• Annals of Clinical Neurophysiology
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• 제22권2호
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• pp.61-66
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• 2020

Critical illness neuromyopathy (CINM) is a common but frequently underdiagnosed condition in critically ill patients that contributes to ventilator weaning failure and limb weakness in intensive care unit (ICU). CINM is subdivided into critical illness polyneuropathy and critical illness myopathy, and the occurrence of these conditions in the ICU is associated with multiple organ failure due to sepsis or certain medications. CINM survivors might have persistent functional disabilities and a poor quality of life. This situation demonstrates the need for efforts to minimize or prevent CINM in critically ill patients. This article provides a current overview of CINM and the associated clinical strategies.

• 동의생리병리학회지
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• 제24권4호
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• pp.571-579
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• 2010

The advancement of medical technology has made it possible to treat various incurable diseases. Especially organ transplantation can give another life to the patients who have organ failure and could not find any other ways to treat their diseases. According to the development of medical technology and immunosuppressive drugs, the rate and extent of organ transplantation is increasing these days. New medical technologies like organ transplantation brought on critical issues and these have changed the way of thinking and morals that has been the fundamental rules in our society. Bioethics is already an important field of medicine and oriental medicine should investigate the problem caused by the development of medical technology and life science and should form a view of life in oriental medicine. Oriental medicine is East Asian traditional medicine based on "Huangdi-Neijing", constructed by the system of Jangfu and meridian. The traditional therapies of oriental medicine have completed a scientific system on the point of view that looks on human and nature equally. This process continued to form a new medical theory as the environment was changed and the new diseases were appeared since "Huangdi-Neijing" and "Shoganron" showed a new scope to investigate human and diseases. Therefore, it is important to develop the point of view of oriental medicine as the medical situation was changed. Oriental medicine has a holistic view that considers human as a little cosmos resonated by a big cosmos and regards the possibility to recover and to regulate the energy in our body. This theory is a basic idea of oriental philosophy. Oriental medicine focuses on the balance of yin and yang of the body and tries to harmonize the imbalance of yin and yang caused by the life style and environment. This can solve many problems that cannot be settled by modern medicine and this can accomplish the new paradigm of oriental medicine that is needed these days.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 1999년도 Japanese Journal of Medical Physics
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• pp.157-157
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• 1999

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.115-121
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• 2001

The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

• Journal of Radiation Protection and Research
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• 제11권1호
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• pp.44-50
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• 1986

천연우라늄의 생체내 흡수 및 분포의 역학적 정보와 반응을 알기 위하여 질산우라늄을 투여하여 변동되는 조직분포 및 혈중 BUN, Creatinine, SGPT 및 SGOT의 활성도를 측정하였다. 조직중의 우라늄 함량은 방사화분석법을 이용하여 방출되는 ${\gamma}$ 에너지의 강도를 측정함으로써 조사 하였다. 이때 시간이 경과함에 따른 질산우라늄의 조직분포의 양상은 특히 폐가 다른 장기에 비하여 현저하게 축적되는 것을 관찰하였다. 한편 25 mg/kg의 질산우라늄 투여시 비효소계인 질소대사의 임상적 지표인 BUN 및 Creatinine값은 예민한 반응을 나타냈으나 효소계의 SGPT 및 SGOT의 활성도에는 큰 변화가 없었다. 1 mg/kg의 질산우라늄 투여에 의한 SGPT 및 SGOT의 활성도의 변화는 복강투여후 90분에 최고치를 나타내다가 회복되었다. 우라늄 흡수의 조직분포의 실험결과 간장 및 신장의 축적이 흡수초기에 최고치를 나타내다 다시 감소되는 결과로 미루어 보아 우라늄의 독성을 가장 크게 나타나는 결정장기(critical organ)는 신장이나 간장이 아니고 폐장임을 알 수 있었다.

• 대한방사선치료학회지
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• 제27권1호
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• pp.87-95
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• 2015

목 적 : 안와 주변 방사선 치료 시 수정체 피폭선량감소를 위하여 사용된 2차 차폐 block의 유용성을 알아보고자 한다. 대상 및 방법 : Human phantom(Alderson Rando Phantom, The Phantom Laboratory, USA)을 사용하여 CT(Somatom Definition AS, Siemens, Germany) 모의촬영 후 전산화치료계획시스템(Pinnacle, PHILIPS, USA)을 통해 실제 치료와 유사한 IMRT치료계획을 실시하였다. 2차 차폐를 위하여 두께 3mm 지름 25 mm의 납판과 3 mm tungsten eye-shield block(Extra small size, Radiation Products Design, Inc, USA)를 사용하였으며, TPS(Treatment Planning System) 상의 lens dose와 모의치료 상의 lens dose를 OSLD로 측정 비교하였다. 또한, 5 cm 두께의 acrylic phantom에 동일한 조건의 2차 차폐물인 3 mm 납판과 tungsten eye-shield block을 사용하여 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$)를 조사 및 측정하였으며, 조사야 밖의 누설선 및 투과방사선 영향을 제한시키고자 8 cm 납블럭(O.S.B: Outside Scatter Block)을 적용하여 위와 동일한 실험을 시행하였다. 조사야로부터 1 cm 이격하여 phantom 끝 옆면에 OSLD(Optically Stimulated Luminescence Dosimeter)를 부착하였고, eyelid의 두께에 해당하는 bolus 3 mm를 적용하였다. 결 과 : human phantom을 이용하여 IMRT 치료계획 상의 Lens dose와 실 측정치는 각각 315.9, 216.7 cGy가 측정되었고, 3 mm 납판과 tungsten eye-shield block으로 2차 차폐 후 각각 234.3, 224.1 cGy가 측정되었다. acrylic phantom을 이용한 실험 결과는 no block, 3 mm 납판, tungsten eye-shield block을 사용했을 때 5.24, 5.42, 5.39 cGy가 측정되었으며, 조사야 밖에 O.S.B를 적용하여 no block, 3 mm 납판, tungsten eye-shield block을 실험한 결과 각각 1.79, 2.00, 2.02 cGy가 측정되었다. 결 론 : 광자선 조사 시 critical organ을 보호하기 위하여 2차 차폐를 적용할 시에는 field 외부일지라도 헤드 누설방사선 및 collimator & MLC 투과방사선이 존재하므로 치료부위와 beam 방향에 따라 금속과 같은 높은 원자번호의 차폐물질이 critical organ근처에 있다면 선량 증가의 원인이 될 수 있다는 사실을 알 수 있었다. 따라서 피폭선량 감소를 위한 2차 차폐의 시도는 분명 의미가 있었으나 미 검증된 시도는 오히려 역효과를 가져올 수 있다는 사실을 인지하여 QA를 통해 목적에 부합하는 결과가 나오는지를 사전에 알아보아야 할 것이다.

• Nutrition Research and Practice
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• 제14권1호
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• pp.12-19
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• 2020

BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

• Molecules and Cells
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• 제41권2호
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• pp.83-92
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• 2018

The biological significance and deregulation of the Hippo pathway during organ growth and tumorigenesis have received a surge of interest in the past decade. The Hippo pathway core kinases, MST1/2 and LATS1/2, are tumor suppressors that inhibit the oncogenic nuclear function of YAP/TAZ and TEAD. In addition to earlier studies that highlight the role of Hippo pathway in organ size control, cell proliferation, and tumor development, recent evidence demonstrates its critical role in cancer stem cell biology, including EMT, drug resistance, and self-renewal. Here we provide a brief overview of the regulatory mechanisms of the Hippo pathway, its role in cancer stem cell biology, and promising therapeutic interventions.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.315-322
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• 2018

The high mortality rates associated with acute kidney injury are mainly due to extra-renal complications that occur following distant-organ involvement. Damage to these organs, which is commonly referred to as multiple organ dysfunction syndrome, has more severe and persistent effects. The brain and its sub-structures, such as the hippocampus, are vulnerable organs that can be adversely affected. Acute kidney injury may be associated with numerous brain and hippocampal complications, as it may alter the permeability of the blood-brain barrier. Although the pathogenesis of acute uremic encephalopathy is poorly understood, some of the underlying mechanisms that may contribute to hippocampal involvement include the release of multiple inflammatory mediators that coincide with hippocampus inflammation and cytotoxicity, neurotransmitter derangement, transcriptional dysregulation, and changes in the expression of apoptotic genes. Impairment of brain function, especially of a structure that has vital activity in learning and memory and is very sensitive to renal ischemic injury, can ultimately lead to cognitive and functional complications in patients with acute kidney injury. The objective of this review was to assess these complications in the brain following acute kidney injury, with a focus on the hippocampus as a critical region for learning and memory.

• Journal of Chest Surgery
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• 제55권4호
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• pp.338-356
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• 2022

Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.