• Tuberculosis and Respiratory Diseases
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• 제47권4호
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• pp.451-459
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• 1999

배 경 : 패혈증에서 과도한 활성산소종의 생성은 급성 폐손상의 병리 기전에 중요한 역할을 한다. Catalase 및 MnSOD 등의 항산화 단백은 패혈증 환자의 혈청내 증가하며 급성호흡곤란증후군의 발생 예측 인자 및 패혈증의 예후 인자로 알려져 있다. Peroxiredoxin(Prx) 는 최근 독특하고 중요한 세포내 항산화 단백으로 알려져 있다. 본 연구는 대식세포인 mouse monocyte-macrophages(RAW 264.7) 세포에 산화 스트레스 및 내독소 처리후 Prx I 및 Prx II의 발현 평가하고 패혈증 동물 모델에서 복강세척액 및 기관지폐포세척액내 Prx I, Prx II 및 Trx의 양을 측정하였다. 방 법 : Prx I, Prx II 및 Trx에 대한 특이 항체를 이용하여 immunoblot 분석으로 호중구, 대식세포 및 적혈구에 이들의 분포를 평가하였다. Mouse monocyte-macrophages 세포에 $5\;{\mu}M$ menadione 및 1 mg/ml lipopolysaccharide(LPS) 을 처치하여 Prx I 및 Prx II의 발현을 평가하였으며 6 mg/Kg LPS를 복강내 투여하여 유발한 복강내 패혈증 동물의 복강세척액내 Prx I, Prx II 및 Trx의 양을 측정하였으며 복강내 패혈증 동물 및 5 mg/Kg LPS를 정맥내 투여하여 유발한 정맥내 패혈증 동물에서 기관지폐포세척액내 Prx I, Prx II 및 Trx을 측정하였으며 폐장의 염증 정도와 비교하였다. 결 과 : Prx I 및 Prx II의 분포는 호중구, 폐포대식세포 및 적혈구에서 서로 다른 양상을 보였다. Mouse monocyte-macrophages 세포에 $5\;{\mu}M$ menadione 및 $1\;{\mu}g/ml$ lipopolysaccharide을 처치하였을 때 Prx I 발현은 증가하였으나 Prx II 발현은 변화하지 않았다. 복강내 패혈증 동물에서 복강세척액내 Prx I, Prx II 및 Trx의 양은 증가하였으나 복강내 패혈증 및 정맥내 패혈증 동물에서 기관지폐포세척액내 폐장 염증 정도와 관계없이 Prx I, Prx II 및 Trx의 양은 증가하지 않았다. 결 론 : 세포내 항산화 단백으로서 mouse monocyte-macrophages 세포에서 Prx I의 발현은 산화 스트레스 및 내독소 처치후 증가한다. Prx I, Prx II 및 Trx양은 패혈증 동물 모델에서 국소 염증 부위에서 증가하나 손상된 폐장에서는 증가하지 않는다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.289-292
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• 2015

Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.

• Journal of Chest Surgery
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• 제49권3호
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• pp.157-164
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• 2016

Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of $26.1{\pm}16.7months$. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

• Clinical and Experimental Pediatrics
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• 제46권8호
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• pp.777-783
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• 2003

목 적 : E. coli 패혈성 폐가 유도된 신생자돈에서 Nitric oxide(NO) 가스 흡입요법이 혈역학, 가스교환 및 폐 염증 소견에 미치는 영향을 알아보고자 본 연구를 실시하였다. 방 법 : 23마리의 신생자돈에서 도관 삽입과 기도 삽관을 시행하여 기계적 가스 인공환기를 시키면서 CON군(n=6)은 생리적 식염수 5 mL, PCON(n=9) 및 PNO(n=8) 군은 Escherichia coli strain $69{\times}10^9cfu$(10 mL)를 투여한 후 time-cycled pressure-limited 인공환기기로 PIP 30 $cmH_2O$, 호흡수 분당 30회, $FiO_2$ 1.0, PEEP 4 $cmH_2O$의 설정에서 6시간 동안 유지하였다. PNO군에서는 NO 10 ppm을 E. coli 투여 후부터 실험 종료 시까지 기도 내로 투여하였다. 모든 신생자돈에서 가스교환, 혈역학, 폐기능 지수들을 1시간 간격으로 측정하였고 실험 종료후 폐 조직을 얻어 염증반응 정도 지표인 myeloperoxidase 활성을 측정하였다. 결 과 : E. coli가 기도 내로 투여된 PCON 및 PNO군 모두에서 실험 종료시 E. coli 패혈증이 발생하였다. PCON군에서는 시간에 따라 진행되는 폐동맥 고혈압, 저산소혈증, 고탄산혈증, 및 폐 내 단락과 폐 내 사강의 비율의 증가를 보였고 대조군에서는 실험 종료시까지 의미 있는 변화를 보이지 않았다. NO가 투여된 PNO군에서 폐동맥 고혈압이 감소되지 않았으나 폐 내 단락의 의미 있는 개선과 폐 내 사강 비율 증가의 일부 감소에 기인한 저산소혈증 진행의 완화가 관찰되었다. 폐 염증정도의 지표인 폐조직의 myeloperoxidase 활성도는 PCON군에서 CON군에 비해 의미 있게 증가되었으며 이는 PNO군에서 의미 있게 완화되었다. 결 론 : E. coli 패혈성 폐가 유도된 신생자돈에서 NO 가스 흡입요법은 폐 내 단락 개선을 통해 산소화를 향상시켰으며 또한 폐 염증 소견을 완화시켰다.

• Biomolecules & Therapeutics
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• 제21권1호
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• pp.66-71
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• 2013

Broussonetia papyrifera and Lonicera japonica have long been used in the treatment of inflammatory disorders in Chinese medicine, especially respiratory inflammation. Previously, a new phytoformula (BL) containing B. papyrifera and L. japonica was found to exert strong anti-inflammatory activity against several animal models of inflammation, especially against an animal model of acute bronchitis. In the present investigation, the effects of BL on animal models of septic inflammation and chronic bronchitis are examined. Against lipopolysaccharide (LPS)-induced septic inflammation in mice, BL (200-400 mg/kg) reduced the induction of some important proinflammatory cytokines. At 1 h after LPS treatment, BL was found to considerably inhibit TNF-${\alpha}$ production when measured by cytokine array. At 3 h after LPS treatment, BL inhibited the induction of several proinflammatory cytokines, including IFN-${\gamma}$ and IL-$1{\beta}$, although dexamethasone, which was used as a reference, showed a higher inhibitory action on these biomarkers. Against chronic bronchitis induced by LPS/elastase instillation in rats for 4 weeks, BL (200-400 mg/kg/day) significantly inhibited cell recruitment in bronchoalveolar lavage fluid. Furthermore, BL considerably reduced lung injury, as revealed by histological observation. Taken together, these results indicate that BL may have a potential to treat systemic septic inflammation as well as chronic bronchitis.

• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.127-131
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• 2020

A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.53-57
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• 2016

Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

• Tuberculosis and Respiratory Diseases
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• 제71권2호
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• pp.139-143
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• 2011

Small bowel metastasis of pleomorphic carcinoma of the lung is very rare. A 58-year-old man was admitted to our hospital with abdominal palpable mass in the right upper quadrant area. He underwent right middle and lower lobectomy for early stage pleomorphic carcinoma of the lung approximately 3 months ago. USG-guided biopsy was performed for abdominal mass. Pathologic examination revealed a metastatic pleomorphic carcinoma from the lung. He received chemotherapy followed by radiation therapy but died due to septic shock caused by intestinal stenosis and adhesion. We report the first case of small bowel metastasis by pleomorphic carcinoma of the lung after curative surgery.

• Journal of Chest Surgery
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• 제24권1호
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• pp.98-105
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• 1991

There have been reports concerning the association of laryngeal carcinoma and lung cancer. Second primary respiratory tract malignancies occur frequently in patients who have undergone the treatment of laryngeal cancer probably because they are exposed to the same carcinogen. Recently, we have experienced two patients who developed second primary lung cancer 30 and 41 months after the first diagnosis of laryngeal cancer at the Department of Thoracic & Cardiovascular Surgery, Yonsei University College of Medicine. Relative long interval between the two carcinomas indicated metastasis unlikely. From a therapeutic standpoint, it is of great importance that they should be regarded as separate primaries and not as metastasis. Longevity will depends on a presumption that the lesions are separate primaries and the status of stage at the time of detection of second primary lesion. The follow-up of patients who are seen with carcinomas of the head and neck should be done at regular interval and include a chest roentgenogram and cytologic examination of sputum to detect early changes before the tumors becomes incurable. The first 76 year old patient with left upper lobectomy due to the T2N0M0 lung cancer has been in good condition to present. But the second 55 year old patient with right pneumonectomy due to the T2N0M0 lung cancer died of respiratory failure and septic pneumonia 3 months after operation and chemotherapy.

• 대한융합한의학회지
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• 제4권1호
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• pp.19-27
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• 2022

Objectives: TSepsis and subsequent acute lung injury (ALI) is a critical state of health caused by infection or endotoxins. This study was conducted to evaluate the effect of Water Extract of Aconiti Lateralis Preparata Radix (AR) on lipopolysaccharide (LPS)-induced sepsis in C57BL/6 mice. Methods: Male C57BL/6 mice were intraperitoneally injected with LPS to induce sepsis and ALI. AR was orally fed twice at 30 min and 180 min after LPS injection. At 24 h post injection, mice were sacrificed, bronchoalveolar lavage fluid (BALF) and blood was collected, and lung tissue was harvested. Hematoxylin and eosin staining was performed in lung tissues, wet/dry ratio of the lung tissue was measured, and the serum cytokine and chemokine levels were analyzed. Results: AR revoked the LPS-induced pathological changes in lung tissues, such as abnormal histological structures, immune cell infiltration and lung edema. Also, AR suppressed the neutrophil infiltration into the lung which was greatly increased by LPS injection based on the cell content of collected BALF. Serum cytokines and chemokines were measured, and AR reversed the LPS-induced increase of cytokines such as interleukin 1 beta, interleukin 6, tumor necrosis factor alpha and chemokines including C-X-C motif chemokine ligand 1 and 2. Conclusion: TAR showed a protective effect in the pathological progress of LPS-induced ALI. Especially, AR suppressed lung edema and infiltration of neutrophils by inhibiting cytokine and chemokine expressions. Such results demonstrate the potential of AR as a therapeutic agent for sepsis and sepsis-induced ALI.