• Journal of Trauma and Injury
• /
• 제21권2호
• /
• pp.100-107
• /
• 2008

Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was $37.70{\pm}19.78years$ with 36.6% of the patients being under 30 years fo age. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs.

• Archives of Plastic Surgery
• /
• 제47권5호
• /
• pp.444-450
• /
• 2020

Background Fingertip injuries are the most common type of traumatic injury treated at emergency departments and require prompt and adequate interventions for favorable wound survival outcomes. Hyperbaric oxygen (HBO₂) therapy is well known for its many positive effects on wound healing. We hypothesized that treatment with HBO₂ would improve the graft survival outcomes of amputated fingertip injuries treated with composite grafts. Methods This retrospective observational study included fingertip amputations that were treated between January 2013 and December 2017. A conventional group and an HBO₂ therapy group were statistically compared to evaluate the effect of HBO₂ treatment. Graft survival was categorized as either success or failure. Results Among 55 cases (digits), 34 digits were conventionally treated, while 21 digits were treated with HBO₂. No statistically significant differences were observed between the groups with regard to general characteristics. Among patients with guillotine-type injuries, the composite graft success rate was statistically significantly higher in the group that received HBO₂ therapy than in the conventional group (P=0.0337). Overall, the HBO₂ group also demonstrated a statistically significantly shorter healing time than the conventional group (P=0.0075). As such, HBO₂ treatment facilitates composite graft survival in cases of fingertip injury. Conclusions HBO₂ treatment was associated with an increased composite graft survival rate in guillotine-type fingertip injuries and reduced the time required for grafts to heal.

• Journal of Chest Surgery
• /
• 제28권8호
• /
• pp.772-777
• /
• 1995

Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

• Journal of Korean Neurosurgical Society
• /
• 제59권5호
• /
• pp.485-491
• /
• 2016

Objective : The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. Methods : From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group. Results : The frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant. Conclusion : Using the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.

• Journal of Korean Neurosurgical Society
• /
• 제66권4호
• /
• pp.400-408
• /
• 2023

Objective : Nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2) is a crucial factor for the survival of neuron. The role of NMNAT2 in damage following traumatic brain injury (TBI) remains unknown. This study was designed to investigate the role of NMNAT2 in TBI-induced neuronal degeneration and neurological deficits in rats. Methods : The TBI model was established in Sprague-Dawley rats by a weight-dropping method. Real-time polymerase chain reaction, western blot, immunofluorescence, Fluoro-Jade C staining, and neurological score analyses were carried out. Results : NMNAT2 mRNA and protein levels were increased in the injured-side cortex at 6 hours and peaked 12 hours after TBI. Knocking down NMNAT2 with an injection of small interfering RNA in lateral ventricle significantly exacerbated neuronal degeneration and neurological deficits after TBI, which were accompanied by increased expression of BCL-2-associated X protein (Bax). Conclusion : NMNAT2 expression is increased and NMNAT2 exhibits neuroprotective activity in the early stages after TBI, and Bax signaling pathway may be involved in the process. Thus, NMNAT2 is likely to be an important target to prevent secondary damage following TBI.

• Biomolecules & Therapeutics
• /
• 제26권2호
• /
• pp.93-100
• /
• 2018

Carbon monoxide (CO) is a gaseous molecule produced from heme by heme oxygenase (HO). Endogenous CO production occurring at low concentrations is thought to have several useful biological roles. In mammals, especially humans, a proper neurovascular unit comprising endothelial cells, pericytes, astrocytes, microglia, and neurons is essential for the homeostasis and survival of the central nervous system (CNS). In addition, the regeneration of neurovascular systems from neural stem cells and endothelial precursor cells after CNS diseases is responsible for functional repair. This review focused on the possible role of CO/HO in the neurovascular unit in terms of neurogenesis, angiogenesis, and synaptic plasticity, ultimately leading to behavioral changes in CNS diseases. CO/HO may also enhance cellular networks among endothelial cells, pericytes, astrocytes, and neural stem cells. This review highlights the therapeutic effects of CO/HO on CNS diseases involved in neurogenesis, synaptic plasticity, and angiogenesis. Moreover, the cellular mechanisms and interactions by which CO/HO are exploited for disease prevention and their therapeutic applications in traumatic brain injury, Alzheimer's disease, and stroke are also discussed.

• Archives of Plastic Surgery
• /
• 제47권2호
• /
• pp.182-186
• /
• 2020

We report our experience of treating two patients with ankle amputation with different presentations. The first case was a clean-cut sharp amputation. The second case was an avulsion injury following a motor vehicle accident in a patient who arrived 8 hours after the injury. Replantation was successful in both cases. In avulsion injuries, a secondary operation for wound coverage is required at a later stage. With good strategy and a support team, encouraging limb survival outcomes are possible post-replantation.

• Animal cells and systems
• /
• 제7권3호
• /
• pp.271-277
• /
• 2003

Regulation of endoplasmic reticulum(ER) chaperone, ERp29, in traumatized rat spinal cord was investigated. Compared to the control, ERp29 expression was down-regulated at the lesion site 1 d after spinal cord injury. However, ERp29 expression gradually increased from 3 d after the injury and peaked remarkably after 7 d. Two ER chaperones (GRP94 and BiP) showed constantly strong expression levels 1 d after spinal cord injury while the expression levels of the other two (calnexin and PDI) were unchanged. In the case of ERp72, its expression level was increased 1 d after the injury and gradually decreased thereafter. This study suggests that ERp29 expression in the spinal cord after traumatic injury might be associated with the posttraumatic neural survival, playing a role as a molecular chaperone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권1호
• /
• pp.57-61
• /
• 2021

Immediate implant placement (IIP) in fresh extraction sockets exhibits similar survival and success rates to delayed implant placement in healed sockets. Several advantages of IIP involve shortened total treatment time, reduction of the number of invasive surgeries, and subsequent reduction of patient discomfort due to lack of additional surgeries. The major shortcomings in IIP, however, include the inability to obtain early bony support, presence of a gap between the extraction socket and fixture, and the inability to cover the fixture with soft tissue, leading to increased risk of infection and implant loss. When IIP is performed, atraumatic or minimally traumatic extractions, conservation of the septal bone in molars, minimal flap elevation or flapless surgery, bone grafting the gap between the fixture and the extraction socket, and coverage with soft tissue or a membrane must be considered.

• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.77-86
• /
• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.