http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
응급 현장 초음파에서 측정된 승모판륜 수축 이동과 삼첨판륜 수축 이동의 유용성: 응급실에서 임상적으로 적용하기 위한 비대면 선행 실험연구
조재열,황정성,홍정석 대한응급의학회 2022 대한응급의학회지 Vol.33 No.5
Objective: As a part of point-of-care ultrasound (POCUS), the rapid assessment of cardiac systolic function using tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE) are thought to be valuable tools during a cardiac emergency. This article is an untact pilot experiment before the clinical application of these procedures in an emergency room. Methods: Totally, 206 video samples from YouTube concerning echocardiograms of a normal heart, ischemic heart disease, congestive heart failure, cardiomyopathy, pulmonary hypertension, and pulmonary embolism were extracted and analyzed with free programs opened in internet services. Results: The values of MAPSE, TAPSE, and TAPSE+MAPSE ranged between 13.3±2.3 mm, 23±2.8 mm, and 36± 4.5 mm, respectively, in the normal echocardiogram versus 7.8±2.5 mm, 16.5±5.0 mm, and 24.2±6.4 mm, respectively, in an abnormal echocardiogram (P<0.05). Positive correlations were obtained between MAPSE and TAPSE, MAPSE and TAPSE+MAPSE, and TAPSE and TAPSE+MAPSE (R2=0.346, R2=0.687, and R2=0.871, respectively). MAPSE ≤ 7.7 mm, TAPSE ≤18.5 mm, and TAPSE+MAPSE ≤27.7 mm show 100% sensitivity, and the specificities for an abnormal echocardiogram at these values are 51.8%, 63.3%, and 71.7%, respectively. At TAPSE ≤18.5 mm and TAPSE/ (TAPSE+MAPSE) ≤0.61, the sensitivity of pulmonary hypertension containing a pulmonary embolism is 81.2%, and the specificity is 81%. It is presumed that the lower these values, the higher the emergency. Conclusion: In a cardiac emergency, differentiating left or right systolic heart failure is probably useful by checking not only MAPSE or TAPSE using POCUS, but also determining the ratios MAPSE/(MAPSE+TAPSE) or TAPSE/(MAPSE+TAPSE). However, further retrospective or prospective studies in an emergency room are required for a specific disease diagnosis.
S. abortus 유래 LPS와 E. coli 유래 LPS에 의한 패혈증성 쇽 유도 작용 비교
조재열,유은숙,Cho, Jae-Youl,Yoo, Eun-Sook 대한약학회 2007 약학회지 Vol.51 No.1
Acute septic shock is one of inflammatory diseases mediated by pro-inflammatory cytokines such as tumor necrosis factor (TNF)-${\alpha}$. In this study, we examined the pathological difference and mechanism of lipopolysaccharides isolated from E. coli (E-LPS) or S. abortus (S-LPS) on inducing acute septic shock in ICR mouse. All mice were died by intraperitoneal treatment of S-LPS with 0.75 mg/kg, whereas E-LPS treated with even 3 mg/kg only showed 30% of mice lethal, indicating that S-LPS may be more feasible in triggering a strong septic shock condition. The secretion pattern of TNF-${\alpha}$, a critical pro-inflammatory cytokine in septic shock condition, was also distinct between E-LPS- and S-LPS-treated groups. Thus, S-LPS strikingly increased serum level of TNF-${\alpha}$ (6 ng/ml) at 1 h, while E-LPS just displayed at 2 ng/ml level. However the interaction of S-LPS with LPS receptor toll like receptor (TLR)-4, was not stronger than that of E-LPS, according to experiments with macrophage cell line RAW264.7 cells. Thus, E-LPS rather than S-LPS strongly enhanced the production of TNF-${\alpha}$. Interestingly, S-LPS more strongly up-regulated splenocyte proliferation, compared to E-LPS group, whereas there was no difference between S- or E-LPS treated groups in proliferation of Balb/c- or C57BL/6-originated splenic lymphocytes. Therefore, our data suggest that S-LPS is a more active endotoxin and that the strong septic shock-inducing effect of S-LPS seems due to the enhancement of early TNF-${\alpha}$ production and S-LPS-sensitive lymphocyte proliferation.