http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Cytotoxic Effects of Ropivacaine, Bupivacaine, and Lidocaine on Rotator Cuff Tenofibroblasts
Sung, Chang-Meen,Hah, Young-Sool,Kim, Jin-Su,Nam, Jeoung-Bin,Kim, Ra Jeong,Lee, Sang-Jin,Park, Hyung Bin SAGE Publications 2014 AMERICAN JOURNAL OF SPORTS MEDICINE - Vol.42 No.12
<P><B>Background:</B></P><P>Concern has recently arisen over the safety of local anesthetics used on human tissues.</P><P><B>Hypothesis:</B></P><P>Aminoamide local anesthetics have cytotoxic effects on human rotator cuff tenofibroblasts.</P><P><B>Study Design:</B></P><P>Controlled laboratory study.</P><P><B>Methods:</B></P><P>Cultured human rotator cuff tenofibroblasts were divided into control, phosphate buffered saline (PBS), and local anesthetic study groups; the PBS study group was further subdivided by pH level (pH 7.4, 6.0, and 4.4). The 6 local anesthetic subgroups (0.2% and 0.75% ropivacaine, 0.25% and 0.5% bupivacaine, and 1% and 2% lidocaine) were also studied at 10% dilutions of their original concentrations. Exposure times were 5, 10, 20, 40, or 60 minutes for the higher concentrations and 2, 6, 12, 24, 48, or 72 hours for the lower concentrations. Cell viability was evaluated through live, apoptotic, and necrotic cell rates using the annexin V–propidium iodide double-staining method. Intracellular reactive oxygen species (ROS) and the activity of mitogen-activated protein kinases (MAPKs) and caspase-3/7 were investigated.</P><P><B>Results:</B></P><P>The control and PBS groups showed no significant differences in cell viability (<I>P</I> > .999). In the local anesthetic study groups, cell viability decreased significantly with increases in anesthetic concentrations (<I>P</I> < .001) and exposure times (<I>P</I> < .001), with the exception of the lidocaine subgroups, where this effect was masked by the very high cytotoxicity of even low concentrations. Among the studied local anesthetic subgroups, 0.2% ropivacaine was the least toxic. The levels of intracellular ROS of each local anesthetic subgroup also increased significantly (<I>P</I> < .05). The studied local anesthetics showed increases in the phosphorylation of extracellular signal–regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK), and p38 as well as in levels of caspase-3/7 activity (<I>P</I> < .001).</P><P><B>Conclusion:</B></P><P>The cytotoxicity of the anesthetics studied to tenofibroblasts is dependent on exposure time and concentration. Of the evaluated anesthetics, ropivacaine is the least toxic in the clinically used concentration. The studied anesthetics induce tenofibroblast cell death, mediated by the increased production of ROS, by the increased activation of ERK1/2, JNK, and p38 and by the activation of caspase-3/7.</P><P><B>Clinical Relevance:</B></P><P>This study identified the cytotoxic mechanisms of aminoamide local anesthetics acting on rotator cuff tenofibroblasts. The greatest margin of safety was found in lower anesthetic concentrations in general and more specifically in the use of ropivacaine.</P>
Triple Disruption of the Superior Shoulder Suspensory Complex
Chang-Meen Sung(성창민),Hyung Bin Park(박형빈) 대한견주관절의학회 2012 대한견주관절의학회지 Vol.15 No.2
상부 견갑 현수 복합체(Superior shoulder suspensory complex)의 3중 붕괴는 몇몇 저자들에 의해서만 보고된 극히 드문 손상이다. 저자들은 오구돌기, 견갑극 골절 및 견봉-쇄골 관절의 탈구가 동반된 상부 견갑 현수 복합체의 3중 붕괴 환자를 경험하였기에 보고하고자 한다. 본 환자의 경우 견봉-상완 및 오구-상완 간격을 유지하기 위하여 관혈적 정복 및 내고정을 시행하여 상부 견갑 현수 복합체의 3중 붕괴 모두를 해부학적으로 복원하여 치료하였다. 술 후 6개월에 증상 없이 관절운동범위를 모두 회복하였다. 최종 추시인 5년에는 상부 견갑 현수 복합체의 기능이 완전히 회복된 것을 확인할 수 있었으며, 환자는 수술 결과에 대하여 크게 만족하였다. A triple disruption of the SSSC, an extremely rare injury, has been reported by only a few authors. We present a patient who had sustained a triple disruption of the SSSC: coracoid and scapular spine fractures, and an acromioclavicular joint separation. Treatment consisted of an anatomical restoration of the SSSC, with maintenance of the acromiohumeral and coracohumeral distances; this was achieved by open reduction and internal fixation of the fractures and of the separation. Six months after surgery, the injured shoulder was asymptomatic, with full range of motion. Five years after surgery, at the final follow-up, the function of the SSSC had been restored to the patients complete satisfaction.
극관절와 결절성 낭포의 관절경적 감압술 및 상부관절와순 봉합술 후 잔존 낭포의 경과
성창민(Chang-Meen Sung),이상혁(Sang-hyuk Lee),박형빈(Hyung Bin Park) 대한견주관절의학회 2010 대한견주관절학회지 Vol.13 No.1
서론: 견갑상 신경 마비를 유발하는 극관절와 결절성 낭포에 대하여 여러 가지 치료 방법이 알려져 있으나, 술 후 잔존하는 낭포의 경과에 대한 보고는 미미한 실정이다 대상 및 방법: 견갑상 신경 마비를 동반한 극관절와 결절성 낭포에 대해 관절경적 감압술 및 상부 관절와순 봉합술 시행 후, 평균 15 (12~23)개월 추시 가능하였던 6예를 대상으로 하였다. 술 후, 초음파 및 자기공명 영상으로 극관절와 결정성 낭포의 잔존 여부를 확인하였다. 결과: 수술 직후 시행한 초음파 검사상 5예에서 결절성 낭포가 잔존하고 있었으며, 1예의 경우 완전 소실되었다. 술 후 3개월에 시행한 초음파 검사상 모든 예에서 잔여 낭포가 소실 되었고, 술 후 1년에 시행한 자기공명영상에서도 재발된 경우는 없었다. 결론: 극관절와 결절성 낭포의 관절경적 감압술 및 상부관절와순 봉합술 후 잔존하는 낭포는 3개월 이내 자연 흡수되는 경향이 있는 것으로 판단한다. Purpose: There are many known treatment modalities for spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy. However, to the author’s knowledge, there is no report on the follow-up outcomes focused on remnant cysts. Materials and Methods: Six (n=6) patients with spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy, with a mean follow-up of 15 months (12-23months) following arthroscopic cyst decompression and superior labral repair, were enrolled. Residual cyst was investigated by ultrasonography and MRI. Results: Immediate postoperative ultrasonography revealed complete remission of ganglion cyst in one patient and reduced ganglion cyst size in five patients. Three-month follow-up ultrasonography showed spontaneous complete remission of the residual cysts in all patients. No recurrence on MRI was seen at one-year follow-up. Conclusion: Residual spinoglenoid ganglion cyst remaining after arthroscopic decompression and superior labral repair tends to resolve spontaneously within 3 months of surgery.
( Chi-son Chang ),( Yunsun Choi ),( Seo-yeon Kim ),( Cheonga Yee ),( Mina Kim ),( Ji-hee Sung ),( Sanghoon Lee ),( Suk-joo Choi ),( Soo-young Oh ),( Jeong-meen Seo ),( Cheong-rae Roh ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.1
Objective We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape. Methods This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA group consisted of cases without any fetal structural anomaly, musculoskeletal disorder, chromosomal abnormality, or maternal diabetes. Both groups included only singleton pregnancies. Amniotic fluid index (AFI) and width/length (W/L) ratio as well as the product of width and length (W×L) of stomach were serially assessed during gestation and compared between the 2 groups. To predict EA using W/L ratio and W×L, receiver operating characteristic curve analysis was performed. Results Polyhydramnios was evident in 77.8% of EA cases. We observed 25.9% and 22.2% EA cases with an absent stomach and a small visible stomach, respectively. After 28 weeks, the EA group manifested significantly higher AFI than the non-EA group. After 32 weeks, W/L ratio in the EA group tended to be lower than that in the non-EA group (32-36 weeks: 1.36 vs. 1.72, P=0.092; >36 weeks: 1.43 vs. 1.63, P=0.024). To predict EA, the calculated area under the curve for W/L ratio was 0.651 after 32 weeks. The diagnosis of EA using a cut-off value of W/L ratio <1.376 showed sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio to be 84.6%, 52.9%, 1.796, and 0.081, respectively. Conclusion A low W/L ratio of stomach after 32 weeks with progressive idiopathic polyhydramnios may be used to predict EA.
( Chi Min Park ),( Jeong Meen Seo ),( Min Gew Choi ),( Dae Sang Lee ),( Dong Kyung Chang ),( Kyeong Man Jeon ),( Mi Yong Rha ),( Hyun Jeong Kim ),( Seon Hye Lee ),( Un Mee Kim ),( Young Yun Cho ) 한국정맥경장영양학회 2012 한국정맥경장영양학회 학술대회집 Vol.2012 No.-
Background: Optimal delivery of enteral nutrition (EN) may improve clinical outcomes of critically ill patients and enteral feeding protocols help to improve EN practice. The purpose of this study was to evaluate the impact of implementation of enteral feeding protocol on the improvement in EN practice and on the clinical outcomes of adult critically ill patients. Methods: This was a retrospective cohort study with prospectively collected data. Multidisciplinary working group, including dietitian, nurse, and intensivist, developed the evidence-based protocol by extensive literatures and guideline review. We included the consecutive patients admitted to the medical and surgical ICU and received EN more than 24 hours. The EN practices and clinical outcomes were compared between before and after implementation of enteral feeding protocol. Results: A total of 270 patients were included in this study; 134 patients before implementation, 136 after implementation. Basic clinical characteristics were not different between two phases. Enteral feeding was initiated earlier (35.8 vs 87.1 hours, p=0.001) and more patients received EN within 24 hours (59.6% vs 41.0%, p=0.002) after implementation of protocol. Interval between starting and reaching caloric goal was not different, however more patients reached caloric goal after implementation (52.2% vs 38.3%, p=0.037). Post-implementation group used more prokinetics (53.7% vs 34.3%. p=0.001) and less parenteral nutrition. Diarrhea and gastrointestinal bleeding were significantly decreased after implementation. There was no difference in clinical outcomes including ICU death, ICU free day, and hospital day. Conclusion: The implementation of enteral feeding protocol significantly improved the practices of EN and decrease complications in critically ill patients. The clinical outcomes were not different before and after implementation.