• Journal of Chest Surgery
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• v.46 no.3
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• pp.197-201
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• 2013

Background: Most traumatic tracheobronchial injuries are fatal and result in death. Some milder cases are not life threatening and are often missed at the initial presentation. Tracheobronchial rupture is difficult to diagnose in the evaluation of severe multiple trauma patients. We reviewed the traumatic tracheobronchial injuries at Konyang University and Eulji University Hospital and analyzed the clinical results. Materials and Methods: From January 2001 to December 2011, 23 consecutive cases of traumatic tracheobronchial injury after blunt trauma were reviewed retrospectively. We divided them into two groups by the time to diagnosis: group I was defined as the patients who were diagnosed within 48 hours from trauma and group II was the patients who diagnosed 48 hours after trauma. We compared the clinical parameters of the two groups. Results: There was no difference in the age and gender between the two groups. The most common cause was traffic accidents (56.5%). The Injury Severity Score (ISS) was 19.6 in group I and 27.5 in group II (p=0.06), respectively. Although the difference in the ISS was not statistically significant, group II tended toward more severe injuries than group I. Computed tomography was performed in 22 cases and tracheobronchial injury was diagnosed in 5 in group I and 6 in group II, respectively (p=0.09). Eighteen patients underwent surgical treatment and all four cases of lung resection were exclusively performed in group II (p=0.03). There were two mortality cases, and the cause of death was shock and sepsis. Conclusion: We believe that close clinical observation with suspicion and rigorous bronchoscopic evaluation are necessary to perform diagnosis earlier and preserve lung parenchyma in tracheobronchial injuries from blunt trauma.

• Korean Circulation Journal
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• v.53 no.6
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• pp.387-403
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• 2023

Background and Objectives: Myocardial ischemia and reperfusion injury (MIRI) has high morbidity and mortality worldwide. We aimed to explore the role of long noncoding RNA lysyl oxidase like 1 antisense RNA 1 (LOXL1-AS1) in cardiomyocyte pyroptosis. Methods: Hypoxia/reoxygenation (H/R) injury was constructed in human cardiomyocyte (HCM). The level of LOXL1-AS1, miR-761, phosphatase and tensin homolog (PTEN) and pyroptosis-related proteins was monitored by quantitative real-time polymerase chain reaction or western blot. Flow cytometry examined the pyroptosis level. Lactate dehydrogenase (LDH), creatine kinase-MB and cardiac troponin I levels were detected by test kits. Enzyme-linked immunosorbent assay measured the release of inflammatory cytokines. Dual-luciferase assay validated the binding relationship among LOXL1-AS1, miR-761, and PTEN. Finally, ischemia/reperfusion (I/R) animal model was constructed. Hematoxylin and eosin staining assessed morphological changes of myocardial tissue. NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and casepase-1 expression was determined by immunohistochemistry. Results: After H/R treatment, LOXL1-AS1 and PTEN were highly expressed but miR-761 level was suppressed. LOXL1-AS1 inhibition or miR-761 overexpression increased cell viability, blocked the release of LDH and inflammatory cytokines (interleukin [IL]-1β, IL-18), inhibited pyroptosis level, and downregulated pyroptosis-related proteins (ASC, cleaved caspase-1, gasdermin D-N, NLRP3, IL-1β, and IL-18) levels in HCMs. LOXL1-AS1 sponged miR-761 to up-regulate PTEN. Knockdown of miR-761 reversed the effect of LOXL1-AS1 down regulation on H/R induced HCM pyroptosis. LOXL1-AS1 aggravated the MIRI by regulating miR-761/PTEN axis in vivo. Conclusions: LOXL1-AS1 targeted miR-761 to regulate PTEN expression, then enhance cardiomyocyte pyroptosis, providing a new alternative target for the treatment of MIRI.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.29-32
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• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.462-469
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• 2022

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p<0.01) shorter operative and clamp times than the conventional group. The HMI group also had significantly shorter incision lengths (5.3±0.9 cm) than the conventional group (11.5±2.8 cm). The rates of stroke, TIA, and death at 30 days were not significantly different between the 2 groups. There was no significant difference in the rate of cranial and cervical nerve injuries, and all injuries were transient. A high lesion level (odds ratio [OR], 9.56; 95% confidence interval [CI], 3.21-28.42; p<0.01) and the clamp time (OR, 1.07; 95% CI, 1.03-1.12; p<0.01) were found to be risk factors for nerve injuries. Conclusion: Use of the HMI in CEA for carotid stenosis was advantageous for its shorter operative time, shorter internal carotid artery clamp time, reduced neurologic complications, and improved esthetics.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.971-977
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• 1999

Background: Immunologic and inflammatory responses of cardiopulmonary bypass(CPB) influence postoperative mortality and morbidity with multiple organ injury. It has been reported that ischemia/reperfusion induced-myocardial injury during CPB is causative of release of inflammatory cytokines such as interleukin-6(IL-6) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$). The purpose of this study was to detect the time course of the activated cytokine and troponin-T(TnT), and to examine the correlation between such parameters during CPB. Material and Method: The serial samples were collected from arterial blood via radial arterial catheter in 23 patients who are underwent open heart surgery (OHS) with CPB, the IL-6, TNF-$\alpha$ and TnT were checked. Result: \circled1 IL-6, TNF$\alpha$- and TnT concentration increased significantly during CPB with a peaking level of CPB-off (p 0.05). \circled2 IL-6 had highly positive correlation with aortic cross clamping time and total bypass time(r=0.80, 0.78; p 0.05, respectively). \circled3 There was no correlation among IL-6, TNF-$\alpha$ and TnT. Conclusion: In conclusion, these data showed that elevated production of serum IL-6 during CPB was attributable to ischemia/reperfusion induced-myocardial damage. IL-6 will become a new and sensitive biological marker in assessment of myocardial damage during OHS with CPB. However, further studies will be needed to apply IL-6 in more patient population.

• Journal of Korea Association of Health Promotion
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• v.3 no.2
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• pp.147-164
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• 2005

The purpose of this study was to examine the effects of physical activity on women's health. I conducted literature reviews for meta-analyses and randomized controlled trials with the target diseases including cardiovascular diseases, diabetes, cancers osteoporosis, and pregnancy outcomes. Women who were active had less total mortality and smaller incidence of hypertension, coronary heart diseases, and stroke. Exercise was better than drug therapies in preventing diabetes and effective in preventing colon and breast cancers. Exercise can reduce the risks of falling injury in elderly women. Walking during pregnancy was not harmful to the mothers and their infants, and desirable to prevent the complications of pregnancy or weight gain after pregnancy. Physical activity at work and leisure-time showed similar effects on women's health. Based on these results, moderate-intensity physical activity should be recommended to all women, Resistive, muscle strength, and balance-training exercise also can be recommended. Doctors' advices are effective to make women exercise, especially using handouts or motivational interviewing techniques. It is desirable to recommend to peform other health promotion measures together such as smoking cessation, weight control and diet control.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.643-649
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• 1994

We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.6
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• pp.491-497
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• 2015

Traumatic brain injury (TBI) is a major cause of mortality and long-term disability, which can decrease quality of life. In spite of numerous studies suggesting that Epigallocatechin-3- gallate (EGCG) has been used as a therapeutic agent for a broad range of disorders, the effect of EGCG on TBI remains unknown. In this study, a weight drop model was established to evaluate the therapeutic potential of EGCG on TBI. Rats were administered with 100 mg/kg EGCG or PBS intraperitoneally. At different times following trauma, rats were sacrificed for analysis. It was found that EGCG (100 mg/kg, i.p.) treatment significantly reduced brain water content and vascular permeability at 12, 24, 48, 72 hour after TBI. Real-time PCR results revealed that EGCG inhibited TBI-induced IL-$1{\beta}$ and TNF-${\alpha}$ mRNA expression. Importantly, CD68 mRNA expression decreasing in the brain suggested that EGCG inhibited microglia activation. Western blotting and immunohistochemistry results showed that administering of EGCG significantly inhibited the levels of aquaporin-4 (AQP4) and glial fibrillary acidic protein (GFAP) expression. TBI-induced oxidative stress was remarkably impaired by EGCG treatment, which elevated the activities of SOD and GSH-PX. Conversely, EGCG significantly reduced the contents of MDA after TBI. In addition, EGCG decreased TBI-induced NADPH oxidase activation through inhibition of $p47^{phox}$ translocation from cytoplasm to plasma membrane. These data demonstrate that EGCG treatment may be an effective therapeutic strategy for TBI and the underlying mechanism involves inhibition of oxidative stress.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.944-949
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• 1993

Clinical analysis were performed on 247 cases of thoracic trauma, those were admitted & treated at the department of thoracic & cardiovascular surgery,Hanyang University Hospital during the period from Jan,1989 to June,1992. Age distribution of those was from 2 to 80 years old & mean age was 38 years old. The ratio of male to female patient was 186:61 [3:1].This ratio revealed high incidence in male patient. The most common cause of trauma was traffic accident in this series.The modes of injury were as follows: traffic accident 124 cases[50.2%],fall down 52 cases[21.05%], stab wound 47 cases[19.03%] and gun-shut wound 1 case.Ellapse time from accident to admission were 141 cases [57.09%] under 6 hr.Rib fracture were observed in 159 cases[64.37%], hemo or pneumothorax were observed 134 cases[54.25%] of total cases and location distributed Right:Left:Both[74:112:37], in left predominant. Conservative,non-operative treatment were performed in 128 cases and operation[open thoracotomy] 32 cases.Mortality was 1.6%[4 cases] & most common cause of death were due to irreversible shock with brain edema. Conclusively, more evaluation & co-operation of other department were expected treatment & better prognosis.