• Journal of Trauma and Injury
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• v.33 no.3
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• Journal of Ginseng Research
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• v.22 no.3
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• pp.181-187
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• 1998

Nitric Oxide (NO), derived from L-arginine, is produced by two types (constitutive and inducible) of nitric oxide synthase (NOS). The NO produced in large amounts by the inducible NOS is known to be responsible for the vasodilation and hypotension observed in septic shock. We have found three polyacetylene compounds which inhibited the production of NO in LPS-activated RAW 264.7 cells. Their structures were identified as panauynol, ginsenoyne A and PQ-6 by the spec- troscopic analysis (IC50 values were 32.3 $\mu$M, 2.3 $\mu$M, 1.5 $\mu$M, respectively). These polyacetylenes may be useful candidates for the development of new drug to treat endotoxemia and inflammation accompanied by the overproduction of NO.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.1
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• pp.167-171
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• 2004

This study investigated a HSP70 expression of Puerariae Radix in cerebral ischemia. The global cerebral ischemia was induced by bilateral common carotid arteries occlusion under hypotension (40 mmHg) in Sprague-Dawley rats. After the treatment of Puerariae Radix extract, the heat shock protein 70 (HSP70) expressions were measured immunohistochemically. The upregulation of HSP70 expression in hippocampal regions resulted by cerebral ischemia. Then Puerariae Radix treatment demonstrated significant decrease of HSP70 expressions in CA1 region and dentate gyrus of the hippocampus as compared with control group. These results suggested that Puerariae Radix reveals the neuroprotective effect through the control of noxious stress stimulations to neurons.

• YAKHAK HOEJI
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• v.42 no.5
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• pp.540-543
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• 1998

The nitric oxide (NO) produced in large amounts by inducible nitric oxide synthase is known to be responsible for the vasodilation and hypotension observed in septic shock. We have found that 8-epi-xanthatin from Xanthium strumarium L. inhibited the production of NO in LPS-activated RAW 264.7 cells ($IC_{50}$ value was 1.5 ${\mu}$M). This activity was resulted from the suppressing of inducible nitric oxide synthase enzyme expression.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.88-92
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• 2005

Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.

• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.165-173
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• 2019

Purpose: Norepinephrine (NE) is a neurotransmitter of the sympathetic nervous system. It is used for treating hypotension on distributive shock, central nervous system injury, or sepsis. There are several reports that state that alcohol suppresses vasoconstriction by NE. Thus, our hypothesis is that the effect of NE is reduced in alcohol-drinking patients with distributive shock. We investigated whether alcohol suppresses NE-induced contraction and aimed at finding a solution to this problem. Methods: For this study, we used the aorta from male Sprague-Dawley rats (9-11 weeks) and an isometric contraction system. Results: Our results showed that alcohol suppresses NE contraction and does not affect epinephrine induced a contraction. Moreover, in the presence of alcohol, a 7:3 mixture of NE and epinephrine induced a contractile force similar to that induced by NE under normal conditions. Conclusion: We found that the vasoconstrictive force of NE decreased in the blood vessels in which alcohol was present, which was not because endothelial cells. The reduced contractile force was most similar to that induced by a 7:3 mixture of NE and epinephrine.

• The Korean Journal of Physiology and Pharmacology
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• v.10 no.2
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• pp.85-94
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• 2006

A splanchic artery occlusion for 90 min followed by reperfusion of the mesenteric circulation resulted in a severe form of circulatory shock, characterized by endothelial dysfunction, severe hypotension, marked intestinal tissue injury, and a high mortality rate. The effect of defibrotide, a complex of single-stranded polydeoxyribonucleotides having antithrombotic effect, was investigated in a model of splanchnic artery occlusion (SAO) shock in urethane anesthetized rats. Occlusion of the superior mesenteric artery for 90 min produced a severe shock state, resulting in a fatal outcome within 120 min of reperfusion in many rats. Defibrotide (10 mg/kg body weight) 10 min prior to reperfusion significantly improved mean arterial blood pressure in comparison to vehicle treated rats (p＜0.05). Defibrotide treatment also significantly attenuated in the increase of plasma amino nitrogen concentration, intestinal myeloperoxidase activity, intestinal lipid peroxidation, infiltration of neutrophils in intestine and thrombin induced adherence of neutrophils to superior mesentric artery segments. Superoxide anion and hydrogen peroxide production in $1{\mu}M$ formylmethionylleucylphenylalanine (fMLP)-activated PMNs was inhibited by defibrotide in a dose-dependent fashion. Defibrotide effectively scavenged hydrogen peroxide, but not hydroxyl radical. Treatment of SAO rats with defibrotide inhibited tumor necrosis factor-${\alpha}$, and interleukin-1${\beta}$ productions in blood in comparison with untreated rats. These results suggest that defibrotide partly provides beneficial effects by preserving endothelial function, attenuating neutrophil accumulation, and antioxidant in the ischemic reperfused splanchnic circulation

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.112-116
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• 2017

Kawasaki disease (KD) is an acute febrile mucocutaneous lymph node syndrome that commonly presents with stable hemodynamic status during the acute phase. An 8-year-old boy initially presented with severe hypotension and acute kidney injury. He was placed in the intensive care unit and was diagnosed with KD. Observed clinical features were defined as KD shock syndrome. His coronary artery was dilated during the subacute phase. Furthermore, he was given anti-hypertensive medications, owing to hypertension as an unusual complication of KD. We knew the importance of monitoring for blood pressure considering vasculitis as an aspect of the main pathogenesis of KD.

• The Korean Journal of Physiology
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• v.9 no.1
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• pp.33-37
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• 1975

Adult rabbits were anesthetized with nembutal, 30 mg/kg. Carotid artery and jugular vein were exposed surgically and cannulated with polyethylene tubing. Arterial blood pressure was recorded via pressure transducer on the physiograph and $100{\mu}g/ml$ of histamine solution was infused through the jugular vein by using the constant infusion pump with a rate of 0.92 ml/min or 1.40 ml/min. Mean arterial blood pressure was maintained at $40{\sim}70 mmHg$ and hypotension was kept for 2 hours. After the termination of this period, blood was taken and osmotic fragility was mea sured immediately. Also, every sample of normal blood and shocked blood was incubated for 1 hour or 2 hours at $37^{\circ}C$ in order to see whether or not there was some influence of incubation. Furthermore to clarify which component was responsible for the change on the fragility, the mixtures of normal blood cells with shocked plasma and shocked blood cells with normal plasma were also incubated at $37^{\circ}C$ for one or two hours and fragility in such cases was measured. The data obtained were analysed by probit-plot method and the concentration of saline solution at which the hemolysis started to occur, 50% of blood cells were hemolysed and that at which the red blood cells hemolysed completely were determined. The values for the blood of hypotension stage were compared with those of the control blood. The results obtained were as fellows: 1. Osmotic fragility of red blood cell was increased in hypotensive state induced by histamine. 2. The differences of osmotic fragility after two hours of incubation were negligible both in normal blood and in that of hypotensive state. 3. Osmotic resistance of normal red blood cell incubated in shock plasma was less than that of shock red blood cell incubated in normal plasma. It was suggested that plasma in hypotensive state caused by histamine might be primarily responsible for the alteration of red blood cell fragility.