• Title/Summary/Keyword: intravascular lung

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Correlation between the time elapsed after liposuction and the risk of fat embolism: An animal model

  • Lim, Kwang-Ryeol;Cho, Jeong-Min;Yoon, Chung-Min;Lee, Keun-Cheol;Lee, Sang-Yun;Ju, Mi-Ha
    • Archives of Plastic Surgery
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    • v.45 no.1
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    • pp.14-22
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    • 2018
  • Background Liposuction has become one of the most frequently performed procedures in the field of aesthetic surgery. Fat embolism syndrome after liposuction can easily be overlooked or underestimated; however, occasionally, fulminating fat embolism syndrome can develop and lead to a critical situation within 2-3 days after lipoplasty. Changes over time in the amount of circulating fat particles and the histology of major organs have not yet been studied. Methods This study was conducted using 18 male Sprague-Dawley rats aged 12 weeks and weighing 500-628 g (average, 562 g). Fifteen rats were used as the experimental group and 3 as the control group. Under general anesthesia, tumescent-technique liposuction was performed at the lateral flank areas and abdomen for 1 hour. Blood, lung, and brain tissue specimens were obtained at 1 hour, 1 day, and 2 days after the liposuction procedure. Results The average number of fat particles in the blood samples was 25,960/dL at 1 hour, 111,100/dL at 24 hours, and 21,780/dL at 48 hours. The differences between study groups were statistically significant. Both intravascular and extravascular fat particles with inflammation were seen in all 15 rats, as were inflammatory cell infiltration, hemorrhage, and consolidation with shrinkage of the lung alveoli. Conclusions These results imply that there is a strong possibility of fat embolism syndrome after liposuction in real clinical practice, and the first 24-48 hours after the operation were found to be the most important period for preventing pulmonary embolism and progression to fulminating fat embolism syndrome.

Rapid and Easy Diagnosis of Rabbit Haemorrhagic Disease by In Situ Hybridization (In situ Hybridization에 의한 토끼출혈증(rabbit haemorrhagic disease)의 신속.간편한 진단)

  • Park, Nam-Yong;Cho, Ho-Seong;Cho, Kyoung-Oh;Kim, Sang-Jip;Park, Hyung-Seon
    • Korean Journal of Veterinary Pathology
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    • v.5 no.2
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    • pp.57-62
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    • 2001
  • Recently various molecular diagnostic techniques have been used to identify rabbit hemorrhagic disease virus (RHDV), a causative agent responsible for acute hepatitis and disseminated intravascular coagulation in rabbit. But they were hard to perform and time consuming. To detect RHDV in a rapid and easy way, we developed biotinylated oligonucleotide probe within ORF 1 region encoding the polyprotein of RHDV in formalin-fixed and paraffin-embedded tissues from various tissues of 20 rabbits naturally infected with RHDV, Our in situ hybridization (ISH) was quickly carried out within two hours by MicroProbe capillary action system. The ISH produced a positive reaction in liver, kidney and lung. In conclusion, ISH with a biotintlated oligonucleotide probe provided a useful diagnostic method for detecting RHDV.

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Simultaneous infection with rabbit hemorrhagic disease virus and Pasteurella multocida in rabbits

  • Lee, Yun Chan;Oh, Yeonsu;Choi, Sang Ho;Chae, Mi Kyung;Na, Ki Bok;Yook, Sim Yong;Han, Jeong Hee
    • Korean Journal of Veterinary Service
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    • v.44 no.1
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    • pp.35-43
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    • 2021
  • Rabbit infectious hemorrhagic fever has been reported in rabbits worldwide. The disease is also frequently reported on Korean rabbit farms, and the pathological study of 9 rabbits on such disease-occurring farms was attempted to identify the pathogen. Clinical signs were torticollis and ear ulceration. Most rabbit died with bloody nasal discharges. At necropsy, multiple hemorrhages and inflammation were observed in heart, lung, liver and uterus. The main histopathologic features were hemorrhagic suppurative meningoencephalitis, fibrinous bronchointerstitial pneumonia, bacteremia, liver cell necrosis, multifocal hemorrhages in kidney and disseminated intravascular coagulopathy. The viral VP60 gene of RHDV was identified by Reverse Transcriptase PCR. Pasteurella multocida organisms were cultured, identified by biochemical test and serotyped as A by multiplex capsular typing PCR. In conclusion, the fatal hemorrhagic disease was due to combined infection with both RHDV and P. multocida in rabbits. To our knowledge, this is the first case report about co-infection with both RHDV and P. multocida in rabbits in Korea.

Gas Transfer and Hemolysis Characteristics of a New Type Intravenous Lung Assist Device (혈관 내 신형 폐보조장치의 기체전달 및 용혈 특성)

  • 김기범;권대규;정경락;이삼철
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.121-126
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    • 2003
  • The purpose of this work was to assess and quantify whether the beneficial effects in long-term gas exchange at exciting frequency were obtained at different frequencies as well and then to develop a vibrating intravascular lung assist device(VIVLAD), for Patients suffering from acute respiratory distress syndrome(ARDS) or chronic respiratory problems. We investigate the optimal condition of the frequency band excited with new vibrator at state of limit hemolysis when blood hemolysis came to through a membrane vibration action. The experimental design and procedures were given for a device used to assess the effectiveness of membrane vibrations. Quantitative experimental measurements were performed to evaluate the performance of the device . and to identify membrane vibration dependence on blood hemolysis. We developed an analytical solution for the hydrodynamics of flow through a bundle of sinusoidally vibrated hollow fibers that is used to provide some insight into how wall vibrations might enhance the performance of the VIVLAD. In the result, it was measured that the effect of various excited frequencies in gas transfer rate and hemolysis from the maximum gas transfer rate at no vibration when the maximum gas transfer rates showed at module type 6, module type 6 consisted of 675 hollow fiber membranes The maximum oxygen transfer rate was caused by the occurrence of maximum amplitude and transfer of vibration to hollow fiber membranes when it was excited by the frequency band of 7Hz at each blood flow rate. because this frequency became the End mode resonance frequency of the flexible in blood flow. Also, when module type 6 was excited at an excited frequency of 7Hz. blood hemolysis was low. Therefore, we decided that the limit of hemolysis frequency is 7Hz . because maximum amplitude occurred at this frequency.

Fat Embolism Syndrome with Pulmonary Hemorrhage of Unknown Origin (원인을 알 수 없는 폐출혈을 동반한 지방색전 증후군 1예)

  • Jeong, Hye-Cheol;Jung, Ki-Hwan;Kim, Byung-Gyu;Kim, Kyung-Kyu;Lee, Sang-Youb;Park, Sang-Myun;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kim, Han-Gyum;Yoo, Sa-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.383-387
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    • 2000
  • Fat embolism syndrome is a rare but serious complication occurring mostly in patients with long bone fractures and occasionally in patients who have had an underlying disease. For example, pancreatitis, diabetes mellitus, alcoholic liver disease and connective tissue disease can be risk factors. The 44-year old woman with a sudden dry cough, blood tinged sputum, and exertional dyspnea visited the Korea University Hospital. Petechiae on her anterior chest wall was found. Chest X-ray and CT showed patchy opacities and multifocal ground-glass opacities in both lung fields. An open lung biopsy demonstrated diffuse pulmonary hemorrhage and intravascular macrovesicular fat bubbles. After conservative management, her symptoms and radiologic findings were significantly improved. A case of fat embolism syndrome without any known risk factors is reported.

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Clinical Analysis of Ventilator-associated Pneumonia (VAP) in Blunt-chest-trauma Patients (흉부둔상환자에서 인공호흡기 관련 폐렴환자의 임상적 분석)

  • Oh, Joong Hwan;Park, Il Hwan;Byun, Chun Sung;Bae, Geum Suk
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.291-296
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    • 2013
  • Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.

Liquid Flow and Pressure Drop of an Outside Flow Membrane Oxygenator with Hollow Fibers (외부흐름 중공사 막형 인공폐의 액체흐름과 압력손실)

  • 이삼철;김기범
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.27-32
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    • 2002
  • The purpose of this study was to evacuate the effects of the number of tied hollow fibers in a novel membrane oxygenator that satisfied the limiting factor of minimizing the friction loss in the intravascular blood flow Pattern. The membrane oxygenator is a bundle consisted of several hundred ho1low fibers haying the outside diameter of 380 $\mu m$ and the axial jacket length of 600 mm. The eight different variation of tied hollow fibers in a bundle were designed. and the liquid flow pattern was controlled by a pump. The liquid pressure drop was measured by in vitro experiments using water and g1ycero1. Uniform blood flow pattern was observed for each number of tied hollow fibers. Pressure drop was 13-16 mmHg outside of the membrane oxygenator consisting of up to 700 ho1low fibers. More effective contact of liquid with the tied ho1low fibers was observed as a decrease in the number of the tied hollow fibers. and resulted in the enhancement of the friction tractor

A Case of Hantavirus Pulmonary Syndrome (한타바이러스 폐 증후군)

  • Lee, Kye-Young;Kim, Yun-Seup;Jee, Young-Koo;Bai, Hyun-Ju;Yun, Sung-Cheul;Kim, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1382-1389
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    • 1997
  • Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases : prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.

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Engraftment of Human Mesenchymal Stem Cells in a Rat Photothrombotic Cerebral Infarction Model : Comparison of Intra-Arterial and Intravenous Infusion Using MRI and Histological Analysis

  • Byun, Jun Soo;Kwak, Byung Kook;Kim, Jae Kyun;Jung, Jisung;Ha, Bon Chul;Park, Serah
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.467-476
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    • 2013
  • Objective : This study aimed to evaluate the hypotheses that administration routes [intra-arterial (IA) vs. intravenous (IV)] affect the early stage migration of transplanted human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in acute brain infarction. Methods : Male Sprague-Dawley rats (n=40) were subjected to photothrombotic infarction. Three days after photothrombotic infarction, rats were randomly allocated to one of four experimental groups [IA group : n=12, IV group : n=12, superparamagnetic iron oxide (SPIO) group : n=8, control group : n=8]. All groups were subdivided into 1, 6, 24, and 48 hours groups according to time point of sacrifice. Magnetic resonance imaging (MRI) consisting of T2 weighted image (T2WI), $T2^*$ weighted image ($T2^*WI$), susceptibility weighted image (SWI), and diffusion weighted image of rat brain were obtained prior to and at 1, 6, 24, and 48 hours post-implantation. After final MRI, rats were sacrificed and grafted cells were analyzed in brain and lung specimen using Prussian blue and immunohistochemical staining. Results : Grafted cells appeared as dark signal intensity regions at the peri-lesional zone. In IA group, dark signals in peri-lesional zone were more prominent compared with IV group. SWI showed largest dark signal followed by $T2^*WI$ and T2WI in both IA and IV groups. On Prussian blue staining, IA administration showed substantially increased migration and a large number of transplanted hBM-MSCs in the target brain than IV administration. The Prussian blue-positive cells were not detected in SPIO and control groups. Conclusion : In a rat photothrombotic model of ischemic stroke, selective IA administration of human mesenchymal stem cells is more effective than IV administration. MRI and histological analyses revealed the time course of cell migration, and the numbers and distribution of hBM-MSCs delivered into the brain.

Effects of FK224, a $NK_1$ and $NK_2$ Receptor Antagonist, on Plasma Extravasation of Neurogenic Inflammation in Rat Airways (미주 신경의 전기적 자극으로 유발된 백서의 기도내 혈장 유출에 대한 FK224의 효과)

  • Shim, Jae-Jeong;Lee, Sang-Yeub;Lee, Sang-Hwa;Park, Sang-Myun;Seo, Jeong-Kyung;Cho, Jae-Yun;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.744-751
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    • 1995
  • Background: Asthma is an inflammatory disease because there are many inflammatory changes in the asthmatic airways. Axon reflex mechanisms may be involved in the pathogenesis of asthma. Sensory neuropeptides are involved in this inflammation, which is defined as neurogenic inflammation. Substance p, neurokinin A, and neurokinin B may be main neuropeptides of neurogenic inflammation in airways. These tachykinins act on neurokinin receptors. Three types of neurokinin receptors, such as $NK_1$, $NK_2$, and $NK_3$, are currently recognized, at which substance p, neurokinin A, and neurokinin B may be the most relevant natural agonist of neurogenic inflammation in airways. The receptor subtypes present in several tissues have been characterized on the basis of differential sensitivity to substance p, neurokinin A, and neurokinin B. Plasma extravasation and vasodilation are induced by substance p more potently than by neurokinin A, indicating NK1 receptors on endothelial cells mediate the response. But airway contraction is induced by neurokinin A more potently than by substance P, indicating the $NK_2$ receptors in airway smooth muscles. These receptors are used to evaluate the pathogenesis of brochial asthma. FK224 was identified from the fermentation products of Streptomyces violaceoniger. FK224 is a dual antagonist of both $NK_1$ and $NK_2$ receptors. Purpose: For a study of pathogenesis of bronchial asthma, the effect of FK224 on plasma extravasation induced by vagal NANC electrical stimulation was evaluated in rat airway. Method: Male Sprague-Dawley rats weighing 180~450gm were anesthetized by i.p. injection of urethane. Plasma extravasation was induced by electrical stimulation of cervical vagus NANC nerves with 5Hz, 1mA, and 5V for 2 minutes(NANC2 group) and for sham operation without nerve stimulation(control group). To evaluate the effect of FK224 on plasma extravasation in neurogenic inflammation, FK224(1mg/kg, Fujisawa Pharmaceutical Co., dissolved in dimethylsulphoxide; DMSO, Sigma Co.) was injected 1 min before nerve stimulation(FK224 group). To assess plasma exudation, Evans blue dye(20mg/kg, dissolved in saline) was used as a plasma marker and was injected before nerve stimulation. After removal of intravascular dye, the evans blue dye in the tissue was extracted in formamide($37^{\circ}C$, 24h) and quantified spectrophotometrically by measuring dye absorbance at 629nm wavelength. Tissue dye content was expressed as ng of dye per mg of wet weight tissue. The amount of plasma extravasation was measured on the part of airways in each groups. Results: 1) Vagus nerve(NANC) stimulation significantly increased plasma leakage in trachea, main bronchus, and peripheral bronchus compared with control group, $14.1{\pm}1.6$ to $49.7{\pm}2.5$, $17.5{\pm}2.0$ to $38.7{\pm}2.8$, and $12.7{\pm}2.2$ to $19.1{\pm}1.6ng$ of dye per mg of tissue(mean ${\pm}$ SE), respectively(p<0.05). But there was not significantly changed in lung parenchyma(p>0.05) 2) FK224 had significant inhibitory effect upon vagal nerve stimulation-induced airway plasma leakage in any airway tissues of rat,such as trachea, main bronchus, and peripheral bronchus compared with vagus nerve stimulation group, 49%, 58%, and 70%, respectively(p<0.05). Inhibitory effect of FK224 on airway plasma leakage in neurogenic inflammation was revealed the more significant in peripheral bronchus, but no significant in lung parenchyma. Conclusion: These results suggest that FK224 is a selective NK receptor antagonist which effectively inhibits airway plasma leakage induced by the endogenous neurotransmitters relased by neurogenic inflammation in rat airway. Tachykinin receptor antagonists may be useful in the treatment of brochial asthma.

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