• The Korean Journal of Physiology and Pharmacology
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• 제15권5호
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• pp.273-277
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• 2011

Nitric oxide (NO) and atrial natriuretic peptide (ANP) may induce vascular relaxation by increasing the production of cyclic guanosine monophosphate (cGMP), an important mediator of vascular tone during sepsis. This study aimed to determine whether regulation of NO and the ANP system is altered in lipopolysaccharide (LPS)-induced kidney injury. LPS (10 $mg{\cdot}kg^{-1}$) was injected in the tail veins of male Sprague-Dawley rats; 12 hours later, the kidneys were removed. Protein expression of NO synthase (NOS) and neutral endopeptidase (NEP) was determined by semiquantitative immuno-blotting. As an index of synthesis of NO, its stable metabolites (nitrite/nitrate, NOx) were measured using colorimetric assays. mRNA expression of the ANP system was determined by real-time polymerase chain reaction. To determine the activity of guanylyl cyclase (GC), the amount of cGMP generated in response to sodium nitroprusside (SNP) and ANP was calculated. Creatinine clearance decreased and fractional excretion of sodium increased in LPS-treated rats compared with the controls. Inducible NOS protein expression increased in LPS-treated rats, while that of endothelial NOS, neuronal NOS, and NEP remained unchanged. Additionally, urinary and plasma NOx levels increased in LPS-treated rats. SNP-stimulated GC activity remained unchanged in the glomerulus and papilla in the LPS-treated rats. mRNA expression of natriuretic peptide receptor (NPR)-C decreased in LPS-treated rats, while that of ANP and NPR-A did not change. ANP-stimulated GC activity reduced in the glomerulus and papilla. In conclusion, enhancement of the NO/cGMP pathway and decrease in ANP clearance were found play a role in the pathogenesis of LPS-induced kidney injury.

• The Korean Journal of Physiology and Pharmacology
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• 제25권4호
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• pp.281-296
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• 2021

The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetes-induced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholine-induced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O₂ for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (L-NAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IR-induced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

• 대한기관식도과학회지
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• 제16권2호
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• pp.121-125
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• 2010

Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.461-466
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• 2005

Despite the major advances in the microvascular surgery with success rates of up to 98%, failure and vascular complications still remain even in the experienced hands. Failure of blood to flow across an anastomosis is usually caused by three factors: (1) Technical errors; (2) Undetected damage more proximally or via vasospasm; or (3) A clot or a thrombus. The success of a microvascular surgery depends on the severity of the vascular injury and, proper debridement of an injured vessel, and the failure rate of microvascular anastomosis in cases of trauma is higher as the thrombogenic possibility is increased by the endothelial damage. From January to November in 2003, 460 patients were underwent microvascular surgery(270 replantations and 190 free flap transfers) and re-operations were performed in 15 cases. Cases were reviewed by clinical and operative records. In these cases, causes of post-operative circulation insufficiency were identified as 9 vascular spasms and 6 thromboses at the previous anastomotic site. The average of re-operative success rate was 73%(60% in replantations and 100% in free flaps). In conclusion, through precise postoperative monitoring and assessment, immediate surgical re-exploration could be performed when a vascular complication is suspicious, the success rate of microvascular surgery would be increased more.

• 한국직업건강간호학회지
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• 제28권2호
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• pp.75-82
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• 2019

Purpose: This study aimed to determine the influence of injury and/or injured area classification on depression in patients with industrial injuries. Methods: The participants comprised438 patients who consented to participate and completed self-reported questionnaires. Data were analyzed using SPSS/WIN version 22.0 for descriptive statistics, $x^2$ test, fisher's exact test, ANOVA, and post-hoc $Scheff{\acute{e}}$ test. A stepwise multiple regression analysis was used to identify factors influencing depression. Results: The results indicated that the effect of disease classification and injured areas on depression were significantly different in patients with industrial injuries. The results further showed that severe depression was significantly higher in cardiovascular patients and patients with an injured area of the head and waist. The most powerful predictor was age (50~59 years), return to work (reemployment), disease classification (cardiovascular), and injured area (head, including vascular disease). Conclusion: This study showed that the most influential variable of depression in patients with industrial injuries were cardiovascular issues, injury areas of the head and waist, being aged 50~59 years, and reemployment. To reduce depression in these patients, it is important to develop and implement a psychiatric rehabilitation program that helps patients to formulate a concrete plan and goal for recovery, enabling patients to actively engage in their rehabilitation.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.16-44
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• 2003

Skeletal muscle regeneration is a vital process for various muscle myopathies and muscular adaptation to physiological overload. Angiogenesis is the key event in the process of muscle regeneration, and vascular endothelial growth factor(VEGF) plays an important role in it. The purpose of this study was to evaluate the effect of GaAlAs(830nm) laser and immunoreactivity of VEGF on angiogenesis after muscle contusion injury. Muscle contusion injury was induced in the triceps surae muscle by dropping a metal bead(31.4g). GaAlAs laser irradiation(power 20 mW, frequency 2000 Hz, treatment time 15 min) was applied directly to the skin of injured muscle daily for seven days. The experimental group I was irradiated immediately by laser after injury, whereas the experimental group II was irradiated after 1 day of injury. The control group was non-irradiated. The results of this study were as follows. 1. In morphological observation, there were no significant changes in experimental and control groups for 7 days. At 3 days, however, the splited muscle fibers were observed in experimental groups, and the muscle atrophy and granular tissue viewed at 7 days in control group. 2. The VEGF was expressed in muscle fiber that located in the interspace between gastrocnemius and soleus muscles. As the time coursed, the immunoreactivity of VEGF also seemed to be strong in the individual muscle fibers. 3. The experimental group I & II showed higher immunoreactivity of VEGF than control group(p<0.05). Then, the experimental group I showed higher than group II especially(p<0.05). These data suggest GaAlAs semiconduct diode laser irradiation(830nm) enhanced angiogenesis in the skeletal muscle induced contusion injury, and immediate laser irradiation after injury promoted the angiogenesis greatly than after 1 day of injury.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.510-513
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• 2006

Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.199-207
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• 2003

신생아의 정상적인 발달을 저해하고 조기 사망의 주된 원인이 되고 있는 주산기 뇌손상에 관한 신경병리적 기전을 살펴보고자 하였다. 발달하고 있는 과정에서의 주산기 뇌손상은 주로 저산소성-허혈성 뇌손상과 출혈성 뇌손상에 의한 경우가 많다. 저산소성-허혈성 뇌손상과 관련하여 에너지 부전, 세포흥분독성, 미성숙 백질의 선택적 취약성을 고려해 볼 수 있다. 첫번째, 세포호흡에 관여하는 미토콘드리아의 손상과 관련하여 즉각적인 병리와 함께 지연된 양상의 손상을 보인다. 미토콘드리아의 호흡률이 감소하고 칼슘이온의 농도가 상승하여 세포 괴사 및 세포사멸 과정이 진행된다. 두번째, 흥분성 아미노산과 관련하여 미성숙한 뇌에는 NMDA 수용기-채널 복합체의 기능이 매우 풍부하고, phosphoinositide 가수분해가 높아서 흥분독성에 상당히 취약하다. 세 번째, 수초 형성에 중요한 역할을 하는 희돌기교세포가 주산기 뇌손상 특히, 저산소성-허혈성 손상에 취약하다. 희돌기교세포는 글루타메이트에 의한 자유유리기과 사이토카인 손상에 취약하다. 뇌출혈과 관련하여, 미성숙한 뇌는 뇌실 주위에 혈관층이 풍부하나 매우 약한 상태로 재관류 혹은 혈류의 증가로 인해 쉽게 파열된다. 특히 32주 이내인 경우 이러한 손상으로 인해 뇌실주위 백질연화증이 초래된다.

• 대한정형외과스포츠의학회지
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• 제12권1호
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• pp.16-23
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• 2013

슬관절의 다발성 인대 손상은 2개 또는 그 이상의 인대가 손상된 경우를 의미하고, 이 중 3개 또는 4개의 인대 파열이 일어나게 되면 대퇴골-경골 관절의 통합성이 파괴된 상태, 즉 슬관절의 탈구가 일어날 수 있다. 슬관절의 다발성 인대 손상이 있는 경우 혈관, 신경 상태를 단계적으로, 세심하게 평가하여야 하며 동맥 손상이 의심 시 지체하지 말고 응급 수술을 시행하여야한다. 슬관절의 다발성 인대 손상 치료에는 여러 이견이 있을 수 있으나 보존적 치료보다는 수술적 치료가, 지연 수술보다는 조기 수술이 권유되고, 전, 후방 십자 인대의 경우 재건술이, 후외방 인대의 경우 재건술이, 내측 측부 인대의 경우 봉합술 혹은 재건술이 권유되며, 다발성 인대 손상은 단일 인대 손상보다는 좀더 적극적인 치료가 요할 것으로 사료된다.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.435-440
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• 2023

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.