• Title/Summary/Keyword: Vascular injury

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Arterialized Venous Free Flap at the Insufficient Vascular Recipient Bed in Finger Reconstruction (수지 재건시 불충분한 혈행상태의 수혜부에 시행한 동맥화 정맥 유리 피판술)

  • Lee, Young-Keun;Park, Ki-Tae;Lee, Jun-Mo;Park, Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.131-136
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    • 2012
  • Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

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Curcumin targets vascular endothelial growth factor via activating the PI3K/Akt signaling pathway and improves brain hypoxic-ischemic injury in neonatal rats

  • Li, Jia;An, Yan;Wang, Jia-Ning;Yin, Xiao-Ping;Zhou, Huan;Wang, Yong-Sheng
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.5
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    • pp.423-431
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    • 2020
  • This study aimed to evaluate the effect of curcumin on brain hypoxic-ischemic (HI) damage in neonatal rats and whether the phosphoinositide 3-kinase (PI3K)/Akt/vascular endothelial growth factor (VEGF) signaling pathway is involved. Brain HI damage models were established in neonatal rats, which received the following treatments: curcumin by intraperitoneal injection before injury, insulin-like growth factor 1 (IGF-1) by subcutaneous injection after injury, and VEGF by intracerebroventricular injection after injury. This was followed by neurological evaluation, hemodynamic measurements, histopathological assessment, TUNEL assay, flow cytometry, and western blotting to assess the expression of p-PI3K, PI3K, p-Akt, Akt, and VEGF. Compared with rats that underwent sham operation, rats with brain HI damage showed remarkably increased neurological deficits, reduced right blood flow volume, elevated blood viscosity and haematocrit, and aggravated cell damage and apoptosis; these injuries were significantly improved by curcumin pretreatment. Meanwhile, brain HI damage induced the overexpression of p-PI3K, p-Akt, and VEGF, while curcumin pretreatment inhibited the expression of these proteins. In addition, IGF-1 treatment rescued the curcumin-induced down-regulated expression of p-PI3K, p-Akt, and VEGF, and VEGF overexpression counteracted the inhibitory effect of curcumin on brain HI damage. Overall, pretreatment with curcumin protected against brain HI damage by targeting VEGF via the PI3K/Akt signaling pathway in neonatal rats.

Endotoxin Induces Late Increase in the Production of Pulmonary Proinflammatory Cytokines in Murine Lupus-Like Pristane-Primed Modelp

  • Chae Byeong-Suk;Park Jeong-Suk;Shin Tae-Yong
    • Archives of Pharmacal Research
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    • v.29 no.4
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    • pp.302-309
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    • 2006
  • Lupus-like syndrome is characterized by multiple organ injuries including lungs and kidneys. Endotoxin induces a transiently intent systemic inflammatory response and indirectly transient acute lung injury in normal condition. However, whether endotoxin may trigger the persistent development of lung injury in chronic, inflammatory lupus-like syndrome compared with normal condition remains unclear. We examined the pulmonary vascular permeability and production of proinflammatory cytokines, such as TNF-${\alpha}$, IL-6, IL-10 and IFN-${\gamma}$, which play prominent roles in the pathogenesis of lupus-like tissue injury, 6 hand 72 h after i.p. lipopolysaccharide (LPS; endotoxin) injection in pristane-primed chronic inflammation ICR mice characterized by a lupus-like syndrome. These results demonstrated that levels of serum IL-6, IL-10 and IFN-${\gamma}$ and bronchoalveolar lavage (BAL) IL-6 and IFN-${\gamma}$ were remarkably increased 6 h in LPS-exposed pristane-primed mice compared with pristane-primed controls, while pulmonary vascular permeability and levels of serum and BAL TNF-${\alpha}$ were not. And levels of BAL TNF-${\alpha}$, IL-6 and IL-10 were significantly enhanced 72 h in LPS-exposed pristane-primed mice compared with pristane-primed controls. Also, LPS significantly induced the increased in vitro production of TNF-${\alpha}$, IL-6 and IL-10 by lung cells obtained from LPS-exposed pristane-primed mice compared with LPS-exposed normal mice. Our findings indicate that LPS may trigger persistent progression of lung injury through late overproduction of BAL TNF-${\alpha}$, IL-6, and IL-10 in lupuslike chronic inflammation syndrome compared with normal condition.

Traumatic Rupture of the Subcutaneous Bypass Vascular Graft - A case report - (피하 우회 인조혈관의 외상성 파열 1례)

  • Lee, Jung Eun;Jang, In-Seok;Yang, Jun Ho;Kim, Sung-Hwan;Kim, Jong Woo;Choi, Jun Young;Rhie, Sang Ho
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.172-174
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    • 2005
  • Trauma of the vascular structure is not poplular event. In obstructive atherosclerotic vascular disease, we sometimes have needed bypass surgery. The long length subcutaneous prosthetic vascular graft are vulnerable to injury. But prosthetic vessel rupture after trauma has been rare report. A 68-year-old man was referred to Department of Emergency of the Gyeongsang National University Hospital. After he had had a blunt trauma, he found a newly appearing pulsating mass of 10 cm diameter on his right chest wall. The lesion had a turbulent blood flow in the cavity of the mass by ultrasonographic finding. The lesion was a rupture of superficial prosthetic vascular graft under the skin.

An Experience of Inferior Vena Caval Ligation in Traumatic Injury (하공정맥 손상의 치험 1례)

  • 이성행
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.209-212
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    • 1973
  • Because of the. rise in the incidence of high speed automobile accident and various gun shot wound, complicated vascular injuries are becoming more frequent. Inferior vena caval injury seems to be also in high incidence, but reports in the literature were rare. because of potentially lethal. Recently we have experienced a case of inferior vena caval injury due to stab wound on the posterior aspect of the right abdomen. This was successfully treated with inferior caval ligation on the both, proximal and distal of the injured infrarenal vena cava.

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Stent Graft Repair of Penetrated Injury of the Common Carotid Artery

  • Kim, Soon Jin;Ryu, Sang Woo;Chekar, Jaykey;Kim, Yong Tae;Seo, Bo Ra
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.172-175
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    • 2016
  • Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

Treatment for Maior Vascular Injuries of Lower Lumbar Disc Surgery -2 Cases Report (요추 추간판 제거술중 발생한 대혈관 손상 수술 치험 -2례 보고-)

  • Kim, Seung-U;Hwang, Yun-Ho
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.621-624
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    • 1997
  • Conventional surgery for lower lumbar disc herniation is a common practice and its vascular complications have been reported rarely. If the hypotension is severe or prolonged postoperatively, one should suspect vascular injury and perform urgent laparotomy. We experienced two cases of major vascular injuries following semi-laminectomy and discectomy.

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A model of Isolated Renal Hemoperfusion (허혈/재관류 손상연구를 위한 체외 신장 재관류 모델)

  • Nam, Hyun-Suk;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.441-444
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    • 2009
  • Ischemia-reperfusion (I/R) injury is associated with an increased risk of acute rejection, delayed graft function and long-term changes after kidney transplantation. The reperfusion models remain unsolved complications such as vascular obstruction and blood leakage. We developed an alternative model of isolated hemoperfusion in porcine kidneys. In the present study we introduced a newly developed reperfusion method. A connector was used instead of surgical suture for the vascular anastomosis on the inguinal region in which main femoral vessels are parallel and big enough to perfuse the kidney. To assess renal perfusion quality of the modified hemoreperfusion model, we analyzed both hemodynamic values and patterns of I/R injury following a renal reperfusion. Following unilateral nephrectomy, the kidneys were preserved for 0, 24 and 48 hours at $4^{\circ}C$ with histidine-tryptophan ketogluatarate (HTK) solution and reperfused for 3 hours by vascular anastomosis connected to the femoral artery and vein in inguinal region. Histolopathological examinations were assessed on kidney biopsy specimens, taken after each cold storage and reperfusion. No differences of hemodynamic values were observed between aorta and femoral artery. The average warm ischemia time before reperfusion start was $7.0{\pm}1.1$ minutes. There were no complications including vascular obstruction and blood leakage during the reperfusion. I/R injury of the perfused kidneys in this model was dependent upon the cold ischemia time. The results support that the modified perfusion model is simple and appropriate for the study of early renal I/R injury and transplant immunology.

The literatual study on the cerebral vascular dementia in oriental and occidental medicine (뇌혈관성(뇌혈관성) 치매(痴?)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Ann, Tak-Weon;Hong, Seog;Kim, Hee-Chul
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.40-70
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    • 1996
  • In the literatual study on the cerebral vascular dementia, the results were as follows : 1. Cerebral vascular dementia is so called apoplectic dementia, because it almost occurs after apoplexy, the attack rate has gradually increased by increase of life, so it exert a harmful influence to geriatric diseases. 2. The etiological factors are summarized on deficiency in the heart, kidney, liver(心, 腎, 肝虛), pathogenic wind(豊) pathogenic fire(火) phlegm(痰) and stagnated blood(瘀血) in the oriental medicine, and multiple cerebral infarction, cerebral anemia, decrease of cerebral vascular flow are etiological factors in the occidental medicine. 3. The region of infarction and attack of cerebral vascular dementia have a close connection, and generally the cerebral vascular dementia easily occur in injury of white matter of brain. 4. Symptoms of cerebral vascular dementia are dysphasia, walking disorder, hemiplegia, sensory paralysis, disturbance of memory, judgement, calculation, emotion incontinence, speech impediment, silence or talkative, lower thinking ability and depersonalization, and symptoms are aggravated by stage. 5. Therapeutic herb medicines are Palpungsan(八風散), Baepungsan(排風散), Jinsaanshinhwan(辰砂安神丸), Sabacksan(四白散), Kanghwalyupungsan(姜活愈風散), Woohwangchungshimhwan(牛黃淸心丸), and they are used to dispelling pathogenic wind(祛風), soothe the nerves(安神), dispel pathogenic heat from lung, nourish the blood(淸肺養血).

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Role of Interleukin-4 in Atherosclerosis

  • Lee, Yong-Woo;Hirani, Anjali A.
    • Archives of Pharmacal Research
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    • v.29 no.1
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    • pp.1-15
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    • 2006
  • Vascular endothelial cell injury or dysfunction has been implicated in the onset and' progression of cardiovascular diseases including atherosclerosis. A number of previous studies have demonstrated that the pro-oxidative and pro-inflammatory pathways within vascular endothelium play an important role in the initiation and progression of atherosclerosis, Recent evidence has provided compelling evidence to indicate that interleukin-4 (IL-4) can induce proc inflammatory environment via oxidative stress-mediated up-regulation of inflammatory mediators such as cytokine, chemokine, and adhesion molecules in vascular endothelial cells. In addition, apoptotic cell death within vascular endothelium has been hypothesized to be involved in the development of atherosclerosis. Emerging evidence has demonstrated that IL-4 can induce apoptosis of human vascular endothelial cells through the caspase-3-dependent pathway, suggesting that IL-4 can increase endothelial cell turnover by accelerated apoptosis, the event which may cause the dysfunction of the vascular endothelium. These studies will have a high probability of revealing new directions that lead to the development of clinical strategies toward the prevention and/or treatment for individuals with inflammatory vascular diseases including atherosclerosis.