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Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen

  • Choi, Kyunghak;Jung, Kwang-Hwan;Keum, Min Ae;Kim, Sungjeep;Kim, Jihoon T;Kyoung, Kyu-Hyouck
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.18-22
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    • 2020
  • Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.

Screening of Antibrowning Agents for Minimally Processed Vegetables (최소가공채소류에 적합한 갈변방지제의 선발)

  • Park, Woo-Po;Cho, Sung-Hwan;Lee, Dong-Sun
    • Korean Journal of Food Science and Technology
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    • v.30 no.2
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    • pp.278-282
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    • 1998
  • Peeled garlic, soybean sprouts, cut onion and cut green pepper were treated by dipping in solutions of different antibrowning agents, and then stored at $10^{\circ}C$. Surface color and polyphenol oxidase activity of produce were measured through the storage. Tested antibrowning agents include ascorbic acid, citric acid and allyl isothiocyanate. The commodities showed different responses to the antibrowning agent solutions; 1% citric acid for peeled garlic, 1% ascorbic acid for soybean sprouts, 2% citric acid for cut onion, and 1% ascorbic acid for cut green pepper showed better retardation in browning than the other treatments for respective product. For peeled garlic, surface browning was concomitant with increase in polyphenol oxidase activity during storage. On the other hand, there was no positive correlation between surface browning and polyphenol oxidase activity for the other stored products.

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Immunohistochemical Observation of Plasma Cell Granuloma in Intraoral Chronic Inflammatory Lesions (구강내 만성염증병소에서 보이는 형질세포육아종의 면역조직화학적 관찰)

  • Kim, Yeon-Sook;Lee, Suk-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2011
  • Purpose: Chronic inflammatory gingival lesions occur as pyogenic granulomas or non-specific chronic suppurative lesions. Methods: Of the 59 chronic inflammatory gingival lesions examined, plasma cell granuloma (n=14), which showed an intense antibody-mediated immune reaction with the increased infiltration of plasma cells, was observed as a pseudotumor-like gingival overgrowth and myofibroblastic or fibrohistiocytitc proliferation of stromal cells with a heavy collection of plasma cells. The levels of CD3, CD20, CD31, CD68, RANKL, cathepsin G, cathepsin K, lysozyme, TNF${\alpha}$, MMP-2, and MMP-9 in the 14 cases of gingival plasma cell granuloma with immunohistochemical detection were measured to determine the pathogenetic progresses of the plasma cell granuloma compared to the common pyogenic granuloma (n=45) in the gingiva. Results: The gingival lesions of the plasma cell granuloma could be divided into three histological types, plasma cell predominant type (PPT, n=8), mixed inflammatory cell type (MICT, n=2), and sclerosed fibrosis type (SFT, n=4). The PPT showed a condensed infiltration of plasma cells into the perivascular spaces of the granulomatous lesion with frequent formation of Russel's body in their cytoplasm. The MICT showed the concomitant infiltration of many macrophages together with plasma cells, resulting in the diffuse destruction of stromal fibrous tissue. The SFT showed granulomatous lesions replaced gradually by thick collagenous fibrous tissue, resembling an inflammatory pseudotumor. The SFT expressed strongly the lymphocytic markers, CD3 and CD20, and the macrophage/monocyte markers, CD31 and CD68, but showed reduced expression of common inflammatory markers, TNF${\alpha}$, cathepsin G, lysozyme, MMP-2, and MMP-9, as well as the reduced expression of osteoclastogenic markers, RANKL and cathepsin K. Conclusion: These results suggest that a gingival plasma cell granuloma shows variable gene expression for cell-mediated immunity and stromal tissue degeneration, undergoing sclerotic fibrosis with a persistent inflammatory reaction.

The Study of Blister Caused by Cupping Therapy (부항 시술에 의해 형성된 수포에 관한 고찰)

  • Yun, Hye-Yeon;Kwon, Sun-Oh;Kim, Seung-Tae;Park, Hi-Joon;Hahm, Dae-Hyun;Lee, Hye-Jung
    • Korean Journal of Acupuncture
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    • v.28 no.3
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    • pp.141-150
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    • 2011
  • Objectives : The aims of this study were to evaluate a blister caused by cupping. Methods : We searched relevant case reports, survey, and review articles using databases of online bibliography. Results : 1. The fluid in the blister caused by cupping therapy is normal substance by laboratory analysis. The fluid has no signs of infection in the culture, Gram stain, or tissue biopsy 2. In histological finding, the blister caused by cupping therapy is made by dermo-epidermal seperation at subcellular level. Suction blistering was neither inflammatory nor autolysis activation of lysosomal hydrolases. 3. Blistering times directly, related to suction pressure. Suction blister formation time is accelerated in older subjects compared with younger individuals and higher temperature was more susceptable to the blister compared with lower temperature. The flexor aspect of forearm is a easy site for suction blister formation compared with leg and abdominal site. 4. Blister caused by cupping therapy is treated by regular and judicious changes of sterile dressing over several weeks. The vesicles healed well and left no visible scar. Conclusions : Blister caused by cupping therapy is artificially controlled by doctor's therapeutic purpose. Blister is not histologically injurious to health and the blister is a natural concomitant after cupping therapy.

Antiproliferative Effect of Artemisia argyi Extract against J774A.1 Cells and Subcellular Superoxide Dismutase (SOD) Activity Changes

  • Lee, Tea-Eun;Park, Sie-Won;Min, Tae-Jin
    • BMB Reports
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    • v.32 no.6
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    • pp.585-593
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    • 1999
  • The water and methanol extracts of Artemisia argyi showed significant cytotoxicities against J774A.1 cells but not so much against normal leukocytes. The cytotoxicities were found to be dependent on the extract concentration and the incubation time. The concentration of water and methanol extracts inhibiting 50% of cell proliferation ($IC_{50}$) were estimated to be 44.2 mg/ml and 71.6 mg/ml, respectively. In the presence of Artemisia argyi water extract, total superoxide dismutase (CuZnSOD and MnSOD) activities of media, cytoplasmic and mitochondrial fractions of J774A.1 cells increased in accordance with cytotoxicity. MnSOD was found to be the main component of enhanced total SOD activities, particulary in the mitochondrial fraction. In contrast to SOD, catalase and glutathione peroxidase (GPx) were not found in any instance of the current investigation. In addition, substantial amount of $O_2^-$ appeared to be generated in the mitochondrial fraction under the influence of Artemisia argyi. All data put together, it is postulated that Artemisia argyi extracts seem to stimulate $O_2^-$ generation in mitochondria of J774A.1 cells with concomitant increases of SODs. Since $H_2O_2$, the reaction product of SOD on $O_2^-$, is known to be readily converted to very toxic $OH{\cdot}$ in the absence of catalase and/or GPx cooperation, toxicity derived from ROS such as $O_2^-$, $H_2O_2$, and $OH{\cdot}$ may be the main cause of necrosis and/or apoptosis of J774A.1 cells.

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ASSESSMENT OF INFERIOR ALVEOLAR NERVE DAMAGE USING DIGITAL INFRARED THERMOGRAPHIC IMAGING (디지털 적외선 체열 검사를 사용한 하치조 신경 손상의 평가)

  • Lee, Ji-Yeon;Lee, Jae-Hoon;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.488-496
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    • 2004
  • Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

The Anti-tumor Effect of BoJungIkKeeHapDaeChilKi-Tang with Doxorubicin in MKN-45 (보중익기합대칠기탕(補中益氣合大七氣湯)과 Doxorubicin의 병용이 MKN-45의 항암효과에 미치는 영향)

  • Lee Yun-Hee;Kim Bong-Suk;Oh Jung-Han;Lim Hee-Yong;Kim Dong-Woo;Choi Bin-Hye;Byun Joon-Seok
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.92-105
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    • 2004
  • In order to evaluate the anti-tumor and synergic effect of BoJungIkKeeHapDaeChilKi-Tang on doxorubicin, the inhibitory concentration(IC), IC50 and IC90 of single use of doxorubicin and BoJungIkKeeHapDaeChilKi-Tang with their concomitant treatment against MKN-45(Human stomach carcinoma) was observed using MTT(Microculture Tetrazolium test) assay. In addition, their anti-tumor effects were also observed in the xenograft nude mice models agianst MKN-45 cell lines. BoJungIkKeeHapDaeChilKi-Tang has only mimic direct anti-tumor effect against to MKN-45 cell lines but they were decreased general depressed signs induced by implantation of tumor cell lines and increased the total WBC and lymphocyte numbers. So, it is considered or expected that BoJungIkKeeHapDaeChilKi-Tang extracts were reduced by the critical toxicity of doxorubicin and shows favorable synergic effect with doxorubicin and BoJungIkKeeHapDaeChilKi-Tang extracts.

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Synthesis of an Aspartame Precursor Using Thermolysin in Organic Two-Phase System (유기용매 이상계에서 Thermolysin에 의한 아스파탐 전구체 생산)

  • 이인영;안경섭;이선복
    • Microbiology and Biotechnology Letters
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    • v.20 no.1
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    • pp.61-67
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    • 1992
  • The synthesis of N-benzyloxycarbonyl-L-aspartyl-L-phenylalanine methyl ester(ZAPM), a precursor of aspartame, from N-benzyloxycarbonyl-L-aspartic acid(Z-Asp) and L-phenylalanine methyl ester hydrochloride(L-PM-HCl) was investigated in ethylacetate-MES buffer two-phase system using thermolysin. In organic two-phase system, the degree of spontaneous hydrolysis of L-PM. HCl was significantly reduced with increasing the volume ratio of organic to aqueous phase. Stability of thermolysin in organic two-phase system was found to be higher than that in MES buffer solution. More than 90% of initial enzyme activity was maintained after 10 days of incubation in case that the volume of organic phase was equal to that of buffer phase, while the half life of thermolysin was about 2 days in aqueous buffer solution. The results of partitioning of substrates and product in organic two-phase system showed that the difference in partition coefficients between substrates and product was maximum at pH 5.5. The optimal pH for 2-APM synthesis in organic two-phase system was found to be 5.5-5.8, which is consistent with the value expected from the partition experiments. As the concentration of substrates was increased the conversion yield of Z-APM was increased with concomitant reduction of L-PMqHC1 hydrolysis. In case that the concentration of L-PM-HCl and Z-Asp were 160 mM and 80 mM respectively, the conversion yield of Z-APM reached 90% after 28 hrs of reaction. The yield obtained at different volume ratio of organic phase compares well with the predicted equilibrium constant in biphasic system.

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A HEMATOLOGIC STUDY OF ORTHOGNATHIC SURGERY PATIENTS (악교정 수술후 혈액학적 변화에 대한 연구)

  • Lee, Jong-Seok;Ko, Seung-O;Jeong, Kil-Jung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.157-166
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    • 2007
  • Moderns have desire likely to be further good-looking concomitant with a qulitative advancement of the life. Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. It's possible to occur many complication during the operations and especially, an excessive bleeding of those may be fatal and so a tranfusion is performing for the prevention and management of that. The most notable of these for reduction of blood loss is the utilization of induced hypotensive anesthetic technique to reduce the mean arterial pressure between 55 and 60 mmHb. Another method for dealing with blood loss following orthognathic surgery is the transfusion of blood obtained as an autologous tranfusion or from banked blood. Some of the disadvantage of banked blood are overcome with the use of predeposited autologous transfusion. But currently, surgeons try so that even autologous transfusion may not transfuse the patients. We made a comparative study of hematologic change and transfusion requirement based on a series of 200 patients who had an orthognathic surgical procedure at Chonbuk National University during the period 2001-2005. This study is to make a comparative analysis of an post-operative hematologic (Hemoglobin, Hematocrit, Red blood cell) change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.

Selective Toxicity to Central Serotonergic Nervous System in Prenatally and Postnatally Lead-Exposed Rats

  • 서동욱;정은영;정재훈;신찬영;오우택;고광호
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.335-335
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    • 1994
  • Possibility whether lead ingestion can cause selective toxicity to central serotonergic nervous system in rats was tested. Three groups of wistar rats; 1)Control, 2) Low dose and 3) High dose groups, were prepared. In prenatally lead-exposed rats, until parturition from dams, rat pups were intoxicated via placenta of mother rats having received drinking water containing either 0%(control ), 0.05%(low dose) or 0.2%(high dose) of lead acetate respectively, In postnatally lead-exposed rats, right after parturition from dams rat pups received drinking water containing either 0% (control), 0.05%(low dose) or 0.2%(high dose) of lead acetate. At 2, 4, 6 and 8 weeks of age, tryptophan hydroxylase (TPH) activity and Na$\^$+//K$\^$+/-ATPase activity were measured in 4 areas of rat brain; Telencephalon, Diencephalon, Midbrain and Pons/Medulla. TPH activities were assayed by modified method of Beevers et al. (1983) using L-(5-$^3$H)-tryptophan as substrate. TPH activity was determined as a criterion of lead poisoning to central serotonergic nervous system and Na$\^$+//K$\^$+/-ATPase activity as a criterion of non specific lead poisoning to any kinds of tissues. Selective toxicity of lead poisoning to central serotonergic nervous system was evaluated by the changes of TPH activities without concomitant changes of Na$\^$+//K$\^$+/-ATPase activities. In prenatally lead-exposed rats. this selectivity was found in Telencephalon (2 weeks of age), Diencephalon/Midbrain (2 weeks of age), Midbrain (4 and 6 weeks of age), Pons/Medulla (2, 4 and 6 weeks of age) In rats exposed to low dose of lead and Pons/Medulla (2 weeks of age) to high dose of lead. In postnatal Iy lead-exposed rats, this selectivity was found in Telencephalon (8 weeks of age), Diencephalon(8 weeks of age), Pons/Medulla (6 and 8 weeks of age) in rats exposed to low dose of lead and Pons/Medulla (8 weeks of age) to high dose of lead. These results suggest that lead poisoning may exhibit selective toxicity to central serotonergic nervous system.

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