• Title/Summary/Keyword: 창상(創傷)

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Recent Progress in Mussel-inspired Catechol-conjugated Chitosan Hemostats (홍합 모사 카테콜기가 도입된 키토산 지혈제 연구 동향)

  • Seongyeon Jo;Soomi Kim;Chanwoo Park;Seungwon Hong;Hong Kee Kim;Ji Hyun Ryu
    • Journal of Adhesion and Interface
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    • v.24 no.4
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    • pp.113-119
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    • 2023
  • Since it was reported that the unusual amino acid DOPA in synergy with lysine and histidine residues found in mussel adhesive proteins plays a pivotal role in mussel adhesion in underwater environments, there has been a burgeoning development of various catecholamines-based adhesives for biomedical applications. Among these, catechol-conjugated chitosan, containing catecholamine, featuring multiple catechol groups within its aminerich chitosan backbone, has found versatile utility in fields, such as tissue adhesion, wound dressing, tissue healing, hemostats, drug delivery systems, and tissue engineering scaffolds. Significantly, chitosan-catechol is a mussel-inspired material approved by both US Food and Drug Administration (FDA) and KR Ministry of Food and Drug Safety (MFDS) for its effectiveness in hemostasis. This review focuses on 1) general aspects of catechol-conjugated chitosan, highlighting catechol group integration into chitosan backbones, 2) examination of proposed mechanisms of hemostasis, and 3) exploration of diverse physical forms, including solution, hydrogels, patches, and thin films with practical applications inapplicable to hemostasis.

Development of wound segmentation deep learning algorithm (딥러닝을 이용한 창상 분할 알고리즘 )

  • Hyunyoung Kang;Yeon-Woo Heo;Jae Joon Jeon;Seung-Won Jung;Jiye Kim;Sung Bin Park
    • Journal of Biomedical Engineering Research
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    • v.45 no.2
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    • pp.90-94
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    • 2024
  • Diagnosing wounds presents a significant challenge in clinical settings due to its complexity and the subjective assessments by clinicians. Wound deep learning algorithms quantitatively assess wounds, overcoming these challenges. However, a limitation in existing research is reliance on specific datasets. To address this limitation, we created a comprehensive dataset by combining open dataset with self-produced dataset to enhance clinical applicability. In the annotation process, machine learning based on Gradient Vector Flow (GVF) was utilized to improve objectivity and efficiency over time. Furthermore, the deep learning model was equipped U-net with residual blocks. Significant improvements were observed using the input dataset with images cropped to contain only the wound region of interest (ROI), as opposed to original sized dataset. As a result, the Dice score remarkably increased from 0.80 using the original dataset to 0.89 using the wound ROI crop dataset. This study highlights the need for diverse research using comprehensive datasets. In future study, we aim to further enhance and diversify our dataset to encompass different environments and ethnicities.

A STUDY ON THE EXTRACELLULAR MATRIX IN THE ARTIFICIALLY CHEATED CLEFT LIP WOUND HEALING OF RABBIT FETUSES (토끼 태자에 형성시킨 구순열상의 치유과정에서 세포외기질 분포에 관한 연구)

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.28 no.1 s.66
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    • pp.1-15
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    • 1998
  • Adult wound healing is accompanied with inflammation and eventual scar formation, whereas fetal wounds heal rapidly by mesenchymal proliferation without significant inflammatory cell participation and with minimal or no scar formation. The cellular mechanisms underlying these differing forms of wound healing are unknown but the extracellualr matrix through its effects on cell function, may play a key role. Therefore the purpose of this study is to investigate the spatial and temporal deposition of several component of extracellular matrix, which are known to be involved with scar formation, in the artificially created cleft lip wound healing of fetuses. The author had undergone hysterotomy and created cleft lip-like defects on fetuses of New Zealand White Rabbit in mid-third trimester(24 days). Fetuses were divided into the repaired group, the unrepaired group and the sham-operated control group. At 1, 2, 3, 5, 7 days after procedure, fetuses were obtained by Caeserem section. After documenting the viability of fetuses, they were photographed to compare size and facial morphology and sectioned for histological examination by H & E stain and spatial and temporal deposition of collagen typeI, III, IV, V and fibronectit laminin by immunohistochemical method. The findings are summarized as follows 1. There were lack of inflammation in the repaired and the unrepaired group during experimental periods. 2. The reepithelialization of the unrepaired group was slower than that of the repaired group. 3. Collagen I, III, V were found from post-op. third day. There were no difference of distribution in the control, the repaired and the unrepaired group. Collagen types I, III, V were present in all groups with restoration of the normal collagen pattern in the fetus. This implies that lack of scarring in fetal wounds is due to the difference of collagen organization pattern within wound and not simply lack of collagen formation. 4. Collagen IV was slightly increased at post-op. third day and decreased after post-op. fifth day. Eventually there were no differences in the control, the repaired and the unrepaired group. Lminin was found at post-op. fifth day and maintained staining density until post-op. seventh day. There were no differences in the control, the repaired and the unrepaired group. According to staining of laminin and collagen type IV in epithelial basement membrane, formation of epithelial basement membrane was not completed until reepithelialization was finished. 5. According to staining of laminin and collagen type IV, there were no increase of neovascularity in the repaired and the unrepaired group. 6. Fibronectin was increased until post-op. third day at fibrin clot, wound base and margin and decreased after post-op. fifth day. Eventually, there were no differences in the control, the repaired and the unrepaired group. So it implies fibronectin plays a role as provisional matrix for fetal wound healing.

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Effect of Preoperative White Blood Cell Count on Postoperative Course in Patients with Coronary Artery Bypass Grafting (관상동맥우회술 환자에서 술 전 백혈구 수치가 수술 후 경과에 미치는 영향)

  • Son Kuk Hui;Kim Jae Ho;Kim Joung Taek;Yoon Yong Han;Kim Kwang Ho;Baek Wan Ki
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.669-674
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    • 2005
  • Background: There are several studies that report the relationship between leukocytosis and cardiovascular disease mortality. Most of these studies stand on the basis that atherosclerosis is mediated by inflammatory process. By the same token, preoperative white blood cell count is suggested as an independent predictable factor of postoperative mortality and morbidity in coronary artery bypass grafting. The purpose of this study is to define the influence of preoperative white blood cell count on postoperative morbidity and mortality after coronary artery bypass grafting. Material and Method: The medical records of the 133 patients who had undergone isolated coronary artery bypass grafting at Inha University Hospital from 1996 to 2003 were reviewed. Patients were evenly divided into four groups, and named as group A, B, C, and D respectively based on their preoperative white blood cell count in ascending order. The number of patients in each group were 33 with exception of 34 in group A. The range of white blood cell count were from $1.3\times10^3/{\mu}L\;to\;5.9\times10^3/{\mu}L\;in\;group\;A,\; from\;6.0\times10^3/{\mu}L\;to\;7.0\times10^3/{\mu}L\;in\;group\;B,\;from\;7.1\times10^3/{\mu}L\;to\;8.9\times10^3/{\mu}L$ in group C, and from $8.9\times10^3/{\mu}L\;to\;16.9\times10^3/{\mu}L$ in group D. Result: The number of patients with recent myocardial infarction was 0 in group A, $2(6.1\%)$ in group B, $4(12.1\%)$ in group C, and $8(24.3\%)$ in D group, showing proportional increase to the white blood cell count (p<0.01). There were six postoperative deaths; $1(2.9\%)$ in group A, $1(3.0\%)$ in group B, $2(2.6\%)$ in group C, and $2(6.1\%)$ in group D (p=0.44), showing no significant difference between the groups. Postoperative wound infection occurred in 3 patients; all 3 patients were in group D, showing that postoperative wound infection is closely related to the preoperative white blood cell count. Conclusion: The association between preoperative white blood cell count and postoperative mortality could not be defined. The incidence of postoperative wound infection was found to be proportional to the preoperative white blood cell counts.

The effect of alendronates administration duration on the healing of extraction socket in rats: pilot study (알렌드로네이트의 투여기간이 발치와의 치유에 미치는 영향: 예비실험)

  • Kim, Jee-Hwan;Hong, Jong-Hwan;Choi, Hyun-Min;Park, Young-Bum;Moon, Hong-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.3
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    • pp.175-182
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    • 2013
  • Purpose: The purpose of this study was to investigate the effect of different administration duration of alendronate on initial wound healing and new bone formation of extraction socket in rats. Materials and methods: Fifteen male Sprague-Dawley rats (body weight 130-140 g, 4 weeks old, male) were divided into control group (no alendronate administration) and experimental group (alendronate administration). Experimental group was subdivided into 1 week administrated group, 2 week administrated group, 4 week administrated group and 6 week administrated group according to duration of administration. For the experimental groups, during the designated time period (at the time of extraction, 1 week before extraction, 3 week before extraction and 5 week before extraction) till 1 week after extraction, rats were subcutaneously injected with Alendronate at the dose of 1.0 mg/Kg three times a week. Each specimen from 6 week experimental group and control group were used for microarray analysis, and other specimens were used for histological analysis. The rate of new bone formation within the extraction site and bone loss activity was analyzed using TRAP staining. Statistical analysis was performed using Kruskal Wallis test. (${\alpha}=.05$) Results: After one week from the time of extraction, the rate of new bone formation within extraction site for the control group ($16.77%{\pm}1.36%$) compared to the 4 week experimental group ($14.99%{\pm}6.26%$) was lower. However, no statistically significant difference was found. Increase in the number of inactive lacuna (empty lacuna) and decrease in the number of TRAP positive cell were identified with increased duration of administration. There was no significant difference. Conclusion: The results of this study showed as the duration of Alendronate administration increased the rate of new bone formation decreased with loss of bone activity and reduced number of osteoclast.

Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Clinical Study after Video-Assisted Thoracic Surgery and Mid-Axillary Thoracotomy for Recurrent Spontaneous Pneumothorax (재발성 자연 기흉에 대한 정중액과 개흉술과 비디오 흉강경수술의 비교연구)

  • 이정상
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.43-48
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    • 1999
  • Background: Although treatment of spontaneous pneumothorax by video-assisted thoracic surgery(VATS) has generally shown better clinical results than conventional thoracotomy, treatment of spontaneous pneumothorax by midaxillary thoracotomy(MAXT) has also shown good clinical results. The author studied to compare the clinical results of MAXT group I and VATS group II. Material and Method : Group I included 30 midaxillary thoracotomy among 83 operative cases of spontaneous pneumothorax from Jan. 1992 to Dec. 1993. Group II included 30 VATS among 101 operative cases of pneumothorax from Jan. 1994 to Aug. 1995. The author selected the 30 patients, age 18 to 25 years, with recurrent spontaneous pneumothorax in each group. The author analyzed the operative indication, gender, operating time, amounts of the used staplers, tube drainage, total amounts of analgesics used during postoperative 24hr, tube stay time, postoperative complications and mortality. Result: The follow-up periods of both procedures were from 6 to 43 months. The operating time from start of skin incision to end of skin closure was 84.79${\pm}$21.70(from 40 to 150) minutes in MAXT group I and 108.8${\pm}$42.02(from 58 to 120) minutes in VATS group II(P<0.001). The numbers of the used staples useo was 1.31${\pm}$0.6(from 0 to 3) in group I and 3.41${\pm}$2.37(from 0 to 11) in group II. The amounts of postoperative 24hour tube drainage were 220.76${\pm}$106.73(from 65 to 400) ml in group I and 260.63${\pm}$233.18(from 70 to 320) in group II(P>0.05). The amounts of postoperative 24 hourly used analgesics(Tarasyn ) was 1.38${\pm}$1.32(from 0 to 5) amples in group I and 0.72${\pm}$1.02(from 0 to 4) amples in group II (P<0.05). The postoperative tube stay is 5.45${\pm}$30.9 (from 3 to 7) days in group I and 4.75${\pm}$3.1(9 from 2 to 14) days in group II(P>0.05). The number of complications after operations was 2 cases of prolonged air leakage in group I, and in group II. (P is not significant). The number of recurrence after the operation was one in group I and also one in group II(P is not significant). In conclusion, there were no statistical differences in the postoperative 24 hour chest tube drainage, days of postoperative tube stay, postoperative complications and recurrence in the analysis between group I and group II. Conclusion: The author found that group II of VATS between 18 years and 25 years of age in recurrent spontaneous pneumothorax, statistically, requires longer operative time, more number of autosuture staples and less postoperative analgesic dosage than the midaxillary thoracotomy group I.

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Process Development of a Virally-Safe Acellular Bovine Amniotic Membrane for Biological Dressing (바이러스 안전성이 보증된 무세포 소 양막 생물창상피복재 제조 공정 개발)

  • Bae, Jung-Eun;Kim, Chang-Kyong;Kim, Sung-Po;Yang, Eun-Kyung;Kim, In-Seop
    • Microbiology and Biotechnology Letters
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    • v.38 no.4
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    • pp.420-427
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    • 2010
  • A process for manufacturing virally-safe bovine amniotic membrane(BAM) has been developed for biological dressing. BAM was harvested from a healthy bovine placenta, and then the epithelium was removed. The remaining stromal layer was consecutively disinfected with 70% ethanol and 0.05% sodium hypochlorite. The stromal layer was incubated in a decellularization solution containing 0.25%(w/v) trypsin to remove the cellular components. The resulting acelluar BAM was lyophilized to preserve its biochemical and structural integrity. The BAM was packed and exposed to 25 kGy of gamma irradiation for sterilization purpose. Histological, electron microscopical, and biochemical observations showed that the acellualr BAM had intact structural integrity of three dimensional collagen fibers and contained several growth factors, accelerating wound healing, such as EGF (Epidermal growth factor), KGF (Keratinocyte growth factor), and FGF (Fibroblast growth factor). Bovine herpes virus (BHV), bovine viral diarrhoea virus (BVDV), bovine parainfluenza virus type 3 (BPIV-3), and bovine parvovirus (BPV) were chosen as the biological indicators for validation of viral safety of the acellular BAM. Samples from relevant stages of the production process were spiked with each virus and subjected to viral inactivation processes. Viruses were recovered from the samples and then titrated immediately. All the viruses tested were completely inactivated to undetectable levels within 1 h of 70% ethanol treatment. Enveloped viruses such as BHV, BVDV, and BPIV-3 were more effectively inactivated than BPV by 0.05% sodium hypochlorite treatment. BHV, BVDV, and BPIV-3 were completely inactivated to undetectable levels by 25 kGy of gamma irradiation. Also BPV was effectively inactivated by 25 kGy of gamma irradiation. The cumulative log reduction factors of BHV, BVDV, BPIV-3, and BPV were ${\geq}$13.30, ${\geq}$14.32, ${\geq}$15.22, and ${\geq}$7.57, respectively. These results indicate that the production process for acelluar BAM has a sufficient virus-reducing capacity to achieve a high margin of the virus safety.

Transhiatal Esophagectomy in Cardia and Esophageal Cancer (위분문부 및 식도암 환자에서 경열공 식도절제술)

  • Choi Dong-Hui;Jung Kyoung-Won;Kim Dong-Heon
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.1-9
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    • 2005
  • Purpose: The debate is still on-going as to whether a transthoracic esophagectomy (TTE) or a transhiatal esophagectomy(THE) is the proper treatment for patients with cardia and esophageal cancers. This study tries to demonstrate and assess the efficacy and the validity of both surgeries. Materials and Methods: In a retrospective study, data from 52 cases of patients with esophageal and/or cardia cancer who received a surgical operation during the last decade were analyzed. Results: A TTE was done in 20 cases and a THE in 32 cases. The average times for the operations were 558.0 min for a TTE and 451.7 min for a THE (P>0.05). The estimated blood loss was 1,825.0 ml in a TTE and 1459.4 ml in a THE (P>0.05). The amounts of transfusion during the operations were 3.9 units in a TTE and 2.6 units in a THE (P<0.05). Post-operative complications occurred in 15 cases of TTE and 23 cases of THE. The average length of stay in the hospital was 25.6 days for a TTE and 20.6 days for a THE. The 5-year survival rate was $10\%$ for TTE patients and $28\%$ for THE patients (P>0.05). Conclusion: For most factors, including morbidity and mortality, there was no statistically significant difference between a TTE and a THE. However, a THE is expected to be more convenient, leading to a shorter operative duration, a shorter post-operative hospitalization and lesser amounts of hemorrhage and transfusion. Hence, the THE may be a more valid or efficient surgical method for those patients with cardia and esophagus cancer who require a resection of the esophagus. (J Korean Gastric Cancer Assoc 2005;5:1-9)

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The Clinical Effects of Leukocyte-Depleting Filter on Cardiopulmonary Bypass (체외순환 시 백혈구 제거필터 사용의 임상효과)

  • 박경택;최석철;최국렬;정석목;최강주
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.454-464
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    • 2001
  • Background: It has been recognized that systemic inflammatory reaction and oxygen free radical formed by activated leukocyte in the procedure of cardiopulmonary bypass(CPB) frequently produce postoperative cardiac and pulmonary dysfunction. The purpose of this study was to evaluate the efficacy of leukocyte-depleting filters in the cardiopulmonary bypass circuit for patients undergoing open heart surgery(OHS). Material and method: The study involved 15 patients who underwent OHS with a Leukoguard-6 leukocyte filter placed in the arterial limbs of the bypass circuit(filter group, n=15) and 15 patients who did not have the filter(control group, n=15). We analyzed the differences between the groups in intraoperative changes of peripheral blood leukocyte and platelet counts, pre- and postbypass changes of malondialdehyde(MDA), troponin-T(TnT), 5'-nucleotidase(5'-NT) in coronary sinus blood, spontaneous recovery rate of heart beat after CPB, pre-and postoperative cardiac index(Cl) and pulmonary vascular resistance(PVR), and the amounts of postoperative bleeding and sternal wound complication. Result: During CPB, total leukocyte count of the filter group(9,567$\pm$ 842/㎣) was significantly less than that of the control group(13,573+1,167/㎣) (p<0.01), but there was no significant difference in platelet count between the groups. Postoperative levels of MDA(3.78+0.32 $\mu$mol/L vs 5.86+0.65 $\mu$mo1/L, p<0.01), TnT(0.40$\pm$0.04 ng/mL vs 0.59$\pm$0.08 ng/mL, p<0.05) and 5'-NT(3.88$\pm$0.61 U/L vs 5.80$\pm$0.90 U/L, p<0.05) were all significantly lower in the filter group than the control group. Postoperative Cl was higher in the filter group than the control group(3.26$\pm$0.18 L/$m^2$min vs 2.75$\pm$0.17 L/$m^2$/min, p=0.05). PVR of the filter group was lower than that of the control group(65.87$\pm$7.59 dyne/sec/cm$^{5}$ vs 110.80+12.22 dyne/sec/cm$^{5}$ , p<0.01). Spontaneous recovery rate of heart beat in the filter group was higher than that in the control group(12 patients vs 8 patients, p<0.05). Postoperative wound infection occurred in one case in the filter group and 4 case in the control group(p<0.05). Postoperative 24 hour blood loss of the filter group was more than that of the control group (614$\pm$107 mL vs 380+71 mL, p=0.05).

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