• 제목/요약/키워드: vascular injury

검색결과 388건 처리시간 0.024초

전침 자극과 전기 자극의 적용이 근육압좌손상이 유발된 흰쥐의 골격근 내 혈관내피성장인자 발현에 미치는 영향 (Effects of Electroacupuncture and Electrical Stimulation on VEGF Expression After Muscle Crush Injury in Rats)

  • 김민희;이현민;박은세;남기원;김진상
    • 한국전문물리치료학회지
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    • 제13권2호
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    • pp.9-15
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    • 2006
  • Skeletal muscle injury occurs frequently in sports medicine and is the most general form of injury followed by physical impact. There are growth factors which conduct proliferation, differentiation, and synthesis of myogenic prodromal cells and regulate vascular generation for the continued survival of myocytes. The purpose of the present study was to confirm the effects of electroacupuncture (EA) and electrical stimulation (ES) on muscle recovery processes according to vascular endothelial growth factor (VEGF) expression. Eighteen Sprague-Dawley rats were separated into 2 experimental groups and a controlled group. All animals had suffered from crush damage in the extensor digitorum longus for 30 seconds and were killed 1, 3, and 7 days after injury. 30 Hz and 1 mA impulsion for 15 minutes was applied to the EA experimental groups Zusanli (ST36) and Taichong (LR3) using electroacupuncture and the same stimulation was applied to the ES group using an electrical node. Hematoxyline-Eosin staining and VEGF immunohistochemistry were used to ascertain the resulting muscle recovery. There were few morphological differences between the EA and ES groups, and both groups were observed to have tendencies to decrease atrophy as time passed. In the controlled group, gradually diminishing atrophy could be observed, but their forms were mostly disheveled. There were few differences in VEGF expression between the EA and ES groups, and tendencies to have an increased quantity of VEGF with the lapse of time were observed in both groups. In the controlled group, a little VEGF expression could be observed merely 7 days after injury. In conclusion, EA and ES contributed to muscle recovery processes and could be used for the treatment of muscle injury.

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Kidney transplantation using expanded criteria deceased donors with terminal acute kidney injury: a single center experience in Korea

  • Ko, Kyung Jai;Kim, Young Hwa;Kim, Mi Hyeong;Jun, Kang Woong;Kwon, Kyung Hye;Kim, Hyung Sook;Kim, Sang Dong;Park, Sun Cheol;Kim, Ji Il;Yun, Sang Seob;Moon, In Sung;Hwang, Jeong Kye
    • Annals of Surgical Treatment and Research
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    • 제95권5호
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    • pp.278-285
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    • 2018
  • Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

Inhibitory effects of Saiko-Ka-Ryukotsu-Borei-To on the migration and proliferation of vascular smooth muscle cell

  • Chung, Hwa-Jin;Ikuro Maruyama;Tadato Tani;Lee, Sang-Kook
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 2003년도 Annual Meeting of KSAP : International Symposium on Pharmaceutical and Biomedical Sciences on Obesity
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    • pp.100-100
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    • 2003
  • We have reported that oral administration of Saiko-Ka-Ryukotsu-Borei-To (SRB), a traditional Chinese formulation, inhibited the intimal thickening in carotid artery after balloon injury in cholesterol-fed rats. To elucidate its mechanism, the effects of SRB on migration and proliferation of vascular smooth muscle cell (VSMC) were examined in vivo and in vitro. We have reported that oral administration of Saiko-ka-Ryukotsu-Borei-To (SRB), a traditional Chinese formulation, inhibited the intimal thickening in carotid artery after balloon injury in cholesterol-fed rats. To elucidate its mechanism, the effects of SRB on migration and proliferation of vascular smooth muscle cell (VSMC) were examined in vivo and in vitro.

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복부 둔상 후에 발생한 광범위한 하대정맥 손상: 증례보고 (Extensive Inferior Vena Cava Injury Following Blunt Abdominal Trauma: A Case Report)

  • 유영선;문성표
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.219-223
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    • 2014
  • Traumatic injuries of the inferior vena cava (IVC) are the most challenging lesions in abdominal vascular injuries and are associated with a high mortality rate. Although endovascular treatment has been addressed in the management of vascular trauma, surgery is the mainstay in the treatment for IVC injury as an endovascular technique for the venous system has not been developed. We report a case of successful surgical repair of an extensive IVC laceration following a fall.

혈관 손상의 임상적 고찰 (Clinical Study of Vascular Injuries)

  • 정성운;김영규
    • Journal of Chest Surgery
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    • 제40권7호
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    • pp.480-484
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    • 2007
  • 서론: 주요 혈관 손상 시 적절한 진단 및 치료가 지연될 경우 환자가 생명을 잃거나 사지를 절단해야 할 위험이 있게 된다. 이러한 혈관 손상의 적절한 치료를 위한 지침을 세워보고자 본원에서 치료한 증례를 분석하였다. 대상 및 방법: 1999년 5월부터 2004년 9월까지 치료받은 외상성 혈관 손상 환자 26명을 대상으로 연령 및 성별 분포, 혈관 손상의 위치, 원인, 진단방법, 혈관 손상의 형태, 임상소견, 치료방법, 합병증 등을 살펴보았다. 결과: 환자의 연령분포는 평균 39.5세($12{\sim}86$세)였고 손상입은 혈관은 하행대동맥 6예, 대퇴 동맥 4예, 슬와 정맥 4예 등의 순으로 빈번하게 발생하였다. 손상의 원인으로는 의인성 손상이 8예로 가장 많았고 그 다음이 교통사고 7예, 자상 6예, 산업재해 5예 순이었다. 진단방법은 CT와 Arteriogram이 각각 9예씩으로 가장 많았고 수술 중에 발생한 의인성인 경우는 이학적 검사만으로도 진단이 가능하였다. 혈관손상의 형태는 동맥인 경우 가성 동맥류가 10예로 가장 많았고. 부분 절단된 경우가 5예, 완전 절단된 경우가 3예, 폐색이 3예 등이었다. 정맥손상의 경우는 부분절단이 6예, 완전 절단이 2예였고 동정맥루의 형태가 2예 등이었다. 임상 소견은 맥박손실 8예, 냉감 1예, 흉통 6예, 부종 5예, 출혈 5예 등이었다. 치료는 동맥손상인 경우 Graft interposition이 11예로 가장 많았고 primary repair가 4예, 단단 문합이 2예였고 동정맥루 2예는 모두 중재적 시술(endovascular repair)을 시행하였다. 심각한 합병증으로는 지연된 진단 및 치료로 인한 지체 소실이 3예 있었고 3예에서 동반된 신경손상으로 인한 운동장애 그리고 1예에서 다발성 장기 부전으로 사망하였다. 결론: 사지 보존율을 높이고 사망률을 줄이기 위해서는 즉각적인 진단과 치료를 시행할 수 있는 시스템 확보가 필수적이다. 또한 중재적 시술이 증가하는 요즘 경향을 볼 때 발생의 예방을 위한 의사 교육이 중요하며 발생 시 즉각적으로 혈관 외과의사가 개입할 수 있도록 원활한 의사 교환 및 협진 체제가 중요하다고 하겠다.

경저부 혈관손상의 임상적 고찰 (Clinical Study of Neck Base Injury)

  • 우종수
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.378-384
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    • 1978
  • Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

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수지 재건시 불충분한 혈행상태의 수혜부에 시행한 동맥화 정맥 유리 피판술 (Arterialized Venous Free Flap at the Insufficient Vascular Recipient Bed in Finger Reconstruction)

  • 이영근;박기태;이준모;박혁
    • Archives of Reconstructive Microsurgery
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    • 제21권2호
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    • pp.131-136
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    • 2012
  • Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

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Curcumin targets vascular endothelial growth factor via activating the PI3K/Akt signaling pathway and improves brain hypoxic-ischemic injury in neonatal rats

  • Li, Jia;An, Yan;Wang, Jia-Ning;Yin, Xiao-Ping;Zhou, Huan;Wang, Yong-Sheng
    • The Korean Journal of Physiology and Pharmacology
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    • 제24권5호
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    • pp.423-431
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    • 2020
  • This study aimed to evaluate the effect of curcumin on brain hypoxic-ischemic (HI) damage in neonatal rats and whether the phosphoinositide 3-kinase (PI3K)/Akt/vascular endothelial growth factor (VEGF) signaling pathway is involved. Brain HI damage models were established in neonatal rats, which received the following treatments: curcumin by intraperitoneal injection before injury, insulin-like growth factor 1 (IGF-1) by subcutaneous injection after injury, and VEGF by intracerebroventricular injection after injury. This was followed by neurological evaluation, hemodynamic measurements, histopathological assessment, TUNEL assay, flow cytometry, and western blotting to assess the expression of p-PI3K, PI3K, p-Akt, Akt, and VEGF. Compared with rats that underwent sham operation, rats with brain HI damage showed remarkably increased neurological deficits, reduced right blood flow volume, elevated blood viscosity and haematocrit, and aggravated cell damage and apoptosis; these injuries were significantly improved by curcumin pretreatment. Meanwhile, brain HI damage induced the overexpression of p-PI3K, p-Akt, and VEGF, while curcumin pretreatment inhibited the expression of these proteins. In addition, IGF-1 treatment rescued the curcumin-induced down-regulated expression of p-PI3K, p-Akt, and VEGF, and VEGF overexpression counteracted the inhibitory effect of curcumin on brain HI damage. Overall, pretreatment with curcumin protected against brain HI damage by targeting VEGF via the PI3K/Akt signaling pathway in neonatal rats.