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임종찬(Jong Chan Lim),유호준(Ho Jun Yoo),심상준(Shang Jun Shim),유석희(Suk Hee Yu),이현순(Hyun Soon Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.5
N/A Acute cortical necrosis is a rare but catastrophic disease due to complete or partial destruction of all elements of the renal cortex. The clinical picture of the disease is characterized by acute renal failure, often with a fatal outcome. We report a case of acute cortical necrosis following an operation of the abdominal stab wound. A 22-year-old man was admitted to our hospital because of an abdominal stab wound. A segmental resection of the sigmoid colon and midileum and end to end anastomosis were performed. Oliguria developed on the third hospital day and was treated with hemodialysis therapy on the third hospital day and was treated with hemodialysis therapy on the 5th hospital day. The anuria persisted for 20 days and the total period of oliguria was 28 days. On the 73rd hospital day, a kidney needle biopsy was done and microscopic examination of the specimen showed cortical necrosis of the patchy form with fibrosis and calcification, The patient had received a total of 13 hemodialysis therapy sessions and was complicated by an episode of septicemia which originated from the indwelling femoral catheter. The recovery of renal function was incomplete but was sufficient to persist without hemodialysis therapy.
김성수(Sung Soo Kim),강응택(Eung Taek Kang),유석희(Suk Hee Yu),이지훈(Jee Hoon Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.6
N/A Acute renal failure is a clinical syndrome characterized by a sudden decrease in renal function which was previously normal. Although there are many clinical studies on acute renal failure in Korea, those are different from one another according to inestigators because of the application of different criteria for acute renal failure. To know the clinical features of acute renal failure treted by hemodialysis, we reviewed retrospectively 70 patients with acute renal failure who had been hospitalized at Department of Intetmal Medicine, Chung-Ang University Hospital between anuary 1985 and December 1989. The results were as follows; 1) Male of female ratio was 1.8:1, and mea age was 49. 7 years. The mean age of postoperative group was 58.2 years and significantly highre than other groups (p<0. 05). 2) Acute renal failure was classified according to clinical background such as medical group 44.3% (31 cases), postoperative group 34.3% (24 cases), posttraumatic group 14.3%, (10 cases) and postrenal group 7. 1% (5 cases). 3) Indications of first hemodialysis were CNS symptoms (23 cases), massive volume overload (15 cases), gastrointestinal symptoms (13 caws), hyperkalemia and acidosis (8 cases). Prophylactic dialysis was performed in 11 cases. 4) The mean numbers of hemodialysis was 4, but 6 in postoperative group and posttraumatic groups were higher than other groups, 5) Infections as the cause of acute renal failure were 18 cases, as complications 28 cases and as the cause of death 12 cases (37.5%). 6) Bleeding as the cause of acute renal failure were 18 cases, as complications 20 cases (G-I bleeding: 9 cases) and as the causes of death 5 cases (16%). 7) 62 cases were the oliguric renal failure and 8 cases were nonoliguric renal failure. The mean duration of oliguria was 12.2 days. Those of postoperative group and posttraumatic group was l6.5 days, 15.7 days respectively and these were longer than other groups. 8) The mortality rate was 45.7 (32 cases). The highest mortlity rate wa70.0% in posttraumatic group and significantly higher than other groups (p<0.01). 9) The causes of death were infection (10 cases), underlying diseases (9 cases), cardiogenic causes (6 cases) and bleeding (5 cases). The causes of 2 cases were unknown.
류마티스 섬유모세포양 활막세포에서 저산소증이 시토카인 생산에 미치는 영향
안중경 ( Joong Kyung Ahn ),전찬홍 ( Chan Hong Jeon ),고재현 ( Jae Hyun Koh ),김진희 ( Jin Hee Kim ),최화정 ( Hwa Jung Choi ),안광성 ( Kwang Sung Ahn ),차훈석 ( Hoon Suk Cha ),유석희 ( Suk Hee Yu ),고은미 ( Eun Mi Koh ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.1
Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased production of cytokines, proliferation of fibroblast-like synoviocytes (FLS) and joint destruction. It is well known that the involved joints in RA are hypoxic. Hypoxia may play a role in the pathogenesis of RA. We thought that hypoxia might alter the production of cytokines by FLS and these changes could affect the biologic behaviors of FLS. Based on that, we investigated whether hypoxia affects the production of cytokines in FLS and the effect of these changes on matrix metalloproteinases (MMPs) expression. Methods: Fibroblast-like synoviocytes from human rheumatoid synovial tissue obtained duringjoint replacement surgery were cultured in vitro. Hypoxic culture was performed by incubating cells in BBL(R) Gaspak pouch(TM) anaerobic system. After incubation under hypoxic condition for 24 hr, the concentrations of various cytokines in culture supernatants were determined by ELISA. To determine the effect of highly expressed cytokines on MMP expression, we performed ELISA of MMP-1, MMP-2 and MMP-3 in cultured FLS, after stimulation with respective cytokines. Results: In hypoxic state, IL-6, IL-8 and vascular endothelial growth factor (VEGF) concentrations were significantly increased compared to those in normoxic condition. However, there were little differences in IL-1, IL-2, IL-4, TNF-α and TGF-β. Stimulation of FLS with IL-6 and IL-8 showed the increased concentrations of MMP-1, MMP-2 and MMP-3. Conclusion: Hypoxic environment of rheumatoid synovium might affect FLS to produce proinflammatory and proangiogenic cytokine such as IL-6 and IL-8. These cytokines again could stimulate MMPs production in FLS leading to joint destruction.