• 한국간담췌외과학회지
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• 제27권3호
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• pp.301-306
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• 2023

Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.

• Journal of Nutrition and Health
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• 제51권5호
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• pp.369-378
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• 2018

본 연구에서 고지방식이로 비만을 유도한 생쥐는 식이 4주 후 지방조직의 형태학적 변화가 관찰되었고 생식기 지방조직의 무게가 증가하였으며, 혈장 중성지방 및 혈당치도 현저하게 증가하였다. 고지방식이 6주 후 몸무게의 유의한 증가가 관찰되기 시작하였으며, 뒤다리넙적근과 어깨사이 지방조직의 무게는 감소하고, 생식기 지방조직 및 간의 무게는 증가하였다. 지방조직의 형태학적 변화가 시작되는 고지방식이 유도 4주 후 혈장 내 40종의 시토카인 및 케모카인의 변화를 동시에 관찰하여 대조군과 비교해 본 결과, CXCL12 (SDF-1)와 CXCL13 (BLC)의 발현이 가장 현저하게 증가하였으며, G-CSF의 발현도 다소 증가하였다. 혈장 내 염증성 시토카인의 발현은 전반적으로 낮았다. 이상의 결과를 종합하면 고지방식이 유도 비만 초기에 만성 염증 상태로 진입하기 전 혈장 내 CXCL12와 CXCL13의 발현이 현저히 증가하는 것을 밝혔으며, CXCL12와 CXCL13의 증가로 B 세포, T 세포 및 단핵구가 혈관을 빠져나가 지방조직 및 지방조직 주변 림프조직으로 이동하여 지방조직 재형성과 국소 지방조직 면역에 관여할 것으로 보인다.

• Tuberculosis and Respiratory Diseases
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• 제67권6호
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• pp.545-550
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• 2009

Background: Endobronchial ultrasonogram (EBUS) has increased the diagnostic yield of a bronchoscopic biopsy of peripheral pulmonary lesions (PPL). This study evaluated the diagnostic yield of EBUS-guided transbronchial biopsy (TBB) and the visibility of EBUS PPL. Methods: Between August 2007 and November 2008, 50 patients (32 men and 18 women, median age, 61.1${\pm}$10 yrs; range, 16 to 80 yrs) whose PPL lesions could not be detected with flexible bronchoscopy were enrolled in this study. Among the 50 patients, 40 cases were malignant lesions (adenocarcinoma 25, squamous cell carcinoma 10, small cell carcinoma 5) and 10 cases were benign lesions (tuberculoma 7, fungal ball 1, other inflammation 2). Results: The mean diameter of the target lesion was 35.4${\pm}$4.3 mm. Of the 50 patients examined, the overall diagnostic yield by EBUS-TBLB was 46.0% (23/50). The visualization yield of EBUS was 66.0% (33/50). A definitive diagnosis of PPL localized by EBUS was established using EBUS-TBLB in 69.6% (23/33) of cases. The diagnostic yields from washing cytology and brushing cytology from a bronchus identified by EBUS were 27.0% and 45.4% respectively. The diagnostic yields reached 78.7% when the three tests (washing cytology, brushing cytology and EBUS-TBLB) were combined. The visualization yield of EBUS in lesions <20 mm was significantly lower than that in lesions ${\geq}$20 mm (p=0.04). The presence of a bronchus leading to a lesion (open bronchus sign) on the chest CT scan was associated with a high visualization yield on EBUS (p=0.001). There were no significant complications associated with EBUS-TBLB. Conclusion: EBUS-TBLB is a safe and effective method for diagnosing PPL. The lesion size and open bronchus signs are significant factors for predicting the visualization of EBUS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.149-156
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• 2001

베타 용혈성 A군 연구균(group A beta-hemolytic streptococcus)에 의한 류마치스성 열 이후에 Sydenham 무도병이 발현되는 환자 군에서 강박 증상 또는 틱 증상이 나타난다는 보고가 있은 후, A군 연구균 감염과 강박 장애 또는 틱 장애 사이의 관계가 주목받게 되었다. A군 연구균 감염 후에 강박 증상 또는 틱 증상이 유발되는 환자들은 갑작스런 발병과 극적인 증상 악화를 보이고 사춘기 이전에 발병하며 무도병 모양의 운동 및 독특한 양상의 운동 과잉 등의 신경학적 이상을 보이고 또 그 경과가 악화 및 완화를 반복하는 양상을 보인다. 이런 임상적 특징을 보이는 소아 환자 군을 PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections)라고 부르게 되었다. 이후 현재까지 강박 장애와 틱 장애뿐 아니라 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 신체이형장애 환자들이 PANDAS 범주에 속한다는 보고들이 있어 왔다. 본 증례는 7세까지 정상적인 발달을 보이다가 A군 연구균 감염 수개월 후부터, 인지 기능, 사회성, 언어 및 의사소통에 장애를 보이고 틱 증상과 함께 얼굴과 손발에 이상 운동을 보이는 환자를 기술하였다. 이에 저자들은 본 증례가 소아기 붕괴성 장애의 양상을 보이는 PANDAS 증례라고 생각되어 이를 문헌 고찰과 함께 보고함으로써, PANDAS가 틱 장애, 강박 장애, 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 그리고 신체이형장애 등의 양상을 보일 뿐 아니라 소아기 붕괴성 장애의 양상을 보일 수 있다는 사실을 보고하고자 한다.

• 한방재활의학과학회지
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• 제15권2호
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• pp.141-154
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• 2005

Objectives : This study was planned to evaluate clinical status of the alopecia patients who had visited oriental medicine clinic. Methods : 80 patients with alopecia, who had visited oriental medicine clinic from January 2004 to August 2004, were examined. Results & Conclusions : 1. The kinds and incidences of Alopecia : androgenetic alopecia 57.5%(46/80), alopecia areatea 20.0%(16/80), telogen effluvium 16.3%(13/80), seborrheic alopecia 6.3%(5/80). 2. In distribution of sex, the rate of male to female was 1:1 and most patients belonged to 20-30 year old group. 3. The most common onset of age was adolescence(63.8%) and the most common duration of hair loss was 1 to 3 years. 4. Among the 30 male androgenetic alopecia patients, Hamilton's type 4 was most common and among the 16 female androgenetic alopecia patients, Ludwig's type II and III were most common. 5. Family history of baldness in Androgenetic alopecia and alopecia areata were 56.5% and 25.0%, respectively. 6. Self-conscious causes of hair loss : stress(48.8%), irregular eating habits(21.3%), and lack of sleep(20.0%). 7. Associated diseases with alopecia patients : chronic neck pain(58.8%), temporomandibular disorders(55.0%) and seborrheic dermatitis(20.0%). 8. Associated symptoms with alopecia Patients : stress(78.8%), sleep disorders(68.8%), irregular eating habits(55.0%), Hot flush(43.8%), Stool disorders(43.8%), cold hands and feet(37.5%) and menstruation disorders(31.3%). 9. The most common scalp type was oily scalp(70.0%) and the symptoms of scalp were iching, dandruff, pain, inflammation. 10. $Bi{\grave{a}}n$ $zh{\grave{e}}ng$(辨證) of alopecia patients : $xu{\grave{e}}-r{\grave{e}}-f{\bar{e}}ng-z{\grave{a}}u$(血熱風燥) (25.0%), $g{\bar{a}}n-sh{\grave{e}}n-b{\grave{u}}-z{\acute{u}}$(肝腎不足) (23.8%), $shi-r{\grave{e}}-sh{\grave{a}}ng-zh{\bar{e}}ng$(濕熱上蒸) (16.3%), $xu{\grave{e}}-r{\grave{e}}-sh{\bar{e}}ng-f{\bar{e}}ng$(血熱生風) (13.8%), $xu{\grave{e}}-x{\bar{u}}-f{\bar{e}}ng-z{\grave{a}}u$(血熱風燥) (13.8%), $y{\bar{u}}-xu{\grave{e}}-z{\check{u}}-lu{\grave{o}}$(瘀血阻絡) (7.5%).

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

• 생명과학회지
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• 제32권6호
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• pp.482-490
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• 2022

근육 양과 근력의 감소에 의한 근감소증은 다양한 병적 상태의 악화, 삶의 질 저하, 사망률의 증가를 동반하며, 기대수명이 증가함에 따라 앞으로도 유병률은 계속 증가할 것이다. 노화 과정에서 만성 산화 스트레스와 염증 반응의 증가는 골격근 소실의 주요 원인으로 작용하며, 에너지 대사에 필수적인 미토콘드리아의 기능 장애와 관련된 자가포식 및 세포사멸 신호의 교란은 근육 단백질의 손실을 가속화한다. 오래전부터 각종 질병의 예방 및 치료에 널리 사용되어온 동충하초의 주요 생리활성물질인 cordycepin의 약리학적 효과는 항산화 및 항염증 작용과 직접적인 관련이 있는 것으로 알려져 있다. 본 총설에서는 근감소증의 예방과 치료에의 적용을 위한 cordycepin의 세포사멸, 자가포식, 단백질의 이화작용 및 근육 재생에 중요한 위성세포의 활성에 대한 연관성을 제시하였다. 비록 현재까지 근감소증에 대한 cordycepin의 연구는 미진한 수준이지만, 그동안의 연구 결과에서 cordycepin은 노화로 인한 미토콘드리아 기능 약화를 억제하고 근육 단백질의 분해를 차단하는 데 기여할 수 있음을 알 수 있다. 또한 근세포 손상에 대한 cordycepin의 보호 효과는 항산화 및 항염증 활성과 밀접한 관련이 있음을 제안한다. 따라서 근세포의 노화방지에 관여하는 cordycepin의 분자생물학적 기전을 중심으로 보다 지속적인 기초 연구가 필요할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5527-5531
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• 2013

Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. Methods: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. Results: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (${\leq}4$) (P=0.01). Age ${\leq}65$, NLR>4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). Conclusions: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.

• 한국발생생물학회지:발생과생식
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• 제12권3호
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• pp.243-250
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• 2008

비만세포는 세포질 내에 다양한 신호전달물질을 과립형태로 함유하고 있는 세포로써, 피부, 기도, 소화관 등의 점막과 결합조직에 주로 분포하고 있으며, 염증반응, 자기방어, 조직재생, 자가면역질환 등 다양한 생리적, 병리적 현상에 관여하고 있는 면역세포이다. 본 연구는 생쥐 연령별 자궁의 발달과 퇴행에 따른 자궁조직 내 비만세포의 분포와 밀도변화를 조사함으로써, 생쥐 자궁에서 비만세포의 기능을 알아보고자 실시하였다. 자궁조직 내 비만세포는 발정주기가 시작되는 생후 6주 이전에는 매우 적은 수가 관찰되었으나, 생후 7주부터 자궁의 조직형태적 발달과 더불어 급격히 증가하기 시작하여 32주에 이르기까지 지속적으로 증가하였다. 그러나 생후 38주부터는 자궁조직의 퇴행과 더불어 비만세포의 밀도도 감소하였다. 비만세포는 자궁의 근층조직에서 주로 관찰되었으며, 주요 세포외기질인 교원섬유도 자궁의 발달, 비만 세포의 밀도 증가와 더불어 그 함량이 증가하였다가 자궁의 퇴행과 함께 감소하였다. 전자현미경적 관찰에서 비만세포는 자궁 근층조직에서 평활근세포, 섬유모세포, 교원섬유와 근접하고 있는 형태로 관찰되었다. 이상의 연구 결과는 비만세포가 자궁에서의 면역기능에 중요한 역할을 할 뿐만 아니라, 분만, 생리주기에 따른 자궁조직의 재생 및 재구성, 그리고 평활 근조직의 수축 등에도 관여할 수 있음을 시사하고 있다.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.13-19
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• 2024

Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.