As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.
Kim, Bo Hyun;Sun, Kyung Hoon;Kim, Sun Pyo;Park, Yongjin
Journal of The Korean Society of Clinical Toxicology
/
v.15
no.2
/
pp.107-115
/
2017
Purpose: Glehnia littoralis has been used to treat ischemic stroke, phlegm, cough, systemic paralysis, antipyretics and neuralgia. The pharmacological mechanisms of Glehnia littoralis include calcium channel block, coumarin derivatives, anticoagulation, anti-convulsive effect, as well as anti-oxidant and anti-inflammatory effects. Alpha-amanitin (${\alpha}$-amanitin) is a major toxin from extremely poisonous Amanita fungi. Oxidative stress, which may contribute to severe hepatotoxicity was induced by ${\alpha}$-amanitin. The aim of this study was to investigate whether Glehnia littoralis ethyl acetate extract (GLEA) has the protective antioxidant effects on ${\alpha}$-amanitin -induced hepatotoxicity. Methods: Human hepatoma cell line HepG2 cells were pretreated in the presence or absence of GLEA (50, 100 and $200{\mu}g/ml$) for 4 hours, then exposed to $60{\mu}mol/L$ of${\alpha}$-amanitin for an additional 4 hours. Cell viability was evaluated using the MTT method. AST, ALT, and LDH production in a culture medium and intracellular MDA, GSH, and SOD levels were determined. Results: GLEA (50, 100 and $200{\mu}g/ml$) significantly increased the relative cell viability by 7.11, 9.87, and 14.39%, respectively, and reduced the level of ALT by 10.39%, 34.27%, and 52.14%, AST by 9.89%, 15.16%, and 32.84%, as well as LDH by 15.86%, 22.98%, and 24.32% in culture medium, respectively. GLEA could also remarkably decrease the level of MDA and increase the content of GSH and SOD in the HepG2 cells. Conclusion: In the in vitro model, Glehnia littoralis was effective in limiting hepatic injury after ${\alpha}$-amanitin poisoning. Its antioxidant effect is attenuated by antidotal therapy.
Lee, Dayong;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul
Clinical and Experimental Reproductive Medicine
/
v.47
no.1
/
pp.1-11
/
2020
Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.
Purpose: Number of arthroscopic surgery is gradually increasing with development of its equipment and technique. Arthroscopic ankle surgery performed with the traction device has various complications and need more time for preparation. We investigated whether the complication rate increased when surgery was performed without the traction device, and compared the complication rate of arthroscopic surgery with the traction device. Materials and Methods: From January 2009 to June 2012, arthroscopic ankle surgery was performed without the traction device in four hundred eleven cases. There were two hundred sixty-one males and one hundred fifty females. The average age at operation was 35 years (range, 17-56), and the average follow up period was 28 months (range, 12-41). Postoperative symptoms and complications were checked. Results: There were difficulties performing arthroscopic surgery without the traction device in five cases with severe traumatic osteoarthritis. However, after burring and shaving, we had enough space to work on. Superficial peroneal nerve symptom was found in two cases, grooving of talus was found in 11, and saphenous vein injury was found in five. Since preparing for the traction device was unnecessary, we were able to save time with the mean duration of surgery of 50 minutes (range, 30-120). Conclusion: With only manual traction, we could explore the entire ankle joint without damage on cartilage. Yet, skilled arthroscopic technique will be necessary for arthroscopic surgery without the traction device.
Purpose: We report here on a solution for the case of a 71 year old lady with cartilage destruction in the left shoulder and the loss of the rotator cuff secondary to post-septic arthritic sequelae. Materials and methods: After thorough laboratory, clinical and radiological investigation of the patient to rule out any foci of active infection, we contemplated performing reverse total shoulder arthroplasty as a primary procedure. Results: At 22 months follow up, the patient had an excellent result according to the UCLA and ASES scales. Conclusion: Reverse total shoulder arthroplasty seems to be an efficient procedure to improve pain and function in the post-septic shoulder accompanying severe rotator cuff injury.
This experiment was conducted to investigate the effects of acid rain in spraying copper hydroxide 77% wettable power(WP) on leaf surface morphology and crop injury of the garlic(Allium sativum L.). Leaf chlorosis, hooked leaves, wrinkled epidermal cells and increased stomata open of garlic were induced by foliar application of simulated acid rain(SAR). It was become to be severe in application of copper hydroxide solution after application of SAR, but those yield of garlic was not significantly different from the untreated control. Leaf chlorosis was sharply increased above 100 ppm of copper ions. Amount of solved copper ions in copper hydroxide solution was remarkably increased below pH 5.5 and the residue in garlic leaves was significantly increased by application of copper hydroxide solution after spraying SAR compared with application of copper hydroxide solution only. When calcium carbonate was applied together with copper hydroxide leaf chlorosis was less than copper hydroxide only.
Cho, Yong Hyun;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyung Moo
Archives of Plastic Surgery
/
v.36
no.5
/
pp.674-677
/
2009
Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.
This study is to suggest some developmental policies by analyzing the activities of first aid party in Kwangju and Chonnam regions for two years from Jan. 1, 1991 to the end of December, 1995. First, the residents in Kwangju and Chonnam regions have the sufficient benefits of emergency medical center, but it will be desirable that general hospital should be established and managed in Kohung peninsula which forms the wide island area far away from big cities. Second, the classification of the degree of severe case in the field by rescue members should be strengthened as the means which can reduce the number of patients transferred to the emergency room and the legal method which rescue members can select the medical agency. Third, children less than 10 are most frequent emergent patients and it is due to parent's indifference and children's in sensibility to safety. So the safely education in the course of infant and elementary education should be strengthened and the method which can keep the self safety through the legal system. Fourth, to increase the rate of emergency measure by rescue members, the reasons of fail of emergency treatment are suggested, the treatment results of each rescue member are analyzed every year and it is desirable that the system which can evaluate the personal ability should be introduced. Fifth, the medical accidents occurred in the case of medical act, by rescue members must lake the legal responsibility, but such a problem can he solved with the compensation of insurance system by government. Sixth, to reduce the time required for transfer, traveling service system for the fixed period in beach should be complemented and extended more and service system at ordinary times should be examined at mountains, the area of traffic jams and large special industrial park. Seventh, since service system with one team of two members of 119 rescue party in expressway cannot be mobilized when multiple accidents occur at the same time, it is considered that service system of two teams of four members should be extended. Eighth, first-aid service in expressway is conducted with rescue and emergency treatment by the rescue party at the same time, but the professional rescue lacks and it may result in the injury of patients. Therefore the creation of rescue party in expressway is the urgent problem.
Kim, So Young;Jeong, Tae-Dong;Lee, Woochang;Chun, Sail;Sunwoo, Sung;Kim, Soon Bae;Min, Won-Ki
Annals of Laboratory Medicine
/
v.38
no.6
/
pp.524-529
/
2018
Background: An increase in neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular injury. Diabetic nephropathy causes typical changes in the kidney, characterized by glomerulosclerosis and eventual tubular damage. We validated the usefulness of plasma NGAL (pNGAL) as a biomarker of tubular damage in patients with diabetic nephropathy. Methods: We included 376 patients with diabetes mellitus (260 patients with chronic renal insufficiency who had not received hemodialysis and 116 hemodialyzed due to diabetic nephropathy) and 24 healthy controls. Patients with chronic renal insufficiency were divided into three groups according to urinary albumin excretion (UAE) levels. pNGAL levels were measured using the Triage NGAL test (Alere, San Diego, CA, USA) and were compared between groups. We also examined whether pNGAL level was related to the degree of albuminuria and cystatin C-based glomerular filtration rate (GFR). Results: Mean pNGAL levels of the healthy controls, chronic renal insufficiency patients with diabetes mellitus, and hemodialyzed patients were $61.9{\pm}5.3ng/mL$, $93.4{\pm}71.8ng/mL$, and $1,536.9{\pm}554.9ng/mL$, respectively. pNGAL level increased significantly in patients with severe albuminuria (P <0.001) and had a moderate correlation with the degree of albuminuria (r=0.467; P <0.001) and GFR (r=0.519; P <0.001). Multivariate regression analysis showed that the pNGAL level was associated with tubular damage independent of patient age, sex, and GFR. Conclusions: pNGAL level independently reflects the degree of tubular damage in patients with diabetic nephropathy. Measurement of pNGAL, combined with UAE, would enable simultaneous, highly reliable assessments of tubular damage for such patients.
In this paper, an attempt has been made to examine the pattern of mortality in Korea during 1970~80. By applying the age-sex specific mortality rates quoted from 1978~79 life tables for Korea published by NBOS, EPB to those of the West pattern of regional model life tables and the far eastern pattern of model life tables for developing countries, life expectancy at birth were calculated. Also the author reviewed the trends of death rates, life expectancy and cause of death using vital registration data and other materials. Summarized results are as follows; 1. Crude death rates in Korea was reduced to one fifth in the 1983 compared to that in 1920's. Life expectancy also improved to almost double in 1985 compared to 1920's. But the difference in the life expectancy between male and female increased during that period and it was recorded as 6.4 years in 1985. This discrepancy was mainly due to the different tempo of decreasing in mortality level by sex, particularly, for the age 40 and above. 2. For the pattern of mortality in Korea, it showed that female mortality could accounted closer to the West pattern model life tables. There were high similarity between actual pattern prevalent in Korea and West pattern. And its coefficient of variance was also very low. However for the case of male, it was difficult to find the exact model life tables for explaining the actual situation on the male mortality pattern which means exist considerable dissimilarity in older ages. The Far eastern pattern of U.N. model life tables show better results than West pattern, however, the deviation of the pattern to actual was severe. Also in Far eastern pattern, high coefficient of variance was existed. Furthermore it was found in the paper that the mortality level of Korean male for the age 40 and above were much higher than that of Far eastern pattern which was reflected the high mortality of the male adult in Far east region. 3. The analysis of cause of death showed that circulatory disease such as cerebrovascular disease and hypertensive disease accounted for the leading cause of death in Korea for the age 40 and above. There should he paid special attention to chronic retrogressive diseases for the older age groups. For younger age groups, injury and poisoning were reported as important cause of death.
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