• YAKHAK HOEJI
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• v.48 no.2
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• pp.159-164
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• 2004

Primary pro-inflammatory cytokines are a trio: tumor necrosis- $\alpha$ (TNF-$\alpha$), interleukine-$\beta$ (IL-$\beta$), and interleukine-6 (IL-6). These cytokines initiate and regulate the acute-phase inflammatory response during infection, trauma, or stress and appear to play an important role in the immune process. Nitric oxide (NO) is a multi-functional mediator, which plays an important role in regulating various biological functions in vivo. NO production by inducible nitric oxide synthase (iNOS) in macrophages is essential for the defense mechanisms against microorganisms and tumor cells. However, over-expression of iNOS by various stimuli, resulting in over-production of NO, contributes to the pathogenesis of septic shock and some inflammatory and auto-immune disease. Solvent fractions of sage ( Salvia officinalis L.), which is cultivated in Jeju-Do, was assayed for their effects on TNF-$\alpha$ and IL-6 production in LPS-stimulated RAW 264.7 macrophages. Hexane and ethylacetate (EtOAc) fraction of sage inhibited the protein and mRNA expression of TNF-$\alpha$ and IL-6 in LPS stimulated RAW 264.7 cells at the concentration of 100 $\mu\textrm{g}$/$m\ell$. Also, incubation of RAW 264.7 cells with the fraction of hexane or EtOAc (50 $\mu\textrm{g}$/$m\ell$) inhibited the LPS induced nitrite accumulation and the LPS/IFN-${\gamma}$ induced iNOS protein. And this inhibition of iNOS protein is concordant with the inhibition of iNOS mRNA expression. Above results suggest that extract of sage may have anti-inflammatory activity through the inhibition of pro-inflammatory cytokines (TNF-$\alpha$, IL-1$\beta$, IL-6), iNOS and NO.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.289-295
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• 1998

Group B Streptococcal sepsis and/or meningitis is one of the most serious and common diseases in the neonatal period with high mortality and frequent complications. We have experienced a case of late onset type group B streptococcal sepsis and meningitis with a complication of subclavian vein catheterization catheterization. This 29-day-old male neonate was admitted to intensive care unit with the presentation of fever and septic shock. He was born with Cesarean delivery at 36 weeks and 3 days of gestational age. He showed multiple episodes of seizure after admission and group B streptococcus was isolated from blood. CSF profiles 10 days after admission showed the features of bacterial meningitis without organism isolated. Diffuse cerebral infarction was detected on brain CT 24 days after admission. In the 13th hospital day, the complication of subclavian vein catheterization occurred; Guide wire was cut during insertion and the distal portion of it(2.5cm) was retained in the left subclavian vein. We removed the retained guide wire with goose-neck snare catheter via right femoral vein. This case was presented with a brief review of the literatures.

• Journal of Trauma and Injury
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• v.30 no.3
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• pp.80-86
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• 2017

Purpose: To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province. Methods: We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015. Results: The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia. Conclusions: As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.

• The Korean Journal of Physiology and Pharmacology
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• v.5 no.5
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• pp.443-449
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• 2001

Previously we reported that THI 52 inhibits tumor necrosis factor $(TNF)-{\alpha}$ mRNA expression in mouse peritoneal macrophages exposed to LPS plus $IFN-{\gamma}.$ In the present study, the effects of THI 52 on vascular reactivity ex vivo, and iNOS protein expression (rat lung) were investigated in LPS-treated rats. Treatment of THI 52 concentration-dependently reduced not only serum nitrite production but also the expression of iNOS protein in rat lung tissues. Thoracic aorta taken from LPS injected rat for 8 h ex vivo resulted in suppression of vasoconstrictor effects to phenylephrine (PE), which was restored by THI 52 (20 mg/kg) 30 min prior to LPS. When measured iNOS activity, treatment of THI 52 concentration-dependently reduced the enzyme activity in RAW 264.7 cells activated with LPS plus $IFN-{\gamma}.$ Likewise, iNOS activity was significantly reduced in lung tissues taken those rats that were injected THI 52 prior to LPS injection compared with LPS injection alone. These results strongly suggest that THI 52 can suppress iNOS gene expression induced by LPS, and restore the vascular contractility to PE. Thus, THI 52, a new synthetic isoquinoline alkaloid, may be beneficial in inflammatory disorders where production of NO is excessed by iNOS expression.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.319-324
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• 2007

Purpose: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. Methods: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. Results: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. Conclusion: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

• Tuberculosis and Respiratory Diseases
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• v.68 no.6
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• pp.350-353
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• 2010

Here we report the first fatality caused by H1N1 influenza virus infection with acute respiratory distress syndrome in Korea. A 55-year-old man presented at our emergency department with dyspnea, fever, diffuse myalgia and malaise. Bilateral lung air-space consolidation was detected on his initial chest radiograph combined with severe hypoxemia. He was supported by mechanical ventilation and treated with antibiotics. A nasopharyngeal aspirate was positive for influenza A rapid antigen and oseltamivir was started on day 3 of admission. The nasal swab sample was positive for influenza H1N1 virus by real-time reverse-transcriptase polymerase chain reaction. Despite aggressive treatment, he had refractory hypoxemia and uncontrolled septic shock. On day 5 of admission he went into cardiac arrest and expired.

• Archives of Pharmacal Research
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• v.27 no.12
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• pp.1220-1225
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• 2004

The overproduction of nitric oxide (NO) by inducible nitric oxide synthase (iNOS) is known to be responsible for vasodilation and hypotension observed in septic shock and inflammation. Inhibitors of iNOS, thus, may be useful candidates for the treatment of inflammatory diseases accompanied by overproduction of NO. In the course of screening oriental anti-inflammatory herbs for the inhibitory activity of NO synthesis, a crude methanolic extract of Curcuma zedoaria exhibited significant activity. The activity-guided fractionation and repetitive chromatographic procedures with the EtOAc soluble fraction allowed us to isolate three active compounds. They were identified as 1,7-bis (4-hydroxyphenyl)-1,4,6-heptatrien-3-one (1), procurcumenol (2) and epiprocurcumenol (3) by spectral data analyses. Their concentrations for the 50% inhibition of NO production $(IC_{50})$ in lipopolysaccharide (LPS)-activated macrophages were 8, 75, 77 ${\mu}M$, respectively. Compound 1 showed the most potent inhibitory activity for NO production in LPS-activated macrophages, while the epimeric isomers, compound 2 and 3 showed weak and similar potency. Inhibition of NO synthesis by compound 1 was very weak when activated macrophages were treated with 1 after iNOS induction. In the immunoblot analysis, compound 1 suppressed the expression of iNOS in a dose-dependent manner. In summary, 1,7-bis (4-hydroxyphenyl)-1,4,6-heptatrien-3-one from Curcuma zedoaria inhibited NO production in LPS-activated macrophages through suppression of iNOS expression. These results imply that the traditional use of C. zedoaria rhizome as anti-inflammatory drug may be explained at least in part, by inhibition of NO production.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.221-225
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• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.150-162
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• 2009

Objectives: Inflammatory mediators, such as nitric oxide (NO), prostaglandin E2 ($PGE_2$) and pro-inflammatory cytokines, TNF-${\alpha}$ and IL-$1{\beta}$ playa critical role in inflammatory immune response. Therefore, intervention of inflammatory mediator production promises therapeutic benefit for treatment of many chronic inflammatory diseases, such as allergic asthma, rheumatoid arthritis, multiple sclerosis, septic shock and neurodegenerative diseases. In this study, the pharmacological effects of the flower MeOH extract Panax notoginseng (Notoginseng Flos; NF) on inflammation were investigated to address potential therapeutic or toxic effects. Methods: RA W264.7 cells were treated with different concentrations of NF methanol (NF-M) extract in the presence or absence of LPS ($1{\mu}g/m{\ell}$). Results: NF-M extract significantly inhibited LPS-induced production of NO, $PGE_2$ and pro-inflammatory cytokines, TNF-${\alpha}$ and IL-$1{\beta}$ in a dose-dependent manner. In addition, NF-M extract suppressed mRNA expressions and protein levels of iNOS, COX-2 and pro-inflammatory cytokines in LPS-stimulated RA W264.7 cells. Conclusion: These results indicated that NF-M extract inhibits LPS-induced production of inflammatory mediators in macrophages and demonstrated that NF-M extract possesses anti-inflammatory properties in vitro.

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.