화상환자에서 호중구 Respiratory Burst의 변화

강희정,조현찬,이봉화 대한임상병리학회 1996 대한임상병리학회지 Vol.16 No.5

What tissue pattern appears after acute cryogenic, laser and radiofrequency thermal injury?

( Ji Min Lee ),( Chang Min Kim ),( Jung Jin Shin ),( Byoung Joon So ),( Il Hwan Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Despite the wide application of cryotherapy, lasers and electrosurgery in dermatology, the related literature provides conflicting data regarding the cryogenic and thermal injury associated with these instruments. Objectives: This study aims to evaluate the histopathological changes following in vivo cryogenic injury and laser-induced thermal damage using CO2 laser, 1,444nm Nd:YAG laser and electrosurgery. Methods: We performed cryogenic injury on rat dorsal skin using 7mm diameter cone by spot-freeze method with four different freezing times (5s, 10s, 20s, 30s). On rat ventral skin, laser-induced thermal damage was done by the above instruments. Incisional biopsy was done andspecimens were stained with hematoxylin and eosin, along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay, to highlight the degree of irreversible cellular injury. Results: The TUNEL-stained sections with cryogenic injury demonstrated deeper and broader shape of tissue damage compared to theoretical ice field model. The acute thermal damage profile differed among devices with respect to depth of penetration and extension of coagulation. Conclusion: This histopathologic evaluation of the acute characterization of injury across devices is helpful in clarifying the differences/similarities in cryotherapy-tissue & laser-tissue interaction following treatment in an in vivo human model.

The Effects of Thermal Injury on Epidermal Langerhans Cells amd Contact Hypersensitivity in Guinea Pigs

Yi, Jong Yuk,Jun, Kyung Ho,Cho, Baik Kee,Houh, Won CATHOLIC MEDICAL CENTER 1990 Bulletin of the Clinical Research Institute Vol.18 No.1

This study was attempted to investigate the effects of thermal injury on epidermal Langerhans cell (LC) and the induction of contact hypersensitivity (CHS), and the relevance of the density of epidermal LC to tile degree of CHS in guinea pigs. The skin was treated with 65℃ for 5 seconds. Epidermal LC count utilized ATPase staining and DNCB (2, 4-dinitrochlor-obenzene) was used as sensitizer. The results were as follows: 1. The number of epidermal to was significantly reduced on day 0, day 5 day 10 and day 15 after thermal injury compared with that of 5 days before thermal injury (p<0.01). 2. CHS was significantly suppressed in groups sensitized on day 0 (group A), day 5 (group B) and day 10 (group C) after thermal injury compared with positive control group (group E) (P < 0.01). 3. CHS was correlated relatively with the density of epidermal LC. 4. Reduced number of epidermal LC and suppressed CHS were recovered to normal 15-20 days after therma1 injury.

The Effectiveness of Infrared Thermography in Patients with Whiplash Injury

Lee, Young Seo,Paeng, Sung Hwa,Farhadi, Hooman F.,Lee, Won Hee,Kim, Sung Tae,Lee, Kun Su The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.57 No.4

Objective : This study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography. Methods : IR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (${\Delta}T$) in the neck and shoulder and changes in the thermal differences (${\Delta}dT$) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (${\Delta}VAS$). The correlations between ${\Delta}dT$ and ${\Delta}VAS$ results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography. Results : The skin temperature of the neck and shoulder immediately after injury showed $1-2^{\circ}C$ hyperthermia than normal. After two weeks, the skin temperature was normal range. ${\Delta}T$ after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. ${\Delta}dT$ before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between ${\Delta}dT$ and reduced ${\Delta}VAS$ (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000). Conclusion : The skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.

피코라이트 산 복용 후 발생한 위점막 열손상의 1예

이동석,이용규,김현석,이승환,전준호 대한상부위장관ㆍ헬리코박터학회 2014 Korean Journal of Helicobacter Upper Gastrointesti Vol.14 No.1

There are many reports about causes of corrosive agents such as acids and alkaline and occasionally hot food in either liquid or solid forms as causes of upper gastrointestinal mucosal injury. However, there have been no reports on bowel preparation solutions as a cause of upper gastrointestinal injury. We describe a case of bowel preparation solution (PICOLIGHT powder) induced thermal injury of the gastric mucosa with a review of the literature.

횡복직근 유리피판술로 유방재건 후 발생한 화상의 임상적 특성

이백권,배준성,안상태,오득영,이종원,한기택 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.4

Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention.During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor).Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.

증례 : 소화기 ; 송편에 의해 유발된 크고 넓은 대칭적 식도궤양 1예

김굉배 ( Goeng Bae Kim ),정재진 ( Jae Jin Jeong ),박설 ( Sul Park ),고재이 ( Jae Ee Ko ),고상훈 ( Sang Hoon Ko ),강현모 ( Hyoun Mo Kang ),이계성 ( Gye Sung Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.5

There are many possible causes of esophageal ulcer, such as reflux esophagitis, pill-induced esophagitis, infectious esophagitis, tuberculosis, syphilis, Behcet`s disease, radiation injury, caustic injury, foreign body-induced injury, esophageal cancer, and so on. However, there are only a few cases of esophageal ulcer by thermal injury from food, and most of these were caused by liquids; few are related to ingestion of solid food. We experienced a case of a large symmetrical esophageal ulcer caused by thermal and compressive injury from a hot solid foodstuff known as ``Song-pyen``, a traditional Korean food, and report the natural course of healing by conservative treatment, with a review of the few available reports regarding such injuries. (Korean J Med 2012;82:589-593)

화상 환자에게서 발생한 감염성 심내막염

윤천재,김경식 대한화상학회 2003 대한화상학회지 Vol.6 No.2

Various Upper Endoscopic Findings of Acute Esophageal Thermal Injury Induced by Diverse Food: A Case Series

Yu Mi Lee,김선문,Ji Young Kim,Hyun Jung Song,Hoon Sup Koo,송경호,Yong Seok Kim,Kyu Chan Huh 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.5

Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A “candy-cane” appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient’s history considering these factors.

Barrier Techniques for Spinal Cord Protection from Thermal Injury in Polymethylmethacrylate Reconstruction of Vertebral Body : Experimental and Theoretical Analyses

박춘근,지철,황장회,권성오,성재훈,최승진,이상원,박성찬,조경석,박춘근,강준기,Park, Choon Keun,Ji, Chul,Hwang, Jang Hoe,Kwun, Sung Oh,Sung, Jae Hoon,Choi, Seung Jin,Lee, Sang Won,Park, Sung Chan,Cho, Kyeung Suok,Park, Chun Kun,Yuan, Ha The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.3

Polymethylmethacrylate(PMMA)는 척추 전적출술후에 척추를 재건하기 위해 사용되지만 액체 형태의 PMMA가 응고하면서 발생되는 열은 척수 신경의 열 손상 가능성을 가지고 있다. 이 연구의 목적은 이미 응고된 PMMA sheet가 척수 신경을 보호하는 방어 벽으로서의 열 차단 역할을 할 수 있는지 또한 열손상으로부터 신경을 보호하기 위해 필요한 방어벽의 최소한의 두께를 탐구하는 데 있다. 실험실에서 제 12번째 흉추체 전 적출후의 상태와 동일한 크기와 모양의 정육면체의 용기를 제작하였다. 60ml의 액체형 PMMA를 용기 안에 주입하여 응고하는 PMMA중심부와 세 가지 다른 두께의(제 1 군 : 0mm, 제 2 군 : 5mm, 제 3 군 : 8mm) 이미 응고된 PMMA sheet의 하부(척수의 전면을 의미)에서 온도를 측정하였다. 또한 이 결과에 대한 위의 세 가지 군에 대해 열역학적 분석도 시행하였다. 응고하는 PMMA 덩이의 중심부에서의 온도는 18회의 실험 동안 매우 일정하여($106.8{\pm}3.9^{\circ}C$)이 실험 모델의 재현성을 보여주고 있었다. 방어 벽이 없는 군(제 1 군)에서 척수 신경 전면의 최고 온도가 $60.3^{\circ}C$이었으나 5mm군 (제 2 군)과 8mm군(제 3 군)에서는 각각 $47.3^{\circ}C$와 $43.3^{\circ}C$로 이미 응고된 PMMA는 통계적으로 유의한(p<0.00005) 온도 차단 효과를 보였다. 최고 온도에 도달하기까지의 계산된 시간은 실제 실험치 보다 35%이내의 오차를 보였으나 최고 온도에 대한 열역학적인 계산치는 실제 실험에서 나타난 수치의 1%이내의 오차를 보였다. 이상의 열역학적인 자료를 토대로 볼 때, PMMA를 이용한 척추의 재건술에서 PMMA 방어벽은 척수의 열손상을 방지하는 효과가 있으며, 이 실험에서 가정한 척수의 열손상 역치인 $39^{\circ}C$이하로 척수 온도를 유지하기 위해 필요한 PMMA방어벽의 두께는 10mm정도로 계산되었다. PMMA 방어벽의 임상 적용에 대해서는 추가적인 임상 실험이 필요하다고 사료된다. Objective : Polymethylmethacrylate(PMMA) is often used to reconstruct the spine after total corpectomy, but the exothermic curing of liquid PMMA poses a risk of thermal injury to the spinal cord. The purposes of this study are to analyze the heat blocking effect of pre-polymerized PMMA sheet in the corpectomy model and to establish the minimal thickness of PMMA sheet to protect the spinal cord from the thermal injury during PMMA cementation of vertebral body. Materials & Methods : An experimental fixture was fabricated with dimensions similar to those of a T12 corpectomy defect. Sixty milliliters of liquid PMMA were poured into the fixture, and temperature recordings were obtained at the center of the curing PMMA mass and on the undersurface(representing the spinal cord surface) of a prepolymerized PMMA sheet of variable thickness(group 1 : 0mm, group 2 : 5mm, or group 3 : 8mm). Six replicates were tested for each barrier thickness group. Results : Consistent temperatures($106.8{\pm}3.9^{\circ}C$) at center of the curing PMMA mass in eighteen experiments confirmed the reproducibility of the experimental fixture. Peak temperatures on the spinal cord surface were $47.3^{\circ}C$ in group 2, and $43.3^{\circ}C$ in group 3, compared with $60.0^{\circ}C$ in group 1(p<0.00005). So pre-polymerized PMMA provided statistically significant protection from heat transfer. The difference of peak temperature between theoretical and experimental value was less than 1%, while the predicted time was within 35% of experimental values. The data from the theoretical model indicate that a 10mm barrier of PMMA should protect the spinal cord from temperatures greater than $39^{\circ}C$(the threshold for thermal injury in the spinal cord). Conclusion : These results suggest that pre-polymerized PMMA sheet of 10mm thickness may protect the spinal cord from the thermal injury during PMMA reconstruction of vertebral body.