• 제목/요약/키워드: pressure injury

검색결과 463건 처리시간 0.028초

급성폐손상환자에서 호기말양압의 변화가 폐모세혈관압에 미치는 영향 (The Effect of Positive end Expiratory pressure on the Pulmonary Capillary Pressure in Acute Lung Injury Patients)

  • 정병천;변창규;이창률;김형중;안철민;김성규;신중수
    • Tuberculosis and Respiratory Diseases
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    • 제49권5호
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    • pp.594-600
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    • 2000
  • 연구배경 : 급성폐손상 환자는 폐의 염증 및 투과성 증가로 폐부종을 보인다. 폐부종의 중요한 결정요인은 폐모세혈관압이며 호기말양압은 폐모세혈관에 영향을 미치는 것으로 알려져 있다. 최근 폐동맥 풍선 도자를 이용한 임상적인 폐모세혈관압 측정법이 발전하여, 이를 이용 하면 폐동맥쐐기압 뿐만 아니라 폐모세혈관압 측정도 가능하게 되었다. 이에 급성폐손상 환자를 대상으로 폐동맥 풍선 도자로 폐동맥쐐기압 및 폐모세혈관압의 변화를 관찰하여 폐동맥쐐기압이 폐모세혈관압올 적절히 반영하는지 알아보고, 호기말양압의 변화가 폐모세혈관압에 미치는 영향을 알아보고자 본 연구를 시행 하였다. 방법 : 급성폐손상으로 기계호흡을 받은 11명의 환자를 대상으로 하였다. 호기말 양압을 0cm$H_2O$에서 시작하여 15분 간격으로 4cm$H_2O$ 씩 증가시켜 12cm$H_2O$까지 변화를 주연서 정해진 PEEP값에서 폐동맥 풍선 도자를 이용한 폐모세혈관압 측정법을 사용하여 자료를 얻었다. 결과 : 호기말양압을 0cm$H_2O$부터 12cm$H_2O$까지 증가시킴에 따라 중심정맥압은 $6.1{\pm}1.6$에서 $9.3{\pm}2.3$mmHg까지 증가하였고, 평균폐동맥압도 $22.7{\pm}7.4$에서 $25.3{\pm}7.3$mmHg까지 증가하였다. 또한 폐동맥쐐기압은 $9.8{\pm}2.1$ 에서 $12.8{\pm}2.1$mmHg로 증가하였고, 폐모세혈관압도 $15.3{\pm}3.3$ 에서 $17.8{\pm}3.2$mmHg로 증가 하였다. 결론 : 급성폐손상 환자에서 폐동맥쐐기압이 폐모세혈관압을 반영하나 호기말양압을 사용하면 폐모세혈관압이 증가하는 것을 관찰하였다. 따라서 급성폐손상 환자의 수액요법에서 폐동맥쐐기압 뿐만 아니라 폐모세혈관압의 감시도 가치가 있을 것으로 기대된다.

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신손상 환자에서 혈관 색전술의 효용성 (Efficiency of Embolization for Kidney Injury)

  • 권영기;장혁수;김병훈;박철희;김천일
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.16-20
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    • 2010
  • Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury.

Analysis of Traumatic Brain Injury Using a Finite Element Model

  • Suh Chang-Min;Kim Sung-Ho;Oh Sang-Yeob
    • Journal of Mechanical Science and Technology
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    • 제19권7호
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    • pp.1424-1431
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    • 2005
  • In this study, head injury by impact force was evaluated by numerical analysis with 3-dimensional finite element (FE) model. Brain deformation by frontal head impact was analyzed to evaluate traumatic brain injury (TBI). The variations of head acceleration and intra-cranial pressure (ICP) during the impact were analyzed. Relative displacement between the skull and the brain due to head impact was investigated from this simulation. In addition, pathological severity was evaluated according to head injury criterion (HIC) from simulation with FE model. The analytic result of brain damage was accorded with that of the cadaver test performed by Nahum et al.(1977) and many medical reports. The main emphasis of this study is that our FE model was valid to simulate the traumatic brain injury by head impact and the variation of the HIC value was evaluated according to various impact conditions using the FE model.

Cardioprotective potential of Korean Red Ginseng extract on isoproterenol-induced cardiac injury in rats

  • Lim, Kyu Hee;Ko, Dukhwan;Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • 제37권3호
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    • pp.273-282
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    • 2013
  • The present study was designed to investigate the cardioprotective effects of Korean Red Ginseng extract (KRG) on isoproterenol (ISO)-induced cardiac injury in rats, particularly in regards to electrocardiographic changes, hemodynamics, cardiac function, serum cardiac enzymes, components of the myocardial antioxidant defense system, as well as inflammatory markers and histopathological changes in heart tissue. ISO (150 mg/kg, subcutaneous, two doses administered at 24-hour intervals) treatment induced significant decreases in P waves and QRS complexes (p<0.01), as well as a significant increase in ST segments. Moreover, ISO-treated rats exhibited decreases in left-ventricular systolic pressure, maximal rate of developed left ventricular pressure ($+dP/dt_{max}$) and minimal rate of developed left ventricular pressure ($-dP/dt_{max}$), in addition to significant increases in lactate dehydrogenase, aspartate transaminase, alanine transaminase and creatine kinase activity. Heart rate, however, was not significantly altered. And the activities of superoxide dismutase, catalase and glutathione peroxidase were decreased, whereas the activity of malondialdehyde was increased in the ISO-treated group. ISO-treated group also showed increased caspase-3 level, release of inflammatory markers and neutrophil infiltration in heart tissue. KRG pretreatment (250 and 500 mg/kg, respectively) significantly ameliorated almost all of the parameters of heart failure and myocardial injury induced by ISO. The protective effect of KRG on ISO-induced cardiac injury was further confirmed by histopathological study. In this regard, ISO treatment induced fewer morphological changes in rats pretreated with 250 or 500 mg/kg of KRG. Compared with the control group, all indexes in rats administered KRG (500 mg/kg) alone were unaltered (p>0.05). Our results suggest that KRG significantly protects against cardiac injury and ISO-induced cardiac infarction by bolstering antioxidant action in myocardial tissue.

Transforming growth factor-beta and liver injury in an arginine vasopressin-induced pregnant rat model

  • Govender, Nalini;Ramdin, Sapna;Reddy, Rebecca;Naicker, Thajasvarie
    • Clinical and Experimental Reproductive Medicine
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    • 제48권2호
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    • pp.124-131
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    • 2021
  • Objective: Approximately 30% of preeclamptic pregnancies exhibit abnormal liver function tests. We assessed liver injury-associated enzyme levels and circulating transforming growth factor beta (TGF-β) levels in an arginine vasopressin (AVP)-induced pregnant Sprague-Dawley rat model. Methods: Pregnant and non-pregnant Sprague-Dawley rats (n=24) received AVP (150 ng/hr) subcutaneously via mini-osmotic pumps for 18 days. Blood pressure was measured, urine samples were collected, and all animals were euthanized via isoflurane. Blood was collected to measure circulating levels of TGF-β1-3 isomers and liver injury enzymes in pregnant AVP (PAVP), pregnant saline (PS), non-pregnant AVP (NAVP), and non-pregnant saline (NS) rats. Results: The PAVP group showed significantly higher systolic and diastolic blood pressure than both saline-treated groups. The weight per pup was significantly lower in the AVP-treated group than in the saline group (p<0.05). Circulating TGF-β1-3 isomer levels were significantly higher in the PAVP rats than in the NS rats. However, similar TGF-β1 and TGF-β3 levels were noted in the PS and PAVP rats, while TGF-β2 levels were significantly higher in the PAVP rats. Circulating liver-type arginase-1 and 5'-nucleotidase levels were higher in the PAVP rats than in the saline group. Conclusion: This is the first study to demonstrate higher levels of TGF-β2, arginase, and 5'-nucleotidase activity in PAVP than in PS rats. AVP may cause vasoconstriction and increase peripheral resistance and blood pressure, thereby elevating TGF-β and inducing the preeclampsia-associated inflammatory response. Future studies should explore the mechanisms through which AVP dysregulates liver injury enzymes and TGF-β in pregnant rats.

Peiminine inhibits myocardial injury and fibrosis after myocardial infarction in rats by regulating mitogen-activated protein kinase pathway

  • Chen, Peng;Zhou, Dengming;Liu, Yongsheng;Wang, Ping;Wang, Weina
    • The Korean Journal of Physiology and Pharmacology
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    • 제26권2호
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    • pp.87-94
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    • 2022
  • Myocardial infarction promotes cardiac remodeling and myocardial fibrosis, thus leading to cardiac dysfunction or heart failure. Peiminine has been regarded as a traditional anti-fibrotic Chinese medicine in pulmonary fibrosis. However, the role of peiminine in myocardial infarction-induced myocardial injury and fibrosis remained elusive. Firstly, rat model of myocardial infarction was established using ligation of the left coronary artery, which were then intraperitoneally injected with 2 or 5 mg/kg peiminine once a day for 4 weeks. Echocardiography and haemodynamic evaluation results showed that peiminine treatment reduced left ventricular end-diastolic pressure, and enhanced maximum rate of increase/decrease of left ventricle pressure (± dP/dt max) and left ventricular systolic pressure, which ameliorate the cardiac function. Secondly, myocardial infarction-induced myocardial injury and infarct size were also attenuated by peiminine. Moreover, peiminine inhibited myocardial infarction-induced increase of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α production, as well as the myocardial cell apoptosis, in the rats. Thirdly, peiminine also decreased the myocardial fibrosis related protein expression including collagen I and collagen III. Lastly, peiminine reduced the expression of p38 and phosphorylation of extracellular signal-regulated kinase 1/2 in rat model of myocardial infarction. In conclusion, peiminine has a cardioprotective effect against myocardial infarction-induced myocardial injury and fibrosis, which can be attributed to the inactivation of mitogen-activated protein kinase pathway.

탄산 가스의 팽창 압력에 의한 식도의 천공 -2례 보고- (Esophageal Perforation Due to Pneumatic Pressure of Carbonated Beverage - Report of two cases -)

  • 장인석;김종우;이정은;최준영;김성호;이상호
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.198-200
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    • 1999
  • 탄산 음료수병에 녹아있던 탄산 가스의 팽창 압력에 의한 식도의 천공은 드물게 보고된다. 이러한 환자를 구강 및 인후의 손상만으로 진단하고 식도 손상을 간과한다면 환자에게는 치명적인 결과를 가져오게 된다. 조기 진단과 적절한 수술적인 중재를 해야만 환자를 구할 수 있게 된다. 조기 진단이 가능하려면 환자의 병력과 이학적 검사로 식도의 천공을 예측해야 한다. 저자들은 탄산 음료가 들어있는 병 입구를 입에 물고 있다가 폭발적 막\ulcorner기화하여 팽창하는 압력에 의해 식도의 천공이 유발된 2례의 증례를 보고한다.

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Outcomes of open neck injuries

  • Noh, Dongsub;Choi, Jin Ho
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.168-172
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    • 2022
  • Purpose: The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries. Methods: In this retrospective study, open neck injury patients who were admitted to the Trauma Center of Daejeon Eulji Medical Center, Eulji University between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality. Results: Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale. Conclusions: Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

Unusual Presentation of a Penetrating Aortic Arch Injury

  • Vural, Fikret Sami;Patel, Atul Kumar;Mustafa, Kashif
    • Journal of Chest Surgery
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    • 제50권4호
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    • pp.295-297
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    • 2017
  • A 27-year-old man was admitted with a penetrating injury at the mid-manubrium. Computed tomographic (CT) angiography showed a f illing def ect in the aortic arch. This was evaluated as a sign of injury and the patient underwent an emergency operation. No active bleeding or clot was f ound in the mediastinum during the operation. The laceration point was between the innominate and the left carotid artery posteriorly. The injury was approached using hypothermic circulatory arrest. Aortotomy and exploration showed a 2-cm-long full-thickness aortic injury with an overlying clot. A filling defect on angiography as a sign of a penetrating arch injury has never been reported previously, but was the main pathological finding on CT angiography in our case. The aorta is a high-pressure system and injuries to it should be treated aggressively.