• 대한영상의학회지
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• 제82권5호
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• pp.1328-1333
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• 2021

쇼크 갑상샘(shock thyroid)은 CT 저혈압 복합체(CT hypotension complex)의 드문 발현 중 하나이며, 쇼크 상황에서 CT상 갑상샘과 갑상샘 주위에 부종이 관찰될 때 진단 가능하다. 쇼크 갑상샘은 비보상성 쇼크를 시사하는 유용한 CT 징후일 수 있다. 이 상태는 가역적이며 적절한 치료를 통해 빠르게 회복될 수 있다. 저자들은 쇼크 갑상선과 일치하는 CT 소견을 보인 패혈성 쇼크 상태의 84세 여자 환자의 증례를 보고한다. 이와 더불어, 문헌에 보고된 임상 및 영상 소견을 함께 고찰하고자 한다. 본 증례는 쇼크 갑상선이 임박한 혈류역학적 불안정성의 초기 지표가 될 수 있으며, 중요한 예후 및 치료적 함의가 될 수 있음을 강조한다.

• Journal of Medicine and Life Science
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• 제17권3호
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• pp.80-85
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• 2020

Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.

• BMB Reports
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• 제33권2호
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• pp.112-119
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• 2000

Three kinds of serine protease inhibitors, members of the Bowman-Birk trypsin inhibitor, were purified from Dolichos lablab seeds and named Dolichos protease inhibitor 1, 2 and 3 (DI-1, DI-2 and DI-3), respectively. Each inhibitor showed a single band with gel mobility at around 15.9, 12.1 and 14.6 kDa on 20% SDS-PAGE under reducing conditions. To characterize inhibitory specificity, the inhibition constant (Ki) for these inhibitors was measured against several known serine proteases. All three Dolichos protease inhibitors (DI-1, DI-2 and DI-3) inhibited the activity of trypsin and plasmin, but had no effect on thrombin and kallikrein (either for human plasma kallikrein or for porcine pancreas kallikrein). DI-1 inhibited chymotrypsin most effectively (Ki = $3.6{\times}10^{-9}\;M$), while DI-2 displayed inhibitory activity for porcine pancreatic elastase (Ki = $6.2{\times}10^{-8}\;M$). Pre-treatment of the 33 mg/kg of DI-mixture (active fractions from $C_{18}$ open column chromatography that included DI-1, DI-2 and DI-3) inhibited the induction of pseudomonal elastase-induced septic hypotension and prevented an increase in bradykinin generation in pseudomonal elastase-treated guinea pig plasma. Also, the increase of kallikrein activity, by injection of pseudomonal elastase, was inhibited by the pretreatment of the DI-mixture in a guinea pig. Since the DI-mixture had no inhibitory effect on kallikrein activity when Z-Phe-Arg-MCA was used as a substrate in vitro, its inhibitory activity in the pseudomonal elastase-induced septic hypotension model might not be due to a direct inhibition of plasma kallikrein in the activation cascade of the Hageman factor and prekallikrein system. These results suggest that the Dolichos DI-mixture might be used as an inhibitor in pathogenic bacterial protease-induced septic shock.

• Journal of Chest Surgery
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• 제35권3호
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• pp.227-230
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• 2002

혈관확장성 쇼크(Vasodilatory shock)는 혈관마비 증후군(vasoplegic syndrome), 심폐바이패스후 혈관마비(post-cardiopulmonary bypass vasoplegia)라고도 불리며, 개심술 직후 나타나는 저혈압, 빈맥, 정상 또는 약간 증가한 심박출량 및 체혈관저항 감소 등을 특징으로 하며, 일반적인 수액공급이나 카테콜아민 혈관수축제(cathecolamine vasopressor)에 대한 반응이 적거나 거의 없기 때문에 개심술후 높은 이환율 및 사망율을 나타내는 상태를 말한다. 저자들은 개심술후 혈관확장성 쇼크(vasodilatory shock)로 진단되는 3명의 환자들에서 저용량의 아르기닌 바소프레신(AVP)를 사용하여 성공적으로 치료하였기에 관련된 문헌 고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제8권1호
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• pp.114-117
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• 2001

저자들은 A군 연구균 감염에 의한 독성 쇼크양 증후군으로 저혈압, 간 기능 장애, 신 기능 장애, 혈소판 감소증을 보인 환아를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한약리학회지
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• 제2권1호
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• pp.99-109
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• 1966

It has been known that the pronounced hypotension resulting from hemorrhage gives rise to compensatory stimulation of the adrenosympathetic system, which leads to an increase of liberation of catecholamines from sympathetic nervous system and adrenal medulla. It is obvious, therefore, that numerous physiological and biochemical changes during the hemorrhagic hypotention might be mediated through the increased liberation of catecholamines. Although an extensive studies have been reported on changes of protein and carbohydrate metabolism in hemorrhagic shock a few studies on the changes of lipid metabolism have been reported. Levenson(1961) observed a marked increase of serum lipids content during hemorrhagic shock and also noticed a marked elevation of serum free fatty acids. He suggested that these effects were due to mobilization and accelerated metabolic breakdown of lipids which might be resulted by sympathetic stimulation as a cause. To elucidate the mechanism of this, author studied the change of serum free fatty acids and blood sugar with relation to catecholamines during experimentally induced hemorrhagic shock in dog. Healthy male mongrel dogs weighing approximately 15kg were used. Under the general anesthesia with pentobarbital, rapid hemorrhage was produced from the femoral artery maintaining blood pressure level of 40 mmHg measured by the manometer connected with the opposite femoral artery throughout the experiment. Serum free fatty acids(FFA) and blood sugar were measured by the methods of Dole(1956) and Folin-wu,(1920) respectively. Tissue catecholamine was measured by Shore and Olin method(1958) using Aminco-Bowman spectrophotofluorometer.

• 대한임상독성학회지
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• 제2권1호
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• pp.41-44
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• 2004

With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

• Clinical and Experimental Pediatrics
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• 제57권12호
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• pp.538-541
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• 2014

Varicella is usually considered to be a benign disease in healthy children; however, serious complications can occur such as necrotizing fasciitis and toxic shock syndrome. We describe a 38-month-old girl with necrotizing fasciitis and streptococcal toxic shock syndrome following varicella. She was previously healthy and vaccinated against varicella at 12 months of age. She had been diagnosed with varicella three days prior to presenting at our facility; she developed fever, vomiting, and painful swelling on her left flank. Her skin lesions worsened, she became lethargic, and had episodes of hypotension and coagulopathy. Necrotizing fasciitis on the left abdominal wall, buttocks, and left thigh was diagnosed by magnetic resonance imaging, and group A Streptococcus was isolated from a tissue culture. She was diagnosed as necrotizing fasciitis and streptococcal toxic shock syndrome, and successfully treated with repeated surgical debridement and fasciotomy, in addition to intensive antibiotics. Our experience suggests that necrotizing fasciitis in patients with varicella should be considered to be a rare complication even with widespread vaccine use. Early diagnosis and intensive treatment are required to prevent a fatal outcome.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.203.2-204
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• 2003

Nitric oxide (NO) produced in large amounts by inducible nitric oxide synthase (iNOS) is known to be responsible for the vasodilation and hypotension observed in septic shock and inflammation. Inhibitors of iNOS, thus, may be useful candidate for the treatment of inflammatory diseases accompanied by the overproduction of NO. We prepared alcoholic extracts of woody plants and screened the inhibitory activity of NO production in lipopolysaccharide (LPS)-activated macrophages after the treatment of these extracts. (omitted)

• 생명과학회지
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• 제12권5호
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• pp.528-534
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• 2002

우리나라에서 식용으로 뿐만아니라 한방재료로 널리 사용되고 있는 녹두(vigna radiata L. wilczek) 로부터 trypsin inhibitor (Mung bean trypsin inhibitor, MBTI)를 분리정제하여 그 특성을 조사하였다 또한 병태동물모델 즉, septic shock induced guinea pig model을 이용하여 MBTI의 약물학적 효과를 평가하였다. MBTI의 분리 및 정제과정은 Sephadex C-50 chromatography, DEAE-celluloseion exchange chromatography 및 trypsin affinity column 을 차례로 이용하였다. 정제한 MBTI는 전기영동 및 아미노산 서열분석결과 분자량 약 8,000 Da 의 BBI-type (Bowman-birk inhibitor type)임을 알 수 있었으며 이들의 생화학적 특성을 구명하였다. 또한 pseudomonal elastase로 유도된 septic shock guinea pig model에서 MBTI 10 mg/kg를 전처치한 결과 hypotention shock 유발이 억제됨을 알 수 있었다.