\circ}C$ and $1.45^{\circ}C$ higher than the same left region on admission day, but the thermal differences$({\Delta}T)$ narrowed to $0.5^{\circ}C$ by the last day. Conclusions : Results suggest that DITI screening is a reliable method of prognosis and that the time required for treatment can be estimated through this method in cases of monoplegia to an upper extremity. Also, progress in treatment is reflected in thermal differences of acupoints of the monoplegic upper extremity in accordance with the theory of meridian. This supports a role for acupuncture and herbal treatment for monoplegia.

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극저전류자극이 손상된 토끼 뇌의 별아교세포 증식에 미치는 효과 (The Effects of Microcurrent Stimulation on the Astrocytes Proliferation at Injured Brain of Rabbit)

  • 김지성;민경옥
    • 대한물리치료과학회지
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    • 제9권3호
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    • pp.107-119
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    • 2002
  • Astrocyte, which shares the greatest part of the brain (about 25%), is a land of glial cell that composes the central nervous system along with microglia, ependymal cell and oligodendroglia. It has 7-9nm of fibers in its cytoplasma, which are composed of glial fibrillary acidic protein (GFAP) and vimentin. As for the functions of the astrocyte, it has, so far, been supposed that the astrocyte will play a cytoskeletal role in maintaining the structure of the cerebrum, play a role as a blood-brain barrier so that it can induce migration of the neuron in its development and substances in the blood cannot go into the nervous tissue, and a role of immunology and phagocytosis. However, it was revealed today that it will be a role in preventing expansion of injury by attaching itself to the connective tissue such as the vessel and the pia mater when the nervous tissue or the arachnoid is injured. Microcurrent stimulation can control current, on the basis of A unit. That is, with such devices using it, it is possible to sense, from the outside, the injured current(wound current) of the lesion and to change it into the normal current, thereby promoting the restoration of the cells. In order to examine the effects of microcurrent stimulation on the injured astrocytes in the rabbits, this study was conducted with 24 New Zealand White Rabbit as its subjects, which were divided into 8 animals of the experiment group and 16 animals of the control group. After the animals in the experiment group were fixed to the stereotaxic apparatus, their hair was removed and their premotor area(association area) perforated by the micro-drill for skull-perforation with the depth of 8mm from the scalp. In one week after the injury, 4 animals in the control group and 8 animals in the experiment group were sacrificed and examined with immunohistochemical method. And in three weeks, the remaining 4 animals in the control group and 8 animals in the experiment group were also sacrificed and examined with the same way. The conclusion has been drawn as follows : In the control group sacrificed in one week after the injury, the astrocytes somewhat increased, compared with the normal animals, and in the group sacrificed in three weeks after the injury, they increased more (p < 0.05). The experiment group A in one week showed a little increase, but there was no significant differences, but the experiment group in three weeks showed more increase, compared with the experiment group in one week (p < 0.05). The experiment group B in one week showed more increase than the control group or the experiment group A, and the experiment group in three weeks showed more increase than the experiment group in one week (p < 0.05). Among the astrocytes, fibrous astrocytes were mostly observed, increasing as they are close to the lesion, and decreasing as they are remote from it. The findings show that microcurrent can cause the astrocytes to proliferate and that it will be more effective to stimulate the cervical part somewhat remote from the lesion rather than to directly stimulate the part of the lesion. Thus, microcurrent stimulation can be one of the methods that can activate the reaction of astrocytes, which is one of the mechanism for treating cerebral injury with hemorrhage. Therefore, this study will be used as basic research data for promoting restoration of functions in the patient with injury in the central nervous system.

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Experimental Study of Endostar Injection Concomitant with Cryoablation on Lung Adenocarcinoma A549 Xenografts

  • Ma, Chun-Hua;Jiang, Rong;Li, Jin-Duo;Wang, Bin;Sun, Li-Wei;Lv, Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6697-6701
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    • 2013
  • Objective: To explore the inhibiting effect and mechanism of Endostar injection concomitant with cryoablation on lung adenocarcinoma A549 xenografts in nude mice. Materials and Methods: A total of 24 nude mice with subcutaneous xenografts of the A549 cell line were established and divided into 4 groups when the maximal diameters of tumors became 1 cm: control group, Endostar group, cryoablation group and combination group (Endostar concomitant with cryoablation). The nude mice were sacrificed after 21-days treatment, tumour tissues were removed to measure their volume, in situ test of TdT-mediated dUTP nick end labeling (TUNEL) was adopted to determine the cellular apoptosis around freezing injury zones, and immunohistochemical SP test was applied for the detection of micro-vessel density (MVD) and vascular endothelial growth factor (VEGF) expression levels. Results: At 21-days after treatment, the growth velocities of control group, Endostar group, cryoablation group and combination group were $236.7{\pm}51.2%$, $220.0{\pm}30.6%$, $159.5{\pm}29.3%$ and $103.3{\pm}25.5%$ (P<0.01), while cellular apoptosis rates of tumors were $21.7{\pm}2.34%$, ($22.17{\pm}1.47$)%, $38.3{\pm}1.37%$ and $49.2{\pm}1.72%$, (P<0.01), respectively, according to the immunohistochemical test. MVD and VEGF expression levels in the combination group were both lower than in other groups (P<0.01), also being positively related (r=0.925, P<0.01). Conclusions: Endostar can significantly improve the inhibitory effects of cryoablation on xenografts of lung adenocarcinoma A549, and the mechanism is probably associated with its function as an inhibitor of tumour neo-angiogenesis through down-regulating VEGF expression.