• 제목/요약/키워드: ischemic injury

검색결과 424건 처리시간 0.05초

급성 수부 손상에서 간과된 혈관성 손상을 가진 수부의 운명 (The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries)

  • 김태범;이용직;이영근;우상현
    • Archives of Reconstructive Microsurgery
    • /
    • 제16권1호
    • /
    • pp.30-38
    • /
    • 2007
  • In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-to-end artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.

  • PDF

Delayed Hemorrhagic Manifestation of Blunt Carotid Artery Injury

  • Lee, Woo-Chang;Min, Kyung-Soo;Kim, Young-Gyu;Kim, Dong-Ho
    • Journal of Korean Neurosurgical Society
    • /
    • 제37권6호
    • /
    • pp.449-452
    • /
    • 2005
  • Blunt carotid artery injury is uncommon, yet not rare. However, it is often underdiagnosed because of inconsistent early symptoms or masking by the presence of coexisting brain and spinal injuries. The delay between the accident and the onset of cerebral ischemic symptoms is variable and has been reported to range from minutes to ten years. However, to our knowledge, there has been no report on a case presented with delayed intracerebral hemorrhage 25months after blunt carotid artery injury. We report on a case with discussion of supporting evidence and possible mechanisms.

Results of Extracorporeal Cardiopulmonary Resuscitation in Children

  • Shin, Hong Ju;Song, Seunghwan;Park, Han Ki;Park, Young Hwan
    • Journal of Chest Surgery
    • /
    • 제49권3호
    • /
    • pp.151-156
    • /
    • 2016
  • Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

In Vivo Protein Transduction: Delivery of PEP-1-SOD1 Fusion Protein into Myocardium Efficiently Protects against Ischemic Insult

  • Zhang, You-en;Wang, Jia-ning;Tang, Jun-ming;Guo, Ling-yun;Yang, Jian-ye;Huang, Yong-zhang;Tan, Yan;Fu, Shou-zhi;Kong, Xia;Zheng, Fei
    • Molecules and Cells
    • /
    • 제27권2호
    • /
    • pp.159-166
    • /
    • 2009
  • Myocardial ischemia-reperfusion injury is a medical problem occurring as damage to the myocardium following blood flow restoration after a critical period of coronary occlusion. Oxygen free radicals (OFR) are implicated in reperfusion injury after myocardial ischemia. The antioxidant enzyme, Cu, Zn-superoxide dismutase (Cu, Zn-SOD, also called SOD1) is one of the major means by which cells counteract the deleterious effects of OFR after ischemia. Recently, we reported that a PEP-1-SOD1 fusion protein was efficiently delivered into cultured cells and isolated rat hearts with ischemia-reperfusion injury. In the present study, we investigated the protective effects of the PEP-1-SOD1 fusion protein after ischemic insult. Immunofluorescecnce analysis revealed that the expressed and purified PEP-1-SOD1 fusion protein injected into rat tail veins was efficiently transduced into the myocardium with its native protein structure intact. When injected into Sprague-Dawley rat tail veins, the PEP-1-SOD1 fusion protein significantly attenuated myocardial ischemia-reperfusion damage; characterized by improving cardiac function of the left ventricle, decreasing infarct size, reducing the level of malondialdehyde (MDA), decreasing the release of creatine kinase (CK) and lactate dehydrogenase (LDH), and relieving cardiomyocyte apoptosis. These results suggest that the biologically active intact forms of PEP-1-SOD1 fusion protein will provide an efficient strategy for therapeutic delivery in various diseases related to SOD1 or to OFR.

Beneficial Effect of Pentoxifylline on Hypoxia-Induced Cell Injury in Renal Proximal Tubular Cells

  • Jung Soon-Hee
    • 대한의생명과학회지
    • /
    • 제10권4호
    • /
    • pp.341-346
    • /
    • 2004
  • Tumor necrosis factor-α (TNF-α) or its mRNA expression are increased in acute nephrosis of various types including ischemia/reperfusion injury. This study was undertaken to determine whether pentoxifylline (PTX), an inhibitor of TNF-α production, provides a protective effect against hypoxia-induced cell injury in rabbit renal cortical slices. To induce hypoxia-induced cell injury, renal cortical slices were exposed to 100% N₂ atmosphere. Control slices were exposed to 100% O₂ atmosphere. The cell injury was estimated by measuring lactate dehydrogenase (LDH) release and p-aminohippurate (PAH) uptake. Exposure of slices to hypoxia increased the LDH release in a time-dependent manner. However, when slices were exposed to hypoxia in the presence of PTX, the LDH release was decreased. The protective effect of PTX was dose-dependent over the concentrations of 0.05∼1 mM. Hypoxia did not increase lipid peroxidation, whereas an organic hydroperoxide t-butylhydroperoxide (tBHP) resulted in a significant increase in lipid peroxidation. PTX did not affect tBHP-induced lipid peroxidation. Hypoxia decreased PAH uptake, which was significantly attenuated by PTX and glycine. tBHP-induced inhibition of PAH uptake was not altered by PTX, although it was prevented by antioxidant deferoxarnine. The PAH uptake by slices in rabbits with ischemic acute renal failure was prevented by PTX pretreatment. These results suggest that PTX may exert a protective effect against hypoxia-induced cell injury and its effect may due to inhibition of the TNF-α production, but not by its antioxidant action.

  • PDF

Alteration of Nitric Oxide Synthase and Guanylyl Cyclase Activity in Rats with Ischemia/Reperfusion Renal Injury

  • Bae, Eun-Hui;Kim, Soo-Wan
    • The Korean Journal of Physiology and Pharmacology
    • /
    • 제10권6호
    • /
    • pp.337-341
    • /
    • 2006
  • The present study was designed to investigate the protein expression of nitric oxide synthase (NOS) and guanylyl cyclase (GC) activity in ischemia/perfusion (I/R) renal injury in rats. Renal I/R injury was experimentally induced by clamping the both renal pedicle for 40 min in Sprague-Dawley male rats. The renal expression of NOS isoforms was determined by Western blot analysis, and the activity of guanylyl cyclase was determined by the amount of guanosine 3', 5'-cyclic monophosphate (cGMP) formed in response to sodium nitroprusside (SNP), NO donor. I/R injury resulted in renal failure associated with decreased urine osmolality. The expression of inducible NOS (iNOS) was increased in I/R injury rats compared with controls, while endothelial NOS (eNOS) and neuronal NOS (nNOS) expression was decreased. The urinary excretion of NO metabolites was decreased in I/R injury rats. The cGMP production provoked by SNP was decreased in the papilla, but not in glomerulus. These results indicate an altered regulation of NOS expression and guanylyl cyclase activity in I/R-induced nephropathy.

A Mouse Model of Photochemically Induced Spinal Cord Injury

  • Piao, Min Sheng;Lee, Jung-Kil;Jang, Jae-Won;Kim, Soo-Han;Kim, Hyung-Seok
    • Journal of Korean Neurosurgical Society
    • /
    • 제46권5호
    • /
    • pp.479-483
    • /
    • 2009
  • Objective : A mouse model of spinal cord injury (SCI) could further increase our basic understanding of the mechanisms involved in injury and repair of the nervous system. The purpose of this study was to investigate whether methods used to produce and evaluate photochemical graded ischemic SCI in rats, could be successfully adapted to mice, in a reliable and reproducible manner. Methods : Thirty female imprinting control region mice (weighting 25-30 g, 8 weeks of age) were used in this study. Following intraperitoneal injection of Rose bengal, the translucent dorsal surface of the T8-T9 vertebral laminae of the mice were illuminated with a fiber optic bundle of a cold light source. The mice were divided into three groups; Group 1 (20 mg/kg Rose bengal, 5 minutes illumination), Group 2 (20 mg/kg Rose bengal, 10 minutes illumination), and Group 3 (40 mg/kg Rose bengal, 10 minutes illumination). The locomotor function, according to the Basso-Beattie-Bresnahan scale, was assessed at three days after the injury and then once per week for four weeks. The animals were sacrificed at 28 days after the injury, and the histopathology of the lesions was assessed. Results : The mice in group 1 had no hindlimb movement until seven days after the injury. Most mice had later recovery with movement in more than two joints at 28 days after injury. There was limited recovery of one joint, with only slight movement, for the mice in groups 2 and 3. The histopathology showed that the mice in group 1 had a cystic cavity involving the dorsal and partial involvement of the dorsolateral funiculi. A larger cavity, involving the dorsal, dorsolateral funiculi and the gray matter of the dorsal and ventral horns was found in group 2. In group 3, most of the spinal cord was destroyed and only a thin rim of tissue remained. Conclusion : The results of this study show that the photochemical graded ischemic SCI model. described in rats, can be successfully adapted to mice, in a reliable and reproducible manner. The functional deficits are correlated an increase in the irradiation time and, therefore, to the severity of the injury. The photothrombotic model of SCI, in mice with 20 mg/kg Rose bengal for 5 minutes illumination, provides an effective model that could be used in future research. This photochemical model can be used for investigating secondary responses associated with traumatic SCI.

뇌허혈 마우스모델에서 양격산화탕이 뇌 손상 완화에 미치는 효과 (Yangkyuksanhwa-Tang Attenuates Ischemic Brain Injury in a Focal Photothrombosis Stroke Model)

  • 한도경;박맑은;권옥선;최병태
    • 생명과학회지
    • /
    • 제29권11호
    • /
    • pp.1258-1266
    • /
    • 2019
  • 양격산화탕은 9가지의 약재로 구성된 처방으로 한의학적 뇌졸중 치료에 가장 널리 사용되는 처방 중 하나이며, 주로 사상체질이론의 소양인 뇌졸중 치료에 적용된다. 본 연구는 실험동물을 이용한 뇌졸중에 대한 양격산화탕의 효과에 대한 연구가 전무하여, photothrombosis로 유발된 허혈성 마우스모델을 이용하여 양격산화탕의 효과를 살펴 보았다. 동물행동학적 변화와 더불어 뇌손상에 미치는 영향을 뇌경색 용적에 대한 조직학적 검색 및 신경염증과 신생세포에 대한 면역조직화학적 검색으로 살펴 보았다. 동물행동학적 결과로 보아, 양격산화탕은 뇌허혈에 의해 손상된 운동기능, 즉 wire grip과 rotarod test에 의한 운동조정과 균형 능력 등에 대한 기능적 회복을 보였으며, 이는 조직학적 검색으로 관찰된 뇌경색 용적의 축소를 동반하였다. 면역조직화학적 결과를 보면, 양격산화탕은 tumor necrosis factor-${\alpha}$와 myeloperoxidase 면역반응세포의 수를 현저히 감소시켰다. 이와 반대로 양격산화탕은 glial fibrillary acidic protein와 ionized calcium-binding adapter molecule 1 면역반응세포의 수를 현저히 증가시켰다. 또한 양격산화탕은 Ki67/doublecortin 면역반응세포의 수를 현저히 증가시켰다. 이상의 결과로 보아, 양격산화탕은 항염증, astrocyte와 microglia의 활성화 및 신경세포의 증식을 통해 뇌경색 용적을 감소시키며, 이는 뇌허혈성 운동장애에 대한 완화 효과로 이어 지는 것을 알 수 있다. 따라서 양격산화탕은 뇌손상에 대한 신경기능적 완화효과를 보여 줌으로서 뇌졸중 환자에 대한 유효한 치료제로 사료된다.

Protective Role of Transduced Tat-Thioredoxin1 (Trx1) against Oxidative Stress-Induced Neuronal Cell Death via ASK1-MAPK Signal Pathway

  • Yeo, Eun Ji;Eum, Won Sik;Yeo, Hyeon Ji;Choi, Yeon Joo;Sohn, Eun Jeong;Kwon, Hyun Jung;Kim, Dae Won;Kim, Duk-Soo;Cho, Sung-Woo;Park, Jinseu;Han, Kyu Hyung;Lee, Keun Wook;Park, Jong Kook;Shin, Min Jea;Choi, Soo Young
    • Biomolecules & Therapeutics
    • /
    • 제29권3호
    • /
    • pp.321-330
    • /
    • 2021
  • Oxidative stress plays a crucial role in the development of neuronal disorders including brain ischemic injury. Thioredoxin 1 (Trx1), a 12 kDa oxidoreductase, has anti-oxidant and anti-apoptotic functions in various cells. It has been highly implicated in brain ischemic injury. However, the protective mechanism of Trx1 against hippocampal neuronal cell death is not identified yet. Using a cell permeable Tat-Trx1 protein, protective mechanism of Trx1 against hydrogen peroxide-induced cell death was examined using HT-22 cells and an ischemic animal model. Transduced Tat-Trx1 markedly inhibited intracellular ROS levels, DNA fragmentation, and cell death in H2O2-treatment HT-22 cells. Tat-Trx1 also significantly inhibited phosphorylation of ASK1 and MAPKs in signaling pathways of HT-22 cells. In addition, Tat-Trx1 regulated expression levels of Akt, NF-κB, and apoptosis related proteins. In an ischemia animal model, Tat-Trx1 markedly protected hippocampal neuronal cell death and reduced astrocytes and microglia activation. These findings indicate that transduced Tat-Trx1 might be a potential therapeutic agent for treating ischemic injury.