• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• 생명과학회지
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• 제33권3호
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• pp.287-294
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• 2023

건강한 adipose tissue는 대사 항상성 통해 비만을 막는데 중요하다고 할 수 있다. Adipose tissue는 포도당과 지질 대사를 통해 에너지 균형에 중요한 역할을 한다. 영양분 상태에 따라, adipose tissue는 지질을 저장하여 커지기도 하고, 지질 분해를 통해 에너지를 소비하기도 한다. 게다가, adipose tissue는 호르몬 분비기관으로 작용이 부각되고 있다. 다양한 adipose tissue 호르몬이 존재하며, metabolic signaling을 통해 다른장기와 조직에 영향을 준다. 예를 들면, adipose tissue에서 분비하는 대표적인 펩타이드 호르몬(adipokine)은 섭식조절을 위해 뇌의 중추신경을 자극한다. 또한 adipocytes도 염증성 cytokines을 분비하여 adipose tissue의 immune cells을 표적으로 한다. 당연하게도, adipocytes는 지질에서 만들어지는 호르몬(lipokine)이 분비되어 특정 수용체와 결합하여 paracrine 및 endocrine으로 영향을 준다. 이러한 adipose tissue 호르몬에 의한 장기 조직 간의 상호작용을 이해하기 위해서는, 세부적인 adipocytes 및 다른 표적 세포에서 metabolic sig- naling이 규명되어야 한다. 그러므로, 과체중이나 비만의 건강하지 못한 adipose tissue에서는 metabolic sig- naling의 비정상적인 조절이 일어난다고 할 수 있다. 새로운 adipose metabolic signaling을 표적으로 하는 치료제는 항 비만 약물개발을 이끌어 낼 수 있다. 본 총설논문은 비만과 대사질환 관점에서 adipose tissue 호르몬과 metabolic signaling의 최신 연구결과를 요약 정리한다.

• Molecules and Cells
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• 제43권11호
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• pp.964-973
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• 2020

Recent studies have highlighted that early enhancement of the glycolytic pathway is a mode of maintaining the proinflammatory status of immune cells. Thiamine, a wellknown co-activator of pyruvate dehydrogenase complex, a gatekeeping enzyme, shifts energy utilization of glucose from glycolysis to oxidative phosphorylation. Thus, we hypothesized that thiamine may modulate inflammation by alleviating metabolic shifts during immune cell activation. First, using allithiamine, which showed the most potent anti-inflammatory capacity among thiamine derivatives, we confirmed the inhibitory effects of allithiamine on the lipopolysaccharide (LPS)-induced pro-inflammatory cytokine production and maturation process in dendritic cells. We applied the LPS-induced sepsis model to examine whether allithiamine has a protective role in hyper-inflammatory status. We observed that allithiamine attenuated tissue damage and organ dysfunction during endotoxemia, even when the treatment was given after the early cytokine release. We assessed the changes in glucose metabolites during LPS-induced dendritic cell activation and found that allithiamine significantly inhibited glucose-driven citrate accumulation. We then examined the clinical implication of regulating metabolites during sepsis by performing a tail bleeding assay upon allithiamine treatment, which expands its capacity to hamper the coagulation process. Finally, we confirmed that the role of allithiamine in metabolic regulation is critical in exerting anti-inflammatory action by demonstrating its inhibitory effect upon mitochondrial citrate transporter activity. In conclusion, thiamine could be used as an alternative approach for controlling the immune response in patients with sepsis.

• Molecules and Cells
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• 제25권1호
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• pp.64-69
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• 2008

Although the arthritis symptoms observed in the K/BxN model have been shown to be dependent on the functions of T and B cells specific to the self antigen glucose-6-phosphate isomerase, less is known about the in vivo roles of $CD4^{+}CD25^{+}$ regulatory T($T_{reg}$) cells in the pathology of K/BxN mice. We determined the quantitative and functional characteristics of the $T_{reg}$ cells in K/BxN mice. These mice contained a higher percentage of $Foxp3^+\;T_{reg}$ cells among the $CD4^+$ T cells than their BxN littermates. These $T_{reg}$ cells were anergic and efficiently suppressed the proliferation of $na\ddot{i}ve$ $CD4^+$ T cells and cytokine production by effector $CD4^+$ T cells in vitro. Antibody-mediated depletion of $CD25^+$ cells caused K/BxN mice to develop multi-organ inflammation and autoantibody production, while the symptoms of arthritis were not affected. These results demonstrate that despite the inability of the $T_{reg}$ cells to suppress arthritis development, they play a critical role protecting the arthritic mice from systemic expansion of autoimmunity.

• Nutrition Research and Practice
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• 제4권4호
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• pp.259-269
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• 2010

Resistance training (RT) is associated with reduced risk of low grade inflammation related diseases, such as cardiovascular disease and type 2 diabetes. The majority of the data studying cytokines and exercise comes from endurance exercise. In contrast, evidence establishing a relationship between RT and inflammation is more limited. This review focuses on the cytokine responses both following an acute bout, and after chronic RT. In addition, the effect of RT on low grade systemic inflammation such as individuals at risk for type 2 diabetes is reviewed. Cytokines are secreted proteins that influence the survival, proliferation, and differentiation of immune cells and other organ systems. Cytokines function as intracellular signals and almost all cells in the body either secrete them or have cytokine receptors. Thus, understanding cytokine role in a specific physiological situation such as a bout of RT can be exceedingly complex. The overall effect of long term RT appears to ameliorate inflammation, but the specific effects on the inflammatory cytokine, tumor necrosis factor alpha are not clear, requiring further research. Furthermore, it is critical to differentiate between chronically and acute Interleukin-6 levels and its sources. The intensity of the RT and the characteristics of the training protocol may exert singular cytokine responses and as a result different adaptations to exercise. More research is needed in the area of RT in healthy populations, specifically sorting out gender and age RT acute responses. More importantly, studies are needed in obese individuals who are at high risk of developing low grade systemic inflammatory related diseases. Assuring adherence to the RT program is essential to get the benefits after overcoming the first acute RT responses. Hence RT could be an effective way to prevent, and delay low grade systemic inflammatory related diseases.

• Clinical and Experimental Pediatrics
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• 제63권7호
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• pp.239-250
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• 2020

The novel coronavirus disease 2019 (COVID-19) is spreading globally. Although its etiologic agent is discovered as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), there are many unsolved issues in COVID-19 and other infectious diseases. The causes of different clinical phenotypes and incubation periods among individuals, species specificity, and cytokine storm with lymphopenia as well as the mechanism of damage to organ cells are unknown. It has been suggested that in viral pneumonia, virus itself is not a direct cause of acute lung injury; rather, aberrant immune reactions of the host to the insults from viral infection are responsible. According to its epidemiological and clinical characteristics, SARS-CoV-2 may be a virus with low virulence in nature that has adapted to the human species. Current immunological concepts have limited ability to explain such unsolved issues, and a presumed immunopathogenesis of COVID-19 is presented under the protein-homeostasis-system hypothesis. Every disease, including COVID-19, has etiological substances controlled by the host immune system according to size and biochemical properties. Patients with severe pneumonia caused by SARS-CoV-2 show more severe hypercytokinemia with corresponding lymphocytopenia than patients with mild pneumonia; thus, early immunomodulator treatment, including corticosteroids, has been considered. However, current guidelines recommend their use only for patients with advanced pneumonia or acute respiratory distress syndrome. Since the immunopathogenesis of pneumonia may be the same for all patients regardless of age or severity and the critical immune-mediated lung injury may begin in the early stage of the disease, early immunomodulator treatment, including corticosteroids and intravenous immunoglobulin, can help reduce morbidity and possibly mortality rates of older patients with underlying conditions.

• Radiation Oncology Journal
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• 제6권2호
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• pp.259-262
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• 1988

만성 골수성 백혈병 치료에 있어서 비장의 방사선 조사는 화학요법에 반응이 없거나, 비종대가 심하여 비장 절제술을 시행할 수 없는 환자 그리고 통증을 동반한 비종대 환자에서 증상완화를 위하여 사용되고 있다. 가톨릭의대 성모병원 방사선과에서는 만성 골수성 백혈병에 있어 비장의 방사선 조준시 초음파를 이용하여 치료범위를 정하는 새로운 방법을 개발하여 이에 보고하는 바이다. 이 방법의 장점은 기존의 방사선 조준기를 사용하여 결정하는 방사선치료범위보다 작으며 비장만을 정확하게 포함 할 수 있으므로 효과적 인 비 장 조사 및 주변 장기의 방사선 보호, 그리고 부작용 등을 감소시킬 수 있다.

• Radiation Oncology Journal
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• 제12권3호
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• pp.295-300
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• 1994

It was the purpose of present study to develop a new thermoseed for heating deep-seated tumors and assessment of the effect of magnetic control on thermoseeds. Aqueous suspension of iron micro spheres (Ferropolysaccharide) was injected directly into the VX-2 hepatoma and heated with 1.2 MHz inductive radiofrequency unit. Aqueous thermoseed suspension was delivered to the tumor by simple percutaneous injection. The limitation of the thermoseed heating method is the positional change of thermoseed particles in the tumor after implantation. The thermoseed particles could enter the systemic blood circulation and cause a severe embolization of a critical organ. To minimize this limitation, we have used the magnetic control after loading the thermoseed in the tumor, W hen ferropolysaccharides were exposed to a strong magnetic field, they magnetized and subsequently exerted a magnetic force on each other, forming larger aggregates of particles. The size of aggregated Particles were too big to enter the systemic blood circulation. Thus, unlike other thermoseed method, we hold the thermoseed particles stationary in the tumor. The temperature of the injected site and immediate vicinity elevated by $4-5^{\circ}C$. The temperature of the surrounding normal hepatic tissue elevated by $1-2^{circ}C$ only. The heating effect within the tumor was variable depending on the density of ferromagnetic aqueous suspension. Our results suggest that inductive heating of tumor injected with ferropolysaccharide solution offers the possibility of effective heat delivery to the defined tumor volume, which is difficult to heat with other heating devices.

• 디지털융복합연구
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• 제11권4호
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• pp.311-320
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• 2013

본 연구는 일 대학 간호과와 비 간호과 학생의 생명의료윤리 의식을 파악하여 대학생들의 올바른 생명윤리 의식 함양에 필요한 윤리교육의 방향과 교육과정 내용을 위한 기초자료를 제공하고자 시도하였다. 생명의료윤리 의식은 4점 만점에 간호과 학생들이 평균 3.04점으로 비 간호과 학생들의 2.88점보다 높았고 이들 간에 유의한 차이가 있었다(t=6.79, p<.001). 두 그룹간에 태아의 생명권, 태아진단, 신생아 생명권, 안락사, 장기이식, 뇌사영역에서 통계적으로 유의한 차이를 나타내었다. 대상자들의 생명의료윤리 의식에 영향을 미치는 주요 요인은 간호과에서는 한 학기 이상 윤리관련 수업 경험 유무, 생명윤리 관련 문제로 고민한 경험 유무, 윤리적 가치관이었고, 비 간호과는 학년으로 나타났다. 결과적으로 대상자들의 낮은 생명의료윤리 의식은 각 학과별로 기본적인 생명윤리 교육부터 고학년으로 올라갈수록 체계적이고 복합적인 윤리적 사고 판단과 의사결정 능력, 가치관 고취를 위한 교육과정을 통해 충족되어야 할 것이다. 추후 생명의료윤리 의식의 하위영역별 집중연구나 질적 연구를 제언한다.

• Tuberculosis and Respiratory Diseases
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• 제76권1호
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• pp.38-41
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• 2014

Immunoglobulin G4 (IgG4)-related disease is a newly recognized condition characterized by fibroinflammatory lesions with dense lymphoplasmacytic infiltration, storiform-type fibrosis and obliterative phlebitis. The pathogenesis is not fully understood but multiple immune-mediated mechanisms are believed to contribute. This rare disease can involve various organs and pleural involvement is even rarer. We report a case of IgG4-related disease involving pleura. A 66-year-old man presented with cough and sputum production for a week. Chest radiography revealed consolidation and a pleural mass at right hemithorax. Treatment with antibiotics resolved the consolidation and respiratory symptoms disappeared, but the pleural mass was unchanged. Video-assisted thoracoscopic surgery was performed. Histopathology revealed dense lymphoplasmacytic infiltration and storiform fibrosis with numerous IgG4-bearing plasma cells. The serum IgG4 level was also elevated. Further examination ruled out the involvement of any other organ. The patient was discharged without further treatment and there is no evidence of recurrence to date.