Kim, Keun-Wook;Lee, Kyeong-Seok;Yoon, Suk-Man;Doh, Jae-Won;Bae, Hack-Gun;Yun, Il-Gyu;Choi, Soon-Gwan;Byun, Bark-Jang
Journal of Korean Neurosurgical Society
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v.29
no.2
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pp.210-216
/
2000
Objectives : Head injury is one of the common causes of death in the industrialized countries, and it is a common cause of subarachnoid hemorrhage. Recently, traumatic subarachnoid hemorrhage(TSAH) has been considered as a major prognostic factor. Some suggested that a certain vasodilating agent may be effective to treat or prevent the secondary brain injury due to vasospasm from TSAH. The role of TSAH is not yet fully solved. The prognosis and clinical significance of the TSAH was evaluated. Methods : A retrospective study was performed. A total of 573 consecutive patients with head injury admitted to our institute from January 1996 to December 1997 were examined with respect to outcome and clinical features. In all patients, computerized tomographic scanning was done within 2 days after the injury. Results : TSAH was found in 68 patients(11.9%). The outcome at discharge of the patients without TSAH was favorable(good recovery and moderate disability) in 84.8%, unfavorable(severe disability and vegetative state) in 8.6%, and the mortality rate 6.7%. However, the outcome was favorable in 51.5%, unfavorable in 20.6%, and the mortality rate 27.9% in patients with TSAH. Although the outcome of the patients with thick TSAH was worse than that of the patients with scanty TSAH, the difference was not statistically significant. The difference of the outcome in patients with TSAH according to the location also lacked statistical significance. TSAH was more common in patients with age of 40 years or more, and patients with low Glasgow coma scores. Patients with TSAH had abnormal pupillary responses, diffuse axonal injuries, intubations and operative interventions more frequently than patients without TSAH. Conclusion : These results strongly suggest that the TSAH per se did not worsen the prognosis. However, it represented the injury to be more severe.
Restoration of the blood flow after a period of ischemia is accompanied by generation of toxic oxygen radicals. This phenomenon may account for the occurrence of reperfusion-mediated tissue injury in ischemic hearts. In in vitro studies, although oxygen radicals can be generated from a variety of sources, including xanthine oxidase system, activated leucocytes, mitochondria and others, the most important source and mechanism of oxygen radical production in the post-ischemic reperfused hearts is unclear. In the present study, we tested the hypothesis that the respiratory chain of mitochondria might be an important source of oxygen radicals which are responsible for the development of the reperfusion injury of ischemic hearts. Langendorff-perfused, isolated rat hearts were subjected to 30 min of global ischemia at $37^{\circ}C$, followed by reperfusion. Amytal, a reversible inhibitor of mitochondrial respiration, was employed to assess the mitochondrial contributions to the development of the reperfusion injury. Intact mitochonria were isolated from the control and the post-ischemic reperfused hearts. Mitochondrial oxygen radical generation was measured by chemiluminescence method and the oxidative tissue damage was estimated by measuring a lipid peroxidation product, malondialdehyde(MDA). To evaluate the extent of the reperfusion injury, post-ischemic functional recovery and lactate dehydrogenase(LDH) release were assessed and compared in Amytal-treated and -untreated hearts. Upon reperfusion of the ischemic hearts, MDA release into the coronary effluent was markedly increased. MDA content of mitochondria isolated from the post-ischemic reperfused hearts was increased to 152% of preischemic value, whereas minimal change was observed in extramitochondrial fraction. The generation of superoxide anion was increased about twice in mitochondria from the reperfused hearts than in those from the control hearts. Amytal inhibited the mitochondrial superoxide generation significantly and also suppressed MDA production in the reperfused hearts. Additionally, Amytal prevented the contractile dysfunction and the increased release of LDH observed in the reperfused hearts. In conclusion, these results indicate that the respiratory chain of mitochondria may be an important source of oxygen radical formation in post-ischemic reperfused hearts, and that oxygen radicals originating from the mitochondria may contribute to the development of myocardial reperfusion injury.
Objectives : This study was designed to evaluate the effects of Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture on pain reduction and nerve regeneration after crush injury in rat sciatic nerve. Methods : Animal model was produced through crush injury of right sciatic nerve and they were divided into four groups; Group I: no treatment control group; Group II: experimental group treated with Ohyaksungi-san(Wuyaoshungi-san); Group III: experimental group treated with Jungsongouhyul pharmacopuncture; Group IV: experimental group treated with Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture. For the assessment of pain, this study was observed the paw withdrawal latency(PWL) and immunoreactivity on the substance-P. For the assessment of nerve regeneration, the sciatic functional index(SFI) and immunoreactivity on the BDNF were measured. Results : 1. In the assessment of pain, the PWL of experimental groups was significantly higher than control group and group IV was significantly higher than other groups at the all days. 2. In immunohistochemical response of substance-P, as time passes, the immunoreactivity of all groups were decreased gradully. Especially, group IV had the lowest immunoreactivity. 3. In the assessment of SFI, the SFI of experimental groups were significantly higher than control group. 4. In immunohistochemical response of BDNF, the BDNF immunoreactivity of all groups was significantly higher than control group and especially, group IV had the highest immunoreactivity at the 14 days after injury. 5. H & E stain was used on the liver and kidney to investigate toxic effect of Jungsongouhyul pharmacopuncture and Ohyaksungi-san(Wuyaoshungi-san) on on 21 days after injury. However there were no any toxic effects both control group and experimental groups. Conclusions : On the basis of these results, we propose that Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture were related to pain reduction and motor nerve recovery, also decreased substance-P expression and increased BDNF expression after crush injury of sciatic nerve, especially these two treatments could be more effective when they were combined simultaneously.
Park Jung Ho;Suh Seung Woo;Park Sang Won;Lee Kwang Suk
Clinics in Shoulder and Elbow
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v.1
no.1
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pp.46-50
/
1998
The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.
Resection of the bowel is necessary for the repair of a ventral hernia after recovery from trauma in some cases. In such instances, polyester or polypropylene meshcannot be used due to the possibility of infection; we had to use biological mesh instead. We report a case in which a traumatic hernia was repaired with Permacol (Covidien, Norwalk, CT, USA). A 42-year-old male patient had been injured by a factory machine seven months prior to admission. At that time, he had abdominal wall injury and small bowel perforation. His abdominal wall had been a defect after operation. A CT scan of the abdomen showed that the left abdominal wall, which is lateral to left rectus abdominis muscle had only one muscle layer, an external oblique muscle, and that a previous abdominal incision had a defect along the entire incision. During the exploration, 10 cm of small bowel was removed due to firm adhesion to the previous surgical scar. Permacol mesh was applied and fixed with transfascial fixations and tacks by using the intraperitoneal onlay mesh technique. There were no complications after the surgery and the patient was discharged without any problems.
Proceedings of the Korean Society of Precision Engineering Conference
/
2004.10a
/
pp.1160-1165
/
2004
The purpose of this study was to calculate three dimensional angular displacements, moments and joint reaction forces of the ankle joint during the waist pulling, and to assess the ankle joint reaction forces according to different perturbation modes and different levels of perturbation magnitude. Ankle joint model was assumed 3-D ball and socket joint which is capable of three rotational movements. We used 6 cameras, force plate and waist pulling system. Two different waist pulling systems were adopted for forward sway with three magnitudes each. From motion data and ground reaction forces, we could calculate 3-D angular displacements, moments and joint reaction forces during the recovery of postural balance control. From the experiment using falling mass perturbation, joint moments were larger than those from the experiment using air cylinder pulling system with milder perturbation. However, JRF were similar nevertheless the difference in joint moment. From this finding, we could conjecture that the human body employs different strategies to protect joints by decreasing joint reaction forces, like using the joint movement of flexion or extension or compensating joint reaction force with surrounding soft tissues. Therefore, biomechanical analysis of human ankle joint presented in this study is considered useful for understanding balance control and ankle injury mechanism.
Objectives: The study investigated the efficacy of oral Korean red-ginseng (RG) on sCRP response mediated by eccentric contraction-induced muscle damage and discussed its mechanism. Methods: Nineteen healthy young subjects (aged 24.4$\pm$2.07 yr) volunteered for this double blind test. They were classified into either the RG group (N=10) or placebo (P) group (N=9) during the 10-d experimental protocol. Blood samples were collected on T1 (baseline), T1 (1h), T2 (1d), T3 (2d) and T4 (3d) after eccentric contraction-induced injury on the seventh day. Statistical analyses were conducted using nonparametric methods (p<0.05). Results: The RG group increased sCRP more than P group and didn't increase soreness peak at T2, not significant. There were no correlations between soreness intensity and sCRP. Oral RG had little efficacy for reducing sCRP at the muscle damage-mediated acute phase; rather, it increased because of its proinflammatory cytokine production. Conclusions: Oral RG could stimulate proinflammatory cytokine production, and occasionally bal-pyo-beob could be helpful for the efficient recovery of muscle injury.
Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.
Proceedings of the Korean Society of Applied Pharmacology
/
1998.11a
/
pp.199-199
/
1998
In this study, the effects of ursodeoxycholic acid (UDCA) on ischemia/reperfusion injury were investigated on retrograded aortic perfusion model. Hearts from Sprague-Dawley rats were perfused with oxygenated Krebs-Henseleit solution (pH 7.4, 37) on a Langendorff apparatus. After equilibration, hearts were treated with ursodeoxycholic acid 10, 20, 40 and 800 M or vehicle (0.04% DMSO) for 10 min before the onset of ischemia. Following 25 min of global ischemia, ischemic hearts were reperfused and allowed to recover for 30 min. The physiological (i.e. heart rate, left ventricular diastolic pressure, coronary flow and time to contracture formation) and biochemical (lactate dehydrogenase, LDH) endpoints were evaluated. In vehicle group, time to contracture formation (TTC) value was 19.5 min during ischemia, LVDP was 20.8 mmHg at the endpoint of reperfusion and LDH activity in reperfusate was 59.7 U/L. Cardioprotective effects of UDCA following ischemia/reperfusion consisted of a reduced TTC (EC$\_$25/ = 16.10 M), reduced LDH release and enhanced recovery of contractile function during reperfusion. Especially, the treatments of UDCA 80 M remarkably increased LVDP (68.1 mmHg) and reduced LDH release (33.2 U/L). Our findings suggest that UDCA ameliorates ischemia/reperfusion-induced myocardial damage, in agreement with physiological and biochemical parameters.
Nephrin, a structural molecule, is also a signaling molecule after phosphorylation. Inhibition of nephrin phosphorylation is correlated with podocyte injury. The PINCH-1-ILK-${\alpha}$-parvin (PIP) complex plays a crucial role in cell adhesion and cytoskeleton formation. We hypothesized that nephrin phosphorylation influenced cytoskeleton and cell adhesion in podocytes by regulating the PIP complex. The nephrin phosphorylation, PIP complex formation, and F-actin in Wistar rats intraperitoneally injected with puromycin aminonucleoside were gradually decreased but increased with time, coinciding with the recovery from glomerular/podocyte injury and proteinuria. In cultured podocytes, PIP complex knockdown resulted in cytoskeleton reorganization and decreased cell adhesion and spreading. Nephrin and its phosphorylation were unaffected after PIP complex knockdown. Furthermore, inhibition of nephrin phosphorylation suppressed PIP complex expression, disorganized podocyte cytoskeleton, and decreased cell adhesion and spreading. These findings indicate that alterations in nephrin phosphorylation disorganize podocyte cytoskeleton and decrease cell adhesion through a PIP complex-dependent mechanism.
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