• The Korean Journal of Physiology and Pharmacology
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• 제26권2호
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• pp.95-111
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• 2022

Chronic obstructive pulmonary disease (COPD) is an important healthcare problem worldwide. Often, glucocorticoid (GC) resistance develops during COPD treatment. As a classic hypoglycemic drug, metformin (MET) can be used as a treatment strategy for COPD due to its anti-inflammatory and antioxidant effects, but its specific mechanism of action is not known. We aimed to clarify the role of MET on COPD and cigarette smoke extract (CSE)-induced GC resistance. Through establishment of a COPD model in rats, we found that MET could improve lung function, reduce pathological injury, as well as reduce the level of inflammation and oxidative stress in COPD, and upregulate expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), multidrug resistance protein 1 (MRP1), and histone deacetylase 2 (HDAC2). By establishing a model of GC resistance in human bronchial epithelial cells stimulated by CSE, we found that MET reduced secretion of interleukin-8, and could upregulate expression of Nrf2, HO-1, MRP1, and HDAC2. MET could also increase the inhibition of MRP1 efflux by MK571 significantly, and increase expression of HDAC2 mRNA and protein. In conclusion, MET may upregulate MRP1 expression by activating the Nrf2/HO-1 signaling pathway, and then regulate expression of HDAC2 protein to reduce GC resistance.

• Journal of Chest Surgery
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• 제13권3호
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• pp.212-218
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• 1980

A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.389-401
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• 2021

본 연구는 질병관리청이 퇴원한 환자를 대상으로 조사 보고한 퇴원손상심층조사 결과 중 충북지역에 거주하는 퇴원환자의 특성을 파악하여 충청북도 지역 주민의 건강증진계획수립을 위한 기초자료로 제시하고자 시도되었으며 2013년부터 2017년까지 100병상 이상의 병원에서 퇴원한 환자를 대상으로 인구·사회학적 특성, 의료기관이용 특성, 의료이용 특성, 질병 특성을 파악하였다. 2013년부터 2017년까지 입원 후 퇴원한 환자 중 보정 값을 적용하여 산출한 총 환자는 1,656,590명으로 추정되었으며 퇴원율(인구 10만은 21,089명이었고 2016년 전국 평균 퇴원율 13,882명보다 높았다. 이 기간 동안 퇴원율이 증가한 지역은 괴산, 영동, 보은, 옥천, 증평, 음성군으로 주로 농촌지역이었으며, 서울을 포함한 타 지역 병원에서 퇴원한 환자는 서울 지역은 감소하였으나 인천, 경기, 대전, 충남지역은 증가하였다. 충북지역 주민의 악성종양으로 인한 퇴원율은 폐암(기관, 기관지암 포함)이 가장 높았으며, 주 진단별 퇴원율은 호흡기계통 질환이 가장 많았고, 퇴원율이 증가하고 있는 감염, 순환기계통, 소화기계통, 비뇨생식계통, 근골격계통질환의 퇴원율을 낮추기 위한 노력이 필요함을 알 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.775-785
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• 1999

목 적 : 폐섬유화증 연구의 동물 실험 모델로 paraquat 중독이 자주 이용되고 있다. 본 연구에서는 paraquat로 유발된 폐섬유화에서 폐섬유화의 정도에 따른 Et-1의 변화를 면역조직화학적으로 관찰하고 스테로이드나 cyclophosphamide의 치료에 따른 Et-1의 변화를 관찰하여 폐섬유화과정에 Et-1의 역할을 밝히고자 하였다. 대상 및 방법 : 수컷 Hartley 기니픽을 4군으로 나누어 실험하였다. I 군은 paraquat를 투여하지 않은 군이었고, II 군용 paraquat를 폐에 주입한 후 cyclophosphamide와 methylprednisolone을 투여한 군이었고 III 군은 paraquat를 폐에 주입한후 methylprednisolone만 투여하였고, IV 군은 paraquat만 투입하였다. I 군을 제외한 나머지 군에서는 PE50 polyethylene tube를 이용하여 paraquat를 우측 폐로 주입하였다. 섬유화의 정도는 H-E와 Masson's trichrome 염색을 통해서 섬유아세포의 침윤정도와 교원질의 침윤정도로 판단하였고, Endothelin-1 면역조직화학염색을 통해서 세포의 활성도를 평가하였다. 각 군의 평균값은 median 값으로 표시하였고, 각 군간의 비교는 Kruskal-Wallis oneway analysis로 시행하였다. 결 과 : 1. Paraquat에 의한 폐 섬유화 Cyclophosphamide나 methylprednisolone의 치료로 paraquat에 의한 섬유아세포의 증식이 억제되었으나 통계학적 의미는 없었다. 교원질의 침윤은 cyclophosphamide와 methylprednisolone을 병합한 경우 paraquat만 투여한 군보다 의미있게 감소하였다(p<0.05). 2. Endothelin-1에 대한 면역조직화학염색 Paraquat의 투여로 발생된 폐섬유화증에 대한 치료의 종류에 따른 Et-1의 발현은 methylprednisolone의 단독 투여로도 폐포의 대식세포를 제외한 기관지 상피세포, 제2형 폐포세포, 혈관 내피세포 및 섬유아세포 등에서 Et-1의 발현이 감소하는 경향을 보였으며, cyclophosphamide와 methylprednisolone을병합한 군에서는 모든 세포에서 의미있게 Et-1의 발현이 감소하였고, 특히 폐포 대식세포와 섬유아세포에서는 methylprednisolone의 단독 투여한 III 군보다 의미있게 감소하였다(Table 2, p<0.05).

• Environmental Analysis Health and Toxicology
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• 제28권
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• pp.7.1-7.9
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• 2013

Objectives We investigated the particle mass size distribution and chemical properties of air pollution particulate matter (PM) in the urban area and its capacity to induce cytotoxicity in human bronchial epithelial (BEAS-2B) cells. Methods To characterize the mass size distributions and chemical concentrations associated with urban PM, PM samples were collected by a 10-stage Micro-Orifice Uniform Deposit Impactor close to nearby traffic in an urban area from December 2007 to December 2009. PM samples for in vitro cytotoxicity testing were collected by a mini-volume air sampler with $PM_{10}$ and $PM_{2.5}$ inlets. Results The PM size distributions were bi-modal, peaking at 0.18 to 0.32 and 1.8 to $3.2{\mu}m$. The mass concentrations of the metals in fine particles (0.1 to $1.8{\mu}m$) accounted for 45.6 to 80.4% of the mass concentrations of metals in $PM_{10}$. The mass proportions of fine particles of the pollutants related to traffic emission, lead (80.4%), cadmium (69.0%), and chromium (63.8%) were higher than those of other metals. Iron was the dominant transition metal in the particles, accounting for 64.3% of the $PM_{10}$ mass in all the samples. We observed PM concentration-dependent cytotoxic effects on BEAS-2B cells. Conclusions We found that exposure to $PM_{2.5}$ and $PM_{10}$ from a nearby traffic area induced significant increases in protein expression of inflammatory cytokines (IL-6 and IL-8). The cell death rate and release of cytokines in response to the $PM_{2.5}$ treatment were higher than those with $PM_{10}$. The combined results support the hypothesis that ultrafine particles from vehicular sources can induce inflammatory responses related to environmental respiratory injury.

• Tuberculosis and Respiratory Diseases
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• 제55권5호
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• pp.516-521
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• 2003

Aspergillus 종 특히 Aspergillus niger는 폐조직에 칼슘 옥살산 결정(oxalate crystal)을 침착시키면서 페손상을 초래하는 것으로 보고되고 있다. 저자들은 Aspergillus niger에 의해 생성된 옥살산염(oxalaic acid)에 의해 환자의 폐손상이 야기되고 그 결과 대량객혈이 발생한 것으로 추정되는 증례를 경험하였기에 보고하는 바이다. 과거에 식도암파 폐결핵으로 치료받은 적이 있는 46세 남자 환자가 고열과 간헐적 객혈, 그리고 흉부 방사선상 공동을 갖는 폐의 이상 음영을 주소로 내원하였다. 입원 후 항생제와 항결핵 치료를 병합하였지만 고열이 지속되었다. 객담 검사상 Aspergillus niger가 반복적으로 배양되어 정맥내 amphotencin B를 주입을 시작하였고, 이후 환자는 간헐적인 객혈은 지속되었으나 열은 소실되었다. 경기관지폐생검으로 얻은 조직에서 균은 동정되지 않았으나, 수많은 칼슘 옥살산 결정과 주위로 급성 염증성 삼출물이 관찰되었다. 환자는 입원 63일째 약 800ml 가량의 대량 객혈이 발생하였고, 기관지 동맥 색전술을 시행하였으나 출혈이 지속되었고 결국 호흡부전으로 사망하였다.