• 대한임상독성학회지
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• 제17권1호
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• pp.7-13
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• 2019

Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

• IMMUNE NETWORK
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• 제7권1호
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• pp.18-25
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• 2007

Background: Although glucocorticoids (GCs) are effective in controlling asthma in the majority of patients, a subset of asthmatics fails to demonstrate a satisfactory response, even to systemic GC therapy. This population is referred to as being "steroid-resistant". The actual mechanism underlying steroid resistance in asthma remains to be elucidated. Methods: We have investigated how dexamethasone (DEX) regulates asthmatic phenotypes in a murine model of asthma, in which mice received i.p. immunization twice, followed by two bronchoprovocations with aerosolized OVA with a one-week interval, which we have recently described. Results: Pretreatment with DEX resulted in an inhibition of NF-${\kappa}B$ activation in asthmatic lungs, and also inhibited bronchoalveolar lavage (BAL) levels of NF-${\kappa}B$-dependent cytokines such as TNF-${\alpha}$ and CC chemokines [eotaxin and monocyte chemotactic protein (MCP)-1]. DEX was effective in suppressing airway hyperresponsiveness (AHR) at 10 h, Th2-dependent asthmatic phenotypes such as airway eosinophilia, BAL levels of Th2 cytokines (IL-5 and IL-13), and mucin production. However, DEX failed to suppress BAL levels of CXC chemokines [macrophage inflammatory protein-2 (MIP-2) and keratinocyte-derived chemokine (KC)] and airway neutrophilia. Conclusion: Airway neutrophilia is among the phenomena observed in patients with severe GC-resistant asthma. This study will provide insight into the molecular basis for airway neutrophila seen in steroid-resistant asthma. Further studies are required to delineate the underlying mechanism of CXC chemokine expression in asthma.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.326-330
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• 2007

Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

• The Korean Journal of Physiology and Pharmacology
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• 제22권5호
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• pp.513-523
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• 2018

The tumor microenvironment greatly influences cancer cell characteristics, and acidic extracellular pH has been implicated as an essential factor in tumor malignancy and the induction of drug resistance. Here, we examined the characteristics of gastric carcinoma (GC) cells under conditions of extracellular acidity and attempted to identify a means of enhancing treatment efficacy. Acidic conditions caused several changes in GC cells adversely affecting chemotherapeutic treatment. Extracellular acidity did inhibit GC cell growth by inducing cell cycle arrest, but did not induce cell death at pH values down to 6.2, which was consistent with down-regulated cyclin D1 and up-regulated p21 mRNA expression. Additionally, an acidic environment altered the expression of atg5, HSPA1B, collagen XIII, collagen XXAI, slug, snail, and zeb1 genes which are related to regulation of cell resistance to cytotoxicity and malignancy, and as expected, resulted in increased resistance of cells to multiple chemotherapeutic drugs including etoposide, doxorubicin, daunorubicin, cisplatin, oxaliplatin and 5-FU. Interestingly, however, acidic environment dramatically sensitized GC cells to apoptosis induced by tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Consistently, the acidity at pH 6.5 increased mRNA levels of DR4 and DR5 genes, and also elevated protein expression of both death receptors as detected by immunoblotting. Gene silencing analysis showed that of these two receptors, the major role in this effect was played by DR5. Therefore, these results suggest that extracellular acidity can sensitize TRAIL-mediated apoptosis at least partially via DR5 in GCs while it confers resistance to various type of chemotherapeutic drugs.

• Annals of Clinical Neurophysiology
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• 제15권2호
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• pp.42-47
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• 2013

Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.37-43
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• 2001

Object : The rapid and early oxygen delivery to brain tissue was a common therapeutic method in the treatment of severe head injury patients. The purpose of this study was to investigate the effect of increased fraction of inspired oxygen in early stage of severe head injury. Methods : The parameters of research were CSF(cerebral spinal fluid) oxygen pressure($PcsfO_2$), lactate, pH, temperature, and CSF carbon dioxide pressure($PcsfCO_2$). We selected 28 patients with head trauma whose the Glasgow Coma Scale(GCS) score was less than 8 point at admission. All patients were mechanically ventilated and monitored with the commercial ICP monitoring device. Each of parameters was compared as increased fraction of inspired oxygen. In experimental cohort of 14 patients, the mean $PcsfO_2$ level was increased to $314.93{\pm}259.15mmHg$ by raising the $FiO_2$ from 40% to 100% for nine hours(p<0.05). And the mean CSF lactate level was decreased to $2.96{\pm}1.98mmol/L$ on 100% $FiO_2$ as compared with $5.98{\pm}3.25mmol/L$ on 40% $FiO_2$ in control group(p<0.05). The only above two parameters were showed statistically meaningful outcome. Conclusions : Although this study was performed in small cohort and short period, these results supports that increased inspired oxygen therapy in severe head injuried patients was recommended as a modality of treatment in future through the continuous survey.

• Journal of Nutrition and Health
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• 제52권4호
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• pp.323-331
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• 2019

Purpose: Glucocorticoids (GCs) are implicated in secondary osteoporosis, and the resulting fractures cause significant morbidity. Polyunsaturated fatty acids (PUFAs) play a vital role in bone metabolism. However, few trials have studied the impact of omega-3 PUFA-containing oils against GC-induced osteoporosis. Therefore, the present study was undertaken to determine whether supplementation with omega-3 PUFA-containing dietary oils such as fish oil, flaxseed oil or soybean oil can impede the development of GC-induced osteoporosis. Methods: The fatty acids (FAs) content of oils was determined using gas chromatography. Male rats were subdivided into 5 groups (8 rats each): normal control (balanced diet), prednisolone control (10 mg/kg prednisolone daily), soybean oil (prednisolone 10 mg/kg + soybean oil 7% w/w), flaxseed oil (prednisolone 10 mg/kg + flaxseed oil 7% w/w), and fish oil (from cod liver; prednisolone 10 mg/kg + fish oil 7% w/w). Results: The study data exhibited a significant depletion in bone mineral density (BMD) and femur mass in the prednisolone control compared to the normal control, accompanied with a marked decrease in the levels of plasma calcium and 1,25-$(OH)_2$-vitamin $D_3$, and elevated levels of C-terminal telopeptide (CTX), tumor necrosis factor-alpha (TNF-${\alpha}$) and malondialdehyde (MDA). Supplementation with fish oil, soybean oil or flaxseed oil helped to improve plasma calcium levels, and suppress oxidative stress and inflammatory markers. Additionally, bone resorption was suppressed as reflected by the decreased CTX levels. However, fish oil was more effective than the other two oils with a significant improvement in BMD and normal histological results compared to the normal control. Conclusion: This study demonstrated that supplementation with dietary oils containing omega-3 PUFAs such as fish oil, soybean oil or flaxseed oil can play a role in the prevention of bone loss and in the regulation of bone metabolism, especially fish oil which demonstrated a greater level of protection against GC-induced osteoporosis.

• Journal of the Korean Data and Information Science Society
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• 제19권3호
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• pp.937-949
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• 2008

The purpose of this meta-analysis was to investigate the anti-hepatotoxic effect of ginseng in rats induced with CC14 or TCDD, the toxicities that cause liver damages. Primary studies were collected from the ScienceDirect database, the DBpia, and the KISS. The data on the effect factors in plasma and in enzyme are listed as many as possible: The effect factors were alanine transaminase(ALT), aspartate transaminase(AST), liver aminopyrine N-demethylase(AD), liver aniline hydroxylase(AH), liver 3,4-Methylenedioxyamphetamine(liver MDA), cytochrome P450(P450), serum alkaline phosphatase(ALP), serum lactate dehydrogenase(LDH), cytochrome b5(Cyto b5), glutathione reductase (GR), Liver glutathione S-transferase(GST), liver glutamyltransferase (GT), Liver($\gamma$-GCS), serum liver 3,4-Methylenedioxyamphetamine(serum MDA), serum sorbitol dehydrogenase(SDH), serum total protein(TP), and serum $\gamma$-glutamyltransferase($\gamma$-GT). In order to investigate the effect of ginseng, the standard mean difference(HG) between the group of rats induced with toxicity(RH) and the group of rats induced with ginseng(RHG) were combined, and the significance of HGs were tested. The combined HGs checked the biases caused by heterogeneity among studies and the publication biases. Then they were adjusted by using the random effect model and trim and fill method. Although the publication biases were assumed, among all plasma factors the HGs of ALT, AST, serum MDA, SDH, TP, and $\gamma$-GT were significant, and among all enzyme factors the HGs of liver MDA, Cyto b5, GR, GST, and GT were significant. The treatment with ginseng significantly affected the plasma and enzyme levels in rats induced with toxicity.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.278-283
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• 2001

Objective : Massive cerebral infarction could be accompanied by severe brain swelling and death secondary to transtentorial herniation. Approximately 10% to 15% of middle cerebral artery infarctions are associated with this phenomenon. However, the effectiveness and timing of decompressive surgery are still controversial. In this study, we present our results on the effect of decompressive craniectomy in life threatening cerebral infarction. Method : We retrospectively analyzed 15 patients who underwent decompressive craniectomy for massive cerebral infarction from January 1997 to April 1999. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : All 15 patients(five men, ten women ; mean age, 52.3 years ; right 11, left 4) were treated with wide craniectomy and duroplasty. The average time interval between onset of symptom and surgical decompression was 2.9 days. Clinical signs of uncal herniation(anisocoria, or fixed and dilated pupils) were presented in 13 of 15 patients. Mean Glasgow coma scale(GCS) was 12.4 points on admission, 8.1 points on preoperative state and 11.8 points postoperatively. Overall outcomes were favorable in 5 cases(Glasgow outcome scale : GOS I, II), unfavorable in 6 cases(Glasgow outcome scale : GOS III, IV) and dead in 4 cases. Conclusion : Early decompressive craniectomy before brain stem compression is considered as an effective lifesaving procedure for massive cerebral infarction unresponsive to aggressive medical therapy.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.108-112
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• 2000

Objective : Many authors suggest that patients with traumatic subarachnoid hemorrhage(tSAH) visible on first CT after heve injury had a significantly worse prognosis than patients who do not. The aim of this study is to identify patients with tSAH who present with a bad prognosis by reviewing their clinicoradiological features and plan appropriate treatments. Patients and Methods : We reviewed and analysed the factors that influenced discharge outcomes in 172 patients with tSAH for a 3-year period. The outcome was divided into good(good recovery and moderate disability of glasgow outcome scale) and good(severe disability, vegetative state and death). Results : A regression analysis of statistical significant factors(p<0.05) among the clinical and CT features ranked them by descending order of contribution to Glasgow Outcome Scale(GOS) scores at the time of discharge from acute hospitalization as follows 1) clinical : admission Glasgow Coma Scale(GCS), hypotension, CT grade, abnormal APTT, skull fracture, hyperglycemia(>160mg/dl), hypoxia, operation, 2) CT : basal cistern effacement(BCE), mass lesion, cortical sulcal effacement(CSE), midline shift. Conclusion : We have also experienced that the CT grading scale proposed by Green et al is a simple and useful prognostic factor. The authors believe that the patients with high CT grade need adjuvant therapies as of well surgery but it seems mandatory to consider early identification and correction of hypotension, hyperglycemia, and hypoxia in emergency setting.