만성 기관지 천식 마우스 모델에서 항 IgE 항체가 기도염증에 미치는 효과

홍태용 ( Tai Yong Hong ),이숙영 ( Sook Young Lee ),강지영 ( Ji Young Kang ),김주상 ( Ju Sang Kim ),김승준 ( Seung Jun Kim ),박성학 ( Sung Hak Park ),김영균 ( Young Kyoon Kim ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.1

Background: Asthma is a disease characterized by chronic airway inflammation and airway hyperresponsiveness. Immunoglobulin E (IgE) plays a key role in the pathogenesis of allergic diseases and asthma. Recently, nonanaphylactogenic antihuman IgE antibody has been used as a therapeutic agent for asthma. Objective: The present study investigated the effect of anti-IgE antibody on the airway inflammation and hyperresponsiveness (AHR) in a mouse model of chronic asthma. Method: We developed a mouse model of chronic asthma for which ovalbumin (OVA)-sensitized female BALB/c-mice were repeatedly exposed to intranasal OVA administration twice a week for 3 months. Anti-IgE antibodies were intravenously administered starting on the 38th day, the next day after 3 challenges and there after once a month during the intranasal OVA challenge of 3 months. Result: Mice chronically exposed to OVA developed sustained eosinophilic airway inflammation and AHR to methacholine compared with control mice. Treatment with anti-IgE antibody inhibited the development of AHR and eosinophilic inflammation. Moreover, anti-IgE antibody treatment reduced the interleukin-5 and interleukin-13 in bronchoalveolar lavage fluid but did not show the change in interleukin-10 and transforming growth factor-β1 levels. Conclusion: These results suggest that anti-IgE treatment can modulate airway inflammation via regulation of Th2 cytokines. (Korean J Asthma Allergy Clin Immunol 2009;29:53-59)

급성 유기인계 농약 중독

이미진,박준석,홍태용,박성수,유연호,Lee, Mi-Jin,Park, Joon-Seok,Hong, Tai-Yong,Park, Sung-Soo,You, Yeon-Ho 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.2

Organophosphate (OP) pesticides are the most common source of human toxicity globally, causing high mortality and morbidity despite the availability of atropine as a specific antidote and oximes to reactivate acetylcholinesterase. The primary toxicity mechanism is inhibition of acetylcholinesterase (AchE), resulting in accumulation of the neurotransmitter, acetylcholine, and abnormal stimulation of acetylcholine receptors. Thus, the symptoms (muscarinic, nicotinic, and central nervous system) result from cholinergic overactivity because of AchE inhibition. OP can also cause rhabdomyolysis, pancreatitis, parotitis, and hepatitis. OP therapy includes decontamination, supportive therapy, and the use of specific antidotes such as atropine and oximes. However, there has been a paucity of controlled trials in humans. Here we evaluated the literature for advances in therapeutic strategies for acute OP poisoning over the last 10 years.

응급실에 내원한 둔상환자의 수혈 필요성 예측인자

오지선 ( Ji Sun Oh ),김형민 ( Hyung Min Kim ),최세민 ( Se Min Choi ),최경호 ( Kyoung Ho Choi ),홍태용 ( Tai Yong Hong ),박규남 ( Kyu Nam Park ),소병학 ( Byung Hak So ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.2

Purpose: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician`s and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. Methods: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. Results: Of blunt trauma patients, 9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR)>100 beats/min, respiratory rate (RR)>20 breaths/min, Glasgow Coma Scale (GCS)<14, Revised Trauma Score (RTS)<11, white blood cell count (WBC)<4000 or >10000, and initial abnormal portable trauma series (C-spine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR>100 beats/min (EXP 3.2), GCS<14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors. Conclusion: In our study, systolic blood pressure (SBP)<90 mmHg, old age>65 years, hemoglobin <13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR>100 beats/min, and GCS<14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room. (J Korean Soc Traumatol 2009;22:218-26)

소생후 혼수환자의 예후 평가지표로서의 ^1H-자기공명분광법의 유용성

홍태용,김영민,최승필,박규남,김세경,안국진 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1

Purpose: The objective of this study was to investigate whether proton magnetic resonance spectroscopy (^1H-MRS) is useful in the prediction of the neurological outcome for comatose patients after successful cardiopumonary resuscitation (CPR). Methods: We prospectively studied 22 patients with a comatose mentality existing for longer than 1 day after cardiac arrest. ^1H-MRS examinations were scheduled to be performed within 5 days after restoration of spontaneous circulation (ROSC). All ^1H-MRS readings were performed by a neuro-radiologist blindly. The best cerebral performance category (CPC) during 6 months after ROSC was used as the final outcome and classified as good (CPC 1-2) or poor (CPC 3-5). Results: Elevated cerebral lactate resonances were found in 14 patients. All of the 14 lactate-positive patients experienced a poor outcome. Five of the 8 lactate-negative patients recovered without neurologic detects, but three of them suffered from severe neurologic defects. The elevated cerebral lactate resonance distinguished between good outcomes (n=5) and poor outcomes (n=17) with three false negatives (sensitivity 82%) and no false positives (specificity100%). Demonstration of brain lactate in ^1H-MRS (p<0.05) proved to be significant in terms of a poor prognosis. Conclusion: ^1H-MRS is of great benefit in the prognostic evaluation of comatose patients with anoxic-ischemic encephalopathy after successful CPR.

토끼 심폐소생술 모델에서 하행대동맥의 지속적인 폐쇄가 뇌허혈에 미치는 영향

김형국,채장성,오동렬,최승필,김세경,홍태용 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: A recent report introduce a new option for cardiopulmonary resuscitation by using of a continuous descending aortic balloon occlusion. The aim of the present study was to evaluate the effect of balloon occlusion of the descending aorta during cardiopulmonary resuscitation on brain ischemia. Methods: Twelve rabbits were enrolled in this study. A 4 French Swan-Ganz catheter was advanced through the right femoral artery into the descending aorta Ventricular fibrillation was induced with an AC current delivered through an electrode catheter advanced into the right ventricle. After 3 minutes of untreated ventricular fibrillation, the rabbits were randomized in two groups: (1) chest compression without balloon occlusion (control group) and (2) chest compression with balloon occlusion of the descending aorta (experimental group). The balloon was inflated for 3 minutes during resuscitation. Defibrillation was attempted at 3 minutes after start of chest compression. At 24 hours after return of spontaneous circulation, brain tissues were fixed in 4% paraformaldehyude and stained with hematoxylin eosin. Then, the ischemic cells in the hippocampal CA1 area were counted. Results: There was significant difference in ischemic neuronal cells between the two groups (control group: 41.8 ±10.9%, experimental group: 16.8 ±6.8%, p<0.05). In the experimental group, carotid blood flow was better than it was in the control group during chest compression (control group:2.4±1.0mL/min, experimental group: 7.6 ±1.9mL/min, p<0.05). Conclusion: These results suggests that balloon occlusion of the descending aorta during resuscitation decreases brain ischemia in rabbits during cardiac arrest.