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Soo Jin Na,하태순,서지영,고신옥,Chae-Man Lim,Won-Il Choi, M.D., Ph.D.,Young-Joo Lee,Seok Chan Kim,전규락,Je Hyeong Kim,김재열,Jae Min Lim,Sunghoon Park,김호철,Jin Hwa Lee, M.D., Ph.D.,Ji-Hyun Lee, M.D., Ph.D.,Jisook Pa 대한중환자의학회 2018 Acute and Critical Care Vol.33 No.3
Background: The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea. Methods: This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study. Results: During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients. Conclusions: Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.
약물치료에 반응을 하지 않았던 비폐쇄성 연하곤란 1 예
조영석(Young Seok Cho),최명규(Myung Gyu Choi),정우철(Woo Chul Chung),정정조(Jeong Jo Jeong),이인석(In Seok Lee),김상우(Sang Woo Kim),김성수(Sung Soo Kim),채현석(Hiun Suk Chae),한석원(Sok Won Han),정인식(In Sik Chung),박두호(Doo Ho Pa 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.1
Dysphagia is a frequent symptom which is observed in about 6% of all population. The most common causes of nonobstructive dysphagia are reported to be esophageal motility disorders, systemic disease and GERD. About 30% of GERD patients complain of dysphagia. Dysphagia in GERD patients is mostly due to peptic stricture but occasionally related to transient segmental esophageal motor disorder. A 42-year old male patient was admitted because of dysphagia and weight loss. He had renal transplantation 5 years ago. The results of esophagogastroduodenoscopic examination, esophagogram and esophageal manometry were normal. Treatment with proton pump inhibitor, prokinetic and anti-depressant was begun but the patient continued to complain of dysphagia. The result of 24 hour ambulatory pH monitoring revealed pathologic reflux. The results of 24 hour ambulatory esophageal manometry and video fluoroscopy were normal. After reassured, he didn`t complain of dysphagia. We report this case of nonobstructive dysphagia accompanied with GERD refractory to medical treatment in patient who had renal transplantation.(Korean Journal of Gastrointestinal Motility 2002;8:47-52)
고령자와 약년자 위암의 임상병리학적 특성 및 수술성적의 비교 검토
권성준(Sung Joon Kwon),최동호(Dong Ho Choi),박영석(Young Seok Park),이홍찬(Hong Chan Lee),이구진(Goo Jin Lee),권오정(Oh Jung Kwon),정파종(Pa Jong Jung),이광수(Kwang Soo Lee),전규영(Kyu Young Jun),원치규(Chi Kyooh Won),곽진영(Jin Youn 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.52 No.4
Kim, Ju-Young,Cho, Hyun-Jai,Sir, Jung-Ju,Kim, Baek-Kyung,Hur, Jin,Youn, Seock-Won,Yang, Han-Mo,Jun, Soo-In,Park, Kyung-Woo,Hwang, Seok-Jae,Kwon, Yoo-Wook,Lee, Hae-Young,Kang, Hyun-Jae,Oh, Byung-Hee,Pa British Medical Association 2009 Cardiovascular research Vol.82 No.3
<P>AIMS: Inflammation, and the subsequent proliferative activity of vascular smooth muscle cells (VSMCs), is one of the major pathophysiological mechanisms associated with neointimal hyperplasia following vascular injury. Although sulfasalazine (SSZ) has been used as an anti-inflammatory and immune-modulatory agent in various inflammatory diseases, its primary targets and therapeutic effects on vascular disease have not yet been determined. We investigated whether SSZ could suppress VSMC growth and prevent neointimal hyperplasia. METHODS AND RESULTS: SSZ was found to have pro-apoptotic and anti-proliferative activity in cultured VSMCs. Unexpectedly, these effects were not mediated by nuclear factor kappa B (NF-kappaB) inhibition, which has been suggested to be the anti-inflammatory mechanism associated with the effects of SSZ. Instead, cell-cycle arrest of the VSMCs was observed, which was mediated by induction of haem oxygenase-1 (HO-1) followed by an increased expression of p21(waf1/Cip1). The underlying mechanism for SSZ-induced HO-1 expression was by reactive oxygen species (ROS)-dependent nuclear translocation and activation of nuclear factor erythroid-2-related factor 2 (Nrf2). In a rat carotid artery balloon injury model, administration of SSZ significantly suppressed neointimal growth. In a series of reverse experiments, inhibition of HO-1 by shRNA, ROS by N-acetylcysteine (NAC) or Nrf2 by dominant-negative Nrf2 abrogated the beneficial effects of SSZ. CONCLUSION: Our data demonstrate that SSZ inhibits VSMC proliferation in vitro and in vivo through a novel signalling pathway and may be a promising therapeutic option for the treatment of proliferative vascular disease.</P>