• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.49-56
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• 2006

배경 : 급성 폐손상은 폐내, 외의 원인질환들에 의해 폐포-모세혈관의 투과성이 증가하며, 폐부종에 의해 급성 저산소성 호흡곤란이 유발되는 증후군이다. 헤파린은 항응고작용 외에 자체적으로 항염증효과를 가지고 있으나, 염증성질환에 헤파린을 투여하면 출혈성 합병증이 발생하기 때문에 실제로 임상에서 이용하는데 제약이 있다. 하지만 헤파린에서 2-O와 3-O sulfate를 제거하면, 항응고 효과가 제거되고 항염증효과는 지니고 있는 비항응고성 헤파린 (nonanticoagulant heparin)으로 변화한다. 본 연구에서는 흰쥐에게 내독소 (LPS)를 투여하거나, 출혈성 쇼크를 일으켜서 유발된 급성폐손상에서 비항응고성 헤파린의 치료효과를 살펴보았다. 방법 : 각 군당 5 마리 이상의 흰쥐 (Balb/c mouse)를 이용하였다. 미정맥 (tail vein)을 통해 생리식염수 또는 비항응고성 헤파린 (50 mg/kg)을 투여한 직후에 내독소를 복강으로 투여하거나 (1 mg/kg), 심장천자를 통해 총 혈액의 1/3 정도로 제거하여 출혈성 쇼크를 유도하여 급성폐손상을 유발하였다. 내독소 투여 또는 출혈성 쇼크 유발 1 시간 후에 흰쥐를 희생시키고 폐를 적출하였고, 폐의 염증성 변화는 사이토카인 ($TNF-{\alpha}$, MIP-2, $IL-1{\beta}$)을 측정하여 살펴보았고, 폐손상의 정도는 myeloperoxidase (MPO) assay와 wet-to-dry weight ratio를 측정하여 알아보았다. 결 과 : 내독소를 투여한 흰쥐의 폐에서 대조군의 폐에 비해 사이토카인의 발현이 증가하고 ($TNF-{\alpha}$; $196.1{\pm}10.8$ vs $83.7{\pm}18.4pg/ml$, MIP-2; $3,000{\pm}725$ vs $187{\pm}26pg/ml$, $IL-1{\beta}$; $6,500{\pm}1167$ vs $266{\pm}25pg/ml$, p<0.05, respectively), 폐의 MPO 활성이 증가하였다 ($27.9{\pm}6.2$ vs $10.5{\pm}2.3U/g$ of lung protein, p<0.05). 출혈성 쇼크를 일으킨 흰쥐의 폐에서 대조군의 폐에 비해 사이토카인의 발현은 증가되지 않았으나, MPO 발현은 증가되었다 ($16.5{\pm}3.2$ vs $10.5{\pm}2.3U/g$ of lung protein, p<0.05). 내독소 투여 또는 출혈성 쇼크에 의해 급성폐손상이 유발된 흰쥐에서 생리적 식염수를 투여하거나 비항응고성 헤파린을 투여한 군 사이에 사이토카인의 발현이나 MPO 활성에 의미있는 차이는 관찰되지 않았다. 결론 : 이상의 결과로 비항응고성 헤파린은 내독소를 투여하거나 출혈성 쇼크를 일으키고 한 시간 뒤에 측정한 흰쥐의 급성폐손상에서 의미있는 치료효과를 보이지 않았다.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.503-516
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• 2001

Background : The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. Method : In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. Results : In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. Conclusion : A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.2
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• pp.111-117
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• 2004

Clinical conditions causing the lower leg injury and pain in athletes include acute injuries which are acute compartment syndrome, acute strain injury, contusion, muscle cramps, and chronic injuries which are chronic exertional compartment syndrome, achilles tendinitis, shin splints and stress fractures. Most injuries occur during running, jumping and playing soccer. Many of these conditions relate to overuse, increased strength, training errors and environment. It is necessary to know the cause of injuries and treatment methods to prevent the sports related lower leg injuries.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.13-19
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• 2007

Purpose: We investigated the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. Materials and Methods: Between February 1999 and October 2006, we evaluated retrospectively the results of acute, isolated posterior cruciate ligament injuries treated conservatively. The subjects consisted of 21 patients. At initial and follow up visits physical examination, $KT-2000^{TM}$ arthrometer and MRI were performed to assess improvement on the knee stability and continuity of the posterior cruciate ligament. IKDC (International Knee Documentation Committee) knee scoring and quadriceps muscle strength were also checked in all population. Comparing the results of initial and follow up examinations we assessed the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. The mean follow up period was 22.7 months. Results: The posterior drawer test showed 14 cases of Grade I, 6 cases of Grade II and 1 case of Grade III progressing 18 cases of Grade I and 3 cases of Grade II. The mean difference of 5.7mm by $KT-2000^{TM}$ arthrometer was changed Into 2.7mm and the continuity of posterior cruciate ligament initially checked by 48.1% on MRI increased to 69.7%. The mean quadriceps muscle strength was grade 'Good' and mean IKDC knee score was nearly grade 'A'. Conclusion: Our study suggests that patients with acute, isolated posterior cruciate ligament injuries treated conservatively may get good clinical outcomes on clinical situation and MRI.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.119-121
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• 2007

It has been reported that there are many cases of chronic shoulder injuries of golf players, however acute injuries at dominant tide are relatively rare. In this paper, we show a case of acute rotator cuff tears at dominant side due to bad swing in middle-aged woman. We suggest that golfers should be cautious with playing at winter to prevent acute rotator cuff tears by starting with a warm-up and correcting faulty swings.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.107-115
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• 2011

Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.46-50
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• 2005

Purpose: The purpose of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute anterior cruciate ligament (ACL) injury and its tear pattern in comparison with arthroscopic finding. Materials and Methods: Sixty consecutive patients with acute ACL injury were taken NRI followed by arthroscopic examination between January 2002 and June 2004. MRI findings were reviewed according to the presence of ACL discontinuity, diffuse swelling or thickening, focal edema, collapse on distal end, and any combined tear. The pathologic findings were then confirmed arthroscopically. The diagnostic accuracy of MRI on ACL tear pattern was analyzed by obtaining its positive predictive value. Results: All fifty two cases with presence of discontinuity on MRI showed ACL rupture arthroscopically. The location of ACL tear, diffuse swelling and focal edema on MRI also corresponded with arthroscopic findings respectively. However, the diagnostic accuracy of MRI was relatively lower in the presence of other ACL patterns such as collapses and combined tear. Conclusion: Preoperative MRI findings seem to be in accordance with arthroscopic findings and is significantly accurate in detection of location and diffuse swelling and focal edema of ACL tear.

• Tuberculosis and Respiratory Diseases
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• v.54 no.5
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• pp.532-541
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• 2003

Background : Phospholipase $A_2$ ($PLA_2$) has been known to be involved in the pathogenesis of acute lung injury (ALI) including ARDS. Since doxycycline has the property of inhibiting secretory group II $PLA_2$, the therapeutic effect of doxycycline hyclate was investigated for gut ischemia/reperfusion (I/R)-induced ALI in Sprague-Dawley rats. Methods : ALI was induced in Sprague-Dawley rats by clamping of the superior mesenteric artery for 60 min, followed by 120 min of reperfusion. To confirm the pathogenetic mechanisms of this ALI associated with neutrophilic oxidative stress, we measured bronchoalveolar lavage (BAL) protein content and lung MPO, and performed cyto-chemical electron microscopy for detection of free radicals, assay of $PLA_2$ activity and cytochrome-c reduction assay. Results : In gut I/R-induced ALI rats, protein leakage, pulmonary neutrophil accumulation, free radical production and lung $PLA_2$ activity were all increased. These effects were reversed by doxycycline hyclate. Conclusion : Doxycycline appears to be effective in ameliorating the gut I/R-induced ALI by inhibiting $PLA_2$, thereby decreasing the production of free radicals from neutrophils.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.341-345
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• 2021

The infrapatellar fat pad (IPFP) is one of three fat pads located about the anterior knee. Injury in this region is relatively common. Damage to the IPFP is caused mostly by an iatrogenic injury from a surgical procedure or repeated small collision trauma. The authors experienced a case of an IPFP injury, that has not been reported in the domestic or international literature. In this case, acute IPFP separation followed by a contusion at the anterior aspect of knee in the kneeling position, confirmed using magnetic resonance imaging. The patient was fully recovered with conservative treatment.

• Applied Microscopy
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• v.33 no.1
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• pp.1-16
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• 2003

As is well known that N-nitroso-N-methylurethane (NNNMU) causes acute lung injury (ALI) in experimental animals. And ALI caused by NNNMU is very similar to ARDS in human being in its pathology and progress. In its context, we investigated the pathogenetic mechanism of ARDS associated with oxidative stress by neutrophils in Sprague-Dawley rat model of NNNMU-induced ALI. NNNMU had increased lung weight/body weight ratio (L/B ratio), lung myeloperoxidase (MPO) activity, protein content and number of neutrophils in bronchoalveolar fluid (BALF) compared with those of control rat (p<0.001, respectively). In contrast, the amount of pulmonary surfactant in BALF was decreased by NNNMU (p<0.001). Morphologically, light microscopic examination denoted pathological findings such as formation of hyaline membrane, infiltration of neutrophils and perivascular cuffing in the lungs of NNNMU-treated rats. In addition, ultrastructural changes such as the necrosis of endothelial cells, swelling and vacuolization of lamellar bodies of alveolar type II cells, and the degeneration of pulmonary surfactant were identified after treatment of NNNMU. Very interestingly, cerium chloride electron microscopic cytochemistry showed that NNNMU had increased the production of cerrous-peroxide granules in the lung, which signified the increased production of hydrogen peroxide in the lung. Collectively, we conclude that NNNMU causes acute lung leak by the mechanism of neutrophilic oxidative stress of the lung.