• Title/Summary/Keyword: Multiorgan

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Baicalin Ameliorates Dysimmunoregulation in Pristane-Induced Lupus Mice: Production of IL-6 and $PGE_2$ and Activation of T cells

  • Chae, Byeong-Suk
    • Natural Product Sciences
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    • v.17 no.4
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    • pp.354-362
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    • 2011
  • Systemic lupus erythematosus (SLE) is a systemic inflammatory autoimmune disease characterized by abnormalities in T cell immunoregulation and hyperreactivity of B cells, leading to autoantibody production and multiorgan injuries. We investigated the effect of baicalin on aberrant immunoregulation in pristane-induced lupus mice. Mice received i.p. a single injection of 0.5 ml of pristane or PBS, and approximately 3 months later, were used as a pristane-induced lupus model or healthy controls. The pristane-induced lupus mice and healthy mice were randomly divided into three groups: healthy mouse group (healthy control), pristane-primed lupus control group (lupus control), and baicalin (BAC)-treated pristane-primed lupus mouse group (BAC-treated lupus). The pristane-induced lupus mice and healthy mice were administrated orally with BAC 50 mg/kg or PBS once in a day for 10 ds. These results demonstrated that levels of serum IL-6, LPS-induced production of IL-6, $PGE_2$ and NO by macrophages, $PGE_2$-stimulated production of IL-6 by macrophages and IFN-${\gamma}$ by thymocytes, and an overexpression of splenic NKT cells and CD69+CD4+ T cells were downregulated in BAC-treated lupus compared to lupus control, while reduced apoptosis of splenic CD4+ T cells were upregulated. Therefore, these findings suggest that BAC may attenuate autoimmunity and disease activity in lupus via downregulation of aberrant activation of T cells and inhibition of overproduction of IL-6 and $PGE_2$ in pristane-induced lupus mice.

Bamboo Culm Extract Downregulated Activation of NKT- and B- cells and Production of IL-6 in Pristane-Induced Lupus Mice

  • Chae, Byeong-Suk;Park, Byung-Hyun
    • Natural Product Sciences
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    • v.15 no.4
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    • pp.222-228
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    • 2009
  • Lupus is characterized by immunoregulatory abnormalities between T- and B-cells leading to autoantibody production and multiorgan injuries. We investigated whether bamboo culm extract (BC) ameliorates aberrant activation of T cells and B cells and attenuate production of IL-6 in pristane-induced lupus mice. Lupus was induced by i.p. a single injection of 0.5 ml of pristane in female BALB/c mice, which, later about 4 months, were used as a lupus model. The pristane-induced lupus mice and healthy mice were injected i.p. with BC 5 ${\mu}l$/kg or PBS once a day for 3 weeks. These results demonstrated that BC significantly decreased levels of serum and BAL IL-6 and production of IL-6 by macrophages with/without LPS, and downregulated expression of NKT cell and CD86+ CD45R/B220+, but not CD80+CD45R/B220+ and CD69+CD4+ in the splenocytes in pristaneinduced lupus mice. Moreover, BC greatly increased Con A-stimulated production of IL-6, IL-10 and IFN-${\gamma}$ by splenocytes obtained from pristane-induced lupus mice. Therefore, our findings suggest that BC may ameliorate lupus pathogenesis in pristane-induced lupus mice via downregulation of aberrant activation of NKT cells and B cells and inhibition of production of IL-6.

Experiment for Animal Heart Transplantation (동물에서의 심장동종이식에 관한 실험)

  • 서경필
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.1-9
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    • 1989
  • We have performed one case of autotransplantation and 11 cases of orthotopic homotransplantation using Korean mongrel dogs, and have scrutinized the hematologic and hemodynamic results. The mean weight of recipients was 15.42*1.2kg and varied from 14kg to 20kg. During the operation, anesthesia and other technical procedures including cardiopulmonary bypass were similar to the usual methods in human cardiac transplantation. It was found that the hematologic values were similar to those of human beings although there was wide variance. Hemodynamically the mean systolic and diastolic arterial pressures were 165.0* 12.9 mmHg and 100.0 *11.8 mmHg respectively, and the mean heart rate was 155.5*23.5/min. All cases died within 24hrs, and the mean survival in all but 6 cases where operative death occurred was 6.83*8.01 hrs[range 2-21 hrs]. The major causes of deaths were bleedings in 7 cases, failure to protect myocardium during the procedure in 2 cases, pulmonary edema in 1 case and multiorgan failure in 2 cases. From the above results we concluded that the most frequent complication was bleeding, and the cardiopulmonary bypass flow of 50-500ml/kg min was not suitable to the dog in CPB. In further experiment after this study, the technical and the bypass flow was increased. Bleeding was not significant. And the immunosuppresion during operation and postoperative period was tried.

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The Clinical Analysis of Traumatic Diaphragmatic Iinjuries (외상성 횡경막 손상의 임상적 분석)

  • 안성국
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1167-1173
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    • 1995
  • We evaluated fifty three cases of traumatic diaphragmatic injuries that we have experienced from Jan.1973 to Oct.1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 39:14 with male dominence. The traumatic diaphragmatic injuries were due to blunt trauma in 37[Left 22, Right 15 cases and penetrating trauma in 16[Left 9, Right 7 cases. In blunt trauma, Preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients[72% , and in penetrating trauma, 14 patients[88% . Among 37 in blunt traumas, 22[58% cases, and among 16 in penetrating traumas, 13[88% cases were operated within 24 hours. The most common herniated abdominal organ in the thorax was stomach[14/53 . The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated. Hospital mortality [including not operated patients[3 was 17%[9/53 and the causes of death were intracranial hematoma[1 , hypertensive encephalopathy[1 and asphyxia[1 , and among operated patients[6 , combined head injury[2 , multiorgan failure[2 , hypovolemic shock[1 , and pulmonary edema & renal failure[1 . All deaths had related to the severity of associated injuries.

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Management of Liver Injuries Following Blunt Abdominal Trauma in Children (소아 복부둔상에 의한 간장손상의 치료)

  • Park, Jin-Young;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.32-40
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    • 1997
  • A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

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Effect of Corticosterone Pretreatment on the Production of LPS-Induced Inflammatory Mediators in Hepa1c1c-7 Cells (Hepa1c1c-7 Cell에서 리포폴리사카라이드로 유도된 염증성 매개인자 생산에 있어서 코르티코스테론 전처리 효과)

  • Chae, Byeong Suk
    • YAKHAK HOEJI
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    • v.60 no.1
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    • pp.8-14
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    • 2016
  • Endotoxemia induces production of inflammatory mediators and acute phase proteins, leading to multiorgan injury and systemic inflammation. Hypothalamic-pituitary-adrenal (HPA) axis activation and glucocorticoids (GCs) release modify endotoxemia-induced inflammatory responses. In the present study, we investigated whether pre-exposure of GCs influences endotoxin-induced production of inflammatory mediators in hepatocytes. Hepa1c1c-7 cells were pretreated with low concentrations of corticosterone for 24 h and then cultured without corticosterone in the presence or absence of LPS. Our results demonstrated that LPS alone significantly enhanced production of IL-6 and CRP but reduced vascular endothelial growth factor (VEGF) compared to controls. Combination of corticosterone pretreatment and LPS significantly upregulated production of IL-6, IL-$1{\beta}$, and VEGF but downregulated CRP compared to those in LPS alone. These findings suggest that in low concentration of corticosterone-preexposed hepatocytes, endotoxemia may induce upregulation of IL-6, IL-$1{\beta}$, VEGF and but downregulation of CRP.

Traumatic Aneurysm Involving Left Ventricle and Descending Thoracic Aorta (외상에 의해 동시에 발생한 가성 좌심실류와 하행 대동맥류의 치험1례)

  • 이서원;이계선
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.617-620
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    • 1997
  • Traumatic aneurysm of both the thoracic aorta and the left ventricle are extremely rare in children because it is characterized by high mortality. We report a case which we experienced recently with sucessful outcome. A Five-year-old boy had a blunt trauma by bongo bus. He had pulmonary hemorrage and pericardial effusion complicated by multiorgan failure threatening his life. Aneurysm of LV and Descending aorta were showed by 2-D echocardiogram and MRI. The atient underwent successful corrective surgery 2 and half momths after trauma, the Postoperative status of this patient was uneventful, now he is being followed up the OPD.

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Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

  • Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.18-22
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    • 2017
  • Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

Use of helicopter emergency medical services with a physician on board in severe pediatric trauma in Korea: a case report

  • Yoonsuk Lee;Gunwoo Kim;Pil Young Jung
    • Journal of Trauma and Injury
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    • v.37 no.3
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    • pp.224-227
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    • 2024
  • In Korea, helicopter emergency medical services (HEMS) with a physician on board were introduced in September 2011, funded by both central and regional governments. HEMS was integrated into the Korean emergency medical system to address the need for EMS in remote rural areas. The present report describes 16-month-old twins who fell from the fifth floor of an apartment building, located approximately 100 km from the nearest level I trauma center. Utilizing HEMS along with initial emergency management by an emergency physician, the patients were transported to the level I trauma center within the critical "golden hour." The children had sustained multiorgan injuries. Without intervention at the scene by an emergency physician, a fatal outcome was anticipated for both children. With the use of HEMS, one patient died, but the other survived with a good prognosis. The use of HEMS flights with an emergency physician on board may improve outcomes for pediatric patients with severe trauma in medically underserved rural areas.

Surgical Treatment of Gastric Gastrointestinal Stromal Tumor

  • Kong, Seong-Ho;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.13 no.1
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    • pp.3-18
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    • 2013
  • Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ's function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials. While some clinical trials are still on-going, neoadjuvant imatinib is suggested when marginally unresectable or multiorgan resection is anticipated to reduce the extent of surgery and the chance of incomplete resection, rupture or bleeding.