• Title/Summary/Keyword: 손상질환

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Antiinflammatory Effects of Heparin in Hemorrhage or LPS Induced Acute Lung Injury (출혈성 및 내독소 투여로 유발된 급성폐손상에서 heparin의 항염증효과)

  • Kim, Jae Yeol;Choi, Jae Chul;Lee, Young Woo;Jung, Jae Woo;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui
    • 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.

Generation Mechanism and Cause of Wrinkle (피부주름살의 발생기전 및 원인)

  • Chung Jin Ho
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.29 no.2 s.43
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    • pp.1-35
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    • 2003
  • 새 천년으로 들어선 2000년도부터 우리나라의 65세 이상 노령인구는 $7.1{\%}$를 차지하게 되어 본격적인 노령화사회 (UN에서 65세 이상인구가 총 인구의 $7{\%}$ 이상일 경우 노령화 사회로 정의)로 진입하였다. 평균수명의 계속적인 증가에 따라 노인 인구는 급격히 늘어날 전망이며, 따라서 노인성 질환의 발생도 늘어나게 되어 가정 또는 사회가 떠 맡아야할 경제적, 정신적 부담은 더욱 증가하게 된다. 건강하고 행복한 인생의 황혼기를 보내는 것은 인간의 권리이며 누구나 바라는 소망이다. 피부의 노화현상은 심장질환, 암 등에 못지 않게 중요하며, 노인의 경제적, 사회적 활동을 심각하게 위축시키고 있다. 피부노화를 예방하고 노인성 피부질환을 치료할 수 있는 방법을 개발함으로써 노인의 경제, 사회활동을 활동적으로 유지시킬 수 있다. 피부노화는 크게 두 종류로 나눌 수 있다. 그 한가지는 내인성노화(intrinsic aging)로서 세월이 흘러감에 따라 피할 수 없는 노화 현상을 말한다. 두번째는 광노화 (photoaging)로서 오랫동안 햇빛에 노출된 얼굴, 손등, 목뒤 등의 피부에서 관찰되는 노화현상을 말하는 것으로 내인성노화 현상과 자외선에 의한 영향이 합쳐진 결과로 발생한다. 광노화 현상은 자외선의 노출을 피하면 예방할 수 있는 피부노화 현상이다. 내인성 노화는 햇빛에 노출되지 않은 피부에서 주로 관찰된다. 임상적 특징은 비교적 경미하며, 잔주름, 피부건조증, 탄력감소 등을 들 수 있다. 그러나 광노화의 임상적 특징은 내인성 노화에 비하여 심하고, 일찍부터 관찰된다. 내인성 노화에 비하여 굵고 깊은 주름이 발생하며, 잔주름도 많이 발생한다. 햇빛에 노출된 피부에 불규칙한 색소침착이 발생하며 일광흑자 (solar lentigo) 등의 색소질환이 증가한다. 피부가 매우 거칠고, 건조해지며, 탄력성이 감소하여 심한경우 피부가 처지게 된다. 피부노화의 대표적인 증상은 주름살이며, 아직까지 그 발생기전에 대하여는 여러 가지 학설이 있으나 정확히 알려져 있지 않다. 피부에 존재하는 교원질, 탄력섬유등 기질단백질의 손상이 피부 주름살의 주 원인으로 알려져 있다. 또한 얼굴에 존재하는 근육의 분포와 움직임, 유전적 소인, 자외선, 흡연, 폐경, 산화적 손상, 열 등 여러 원인이 복합적으로 작용할 것으로 생각된다. 피부주름살의 원인을 밝히고, 원인인자가 피부주름살을 초래하는 분자생물학적 기전을 이해함으로써 주름살을 예방하고 치료할 수 있는 새로운 방법을 개발할 수 있다.

Differences in Medical Care Utilization by Regional Economic Status (지역 소득수준에 따른 의료이용의 차이)

  • Lim, Nam Gu
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.459-467
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    • 2013
  • The purpose of this study was to identify the differences in medical care utilization by regional economic status using the National Hospital Discharge Patients Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized 5 quintiles according to their financial self-reliance ratio. The main results are as follows. First, low economic region has high age-standardized admission rate and standardized mortality rate. Second, of 16 major diseases, cerebrovascular and heart diseases, lung cancer, and stomach cancer reported greater changes in standardized mortality rate by regional economic status. Third, the rate of admission via emergency room in low economic region is higher than that of high economic region. Lastly, in the major illnesses, lower economic status led to an increase in average length of stay. Therefore, In order to bridge the gap in health inequality across regions, a regional medical policy tailored for each region and characteristics of the economic status should be established.

Risk Factor Analysis for Spinal Cord and Brain Damage after Surgery of Descending Thoracic and Thoracoabdominal Aorta (하행 흉부 및 흉복부 대동맥 수술 후 척수 손상과 뇌손상 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Baek Man-Jong;Jung Sung-Cheol;Kim Chong-Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.440-448
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    • 2006
  • Background: Surgery of descending thoracic or thoracoabdominal aorta has the potential risk of causing neurological injury including spinal cord damage. This study was designed to find out the risk factors leading to spinal cord and brain damage after surgery of descending thoracic and thoracoabdominal aorta. Material and Method: Between October 1995 and July 2005, thirty three patients with descending thoracic or thoracoabdominal aortic disease underwent resection and graft replacement of the involved aortic segments. We reviewed these patients retrospectively. There were 23 descending thoracic aortic diseases and 10 thoracoabdominal aortic diseases. As an etiology, there were 23 aortic dissections and 10 aortic aneurysms. Preoperative and perioperative variables were analyzed univariately and multivariately to identify risk factors of neurological injury. Result: Paraplegia occurred in 2 (6.1%) patients and permanent in one. There were 7 brain damages (21%), among them, 4 were permanent damages. As risk factors of spinal cord damage, Crawford type II III(p=0.011) and intercostal artery anastomosis (p=0.040) were statistically significant. Cardiopulmonary bypass time more than 200 minutes (p=0.023), left atrial vent catheter insertion (p=0.005) were statistically significant as risk factors of brain damage. Left heart partial bypass (LHPB) was statistically significant as a protecting factor of brain (p=0.032). Conclusion: The incidence of brain damage was higher than that of spinal cord damage after surgery of descending thoracic and thoracoabdominal aorta. There was no brain damage in LHPB group. LHPB was advantageous in protecting brain from postoperative brain injury. Adjunctive procedures to protect spinal cord is needed and vigilant attention should be paid in patients with Crawford type II III and patients who have patent intercostal arteries.

Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury (스포츠 손상과 비스포츠 손상에 의한 상부 관절와 순 전후방(SLAP) 병변의 비교)

  • Lee, Kwang-Won;Lee, Seung-Hun;Yang, Dong-Hyun;Kam, Byoung-Sup;Choy, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.175-182
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    • 2007
  • Purpose: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a non-sports-induced injury. Materials and Methods: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. Results: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). Conclusion: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.

Alterations of Calcium-binding Protein Immunoreactivities in the Hippocampus Following Traumatic Brain Injury (외상성 뇌손상 후 해마내 칼슘결합단백질 면역반응의 변화)

  • Oh, Yun-Jung;Kim, Baek-Seon;Park, Dae-Kyoon;Park, Kyung-Ho;Ko, Jeong-Sik;Kim, Duk-Soo
    • Applied Microscopy
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    • v.41 no.4
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    • pp.235-248
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    • 2011
  • Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adults and is a major risk factor for the development of posttraumatic epilepsy (PTE). Recent studies have provided significant insight into the pathophysiological mechanisms underlying the development of epilepsy. Although the link between brain trauma and epilepsy is well recognized, the complex biological mechanisms that result in PTE following TBI have not been fully elucidated. Therefore, this study investigated in order to identify whether or not the abnormal expression of calcium-binding proteins in the lesioned hippocampus plays a role in neuronal damage by brain trauma and whether or not the expressions may change in the contralateral hippocampus during the adaptive stage as early time point following TBI. During early time point following TBI, both parvalbumin (PV) and calbindin D-28k (CB) immunoreactivities were decreased with in the lesioned hippocampus. However, these expressions were recovered to control levels as depend on time courses. On the other hand, PV immunoreactivity in contralateral hippocampus was transiently reduced as compared to the control levels, whereas CB expression was unchanged. These findings indicate that the alterations of the calcium-binding proteins, especially PV and CB, may contribute to the neuronal death and/or damage induced by abnormal inhibitory neurotransmission at early time period following brain trauma and the development of epileptogenesis in patients with traumatic brain injury.

Use of Ultrasonography for Foot and Ankle Sports Injuries (족부 및 족관절 스포츠 손상에서 초음파의 활용)

  • Moon, Youngseok;Kim, Chong-bin;Ahn, Jae Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.402-410
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    • 2019
  • Sports injuries of the foot and ankle are commonly encountered in clinical practice. Ultrasound is very useful for the diagnosis of such injuries, because it is more economical, readily accessible, and can perform a dynamic study compared to magnetic resonance imaging. This review focused on the sonographic features of common foot and ankle sports injuries.

Aortic Stenosis in Systemic Lupus Erythematosus Syndrome (전신성 흥반성 낭창에 동반된 대동맥 판막 협착증의 수술 1에)

  • 최주원;김우식;고행일;강윤경;김용인
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.613-616
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    • 2004
  • Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.

The Etiological Relationship between Autoimmune Diseases and HERVs (자가면역 질환과 HERV의 병인학적 관계)

  • 정아람;김희수
    • Journal of Life Science
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    • v.13 no.2
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    • pp.236-240
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    • 2003
  • Human immune system acts to protect the host from infectious agents (bacteria, viruses, fungi, parasites) and from other noxious insults. However, immune diseases are sometimes caused by the impairment of immune system leading to abnormal immune response. Especially, autoimmune diseases are very diverse and often bring serious damage Although many active investigations to reveal the etiological mechanisms concerning the autoimmune diseases, it still remains unclear. After proposing a HERV (human endogenous retrovirus) as a candidate autoimmune gene in type I diabetes, it is newly attracting our attention for demonstrating that an endogenous human retroviral superantigen can be transactivated by interferon-$\alpha$ (IFN- $\alpha$) or Epstein-Barr virus (EBV) infection. These might provide us with powerful clues to carry out further studies to overcome autoimmune diseases as the presentation of a relatively clear connection between endogenous superantigens and human diseases.

특집 : 미세혈관 합병증 - 미세혈관 합병증에 의한 당뇨병성 신증 - 투석, 신장이식 불러오는 만성신장병

  • Song, Jun-Ho
    • The Monthly Diabetes
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    • s.259
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    • pp.17-21
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    • 2011
  • 당뇨병성 신증은 당뇨병의 대표적인 합병증으로 지속적인 고혈당으로 인하여 신장에 있는 미세혈관이 손상을 받아 오랜 시간에 걸쳐 신장의 기능부전을 초래하는 합병증을 말한다. 현재 국내에서 말기신부전증을 일으키는 가장 흔한 질환이 당뇨병이다.

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