• 제목/요약/키워드: vascular injury

검색결과 388건 처리시간 0.034초

외측 상완 유리 판을 이용한 사지 재건술 (Reconstruction of the Extremities with Lateral Arm Free Flap)

  • 이준모;이주홍;김학지
    • Archives of Reconstructive Microsurgery
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    • 제13권1호
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    • pp.51-57
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    • 2004
  • Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

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복합부위통증증후군에 대한 동서의학적 고찰 (The Study on the Eastern and Western Medical Literatures for Complex Regional Pain Syndrome)

  • 김동은;유덕선;정일민;이정한;염승룡;권영달
    • 한방재활의학과학회지
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    • 제19권2호
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    • pp.157-185
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    • 2009
  • Objectives : The aim of this study is to suggest approach of oriental medical management and necessity by research of eastern and western medical literatures for Complex Regional Pain Syndrome(CRPS). Methods : We reviewed the clinical and experimental literatures of eastern and western concerned with CRPS which is related causation, signs and symptoms, diagnosis, etiology and management. Results : 1. CRPS is divided into type I and II by nerve injury. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. These conditions can be charaterized clinically by the sensory abnormalities, vascular abnormalities, oedema, sweating abnormalities, motor or trophic changes. 2. CRPS are well known to patients and physicians relatively, but the pathophysiology, causation and treatments are still unclear. 3. CRPS is needed to take the early diagnosis and multidisciplinary approach for significant effect. 4. CRPS can be regarded for obstruction syndrome of Ki and blood(痺證), blood stasis(瘀血), Wei symptom(痿證), numbness(痲木) in the oriental medical management of CRPS. Conclusions : Above the results, it is suggested that further studies and active approach of management of CRPS will be conducted precisely in oriental medicine.

절식요법 중 글리세린 관장 직후 혈성 설사로 발현한 허혈성 대장염 1예 (A Case of Ischemic Colitis Presenting as Bloody Diarrhea after Glycerin Enema in a Patient on Modified Fasting Therapy)

  • 최효정;박현건;맹태호;유덕주;김성수;정원석
    • 한방재활의학과학회지
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    • 제23권2호
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    • pp.185-191
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    • 2013
  • 본 증례에서는 절식치료 중인 환자에 있어 글리세린 관장을 실시한 직후 발생한 허혈성 대장염 1례에 대해 고찰하여, 관장으로 인한 장관 내압 상승, 상온의 체온보다 낮은 관장액으로 인한 혈관 경련, 선택적 세로토닌 재흡수 억제제에 의한 출혈 경향 증가 및 글리세린 용액의 화학적 삼투작용으로 인한 점막 손상 가능성 등을 제시하였다. 관장으로 인한 이와 같은 부작용을 예방하기 위하여 임상의들의 주의가 요구된다.

Perioperative red blood cell transfusion in orofacial surgery

  • Park, So-Young;Seo, Kwang-Suk;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권3호
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    • pp.163-181
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    • 2017
  • In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

Korean Red Ginseng mitigates spinal demyelination in a model of acute multiple sclerosis by downregulating p38 mitogen-activated protein kinase and nuclear factor-κB signaling pathways

  • Lee, Min Jung;Chang, Byung Joon;Oh, Seikwan;Nah, Seung-Yeol;Cho, Ik-Hyun
    • Journal of Ginseng Research
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    • 제42권4호
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    • pp.436-446
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    • 2018
  • Background: The potential therapeutic values of Korean Red Ginseng extract (KRGE) in autoimmune disorders of nervous system have not been fully investigated. Methods: We used an acute experimental autoimmune encephalomyelitis animal model of multiple sclerosis and determined the effects and mechanism of KRGE on spinal myelination. Results: Pretreatment with KRGE (100 mg/kg, orally) for 10 days before immunization with myelin basic protein $(MBP)_{68-82}$ peptide exerted a protective effect against demyelination in the spinal cord, with inhibited recruitment and activation of immune cells including microglia, decreased mRNA expression of detrimental inflammatory mediators (interleukin-6, interferon-${\gamma}$, and cyclooxygenase-2), but increased mRNA expression of protective inflammatory mediators (insulin-like growth factor ${\beta}1$, transforming growth factor ${\beta}$, and vascular endothelial growth factor-1). These results were associated with significant downregulation of p38 mitogen-activated protein kinase and nuclear factor-${\kappa}B$ signaling pathways in microglia/macrophages, T cells, and astrocytes. Conclusion: Our findings suggest that KRGE alleviates spinal demyelination in acute experimental autoimmune encephalomyelitis through inhibiting the activation of the p38 mitogen-activated protein kinase/nuclear factor-${\kappa}B$ signaling pathway. Therefore, KRGE might be used as a new therapeutic for autoimmune disorders such as multiple sclerosis, although further investigation is needed.

구강내 과다출혈로 내원한 응급환자에 관한 임상적 연구 (A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING)

  • 유재하;강상훈;김현실;김종배
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권5호
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    • pp.383-389
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    • 2002
  • This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

흰쥐의 전층피부손상에서 온청음(溫淸飮)이 신생혈관형성에 미치는 영향 (Angiogenetic Effect of Onchung-Eum on Full-thickness Skin Wound in Rats)

  • 김범회;이해웅;손낙원;박동일
    • 대한예방한의학회지
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    • 제14권1호
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    • pp.97-110
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    • 2010
  • The wound healing process can be categorized as follows : inflammation, fibroplasia, neovascularization, collagen deposition, epithelialization, and wound contraction. During the healing process, various growth factors are secreted to accelerate wound healing. Previous studies have demonstrated that endogenous growth factors, such as vascular endothelial growth factor(VEGF) are the important regulatory polypeptides for coordinating the healing process. They are released from macrophages, fibroblasts, and keratinocytes at the site of injury and participate in the regulation of reepithelization, granulation tissue formation, collagen synthesis and neovascularization. Onchung-Um has been used clinically to treat various skin diseases. In addition, Onchung-Um has been also used for congestive inflammations. In the present study, we evaluated the effects of Onchung-Um on wound healing process and wound size reduction in rats. Full-thickness skin wounds ($15mm\;{\times}\;15mm$) were created on the back of rats. Rats were then divided into 2 groups : The Onchung-Um treated group that was orally administered with a dose of 193.9mg/100g of Onchung-Um extract per day for 15 days and Control group without Onchung-Um administration. Moreover, the histological changes and VEGF immunoexpressions of two groups were estimated. In results, wound closures were significantly accelerated by oral administration of Onchung-Um extract. Furthermore, in Onchung-Um treated group, there were significant increases in fibroblast migration, epithelialization compared with the Control group. VEGF expressions were also increased in Onchung-Um treated group. This study has therefore demonstrated the Onchung-Um can significantly improve the quality of wound healing and scar formation and the oral administration of Onchung-Um extract may increase early tissue angiogenesis in the incisional wound of an experimental animal model.

Altered Gene Expression Profiles in the Lungs of Streptozotocin-induced Diabetic Mice

  • Kim, Jung-Hyun;Rasaei, Roya;Park, Sujin;Kim, Ji-Young;Na, Sunghun;Hong, Seok-Ho
    • 한국발생생물학회지:발생과생식
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    • 제24권3호
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    • pp.197-205
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    • 2020
  • Diabetes mellitus is a common heterogeneous metabolic disorder, characterized by deposition of extracellular matrix, oxidative stress, and vascular dysfunction, thereby leading to gradual loss of function in multiple organs. However, little attention has been paid to gene expression changes in the lung under hyperglycemic conditions. In this study, we found that diabetes inuced histological changes in the lung of streptozotocin-induced diabetic mice. Global gene expression profiling revealed a set of genes that are up- and down-regulated in the lung of diabetic mice. Among these, expression of Amigo2, Adrb2, and Zbtb16 were confirmed at the transcript level to correlate significantly with hyperglycemia in the lung. We further evaluated the effect of human umbilical cord-derived perivascular stem cells (PVCs) on these gene expression in the lung of diabetic mice. Our results show that administration of PVC-conditioned medium significantly suppressed Amig2, Adrb2, and Zbtb16 upregulation in these mice, suggesting that these genes may be useful indicators of lung injury during hyperglycemia. Furthermore, PVCs offer a promising alternative cell therapy for treating diabetic complications via regulation of gene expression.

Tabebuia impertiginosa Martius ex DC(Taheebo)의 혈소판 응집 억제활성에 관한 연구 (Studies on antiplatelet activity of Tabebuia impertiginosa Martius ex DC(Taheebo))

  • 서범석;고관영;박영현;박병수;장성근
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2004년도 춘계학술대회
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    • pp.253-257
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    • 2004
  • Platelet aggregation is a complex phenomenon that probably involves several intracellular biochemical pathways. When activated, platelets change shape, aggregate and release the contents of their intracellular granules. The interactions between platelets and blood vessel walls are important in the development of thrombosis and cardiovascular diseases. When blood vessels are damaged, platelet aggregation occurs rapidly to form haemostatic Plugs or arterial thrombi at the sites of vessel injury or in regions where blood flow is disturbed. These thrombi are the source of thromboembolic complications of atherosclerosis, heart attacks, stroke, and peripheral vascular disease. Therefore, the inhibition of platelet function represents a promising approach for the prevention of thrombosis. Plants constitute a rich source of bioactive chemicals such as phenolics, terpenoids and alkaloids. Plant extracts may be an alternative to currently used medicinal source because they constitute a rich source of bioactive chemicals. This study was performed to investigate the antiplatelet activity of extract of Tabebuia impetiginosa Martius ex DC (Taheebo) and find out which fractions to this activity in rabbit platelet. Taheebo was methanol extracted and solvent fractionated in to five fractions (hexane, chloroform, ethylacetate, butanol and water). And each fractions were investigated inhibitory effects on platelet aggregation induced by various agonists using washed rabbit platelets in vitro.

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GoreTex$^{\circledR}$ 인조혈관을 이용한 해리성 하행 흉부대동맥류 성형술 - 수술치험 2례 - (Aortoplasty with Using Gore-Tex Conduit in Dissecting Aneurysms of Descending Thoracic Aorta - Two Cases Report -)

  • 정진용
    • Journal of Chest Surgery
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    • 제22권5호
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    • pp.816-822
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    • 1989
  • Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.

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