• Journal of Chest Surgery
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• v.37 no.11
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• pp.922-924
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• 2004

A 55 year old male was admitted for dyspnea. The patient was diagnosed as acute myocardiac infarction, and coronary artery bypass grafting was performed with cardiopulmonary bypass. At postoperative day ＃1, Systemic Inflammatory Response Syndrome was developed with fever, leukocytosis, tachycardia, tachypnea and low systemic vascular resistance. The patient was recovered after being treated with high dose of (36 $\mug/min)$ norepinephrine, and was discharged.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.337-339
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• 2006

A 4-year-old, spayed female Maltese dog was presented for evaluation of acute onset of generalized tremor, right-sided head tilt, horizontal nystagmus, and mild ataxia with 4-day duration. However, the dog was bright, alert, and responsive. The neurological examinations revealed that bilateral horizontal-, positional nystagmus, and mild ataxia. Menace responses were also absent in both eyes. Typically, moderate generalized intension tremors were noted in four limbs and the head. No abnormalities were found in hemogram, radiography, and magnetic resonance imaging(MRI). Cytologic examination of cerebrospinal fluid(CSF) revealed a mild nonsuppurative inflammation. Thus, steroid responsive tremor syndrome(SRTS) was strongly suspected because of its inflammatory and idiopathic features. The dog excellently responded to immunosuppressive doses of corticosteroid. Therefore, we definitively diagnosed the dog as SRTS based on the exclusion of other causes of the tremor, clinical signs, and response to treatment. This is a first case report of SRTS in our country and we here describe clinical and neurological features in SRTS.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.627-630
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• 2010

The aim of this study is to investigate neutrophil activation markers among canine ICU (intensive care unit) control, systemic inflammatory response syndrome (SIRS) and sepsis. These markers include WBC (white blood cells), platelets counts, blood film examination (neutrophilic band to segmentation ratio and neutrophilic degenerative changes), and flow cytometric analysis (CD11b expression of neutrophils). As a result, the mean CD11b fluorescence intensity of neutrophils and the neutrophilic degenerative change scores were both significantly higher in sepsis group (P<0.05). In addition, mortality was also found to be correlated with the up-regulation of CD11b expression in circulating neutrophils. This study demonstrates that CD11b expression of neutrophils could be more a reliable biomarker to predict prognosis in ICU patients than traditional blood film examination according to this study.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.102-107
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• 2017

Purpose: Coronary arterial lesions (CALs) were reported to have developed in children with systemic inflammatory diseases, as well as those with Kawasaki disease (KD). The purpose of this study was to confirm that the CAL development in children with KD occurs in a mouse model of sepsis presenting typical systemic inflammatory response syndrome (SIRS). Methods: To induce the sepsis mouse model with SIRS, 6-week-old C57BL/6 mice were intraperitoneally injected with endotoxin. We compared histological findings of the major organs between the control and the sepsis groups and examined CAL in the heart of the septic mice. Results: Infiltrating inflammatory cells were relatively increased in the heart, liver, and kidneys of the sepsis group, compared with those of the control group. We confirmed lymphocytic infiltration in the myocardium (myocarditis) and the pericardial soft tissue of the heart. Furthermore, coronary artery of the septic mouse was identified, but CAL was not observed. Conclusions: In this study, we failed to confirm the existence of CAL in a mouse model of sepsis. However, it is well-known that CALs are seen in many kinds of diseases that cause SIRS. Our findings suggest further investigation into the clinical significance of CAL in various systemic inflammatory diseases, including KD.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.745-753
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• 2001

capillary leak syndrome and organ dysfunction in infants. Removing harmful cytokines and complement anaphylatoxins after cardiopulmonary bypass may attenuate this response. This study was conducted to see if the modified ultrafiltration and postoperative peritoneal dialysis can reduce plasma inflammatory mediators in pediatric cardiac surgery. Material and Method: 30 infants (age 1.1 to 12.6 months) who underwent closures of ventricular septal defect using cardiopulmonary bypass (CPB) were enrolled in this study. These patients were divided into three groups; 10 patients selected randomly underwent modified ultrafiltration (Group U), 10 with small body weights ($\leq$5 kg) received postoperative peritoneal dialysis (Group P), and 10 patients did not undergo modified ultrafiltration nor receivcd peritoneal dialysis (Group C). Serum samples were obtained before and after CPB, and after peritoneal dialysis. Effluents sample were also obtained after modified ultrafiltration or peritoneal dialysis. C3a and interleukin-6 (IL-6) were measured by radioimmunoassay and enzyme-linked immunosorbent assay respectively. Result: There was no differences in CPB time, aortic cross-clamping title, and lowest temperature during CPB. The effluents of peritoneal dialysis contained significant amount of C3a and IL-6, but there was no definitive decrease of serum concentration of C3a and IL-6. The effluents of modified ultrafiltration had some amount of C3a and negligible IL-6, and there was no decrease of serum concentration of these (actors. Conclusion: The effluents of peritoneal dialysis contained significant amount of proinflammatory cytokine, IL-6 and complement, C3a. However this study failed to elucidate the decrease in serum levels of these factors. The modified ultrafiltration also was not able to reduce the serum levels of C3a or IL-6 in our study as well.

• Childhood Kidney Diseases
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• v.2 no.1
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• pp.26-33
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• 1998

This retrospective study was designed to evaluate the prognostic value and histologic correlation of sonography in childhood nephrotic syndrome. Sixty-nine patients with proteinuria over 2g per day at the time of presentation who were treated at the Korea University Hospital were included in this review. They were 1 to 15 years old(mean age, 7.8 years) with 49 males and 20 females. In each patient an ultrasound examination was done using SPA 1000(Diasonics, C.A., U.S.A.) on admission. Tissue specimens were obtained from 46 patients. The paraffin-embedded specimens were reviewed with special reference to interstitial edema, interstitial fibrosis, tubular atrophy, global sclerosis or inflammatory cell infiltrates. Biopsy proven renal disease were minimal change disease(n=20), focal segmental glomerulosclerosis(n=7), membranous glomerulonephritis(n=2), membranoproliferative glomerulonephritis(n=1), $Henoch-Sch\"{o}nlein$ purpura nephritis(n=6), IgA nephropathy(n=5), poststreptococcal glomerulonephritis(n=2), systemic lupus erythematosus(n=1) and Alport syndrome(n=2). There was a significant relationship between increased cortical echogenicity and global sclerosis or tubular atrophy(P<0.05). But no significant relationship was found between increased cortical echogenicity and interstitial fibrosis, interstitial edema, or inflammatory cell infiltration. In biopsy-proven primary nephrotic syndrome(n=30), no significant relationship was found between the increased conical echogenicity and the interstitial edema, interstitial fibrosis, global sclerosis, tubular atrophy or inflammatory cell infiltration. But there was a significant relationship between increased cortical echogenicity and resistance to corticosteroid (P<0.05). These results suggest that increased cortical echogenicity may be due to tubular atrophy or global sclerosis in patients with proteinuria and may be an effective indicator of resistance to corticosteroid in primary nephrotic syndrome.(J Korean Soc of Pediatr Nephrol 2:26-33, 1998)

• The Journal of Korean Medicine
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• v.45 no.2
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• pp.1-8
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• 2024

Objectives: This research is designed to analyze the relationship between Sayeok-tang(四逆湯) and systemic inflammatory response syndrome in literature. Methods: The main treatment symptoms of Sayeok-tang(四逆湯) presented in Sanghanron(傷寒論) and Geumgweyoryak (金匱要略), and the symptoms of Ju-hwang(走黃) and Nae-ham(內陷), which is a sepsis and systemic inflammatory response syndrome in Korean medicine were analyzed. The symptoms of systemic inflammatory response syndrome presented in the related researches including diagnosis criteria and international guideline presented at the consensus conference hosted by the American College of Chest Physicians and The Society of Critical Care Medicine were also compared and analyzed. Results: The main treatment symptoms of Sayeok-tang(四逆湯) and symptoms of systemic inflammatory response were very similar, and were almost identical to the symptoms of Nae-ham (內陷, especially Gun-ham (乾陷) and Heo-ham(虛陷)), which are the Korean medicine descriptions of sepsis and systemic inflammatory response syndrome. Conclusions: Based on the research results, Sayeok-tang(四逆湯) can be used as a treatment of systemic inflammatory response syndrome.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.123-129
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• 1999

Purpose: Acute poststreptococcal glomerulonephritis(APSGN) is a renal disease which is characterized by glomerular proliferation and inflammatory changes due to immune reaction. Although the 95% of patients with APSGN seems to recover fully and present as benign course, the remaining patients show poor prognosis. Therefore comparative retrograde study between APSGN with and without nephrotic syndrome was done to find out the any prognostic indicator to predict the outcome in patients with APSGN. Methods: We had retrospectively analyzed seventy-one patients who were diagnosed as APSGN clinically from Mar.1989 to Feb.1999 in Yonsei university medical center. Sixty-four of the patients was APSGN without nephrotic syndrome(Group A) and seven patients were in APSGN with nephrotic syndrome(Group B). Results: Patients who were diagnosed as APSGN with nephrotic syndrome were seven(9.9%) out of seventy-one. In the comparative study, sex ratio was 1:1 in group A and 1.9: 1 in group B, onset mean age was $8.9{\pm}2.6$ in group A and $8.8{\pm}2.6$ in group B. Following clinical profiles were compared but there were no significant difference between these two groups: WBC count($9413{\pm}2964\;vs\;9368{\pm}2650(/mm^3)$), hemoglobin($10.6{\pm}1.2\;vs\;10.0{\pm}0.9(gm/dL)$), ASO($746.1{\pm}640.7\;vs\;614.9{\pm}475.9(IU/ml)$), $C_3(20.1{\pm}17.0\;vs\;16.9{\pm}13.1(mg/dL)$), $C_4(22.8{\pm}9.5\;vs\;22.6{\pm}6.9(mg/dL)$), BUN($25.8{\pm}26.1\;vs\;28.1{\pm}14.5(mg/dL)$), creatinin($0.8{\pm}0.3\;vs\;0.8{\pm}0.3(mg/dL)$), $C_{cr}(80.6{\pm}28.8{\pm}62.4{\pm}31.4(ml/min/1.73\;m^2$)), the duration of edma, gross hematuria, and hypertension. However, we found that there were a significant difference in the duration of proteinuria($1.95{\pm}2.27\;vs\;13.3{\pm}21.1(months)$)(P<0.05), decreased $C_3$ duration($1.9{\pm}2.9\;vs\;7.3{\pm}5.0(weeks)$)(P<0.05) and especially it was proloned according to the amount of early urine protein excretion. Conclusion: Our study showed markedly prolonged duration of proteinuria and decreased $C_3$ duration in patients with APSGN with nephrotic syndrome. We were not able to find the definite prognostic factor that will guide the outcome of patients with APSGN accompaning nephrotic syndrome, but above findings seemed to represent as a relative indication of the outcome of the disease. All patients recovered completely and we did not experience any cases that progressed into the renal failure.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.4
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• pp.309-316
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• 2021

Sepsis is a physiological response to a source of infection that triggers mechanisms that compromise organ function, leading to death if not treated early. Biomarkers with high sensitivity, specificity, speed, and accuracy that could differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) could bring about a revolution in sepsis treatment. Given the limitations and time required for microbial verification of pathogens, the accurate diagnosis of infection before employing antibiotic therapy is important and clinically necessary. Procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, and proadrenomedullin (ProADM) are the common biomarkers used for diagnosis. The procalcitonin (PCT)-guided antibiotic treatment in patients with acute respiratory infections effectively reduces antibiotic exposure and side effects while improving survival rates. The evidence regarding sepsis screening in hospitalized patients is limited. Clinicians, researchers, and healthcare decision-makers should consider these findings and limitations when implementing screening tools, future research, or policy on sepsis recognition in hospitalized patients. The use of biomarkers in pediatric sepsis is promising, although such use should always be correlated with clinical evaluation. Biomarkers may also improve the prediction of mortality, especially in the early phase of sepsis, when the levels of certain pro-inflammatory cytokines and proteins are elevated.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.72-78
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• 2023

Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.