• Title/Summary/Keyword: Severe injury

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Histological and immunohistochemical effects of Jengjengamiyjintang on the duodenal ulcer induced by HCl-aspirin (정전가미이진탕이 HCl-aspirin으로 유발된 십이지장 궤양에 미치는 조직학적 및 면역조직화학적 연구)

  • Ku, Sae-kwang;Lee, Hyeung-sik;Lee, Jae-hyun
    • Korean Journal of Veterinary Research
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    • v.39 no.6
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    • pp.1168-1179
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    • 1999
  • In order to study the effects of Jengjengamiyjintang on the duodenal ulcer induced by HCl-aspirin in rats, the changes of histological profiles, goblet cells(PAS-positive cells), and the distribution and frequency of cholecystokinin(CCK)-8 and serotonin-producing gastro-entero-endocrine cells were observed after oral administration of Jengjengamiyjintang. Histologically, very severe injury to duodenal epithelium were observed in control groups and these injuries were increased with time intervals. But in the Jengjengamiyjintang administrated groups, no gross lesion of ulcer were demonstrated and histologically minor injury to the mucosal epithelium were observed. PAS-positive cells were increased in the Jengjengamiyjintang administrated groups compared to that of control groups. Severe degranulation of CCK-8- and serotonin-immunoreactive cells were observed in control groups but these phenomenon was seldom in the Jengjengamiyjintang administrated groups. Serotonin-immunoreactive cells were significantly decreased in control groups but increased in Jengjengamiyjintang administrated groups compared with control groups. According to these result, it is suggested that Jengjengamiyjintang would accelerat the healing of the duodenal ulcer but the functional mechanisms were unknown.

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A Case of Lung Injury Caused by Ammonia-Gas Inhalation (암모니아 가스 흡입에 의한 폐 합병증 1예)

  • Lee, Jong-Deog;Sin, Won-Ho;Kim, Kuen-Yong;Lee, Won-Ju;Choi, Jin-Hak;Whang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.1
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    • pp.70-73
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    • 1991
  • We have experienced a case of lung injury caused by accidental inhalation of ammonia gas in a 34 year-old-man. By the explosion of ammonia tank in a refrigerator boat he inhaled ammonia gas. Several minutes later, he suffered from severe dyspnea and visual loss. On arrival at emergency room, analysis of arterial blood gas revealed severe hypoxemia and his chest film showed bilateral pulmonary infiltrates. Under the impression of adult respiratory distress syndrome, mechanical ventilator was applied to the patient. After recovery from ARDS and tracheal edema, he complained of some hemoptysis and productive sputum during the admission. So we checked bronchoscopy and bronchograpy which showed tracheal bullae just above carina and tubular bronchiectatic change in the right lower lobe. We report a case of lung injuries-ARDS, tracheal bullae, and bronchiectasis-caused by inhalation of ammonia gas with the review of the relevant literatures.

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V-Y Latissimus Dorsi Musculocutaneous Flap for Reconstruction of Radiation-induced Skin Injuries on the Back (V-Y 광배근피판을 이용한 등의 방사선 유발 피부 손상의 치험)

  • Shim, Seung-Hyun;Chung, Chul-Hoon;Kim, Kuyl-Hee
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.707-710
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    • 2011
  • Purpose: Cardiac radiofrequency catheter ablation procedures using fluoroscopy were performed for the treatment of supraventricular and selected ventricular tachyarrhythmia. Fluoroscopy is used to localize the position of the intracardiac catheter. Fluoroscopically-guided procedures often involve high radiation doses to patient's skin, but the incidence of serious radiation injuries in these patients is rare. We reported two cases of severe postradiation skin injury on the back treated with the V-Y latissimus dorsi musculocutaneous flap. Methods: These two patients underwent radiofrequency catheter ablation under the diagnosis of Woff Parkinson White syndrome (WPW syndrome). They had radiation-induced skin injuries on the subscapular area and these lesions represented chronic ulceration, surrounding induration, hardness, and dyspigmentation. We treated these lesions with complete excision and coverage with V-Y latissimus dorsi musculocutaneous flap. Results: These two patients had no recurrence and no special complications during 20 months and 12 months follow-up periods and were satisfied aesthetically and functionally. Conclusion: V-Y latissimus dorsi musculocutaneous flap obtained better results functionally and aesthetically compared with conservative management and skin graft in severe radiation-induced skin injuries after cardiac radiofrequency catheter ablation procedure.

Comparative study of geographic differences of severe trauma mortality in Korea (한국의 중증외상 사망률의 지역적 차이에 대한 비교 연구)

  • Jeong, Tae-Wook;Jo, Ji-Yeon;Kim, Seong-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.37-48
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    • 2021
  • Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.

Long-term follow-up of a severely traumatized leg treated with ipsilateral fracture-united fibular transfer in a patient with amputation of the contralateral leg: a case report

  • Kim, Eon Su;Yang, Chae Eun;Kim, Jiye;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.699-702
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    • 2021
  • Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

Diagnosis of Abusive Head Trauma : Neurosurgical Perspective

  • Kwak, Young Ho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.370-379
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    • 2022
  • Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

Lateral Arm Free Flap Reconstruction in a Patient with Severe Burn Scar Contracture of the Bilateral First Web Space (외측 상완 유리 피판을 이용한 양측 제1수지간 중증 화상 반흔 구축의 재건)

  • Yoon, Taekeun;Eun, Seokchan
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.46-49
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    • 2021
  • An anatomically normal first web space is essential for optimal prehensile movements of the thumb and hand. A 28-year-old woman presented with severe scarring and contractures of the first web space of both hands, following a flame burn injury sustained 25 years prior to presentation. First web space contracture may occur secondary to severe injuries, burns (as observed in our patient), or congenital hand anomalies. A significant amount of additional skin is required to release a severe first web space contracture. Reconstruction of wide areas of contractures using only local flaps is challenging. Among other free flaps used in clinical practice, the thinned lateral arm free flap provides flexible vascularized tissue for reconstruction of the skin after severe first web space contracture release. Reconstruction using lateral arm free flaps facilitated thumb abduction and opposition (which were initially difficult) and improved hand function in our patient.

Vacuum-assisted Closure Therapy for Treating Patients with Severe Subcutaneous Emphysema (피하기종의 Vacuum-assisted Closure Therapy)

  • Oh, Tak-hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.276-279
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    • 2015
  • Subcutaneous emphysema is a benign condition following trauma (pneumothorax and oropharyngeal), cervical or thoracic procedures, and mediastinal infection. However, severe subcutaneous emphysema may be related to serious complications such as respiratory failure, airway compromise, and tension- related phenomena. Many alternative therapies have been tried to treat patients with this condition. We report our experience with vacuum-assisted closure therapy for treating patients with severe subcutaneous emphysema.

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Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture in Korea: a case report

  • Woo Seok Kim;Tae Seok Jeong;Woo Kyung Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.290-294
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    • 2023
  • Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

THE CHANGES OF C-REACTIVE PROTEIN IN THE PATIENTS ASSOCIATED WITH MANDIBULAR FRACTURE (하악골 골절 환자에서의 C-Reactive Protein의 변화)

  • Gwak, Jong-Min;Kim, Chul-Hwan;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.35-41
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    • 2006
  • It is well known that concentration of C-reactive protein(CRP) in the serum increase as nonspecific reaction of the various tissue injury. The CRP, synthesized in the hepatocyte, is one of 'acute phase proteins' in the serum. The main signal patterns of this protein are regulated by synthesis of interleukin-I secreted from macrophage in the area of tissue injury. Many studies were performed for quantitative analysis for CRP according to various surgical operation, but the study for fracture patients associated with trauma, especially in mandible, are rare. The mandible fracture have intrinsic danger for infection in oral bacteria associated with open wound in oral cavity, and, are difficult for detection of tissue reaction between surgical swelling and infection by facial swelling. In this study, quantitative analysis for CRP associated tissue injury in mandibular fracture and surgical intervention was done, the results were as follows: 1. After initial mandibular trauma, the value of serum CRP diminished sequentially, most high value was presented in post-traumatic 2 days. 2. The CRP was diminished significantly 2 days after surgical intervention, and maintained normal value in 5 days after surgery. 3. The change of CRP are higher value in surgical intervention than initial trauma, it suggested that tissue injury from surgery was severe than trauma. 4. The high value of CRP was obtained in mandibular fracture combined soft tissue injury than no associated soft tissue injury. 5. In measurement of CRP according to surgical approach, highest serum value in patients of combined intra-oral and extra-oral approach was showed, and intra-oral approach, extra-oral approach, in sequential orders. 6. The CRP value are more higher in patient of 2 fracture site than only one fracture site. From the results obtained in this study, CRP has showed different values in mandibular fracture associated with severity of tissue injury and surgical intervention, and quantitative analysis of CRP value in serum can be applied to the clinical management of mandibular fracture.