• 한국임상수의학회지
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• 제34권3호
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• pp.197-199
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• 2017

A 14-year-old castrated male ShihTzu diagnosed with chronic kidney disease (CKD) 6 months prior was referred to our clinic. The patient had been experiencing symptoms such as vomiting, poor appetite and hind limbs weakness. Hematology tests showed that he had a non-regenerative anemia. With aggressive treatment, the patient's state had gotten worse. He showed ragged breath, vomiting blood and loss of consciousness temporarily. Hematocrit maintained low level. Gastric hemorrhage was strongly suspected by hematemesis. Whole blood transfusion was performed and heparin was used as an anticoagulant. Prior to transfusion, the blood cross matching between donor and patient was performed and the result was compatible. After the transfusion was stabilized, 1 mg of protamine sulfate for each 100 units of heparin was prepared and given intravenously over 3 minutes to reverse the effects of heparin. Immediately after protamine injection, the patient conducted severe anaphylactic shock. Protamine sulfate is used to reverse the anticoagulant action of heparin in dogs and humans. The adverse reaction of protamine sulfate range from mild reaction to fetal cardiac arrest. When using protamine sulfate as heparin neutralization, it can lead to the death of a patient cause of anaphylactic shock. For this reason, the protamine sulfate should be injected slowly with antihistamine and the clinician should carefully monitor patients.

• The Korean Journal of Physiology and Pharmacology
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• 제10권6호
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• pp.337-341
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• 2006

The present study was designed to investigate the protein expression of nitric oxide synthase (NOS) and guanylyl cyclase (GC) activity in ischemia/perfusion (I/R) renal injury in rats. Renal I/R injury was experimentally induced by clamping the both renal pedicle for 40 min in Sprague-Dawley male rats. The renal expression of NOS isoforms was determined by Western blot analysis, and the activity of guanylyl cyclase was determined by the amount of guanosine 3', 5'-cyclic monophosphate (cGMP) formed in response to sodium nitroprusside (SNP), NO donor. I/R injury resulted in renal failure associated with decreased urine osmolality. The expression of inducible NOS (iNOS) was increased in I/R injury rats compared with controls, while endothelial NOS (eNOS) and neuronal NOS (nNOS) expression was decreased. The urinary excretion of NO metabolites was decreased in I/R injury rats. The cGMP production provoked by SNP was decreased in the papilla, but not in glomerulus. These results indicate an altered regulation of NOS expression and guanylyl cyclase activity in I/R-induced nephropathy.

• Journal of Yeungnam Medical Science
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• 제19권1호
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• pp.11-27
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• 2002

Allogenic hematopoietic stem cell transplantation is one of the effective therapy for several hematologic malignancies. Transplantation preparative regimen is designed to eradicate the patient's underlying disease and immunosuppress the patient adequately to prevent rejection of donor's hematopoietic stem cells. So, conventional myeloablative preparative regimens with high-dose chemotherapy or radiotherapy are related to high rate of morbidity and mortality. However, It has become clear that the high-dose therapy dose not eradicate the malignancy in some patients, and that the therapeutic benefit of allogenic transplantation is largely related to graft-versus-leukemia/graft-versus-tumor (GVL/GVT) effect. An new approach is to utilize less toxic, nonmyeloablative preparative regimens to achieve engraftment and allow GVL/GVT effects to develop. This strategy reduces the risk of treatment-related mortality and allows transplantation for elderly and those with comorbidities that preclude high-dose chemoradiotherapy.

• 한국수정란이식학회지
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• 제23권2호
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• pp.127-131
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• 2008

Bone marrow (BM) cell harvesting is a crucial element in the isolation of mesenchymal stem cells (MSCs). A simple method for harvesting cat BM cells is described. The results show that a large number of BM cells can rapidly be harvested from the cat by this simple procedure. MSCs prepared by density-gradient method were spindle-shaped morphology with bipolar or polygonal cell bodies and strongly positive for CD9 and CD44 and negative for CD18 and CD45-like. They were capable of differentiation to adipocytic and osteocytic phenotypes when exposed to appropriate induction media. The advantages of this method are its rapidity, simplicity, low invasiveness, and low donor attrition and good outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.231-238
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• 1994

저자들은 1예의 전두부 연조직 결손과 2예의 경부와 안면에 형성된 다발성의 반혼구축 환자에서 조직확장술올 이용하여 양호한 두경부의 연조직 재건을 얻을 수 있었다. 다양한 연조직의 결손이나 변형에서 적절한 증례를 선택하여 올바르게 적용할 경우 조직 확장술은 유용한 재건방법이 될 수 있을 것으로 생각된다.

• 대한관절경학회지
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• 제14권2호
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• pp.92-101
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• 2010

전방십자인대 재건술에 자가 슬건과 자가 슬개건이 널리 사용되고 있으나 최근 자가 슬건의 사용이 증가하고 있다. 그 이유는 높은 최대 인장 강도, 낮은 공여부 이환률, 이식건의 고정 방법의 발전과 같은 장점 때문으로 보인다. 전방십자인대 재건술을 위해 슬건을 채취 후 슬건이 실제로 재생된다는 연구는 이러한 이론적 장점을 크게 부각시켰다. 그러나 내 회전력의 약화와 굴곡력의 감소와 같은 단점에 대한 우려가 있다. 이러한 굴곡력의 감소에 대해서 논쟁이 있으며, 과연 슬건의 재생 후에 굴곡력을 회복할 수 있는지에 대해 연구가 필요하다. 본 종설에서는 자가슬건의 장점과 단점, 슬건의 재생에 관한 최근의 연구를 고찰하고 저자들의 연구와 경험을 정리하여 기존의 연구와 비교하였다.

• Archives of Reconstructive Microsurgery
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• 제22권1호
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• pp.7-12
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• 2013

Purpose: Breast reconstruction with lower abdominal tissue can produce the best outcome with acceptable rates of long-term complication. However, for cases in which sufficient abdominal tissue is not available, an superior gluteal artery perforator (SGAP) flap can be considered as the next option for autologous breast reconstruction. Materials and Methods: Among a total of 63 women who underwent breast reconstruction with free autologous tissue transfer from July 2010 to April 2011, SGAP flap was performed for four patients. In two cases, patients did not have enough abdominal tissue for sizable breast reconstruction. In another case, the patient had a long abdominal scar due to donor hepatectomy of liver transplantation. In the last case, which was a revisional case after radiation necrosis of a previous pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, a large amount of healthy skin and soft tissue was needed. SGAP flap was elevated in lateral decubitus position. The internal mammary vessels were used for recipient vessels in all cases. Results: Breast reconstruction was performed successfully in all four cases without flap loss. Donor site complication was not observed, except for one case of seroma. The shape of the reconstructed breast was satisfactory in all patients. Conclusion: SGAP flap is an excellent alternative option for the TRAM or deep inferior epigastric artery perforator flap for breast reconstruction. In terms of narrower width, harder consistency of soft tissue, and shorter pedicle, it is clear that the SGAP flap is less competent than the TRAM flap. However, in cases where abdominal tissue is not available, SGAP flap is the only way of providing a large amount of healthy tissue.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.229-236
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• 2007

Purpose: Breast reconstruction with deep inferior epigastric perforator(DIEP) free flap is known to be the most advanced method of utilizing autologous tissue. The DIEP free flap method saves most of the rectus abdominis muscle as well as anterior rectus sheath. Therefore, the morbidity of the donor site is minimized and the risk of hernia is markedly decreased. Methods: We chose the internal mammary artery and its venae comitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels. The number and location of the perforators derived from medial or lateral branch of deep inferior epigastric artery(DIEA) in 23 DIEP flaps were identified. Ten patients underwent evaluation of their abdominal wall function preoperatively and 6 months postoperatively by using Lacote's muscle grading system. Results: Of the 23 patients, a patient with one perforator from lateral branch of DIEA experienced partial necrosis of flap. Total flap loss occurred in one patient. Mild abdominal bulging was reported in one patient 4 months postoperatively probably because of early vigorous rehabilitational therapy for her frozen shoulder. Postoperative abdominal wall function tests in 10 patients showed almost complete recovery of muscle function upto their preoperative level of upper and lower rectus abdominis and external oblique muscle function at 6 months postoperatively. All patients have been able to resume their daily activities. Conclusion: The breast reconstruction with DIEP free flap is reliable and valuable method which provide ample soft tissue from abdomen without compromising the integrity of abdominal wall. Selection of reliable perforators is important and including more than two perforators may decrease fat necrosis and partial necrosis of flap.

• 대한이식학회지
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• 제31권4호
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• pp.200-206
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• 2017

Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P<0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.

• Tuberculosis and Respiratory Diseases
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• 제45권6호
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• pp.1265-1276
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• 1998

연구배경 : NO는 생체내에서 생성되는 유리 반응기로서 혈관 긴장도외 완화, 혈소판 응집 저지, 혈관 내피세포에 대한 백혈구 유착 방해, 감염에 대한 숙주 방어 등에서 중요한 역할을 한다. NO는 전이 금속(transition metal), 산소, 기타 반응기 등과 쉽게 반응하므로 여러 생체내 반응에 관여하여 산화제 손상을 촉진시키거나 감소시킬 가능성이 제기되었다. 급성 폐손상 및 급성 호흡곤란 증후군에서는 폐혈관 내피세포 및 호중구의 상호작용 및 산화제 손상이 매우 중요한 병인으로 알려져 있으며, NO를 급성 호흡곤란 증후군에서 흡입하여 치료하는 것은 산화제에 의한 혈관 내피세포 손상에서 외부로부터 NO를 공급하는 상황이다. 본 연구에서는 외인성 NO의 공여나 내인성 NO 억제가 산화제에 의한 폐미세혈관 내피세포의 손상을 악화시키거나 완화시킬 수 있는지를 관찰하였다. 방 법 : 산화제에 의한 세포손상은 백서 폐미세혈관 내피세포에 과산화수소를 생성하는 glucose oxidase(GO)를 투여하여 야기시키고 이를 $^{51}Cr$ 방출 측정으로 평가하였다. 산화제에 의한 폐혈관 내피세포의 손상에 외인성 NO가 미치는 영향은 NO 공여물인 SNAP 혹은 SNP를 산화제와 동시에 투여하여 평가하였다. 산화제에 의한 폐혈관 내피세포의 손상에 내인성 NO 억제가 미치는 영향은 NOS 길항제인 L-NMMA을 추가로 투여하여 평가하였다. INF-$\gamma$, TNF-$\alpha$ LPS 등으로 내인성 NO 생성을 자극한 후 L-NMMA의 효과도 관찰하였으며, NO 공여물이나 내피세포로 부터의 NO생성은 nitrite 측정으로 평가하였다. 결 과 : 백서 폐 미세혈관 내피세포에서 $^{51}Cr$ 방출이 GO 5mU/ml에서 $8.7{\pm}0.5%$, 10 mU/ml에서 $14.4{\pm}2.9%$, 15 mU/ml에서 $32.3{\pm}2.9%$, 20 mU/ml에서 $55.5{\pm}0.3%$. 30 mU/ml에서 $67.8{\pm}0.9%$로 GO 15 mU/ml 이상에서 대조군의 $9.6{\pm}0.7%$에 비하여 유의하게 증가하였으며 (P<0.05; n=6). 이에 0.5mM L-NMMA를 추가하여도 영향이 없었다. INF-$\gamma$ 500 U/ml, TNF-$\alpha$ 150 U/ml, LPS 1 ${\mu}g/ml$을 배양액에 첨가하여 24시간 경과시 배양액 중 nitrite 농도가 $3.9{\pm}0.3\;{\mu}M$로 증가하였으며, 이에 L-NMMA 0.5 mM을 첨가하면 $0.2{\pm}0.l\;{\mu}M$로 유의하게 억제되었다(p<0.05 ; n=6). INF-$\gamma$, TNF-$\alpha$ LPS 자극후 GO에 의한 $^{51}Cr$ 방출에 L-NMMA는 영향을 주지 않았다. GO 20 mU/ml에 의한 $^{51}Cr$ 방출이 SNAP 100 ${\mu}M$의 추가로 대조군 수준으로 현저히 억제되었으나, SNP, potassium ferrocyanide, potassium ferricyanide 등의 추가는 영향이 없었다. Hanks' balanced salt solution(HBSS) 중의 SNAP 100 ${\mu}M$로 부터 4 시간 동안 nitrite가 $23.0{\pm}1.0\;{\mu}M$ 농도로 축적되었으나, SNP는 1 mM에서도 nitrite가 검출되지 않았다. SNAP은 HBSS 중의 GO가 과산화수소를 시간 경과에 따라 생성하는데 영향이 없었다. 결 론 : 결론적으로 폐미세혈관 내피세포에서 GO에 의하여 생성되는 과산화수소로 산화제 손상을 야기하였으며, NO 공여물인 SNAP으로부터 제공된 외연성 NO가 산화제 손상을 방지하고 이 보호효과는 NO 방출 능력에 의할 가능성이 시사되었다. 따라서 생체내 환경에 따라 외인성 NO가 내피세포에 대한 산화제 손상에 보호 효과가 있을 수 있다고 추정된다.