• Title/Summary/Keyword: pressure injury

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Emergency Trephination Site of Acute Subdural Hematoma (급성 경막하 혈종에서 응급 두개골 천공의 위치)

  • Moon, Soo-Hyeon;Kim, Geun-Hoe;Kwon, Taek-Hyun;Park, Youn-Kwan;Chung, Hung-Seob;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.659-663
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    • 2000
  • The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

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Overview of Pediatric Continuous Renal Replacement Therapy in Acute Kidney Injury (급성 신손상을 가진 소아의 지속적 신대체 요법)

  • Park, Se-Jin;Shin, Jae-Il
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.107-115
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    • 2011
  • Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

Effects of Red Koji-Fermented Bupleuri Radix Extracts on Lipopolysaccharide-Induced Rat Acute Lung Injury (홍국발효 시호(柴胡)가 Lipopolysaccharide로 유발된 급성 폐 손상에 미치는 영향)

  • Seo, Young-ho;Jung, Tae-young;Kim, Jong-dea;Choi, Hae-yun
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.21-44
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    • 2021
  • Objective : This study aimed to assess the preventive effect of Bupleuri Radix aqueous extracts (BR) and red koji-fermented BR (fBR) in lipopolysaccharide (LPS)-induced acute lung injury in a rat model. Methods : Rats were administered 30, 60, or 120 mg/kg/day of fBR for 28 days before LPS treatments. All rats were sacrificed 5 h after LPS treatment (500 ㎍/head, intratracheal instillation). Body weights, lung weights, pulmonary transcapillary albumin transit, arterial gas parameters (pH, partial pressure [Pa] of O2, PaCO2), bronchoalveolar lavage fluid (BALF) protein, lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), total cell numbers, neutrophil/alveolar macrophage ratios, lung malondialdehyde (MDA), and myeloperoxidase (MPO) were measured. In addition, histopathological changes including the luminal surface of alveoli (LSA), thickness of alveolar septum, and number of polymorphonuclear neutrophils (PMNs) were checked. Results : LPS injection led to increases in lung weights, pulmonary transcapillary albumin transit, BALF protein, LDH, TNF-α and IL-1β contents, total cells, neutrophil and alveolar macrophage ratios, lung MDA, MPO, alveolar septum thickness, and PMNs, and decreases in PaCO2 and pH of arterial blood and LSA. However, these LPS-induced acute lung injuries were inhibited by pretreatment of 30, 60, and 120 mg/kg of fBR. The most favorable effects were seen with 30 mg/kg fBR as compared with 60 mg/kg of α-lipoic acid and BR. Conclusions : fBR showed preventive effects on LPS-induced acute lung injury, which resembles acute respiratory distress syndrome. The mechanisms of action were likely via antioxidant and anti-inflammatory means.

Ex Vivo Lung Perfusion of Cardiac-death Donor Lung in Pigs

  • Paik, Hyo Chae;Haam, Seok Jin;Park, Moo Suk;Song, Joo Han
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.154-159
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    • 2014
  • Background: Lung transplantation (LTx) is a life-saving treatment for patients with end-stage lung disease; however, the shortage of donor lungs has been a major limiting factor to increasing the number of LTx. Growing experience following LTx using donor lungs after cardiac death (DCD) has been promising, although concerns remain. The purpose of this study was to develop a DCD lung harvest model using an ex vivo lung perfusion (EVLP) system and to assess the function of presumably damaged lungs harvested from the DCD donor in pigs. Methods: The 40 kg pigs were randomly divided into the control group with no ischemic lung injury (n=5) and the study group (n=5), which had 1 hour of warm ischemic lung injury after cardiac arrest. Harvested lungs were placed in the EVLP circuit and oxygen capacities (OC), pulmonary vascular resistance (PVR), and peak airway pressure (PAP) were evaluated every hour for 4 hours. At the end of EVLP, specimens were excised for pathologic review and wet/dry ratio. Results: No statistically significant difference in OC (P=0.353), PVR (P=0.951), and PAP (P=0.651) was observed in both groups. Lung injury severity score (control group vs. study group: 0.700±0.303 vs. 0.870±0.130; P=0.230) and wet/dry ratio (control group vs. study group: 5.89±0.97 vs. 6.20±0.57; P=0.560) also showed no statistically significant difference between the groups. Conclusions: The function of DCD lungs assessed using EVLP showed no difference from that of control lungs without ischemic injury; therefore, utilization of DCD lungs can be a new option to decrease the number of deaths on the waiting list.

Effects of Abdominal Muscle and Pressure on the Spine Stability during Upright Stance Posture - For the Case where Intervertebral Disc Plays the Role of Mechanoreceptor (추간판이 물리적 자극의 수용기 역할을 하는 경우 기립 상태에서 복압 및 복근의 역할이 척추 안전성에 미치는 영향)

  • Choi, Hae-Won;Kim, Young-Eun
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.1
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    • pp.115-122
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    • 2011
  • Recently, we have proposed a hypothesis that spinal structures have a stress sensor driving feedback mechanism, In the human spine, spinal structure could react to modify muscular action in such a way so as to equalize stress at the disc, therefore reduce the risk of injury, In this analysis, abdominal muscle and abdominal pressure, which were not included in the previous study, were added to identify those effects in spine stability during upright stance posture for the case where the intervertebral disc plays the role of mechanoreceptor, The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Muscle architecture with 46 local muscles containing paraspinal muscle and 6 rectus abdominal muscles were assigned according to the acting directions. The magnitude of 4kPa was considered for abdominal pressure. Minimization of the nucleus pressure deviation and annulus fiber average tension stress deviation was chosen for cost function. Developed model provide nice coincidence with in-vivo measurement (nucleus pressure). Analysis was conducted according to existence of co-activation of abdominal muscle and abdominal pressure. Antagonistic activity of abdominal muscle produced stability of spinal column with relatively small amount of total muscle force. In contrast to the abdominal muscle, effect of abdominal pressure was not clear that was partly depending on the assumption of constant abdominal pressure.

Comparative Analysis of Foot Pressure Distribution by Functional Insole to be Transformed and Restored During Walking (보행 시 변형 및 복원이 가능한 인솔에 대한 족저압력 비교 분석)

  • Park, Seung-Bum;Lee, Kyung-Deuk;Kim, Dae-Woong;Yoo, Jung-Hyeon;Kim, Kyung-Hun
    • Korean Journal of Applied Biomechanics
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    • v.21 no.2
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    • pp.231-241
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    • 2011
  • The purpose of this study was to analyze the distribution of foot pressure generated by active materials of a functional insole. Comfort is an important consideration while selectingfootwear and insoles. Consequently, it has an influence on injury. The development of new materials for functional insoles is considered one of the more important points for their manufacture. The method adopted in this study is as follows. First, ten healthy males were selected as subjects for the study. Each subject's foof was pre-screened podoscope(Alfoots, Korea) to check for the presence of any foot abnormalities, Two kinds of equipment were used for the study: a foot pressure device from Pedar-X, Germany, and a treadmill from Pulsefitness, UK. Next, each subject was asked to test four types of insoles(insoles of outdoor shoes, indoor shoes, walking shoes, and sports shoes) via walking trials on the treadmill at a constant speed of 4.2 km/h. The pressure distribution data(contact area, maximum force, maximum peak pressure, and maximum mean pressure) was collected using the pressure device at a sampling rate of 100 Hz. Results of the tests showed that all four types of functional insoles increased contact areas whit the foot. Further, functional insoles of walking shoes and sport shoes decreased the foot pressure. From these results, we conclude that the active materials of functional insoles of shoes can increase the contact area and provide greater comfort.

Experimental Studies on the Effect of Ginsenoside Rg1 Mixtures in an Isolated Rat Heart after Ischemic Arrest and Reperfusion (흰 쥐 적출 심장에서 비작업성 관류 회로를 이용한 인삼 성분 Ginsenoside Rg1 Mixtures의 심근 보호 효과에 관한 실험적 연구)

  • 김동원;신원선;이재영;김범식;조규석;유세영
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.567-575
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    • 1998
  • Panax Ginseng C.A. Meyer has been known for hundreds of years as the most valuable drug having mysterious effects among all the herbal medicines and plants in Korea. Also, many experimental studies have been performed recently that the various effects were identified and applied clinically. So we attempted an experimental study on the effect of ginsenoside Rg1 mixtures in an isolated rat heart with the use of the Langendorff model. The objective of this study was to determine whether this ginsenoside Rg1 mixtures would protect the myocardial injury after ischemic arrest and reperfusion. Isolated rat hearts were allowed to equilibrate for 20 minutes and were then subjected to 15 minutes of normothermic ischemia. After this ischemic period, isolated rat hearts were allowed to reperfusion for 10 minutes(Ischemic Group). In other group , isolated rat hearts were perfused for 60 minutes continuously with normothermia( Normothermic Group). Hemodynamic and biochemical parameters such as heart rate, left ventricular pressure, +dp/dt max, coronary blood flow and cardiac enzymes were measured during initial perfusion, ischemia, reperfusion period (Ischemic group) and 20, 40 and 60 minutes after continuous perfusion(Normothermic group). After completion of the experiment, this data was evaluated and the following results were obtained. 1. Heart rates showed an increase in both ischemic and normothermic experimental groups, but statistically significant differences were not identified. 2. LVP(Left Ventricular Pressure) showed statistically significant differences in both ischemic and normothermic experimental groups(p<0.005, p<0.01). 3. +dp/dt max showed statistically significant differences in both ischemic and normothermic experimental groups(p<0.01, p<0.01). 4. There were no statistically significant differences in coronary blood flow and cardiac cenzymes in all groups, but experimental groups seemed to have better protection and recovery. These results suggest that ginsenoside Rg1 mixtures has a protective effect on the myocardial injury after ischemia and reperfusion.

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Usability test of pulling cable exercise machine in the spinal cord injury disabled: Focusing on deriving improvement (척수 손상 장애인 대상 장애인용 풀링 케이블 운동기구의 사용성 평가: 개선점 도출을 중심으로)

  • Sung Shin Kim;Myo Jung Choi;Hyosun Kweon;Kwang Ok An;Young-Hyeon Bae
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.16-32
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    • 2024
  • Background: Exercise equipments and assistive devices for the disabled are being developed, but improvements for usability are still needed. The purpose of this study was to improve and utilize the developed exercise equipment and assistance devices by conducting usability test for people with spinal cord injury. Design: Cross-sectional Study. Methods: Scenarios and usability indicators were derived by conducting a preliminary usability test, 5 non-disabled men and women aged 19 or older. In the scenario, a total of 9 tasks were sequentially performed, including 2 tasks of entry and exit, 5 tasks of assistance devices and weight stack adjustment, and 2 tasks of pre exercise and exercise. The usability indicators were task success (success or fail), execution time (sec), safety, and convenience. For safety, 7 questions (Likert scale, 1~5 point) related to safety, stability and hazard were derived, and for convenience, the system usability scale (SUS score) was used (range: 0~100, 50 percentile rank is 68 point). Results: As a result of the usability test of people with spinal cord injury, there was a large variation among subjects in the task of adjusting the position of the pulley and support in the execution time (11.64~25.44 seconds), and one person failed to adjust the pulley. The safety level showed a lower score (score = 3 points) than other items in the item of entrapment or skin pressure, and in the case of SUS, the average score was 64.5 points, which was close to the acceptable level. Conclusion: Through the usability test, it was confirmed that exercise equipment for the disabled needs improvement in operability, pinching, and pressure, and that it is necessary to develop an assistive device that provides unrestrained posture information (biofeedback) to maintain correct posture during exercise.

Effects of Tire Pressure on Biceps Brachii and Triceps Brachii Activity When Operating a Manual Wheelchair

  • Lee, Sang-Yeol;Lee, Su-Kyoung
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.3
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    • pp.55-58
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    • 2016
  • PURPOSE: This study was measured the differences in the flexor and extensor muscle activities of the elbow joints based on the tire pressure of wheelchairs during propulsion, investigating the optimal tire pressure for improving occupants' propulsion and avoiding related injury. METHODS: Ten healthy volunteers (10 men aged $23.1{\pm}1.9years$, weight: $67.9{\pm}3.4kg$, height: $175.1{\pm}2.7cm$) took part in the study. The mean values used in the statistical process were obtained from values measured while a subject sitting on a wheelchair propelled himself forward for 10 meters on a flat floor at maximum speed. The tire pressure of the wheelchairs was set at 100 psi, 50 psi, and 25 psi. All of the subjects performed wheelchair propulsion for each pressure. This study was measured the activation of the biceps brachii and triceps brachii muscles on the dominant side during wheelchair propulsion. The measured data was analyzed using one-way analysis of variance (ANOVA) via the statistical package for the social sciences (SPSS) version 12.0 for Windows to compare the muscle activity. RESULTS: The muscle activities of the biceps brachii and triceps brachii were significant differences between each pressure group. The post hoc test found statistically significant differences between 100 psi and 50 psi and 100 psi and 25 psi for the biceps brachii and triceps brachii muscles, respectively. CONCLUSION: The maintaining proper tire pressure in a wheelchair may help to prevent overuse syndrome in the occupant's elbow joints.

Treatment of Recurrent Ischial Pressure Sore Using Sclerotherapy with Absolute Ethanol (순수 에탄올을 이용한 재발된 좌골부위 압박궤양의 경화요법적 치료)

  • Song, Hoon;Park, Sang Keun;Kim, Jong Whan;Hong, In Pyo
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.627-631
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    • 2006
  • Purpose: Ischial region is common site of pressure sore as well as greater trochanteric area. In general, ischial pressure sore associated with a large subcutaneous bursa often requires radical surgical treatment. The authors performed sclerotherapy using absolute ethanol which was considered as an alternative in treating recurrent ischial pressure sore. Methods: From may 2005 to February 2006, 11 ischial pressure sore patients were treated sclerotherapy using absolute ethanol. The authors performed sclerotherapy using absolute ethanol in 11 patients in whom the ischial sore has recurred despite of multiple radical surgical treatment. The patients' original disorders were spinal cord injury in 9 patients, cerebral palsy in 1 patient and giant cell tumor in thoracic vertebrae 1 patient. Results: Recurrence of pressure sore was not found in any patient during the follow-up period. The swap of the bursa taken before the surgery was germ cultured and compared with the discharge from an end of the inserted drain tube. The germ cultured results after the surgery were tested negative in all patients. Conclusion: This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. We felt that aforementioned treatment modality may be considered as an alternative in treating recurrent ischial pressure sore.