• Title/Summary/Keyword: 급성기

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The Role of Pulmonary Capillary Pressure in the Oxygen Free Radical-Induced Acute Lung Injury (산소기에 의한 급성 폐손상에서 폐모세혈관압의 역할에 관한 연구)

  • Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.474-483
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    • 1992
  • Background: Regardless of its causes, acute lung injury is characterized pathophysiologically by increased pulmonary arterial pressure and the protein-rich edema. Many inflammatory mediators are known to be involved in the pathogenesis of acute lung injury, including oxygen free radicals (OFR). But the changes in pulmonary capillary pressure in the OFR-induced acute lung injury is not clear. While the pulmonary edema characterized by the movement of fluid and solutes is dependent on the pressure gradient and the alveolar-capillary permeability, the role of pulmonary capillary pressure in the development of pulmonary edema is also not well understood. Method: Male Sprague-Dawley rats were divided into 5 groups: normal control (n=5), xanthine/xanthine oxidase (X/XO)-treated group (n=7), catalase-pretreated group (n=5), papaverine-pretreated group (n=7), and indomethacin-pretreated group (n=5). In isolated perfused rat lungs, the sequential changes in pulmonary arterial pressure, pulmonary capillary pressure by double occlusion method, and lung weight as a parameter of pulmonary edema were determined. Results: Pulmonary arterial pressure and pulmonary capillary pressure were increased by X/XO. This increase was significantly attenuated by catalase and papaverine, but indomethacin did not prevent the X/XO-induced increase. Lung weight gain was also observed by X/XO perfusion. It was prevented by catalase. Papaverine did not completely block the increase, but significantly delayed the onset. Indomethacin had no effect on the increase in lung weight. Conclusion: These data suggest that increased pulmonary capillary pressure by OFR may aggravate pulmonary edema in the presence of increased alveolar-capillary permeability and this may not be mediated by cyclooxygenase metabolites.

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Physiological studies on the sudden wilting of JAPONICA/INDICA crossed rice varieties in Korea -III. Relationship between wilting injury and the rice root developing system (일(日)·인원연교잡(印遠緣交雜) 수도품종(水稻品種)의 급성위조증상(急性萎凋症狀) 발생(發生)에 관(關)한 영양생리학적(營養生理學的) 연구(硏究) -III. 수도근계(水稻根系)의 발달(發達)과 위조증상(萎凋症狀) 발생(發生)과의 관계(關係))

  • Kim, Yoo-Seob
    • Korean Journal of Soil Science and Fertilizer
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    • v.22 no.2
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    • pp.122-126
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    • 1989
  • The study was performed to examine varietal differences of wilting injury in terms of the root developing system and root activity. The field survey was conducted at the farmer's, and the experimental fields. The experimental investigation was done at different growth stage of rice plant in the sand culture condition. The results were summarized as follows: 1. The T/R ratio of healthy plants was greater than that of the wilted plants in Yushin. 2. Regardless of plant parts, the root activity of the wilted plants decreased in Yushin. The T/R ratio of Yushin tended to increase at the vegitative stage while the Photosynthate distribution to root decreased at the later stage. 3. The root activity and the plant growth rate were higher at vegetative growth stage, while the root activity at reproductive stage decreased. 4. The root activity of Milyang 23, which has relatively less injury of wilting, did not significantly differ between the wilted and the healthy plants. The root was thick and T/R ratio was low.

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Application of Veno-venoarterial Extracorporeal Membrane Oxygenation in Multitrauma Patient with ARDS - A case report - (다발성 외상으로 유발된 급성호흡부전증후군 환자에서 정맥-정맥동맥 체외막 산화기(ECMO)의 적용 - 1예 보고 -)

  • Lee, Sung Jun;Chee, Hyun Keun;Hwang, Jae Joon;Kim, Jun Seok;Lee, Song Am;Kim, Jin Sik
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.104-107
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    • 2010
  • Acute respiratory distress syndrome (ARDS) is difficult to treat and it is often fatal. If the medical treatment for ARDS is not effective, then extracorporeal membrane oxygenation (ECMO) can be applied to the patient. A 22-year-old female who suffered multiple traumatic injuries due to a car accident presented with acute respiratory distress syndrome. Veinarterial extracorporeal membrane oxygenation (VA ECMO) was started to treat her respiratory failure. With the VA ECMO, the systemic oxygen saturation remained at only 84%, and so the ECMO system was switched to V-VA ECMO via an additional venous outflow through the right jugular vein to increase both the systemic and pulmonary oxygen saturation. After conversion to the V-VA type ECMO, the systemic oxygen saturation increased to 94% and the partial pressure of oxygen ($PaO_2$) increased to 65 mmHg. We report here on a successful case of ECMO conversion from the VA type to the V-VA type in a patient with severely hypoxic respiratory failure.

The Effectiveness of Antibiotics in Acute Diarrhea of Children (항생제가 소아의 급성 설사에 미치는 영향)

  • Kim, Eun Ju
    • Pediatric Infection and Vaccine
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    • v.6 no.2
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    • pp.203-209
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    • 1999
  • The beneficial effects of antibiotics in acute diarrhea of children were analysed 10 assess their effectiveness since many physicians use them to treat acute diarrhea. Searching 124 charts of patients admitted from August 1996 to July 1997, they were divided into two groups, an antibiotic negative (N) group of 28 patients and a positive (P) group of 96 patients. The admission period was significantly shorter in N group than P group (P=0.0057). Duration of fever and diarrhea were also shorter in N group (P=0.0328 and 0.0184 respectively). Although it was not statistically significant. duration of vomit and frequency of diarrheal episodes per day were lower in N group (P=0.7091 and 0.061, respectively). Age, sex, duration of diarrhea before the admission and CRP collected on the day of admission were not statistically different between the two groups (P=0.5866, 0.093, 0.3502 and 0.2628 respectively).

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Changes of Lipid and Lipoprotein Compositions in Kawasaki Disease and its Impact on Cardiac Complications (가와사끼병에서 혈중 지질과 지단백의 변화와 심장 합병증에 미치는 영향에 관한 연구)

  • Yun, Sin Weon;Lee, Ho Seok;Kim, Dong Woon;Rhee, Kang Won;Jung, Young Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1370-1377
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    • 2005
  • Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction (젊은 급성 심근경색증 환자에서 좌심실 이완 기능 및 충만압이 관상동맥중재술 후 임상 경과에 미치는 영향)

  • Cho, Eun Young;Jeong, Myung Ho;Yoon, Hyun Ju;Kim, Yong Cheol;Sohn, Seok-Joon;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Ahn, Youngkeun;Cho, Jae Young;Kim, Kye Hun;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.538-547
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    • 2018
  • Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, $39.5{\pm}5.3$ years) versus abnormal (n = 154, $43.5{\pm}5.1$ years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

Natural History of Conservatively Treated Posterior Cruciate Ligament Injury (보존적으로 치료된 급성 단독 후방십자인대 손상의 자연 경과)

  • Ahn, Jin-Hwan;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.13-19
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    • 2007
  • Purpose: We investigated the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. Materials and Methods: Between February 1999 and October 2006, we evaluated retrospectively the results of acute, isolated posterior cruciate ligament injuries treated conservatively. The subjects consisted of 21 patients. At initial and follow up visits physical examination, $KT-2000^{TM}$ arthrometer and MRI were performed to assess improvement on the knee stability and continuity of the posterior cruciate ligament. IKDC (International Knee Documentation Committee) knee scoring and quadriceps muscle strength were also checked in all population. Comparing the results of initial and follow up examinations we assessed the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. The mean follow up period was 22.7 months. Results: The posterior drawer test showed 14 cases of Grade I, 6 cases of Grade II and 1 case of Grade III progressing 18 cases of Grade I and 3 cases of Grade II. The mean difference of 5.7mm by $KT-2000^{TM}$ arthrometer was changed Into 2.7mm and the continuity of posterior cruciate ligament initially checked by 48.1% on MRI increased to 69.7%. The mean quadriceps muscle strength was grade 'Good' and mean IKDC knee score was nearly grade 'A'. Conclusion: Our study suggests that patients with acute, isolated posterior cruciate ligament injuries treated conservatively may get good clinical outcomes on clinical situation and MRI.

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Clinical Analysis of Postoperative Acute Renal Failure in the Patients undergoing Cardiovascular Operation with CPB (개심술 후 발생한 급성 신부전의 임상적 고찰)

  • 편승환;노재욱;방정희;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.494-501
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    • 1998
  • From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass(CPB). Because we were interested in new development of ARF(prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation(serum creatinine level less than 1.5 mg/dL) was registered in 198(74%) patients. Of these, 27(14%) patients showed postoperative renal complication, including 20(10%) patients classified as renal dysfunction(serum creatinine level between 1.5 and 2.5 mg/dL) and 7(4%) patients as acute renal failure(serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed(p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality(odd ratio 2.52∼11.25), along with cardiovascular(odd ratio 4.20) and respiratory(odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age(odd ratio 1), need for emergency operation(odd ratio 3.78), low-output syndrome(odd ratio 3.66), respiratory complication(odd ratio 1.30), need for deep hypothermic circulatory arrest(odd ratio 1.4). The 13 patients(7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.

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Acute Toxicity of Nitrite, Ammonia and Hydrogen Sulfide for Early Developmental Stages of Fenneropenaeus chinensis (대하의 초기생활사에 있어 아질산, 암모니아 및 황화수소의 급성독성)

  • Ji, Jeong-Hun;Gang, Ju-Chan
    • Journal of fish pathology
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    • v.17 no.3
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    • pp.199-205
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    • 2004
  • Effects of nitrite, ammonia and hydrogen sulfide on survival of the early developmental stages of Fenneropenaeus chinensis were determined under continuous flow-through system. The 96hr-$LC_{50}$ values of mysis stage were 18.4 mg/L, 0.69 mg/L and 13.5 $\mu{g}/L$ for nitrite, ammonia and hydrogen sulfide, respectively; 28.3 mg/L, 1.23 mg/L and 20.7 $\mu{g}/L$ for post larva stage and 39.8 mg/L, 1.73 mg/L and 28.5 $\mu{g}/L$ for juvenile stage, respectively. The Fenneropenaeus chinensis sensitivity for the three pollutants was in the order of hydrogen sulfide>ammonia>nitrite. The mysis/post larva, mysis/juvenile and post larva/juvenile ratios of nitrite, ammonia and hydrogen sulfide toxicity were >1.5, >2.0 and <1.5 times, respectively, and mysis were found to be more sensitive to pollutants than juvenile in all cases.

The evaluation of risk for aspiration using lipid-laden macrophage index in infants with bronchiolitis (지질함유 대식세포 지표(lipid-laden macrophage index)를 이용한 세기관지염 환아에서 흡인의 위험성 평가)

  • Koh, Ji Yeon;Kang, Hee;Chung, Ju Young;Han, Tae Hee;Kim, Chang Keun
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.763-768
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    • 2006
  • Purpose : We investigated the risk of aspiration using the lipid-laden macrophage index(LLMI) from laryngeal lavages in infants with bronchiolitis. Methods : Laryngeal lavages from 22 infants with acute bronchiolitis caused by respiratory syncytial virus(RSV) were evaluated during the acute stage. Repeat studies were performed at 3 to 4 weeks after the initial study(remission stage). Lavage cell counts and differentials were determined. The amount of lipid per single macrophage was evaluated and the LLMI was determined by evaluating 100 cells. Comparisons between acute stage and remission stage were made. Twenty-four hour pH monitoring(pHm) was performed in 12 patients. Results : The total cell number was significantly higher in the acute stage compared with the remission stage(P<0.05). The LLMIs in the acute stage were significantly higher than those in the remission stage(P<0.05). The neutrophils percentage of laryngeal lavage correlated with the LLMI(r=0.69, P<0.001). Four children had positive pHm recordings(pH-positive infants) and eight had negative pHm recordings(pH-negative infants). The pH-positive infants had higher LLMI and higher neutrophils percentage than those of the pH-negative infants(P<0.05). Conclusion : These findings suggest that there is a transient increased risk of aspiration during bronchiolitis. The LLMI from laryngeal lavage may be a useful marker for pulmonary aspiration in infants with bronchiolitis.