• Tuberculosis and Respiratory Diseases
• /
• 제65권4호
• /
• pp.334-338
• /
• 2008

흉막의 고립성 섬유성 종양은 주로 흉막통, 호흡곤란, 기침 등의 증상으로 발현하거나 무증상으로 발견되는 경우가 대부분이다. 본 증례의 환자는 흉막의 고립성 섬유성 종양의 거대한 종괴 영향에 의한 압박증상과 동반된 폐렴, 패혈 쇼크와 급성 호흡곤란의 진행으로 매우 치명적인 임상 양상을 보였으며, 기계환기법과 항생제, 승압제 등의 치료 후에 종양절제술로 호전되었다. 저자들은 흉막의 고립성 섬유성 종양으로 인한 치명적인 임상 경과를 보인 증례 1예를 경험하였기에 문헌고찰과 함께 보고한다.

• Childhood Kidney Diseases
• /
• 제17권2호
• /
• pp.127-131
• /
• 2013

요낭종이란 신장 및 비뇨기계로부터 누출된 소변이 신장 및 신우 주위에 캡슐상의 낭종을 형성하는 드문 질환으로 자연발생적인 신우의 파열로 인한 누출은 매우 드물며, 대부분 요로와 신우 내강의 압력 증가에 의해 발생한다. 본 증례에서 18세 여자 환아는 내원 7일 전부터 시작된 고열과 핍뇨 및 호흡곤란을 주소로 내원하였다. 환아는 출생시 다운 증후군을 진단받았으며 평소 배뇨는 원활하였다. 입원 후 환아는 패혈증 쇼크 및 급성 신손상, 급성 호흡 곤란 증후군 진단 하에 항생제 및 스테로이드 충격 요법 시행 후 핍뇨, 호흡곤란 및 혈액검사 호전 소견 보였으나 7일 동안 유치된 도뇨관 제거 후 환아는 요 폐색 소견이 관찰되었다. 복부 전산화 단층 촬영상 좌측 신장 주위에 요낭종이 확인되어 좌측 요관에 Double-J catheter가 삽입 되었으며 신우의 파열 부위에 조영제 누출이 확인되었다. 시술 후 요 폐색 소견은 호전되었고, 배뇨성 방광 요도 조영술 상 좌측 신장의 4단계 방광 요관 역류가 관찰되었다. Double-J catheter 제거 3개월 후 좌측 신장 주변의 요낭종은 대부분 소실되었고, 좌측 신장의 방광 요관 역류는 보이지 않았다. 저자들은 급성 신부전 환아에서 유치 도뇨관 제거 후 배뇨곤란 및 요 폐색 소견을 보인 신 주위 요낭종 1례를 경험하였기에 보고하는 바이다.

• Journal of Trauma and Injury
• /
• 제21권2호
• /
• pp.128-135
• /
• 2008

Purpose: As the care of surgical patients becomes increasingly complex and catheter-based techniques are more frequently applied, the pattern of iatrogenic vascular injuries may be increasing. Major vascular injuries can jeopardize a patient's life or limb survival. The purpose of this study was to examine the current etiology and prognosis for iatrogenic vascular injuries. Methods: We reviewed medical records of 29 cases of iatrogenic vascular injury that were treated Seoul National University Bundang Hospital between October 2003 and October 2008. We studied clinical variables including demographics, cause of injury, clinical presentations, management and prognosis. Results: The mean age was 60.8 years (range: 25-86), and the male to female ratio was 1.9 : 1. The causes of injuries were operation related complication in 18 cases (62.1%), endovascular intervention and diagnostic angiography in 11 cases (37.9%). The types of vascular injury were partial severance in 14 cases, pseudoaneurysm in 8, arteriovenous fistula (AVF) in 3, thrombosis in 2, complete severance in 2. Especially, device related complication including percutaneous closing device were occurred in 9 and the others came from inadvertent physician's procedure. Primary repair were done in 12 cases, end-to-end anastomosis in 5, interposition graft in 4, ligation in 2, patch angioplasty in 1, peudoaneurysm excision and arteriorrhaphy in 1, hematoma evacuation in 1, and endovascular repair in 3. There were 2 cases of mortality, one of them due to hemorrhagic shock and the other due to septic shock. Conclusion: Proper selection of treatment modalities should be important to have better outcome according to the type of injury as well as anatomical location. Each physician should be familiar to new device as well as patient's topographical feature. Immediate referral to vascular specialist is also essential to reduce morbidity.

• Radiation Oncology Journal
• /
• 제24권4호
• /
• pp.317-321
• /
• 2006

67세 남자환자가 하지의 악성섬유조직구종으로 진단받고 광범위 절제술 후 방사선치료를 받는 동안 연쇄구균독소충격증후군이 발생하여 그 예를 소개하고자 한다. 환자는 수술 후 증감하는 부종이 있어 약 1개월간 비스테로이드소염제를 복용하였다. 환자는 C형 간염보균자였으며, 당뇨, 고혈압의 과거력이 있었다. 환자는 수술 후 방사선치료를 계획하여, 주 5회 조사하여 32.4 Gy를 치료받았다. 이틀간의 주말 치료중단이후 갑자기 방사선치료 받은 우측 대퇴부에 홍반성 염증이 발생하였고, 열, 오한, 소변감소증이 동반되었다. 환자는 즉시 감염내과에 의뢰되었고, 독소충격증후군이 의심되어 즉시 입원하였다. 입원당시 환자는 저혈압, 소변감소증, 변비, 비정상적인 신기능 및 간기능 소견을 보였다. 환자의 혈액 배양 결과 스트렙토콕쿠스 피오게네스균(Streptococcus pyogenes)이 검출되었다. 환자는 연쇄구균독소충격증후군으로 진단받고 적절한 항생제치료와 수액공급을 받았다. 연쇄구균독소충격증후군은 생명을 위협하는 종양학적 응급상황으로 즉각적인 처치가 필요하다. 본 예의 환자는 C형 간염보균, 수술 후 증감되는 부종, 지속적인 비스테로이드소염제 복용과 방사선치료가 연쇄구균독소충격증후군을 일으킨 인자들로 생각되어진다.

• Journal of Gastric Cancer
• /
• 제12권1호
• /
• pp.26-35
• /
• 2012

Purpose: Emergency operations for perforated peptic ulcer are associated with a high incidence of postoperative complications. While several studies have investigated the impact of perioperative risk factors and underlying diseases on the postoperative morbidity after abdominal surgery, only a few have analyzed their role in perforated peptic ulcer disease. The purpose of this study was to determine any possible associations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. Materials and Methods: In total, 142 consecutive patients, who underwent surgery for perforated peptic ulcer, at a single institution, between January 2005 and October 2010 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. Results: The postoperative morbidity rate associated with perforated peptic ulcer operations was 36.6% (52/142). Univariate analysis revealed that a long operating time, the open surgical method, age (${\geq}60$), sex (female), high American Society of Anesthesiologists (ASA) score and presence of preoperative shock were significant perioperative risk factors for postoperative morbidity. Significant comorbid risk factors included hypertension, diabetes mellitus and pulmonary disease. Multivariate analysis revealed a long operating time, the open surgical method, high ASA score and the presence of preoperative shock were all independent risk factors for the postoperative morbidity in perforated peptic ulcer. Conclusions: A high ASA score, preoperative shock, open surgery and long operating time of more than 150 minutes are high risk factors for morbidity. However, there is no association between postoperative morbidity and comorbid disease in patients with a perforated peptic ulcer.

• 대한한의학방제학회지
• /
• 제16권1호
• /
• pp.79-94
• /
• 2008

Although inflammatory mediators such as nitric oxide(NO) and pro-inflammatory cytokines are involved in host defense mechanism, these overproduction contributes to the pathogenesis of several diseases such as otitis media, hearing loss, periodontitis, bacterial sepsis, rheumatoid arthritis, chronic inflammation and autoimmune diseases. We investigate the anti-inflammatory effects of water extract from Ji-Pae-San(JPSWE) fomulated with Angelica dahurica plus Fritillaria Verticillata, Angelica dahurica(ADWE), and Fritillaria Verticillata(FUVE) in vitro and in vivo. Each extract inhibited the production of inflammatory mediators(NO, $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, and prostaglandin $E_2$) and the expression of inducible NO synthase(iNOS) and cyclooxygenase-2(COX-2) in lipopolysaccharide(LPS)-stimulated RAW 264.7 macrophages in a dose-dependent manner. These inhibitory effects were synergistically increased by their combination. JPSWE also inhibited $TNF-{\alpha}$, $IL-1{\beta}$, IL-6. and $PGE_2$ production as well as COX activity in LPS-stimulated mice. Moreover, JPSWE significantly suppressed death by LPS-septic shock in mice(survival rate: 100%). These results suggest that Ji-Pae-San may be useful for therapeutic drugs against inflammatory immune diseases, probably by suppressing the production of inflammatory mediators.

• BMB Reports
• /
• 제47권8호
• /
• pp.451-456
• /
• 2014

Parthenolide, a natural product derived from Feverfew, prevents septic shock and inflammation. We aimed to identify the effects of parthenolide on the RANKL (receptor activator of $NF-{\kappa}B$ ligand)-induced differentiation and bone resorbing activity of osteoclasts. In this study, parthenolide dose-dependently inhibited RANKL-mediated osteoclast differentiation in BMMs, without any evidence of cytotoxicity and the phosphorylation of p38, ERK, and $I{\kappa}B$, as well as $I{\kappa}B$ degradation by RANKL treatment. Parthenolide suppressed the expression of NFATc1, OSCAR, TRAP, DC-STAMP, and cathepsin K in RANKL-treated BMMs. Furthermore, parthenolide down-regulated the stability of c-Fos protein, but could not suppress the expression of c-Fos. Overexpression of NFATc1 and c-Fos in BMMs reversed the inhibitory effect of parthenolide on RANKL-mediated osteoclast differentiation. Parthenolide also inhibited the bone resorbing activity of mature osteoclasts. Parthenolide inhibits the differentiation and bone-resolving activity of osteoclast by RANKL, suggesting its potential therapeutic value for bone destructive disorders associated with osteoclast-mediated bone resorption.

• 한국응용약물학회:학술대회논문집
• /
• 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
• /
• pp.293-293
• /
• 1994

본 연구에서는 Scutellariae Radix (黃芩)으로부터 분리한 다섯종의 플라보노이드와 그외 구조면에서 관심이 있는 아홉가지 관련 플라보노이드 물질들에 대한 브라디키닌 길항활성물 적출장관 및 여러 in vivo 실험을 통하여 검색하였다. 적출회장 및 자궁실험에 서는 검체들이 거의 모두 BK 길항효과를 나타내었고 특히 적출 자궁실험에서 skullcalflavone 11 와 2'-methoxyflavone이 40 $\mu\textrm{g}$/ml 농도에서 각각 90 및 87%의 억제율을 나타내어 가장 억제적이었다. in vivo 검색에서는 플라보노이드들과 양성대조약물로 사용된 마스피린은 각 실험개시 24시간 및 1시간전에 200 mg/kg의 용량으로 생쥐에게 경구투여하여 BK 길항활성을 비교하였다. 혈장일출, 초산으로 인한 신전반응 및 LPS-유도 septic shock 유발억제 실험에서 특히 2'-methoxyflavone은 신전반응 및 내독소 실험에서 거의 완전하게 억제효과를 나타내었다. 이러한 플라보노이드들은 펩타이드구조를 가진 BK길항제와 비교하여 효력을 낮으나 non-peptide구조로 인해 생리적조건에서 보다 안정한 물질로 연구될 가치가 있다. 본 실험에서는 또한 체내에서 BK와 그 생리작용이 아주 유사한 히스타민에 대한 길항제들중 피페라진핵을 지니고 있는 약물들에 대한 BK 억제효과를 검토해본 결과 homochlorcyclizine이 가장 큰 억제효과를 나타냈으며 이 물질의 해리함수는 6.25 이었고 correlation coefficient는 0.984 로 경쟁적 길항제 이었다. 반면 수용체 결합실험에서는 이 약물은 25%의 수용체결합 억제활성을 나타내었다.

• Journal of Microbiology and Biotechnology
• /
• 제25권11호
• /
• pp.1849-1855
• /
• 2015

Staphylococcus aureus plays an important role in sepsis, septic shock, pneumonia, and wound infections. Here, we demonstrate that Lactobacillus plantarum extracts inhibited S. aureus-induced cell death of a human epithelial cell line, HT-29. In particular, we have shown that S. aureus-induced cell death was abolished by neutralization of α-toxin, indicating that α-toxin is the major mediator of S. aureus-induced cell death. DNA fragmentation experiment and caspase assay revealed that the S. aureus-induced cell death was apoptosis. L. plantarum extracts inhibited the generation of effector caspase-3 and the initiator caspase-9 in S. aureus- or α-toxin-induced cell death. Moreover, expression of Bcl-2, an anti-apoptotic protein, was activated in L. plantarum extract-treated cells as compared with the S. aureus- or α-toxin-treated only cells. Furthermore, S. aureus-induced apoptosis was efficiently inhibited by lipoteichoic acid and peptidoglycan of L. plantarum. Together, our results suggest that L. plantarum extracts can inhibit the S. aureus-mediated apoptosis, which is associated with S. aureus spreading, in intestinal epithelial cells, and may provide a new therapeutic reagent to treat bacterial infections.

• 대한한방종양학회지
• /
• 제5권1호
• /
• pp.137-150
• /
• 1999

Macrophage play a major role in host defence against infection and tumor development and this activity is regulated through the production of several mediators. In particular, the production of NO by macrophages mediates killing or growth inhibition of tumor cells, bacteria, fungi and parasites. However, over-expression of iNOS by various stimuli, resulting in over-production of NO, contributes to the pathogenesis of septic shock and some inflammator and auto-immune disease. Therefore, it would be valuable to develop potent and selective inhibitors of for potential therapeutic use. Thus the agent that supprees the expression of iNOS mRNA or enzyme protein will be usefull for the prevention of various diseases. We are intersted in identifying selective inhibitiors of iNOS which might be useful intreating inflammatory human diseases. In summary, we have demenstrated that scopoletin, isolated from Seman Armenicae and Radix Trichosanthis the production of NO induced by $IFN-\gammer$ plus LPS in RAW 264.7 macrophages, The mechanism for the inhibition of NO production was due to suppression of the expression of iNOS mRNA or enzyme protein.