• 제목/요약/키워드: Type IV injury

검색결과 33건 처리시간 0.021초

Differential Subsampling with Cartesian Ordering Contrast-Enhanced Magnetic Resonance Angiography for the Preoperative Assessment of Anterolateral Thigh Flap

  • Yunfeng Shen;Xiucun Li;Chao Zhang;Hai Zhong;Weiqiang Dou
    • Korean Journal of Radiology
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    • 제23권8호
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    • pp.803-810
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    • 2022
  • Objective: To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrast-enhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. Materials and Methods: Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. Results: Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. Conclusion: CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

흰쥐의 손상된 뇌조직에서의 유전자 발현 변화에 대한 홍화(紅花) 추출물 투여의 작용 (Genome Wide Expression Analysis of the Restored Changes by Carthami Flos Extract Treatment on Rat Brain Injury)

  • 김부여;임세현;이금산;김형우;임지연;조수인
    • 대한한방내과학회지
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    • 제31권4호
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    • pp.706-713
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    • 2010
  • Objectives : The source is from the flower of Carthamus tinctorius L., family Compositae. It is used in clinical medicine to promote blood circulation, remove blood stasis, promote menstruation and alleviate pain. In the present study, we investigated the genome wide analysis of Carthami Flos on the intra-cranial hemorrhage(ICH) model. Methods : ICH in rat was induced by injection of collagenase type IV and Carthami Flos extract(CFe) was administered orally. The molecular profile of cerebral hemorrhage in rat brain tissue was measured using microarray technique to identify up- or down- regulated genes in brain tissue. Results : Expression profile showed that diverse genes were up- or down-regulated by ICH induction. Administration of CFe restored the expression level of some of altered genes by ICH to normal expressional level. Interestingly, these recovered genes by CFe were involved in the same biological pathways which were significantly activated or suppressed by ICH. Conclusion : The above results might explain the therapeutic mechanism of CFe on ICH. Further, by analyzing interaction network, core genes was identified which could be key molecular targets of CFe against ICH.

견봉쇄골 관절탈구의 수술적 치료의 비교 (A Clinical Analysis of Acute Acromioclavicular Dislocation)

  • 김영규;이범구;문도현;고진홍;이수찬;박홍기;최상규
    • Clinics in Shoulder and Elbow
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    • 제1권1호
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    • pp.26-34
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    • 1998
  • The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.

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견관절 병변과 관련된 이두박건 활차의 관절경적 소견 (Arthroscopic Findings of Biceps pulley in Shoulder Pathology)

  • 최창혁;김신근;장우창;이승진
    • 대한관절경학회지
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    • 제6권2호
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    • pp.136-141
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    • 2002
  • 목적 : 이두박건 구 입구에서 이두박건의 내측 전위를 방지해주며, 관절내 활주를 유도해 주는 이두박건 활차는 상부 관절순 및 회전근개의 작용에 영향을 받아 발달하며, 형태학적인 혹은 기능적인 변형이 생길 수 있다. 본 연구를 통해 관절경으로 관찰한 이두박건 활차를 형태학적으로 분류하고, 견관절의 병변과의 관계를 확인하고자 하였다. 대상 및 방법 : 2002년 1월부터 7월까지 견관절경 검사 및 수술적 치료를 시행한 환자 49명에 대해서 이구박건 활차의 양상을 stretched type, sling type, detached sung type, concealed type으로 분류하여 관찰하였으며, 대상자는 전방 견관절 불안정성 22례, 회전근 개 파열 12례, 충돌증후군 5례, 동결견 6례, 상부 관절순 병변 2례, 견갑흉곽 점액낭염 1례, 그리고 이두박건 장두 탈구 1례 이었다. 결과 : 전체 49례중 전형적인 양상인 stretched type은 24례$(49\%)$에서 관찰되었으며, sling type은 5례$(10\%)$, detached sling type은 2례, 그리고 concealed type이 1례 관찰되었으며, 회전근 개 파열이 이두박건 장두 부위까지 연장된 8례를 포함한 17례 $(35\%)$의 경우 그 양상을 확인 할 수 없었다. 결론 : 관절내 이두박건 장두의 내측전위를 방지하고 활주를 유도하는 이두박건 활차의 형성, 발달 및 증상의 유발에는 견관절의 병변 및 체상운동의 정도등이 영향을 미칠 수 있을 것으로 생각되었다.

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종골 골절의 수술적 치료 후 방사선학적 평가와 임상적 결과의 상관 관계: 종골 골절의 술 후 방사선학적인 평가 (Correlations between the Clinical Results and Radiologic Evaluation after Surgical Treatment of Calcaneal Fracture)

  • 박현우;김연준
    • 대한족부족관절학회지
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    • 제14권2호
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    • pp.157-160
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    • 2010
  • Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

Paraquat의 편측 기관지 주입에 의해 유발된 폐섬유화증에서 Cyclophosphamide와 Methylprednisolone의 투여에 따른 Endothelin-1의 발현의 변화 (The Effects of Treatment with Cyclophosphamide and Methylprednisolone on Expression of Endothelin-1 in Unilateral Instillation of Paraquat-induced Pulmonary Fibrosis in Guinea Pigs)

  • 이소라;정혜철;김경규;이상엽;이신형;조재연;심재정;인광호;최종상;유세화;강경호
    • Tuberculosis and Respiratory Diseases
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    • 제46권6호
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    • pp.775-785
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    • 1999
  • 목 적 : 폐섬유화증 연구의 동물 실험 모델로 paraquat 중독이 자주 이용되고 있다. 본 연구에서는 paraquat로 유발된 폐섬유화에서 폐섬유화의 정도에 따른 Et-1의 변화를 면역조직화학적으로 관찰하고 스테로이드나 cyclophosphamide의 치료에 따른 Et-1의 변화를 관찰하여 폐섬유화과정에 Et-1의 역할을 밝히고자 하였다. 대상 및 방법 : 수컷 Hartley 기니픽을 4군으로 나누어 실험하였다. I 군은 paraquat를 투여하지 않은 군이었고, II 군용 paraquat를 폐에 주입한 후 cyclophosphamide와 methylprednisolone을 투여한 군이었고 III 군은 paraquat를 폐에 주입한후 methylprednisolone만 투여하였고, IV 군은 paraquat만 투입하였다. I 군을 제외한 나머지 군에서는 PE50 polyethylene tube를 이용하여 paraquat를 우측 폐로 주입하였다. 섬유화의 정도는 H-E와 Masson's trichrome 염색을 통해서 섬유아세포의 침윤정도와 교원질의 침윤정도로 판단하였고, Endothelin-1 면역조직화학염색을 통해서 세포의 활성도를 평가하였다. 각 군의 평균값은 median 값으로 표시하였고, 각 군간의 비교는 Kruskal-Wallis oneway analysis로 시행하였다. 결 과 : 1. Paraquat에 의한 폐 섬유화 Cyclophosphamide나 methylprednisolone의 치료로 paraquat에 의한 섬유아세포의 증식이 억제되었으나 통계학적 의미는 없었다. 교원질의 침윤은 cyclophosphamide와 methylprednisolone을 병합한 경우 paraquat만 투여한 군보다 의미있게 감소하였다(p<0.05). 2. Endothelin-1에 대한 면역조직화학염색 Paraquat의 투여로 발생된 폐섬유화증에 대한 치료의 종류에 따른 Et-1의 발현은 methylprednisolone의 단독 투여로도 폐포의 대식세포를 제외한 기관지 상피세포, 제2형 폐포세포, 혈관 내피세포 및 섬유아세포 등에서 Et-1의 발현이 감소하는 경향을 보였으며, cyclophosphamide와 methylprednisolone을병합한 군에서는 모든 세포에서 의미있게 Et-1의 발현이 감소하였고, 특히 폐포 대식세포와 섬유아세포에서는 methylprednisolone의 단독 투여한 III 군보다 의미있게 감소하였다(Table 2, p<0.05).

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경골 고평부 골절의 반월상 연골 파열 양상 (Characteristics of Meniscus Tear in Tibial Plateau Fractures)

  • 이동훈;김병국;김재화;정주환;이인성;이준구;이순철
    • 대한관절경학회지
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    • 제16권1호
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    • pp.9-16
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    • 2012
  • 목적: 경골 고평부 골절은 슬관절에 다양한 문제를 발생시킨다. 본 연구는 관절경하 경골 고평부 골절에서 반월상 연골 손상 양상을 확인하고자 한다. 대상 및 방법: 2007년 3월부터 2010년 3월까지 경골 고평부 골절을 진단 받은 39명의 환자 중 33명 환자를 대상으로 골절 고정 시내 관절경을 시행하였다. Schatzker 분류에 따르면 1명의 I형(3.3%), 19명의 II형(53.3%), 4명의 III형(13.3%), 2명의 IV형(6.6%), 2명의 V형(6.6%), 5명의 VI형(20%) 소견을 보였다. 결과: 25명의 환자(75.8%)에서 외측 반월상 연골 파열 소견을 보였다. Schatzker II형 환자 19명 중 18명의 환자(94.7%)가, Schatzker III형 환자 4명 중 3명의 환자(75%)가, Schatzker VI형 환자 5명 중 4명의 환자(80%)가 반월상 연골 파열 소견을 보였다. 반월상 연골 중 가장 많이 손상된 부분은 외측 연골의 전각부분이다(22/25). 25명의 반월상 연골 파열 환자 중, 한 명을 제외한 모든 환자에서 반월상 연골 변연부 수직 종파열 양상을 보였으며, 이는 대부분의 경우에 있어 관절경하 봉합술을 시도할 수 있었다. 결론: 경골 고평부 골절에 있어 관절경하 반월상 연골 손상에 대한 파악 및 치료에 유용하며, 경골 고평부 골절환자에서 관절경을 권한다.

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이성대상포진으로 인한 안면신경마비환자 11례에 대한 임상적 고찰 (Clinical Studies on 11 Cases of Facial Nerve Palsy in Herpes Zoster Oticus)

  • 김윤미;백용현;이재동;박동석;김창환;고형균
    • Journal of Acupuncture Research
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    • 제19권5호
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    • pp.234-246
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    • 2002
  • Background: Herpes Zoster Oticus, which can be caused from infection by Varicella-zoster virus, is known to be expected poor prognosis, since it has higher possibility of complete injury of facial nerve. Conservative therapy of the Western medicine is effective on the treatment for the herpes zoster and pain. However, its effectiveness on the facial verve palsy has not been proven. Objective : This study was performed to evaluate the treatment of oriental medicine and an analyze prognosis of the facial nerve palsy in Herpes Zoster Oticus. Methods : This retrospctive study was conducted to observe the clinical manifestation of Herpes Zoster Oticus, and the result of electrical diagnostic study on the patients with the facial nerve palsy in Herpes Zoster Oticus who were diagnosed and treated at the Department of Acupuncture & Moxibustion in Kyung Hee Oriental Medical Hospital. Results : 1. According to the six clinical types of Herpes Zoster Oticus, the patients in this study can be grouped as 7 cases of the type II, 2 cases of the type V, and one case of the type IV and the type VI. 2. The shorter the period from onset to the first visit to a hospital, the prognosis of facial nerve palsy in Herpes Zoster Oticus was the better. 3. According to the follow up study, the H-B grades of all cases were improved. 4. According to the follow up study, the result of electrical diagnostic study was improved. Conclusions : We found in our study that the treatment of oriental medicine, such as acupuncture, herbal medicine and aroma therapy, helps the recovery of facial nerve palsy in Herpes Zoster Oticus. The further clinical study about the more cases of facial nerve palsy in Herpes Zoster Oticus and comparative study between the group of oriental medicine and that of western medicine are needed.

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Genome Wide Expression Analysis of the Effect of Woowhangchongshim-won on Rat Brain Injury

  • ;;;;;조수인
    • 대한한방내과학회지
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    • 제30권3호
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    • pp.594-603
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    • 2009
  • Objectives : ICH breaks down blood vessels within the brain parenchyma, which finally leads to neuronal loss, drugs to treat ICH have not yet been established. In this experiment, we measured the effect of Woowhangchongshim-won (WWCSW) on intracerebral hemorrhage (ICH) in rat using microarray technology. Methods : We measured the effect of WWCSW on ICH in rat using microarray technology. ICH was induced by injection of collagenase type IV, and total RNA was isolated. Image files of microarray were measured using a ScanArray scanner, and the criteria of the threshold for up- and down-regulation was 2 fold. Hierarchical clustering was implemented using CLUSTER and TREEVIEW program, and for Ontology analysis. GOSTAT program was applied in which p-value was calculated by Chi square or Fisher's exact test based on the total array element. Results : WWCSW-treatment restored the gene expression altered by ICH-induction in brain to the levels of 76.0% and 70.1% for up- and down-regulated genes, respectively. Conclusion : Co-regulated genes by ICH model of rat could be used as molecular targets for therapeutic effects of drug including WWCSW. That is, the presence of co-regulated genes may represent the importance of these genes in ICH in the brain and the change of expression level of these co-regulated genes would also indicate the functional change of brain tissue.

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천궁(川芎)의 뇌조직출혈 흰쥐 힝염증반응에 대한 연구 (Anti-inflammatory Effects of Cnidium Rhizoma against Intracerebral Hemorrhage in Rats)

  • 백동하;김도훈;김연섭
    • 대한본초학회지
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    • 제29권2호
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    • pp.33-38
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    • 2014
  • Objectives : Inflammation is mediated by cellular components, such as leukocytes and microglia, and molecular components, including cytokines, extracellular proteases, and reactive oxygen species. Cnidium Rhizoma effects the anti-inflammatory, antioxidant, suppression of the microglia activation and protection of the nerve cell injury. For this reason, we investigated the anti-inflammatory effects of water extracts of Cnidium Rhizoma on intracerebral hemorrhage (ICH). Method : ICH was induced by the stereotaxic intracerebral injection of bacterial collagenase type IV (0.23 $U/{\mu}{\ell}$, 0.1 ${\mu}{\ell}/min$) in Sprague-Dawley rats. We orally administrated once 3 hours after ICH, then 2 times at 24-hour intervals the water extracts of Cnidium Rhizoma (500 mg/kg), myeloperoxidase (MPO) was observed by using immunofluorescense and expression of inducible nitric oxide synthase (iNOS), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and microglia were observed by using immunohistochemistry. Results : Infiltration of MPO expressing neutrophil, expression of iNOS and TNF-${\alpha}$ and activated microglia were significantly reduced in peri-hematoma of the rats fed with water extracts of Cnidium Rhizoma. Conclusion : These results demonstrated that water extracts of Cnidium Rhizoma suppressed an inflammatory reaction through inhibition of MPO, iNOS and TNF-${\alpha}$ positive cell and activated microglia number in peri-hematoma of ICH-induced rats.