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Involvement of Protein Kinase C-δ in Vascular Permeability in Acute Lung Injury
안종준,정종필,박순은,이민현,권병석,조홍래 대한면역학회 2015 Immune Network Vol.15 No.4
Pulmonary edema is a major cause of mortality due to acute lung injury (ALI). The involvement of protein kinase C-δ (PKC-δ) in ALI has been a controversial topic. Here we investigated PKC-δ function in ALI using PKC-δ knockout (KO) mice and PKC inhibitors. Our results indicated that although the ability to produce proinflammatory mediators in response to LPS injury in PKC-δ KO mice was similar to that of control mice, they showed enhanced recruitment of neutrophils to the lung and more severe pulmonary edema. PKC-δ inhibition promoted barrier dysfunction in an endothelial cell layer in vitro, and administration of a PKC-δ-specific inhibitor significantly increased steady state vascular permeability. A neutrophil transmigration assay indicated that the PKC-δ inhibition increased neutrophil transmigration through an endothelial monolayer. This suggests that PKC-δ inhibition induces structural changes in endothelial cells, allowing extravasation of proteins and neutrophils.
경피적 확장 기관절개술(Percutaneous Dilatational Tracheostomy)의 시술 용이성 및 합병증
안종준 ( Jong Joon Ahn ),고윤석 ( Youn Suck Koh ),진재용 ( Jae Yong Chin ),이기만 ( Ki Man Lee ),박완 ( Wann Park ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soo 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.6
P-107 말초 폐결절에 대한 기관지초음파 내시경 검사에서 CT work station 적용을 통한 진단률 개선에 관한 예비연구
배수현,안종준,제갈양진,서광원,나승원,이태훈,강병주,김진형,권운정,임소연 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.0
연구배경: 폐암이 의심되는 말초 폐결절의 경우 전통적으로 CT 유도하 경피적 폐생검 방법이 고려되어 왔다. 하지만 병변의 위치나 환자의 폐기능, 협조도 상태에 따라 시술이 불가능한 경우가 있고, 합병증의 우려가 큰 경우 통상적 방법으로는 검사를 시행할 수 없어 대안을 모색해야하는 경우가 있다. 기관지내시경술의 발전으로 말초 폐병변에 대한 경기관지 폐생검이 시행되고 있으나 병소의 크기, 접근성, 진단율 등의 차이가 있어 정확한 검사를 위한 여러 방법의 시도가 필요하다. 이에 본원에서는 말초 폐결절의 기관지초음파내시경을 통한 경기관지 폐생검시 Aquarius iNtuition CT workstation의 적용을 통해, 조직검사 진단율 개선이 가능한지 알아보고자 하였다. 대상 및 방법: 2017년 2월부터 8월까지 폐 결절 혹은 종괴로 울산대병원을 방문한 환자 중 초음파기관지내시경을 이용한 경기관지폐생검에 동의한 환자 80명을 대상으로 기관지 내시경 전 CT를 시행하고 이 image를 CT workstation을 이용하여 재구성한 군(CW)과 재구성하지 않은 군(non-CW)로 나누어 검사를 시행하였다. 결과: 80명 중 34명의 환자가 CW군에 속하였다. 전체 환자의 평균 나이는 66.74 ± 11.66였으며 전체 진단률은 68.8% 였으며 CW/non CW 군의 진단률은 각각 67.6% vs 69.6% (p=0.855)였고 시술시간 각각 22.38 ± 9.57 (min) vs 23.32 ± 7.57 (min) 으로 진단률과 시술시간 등 두 군에서 통계학적 차이는 관찰되지 않았다. 전체검사자에게서 주요합병증은 관찰되지 않았으며 시술 뒤 3명(3.75%)의 환자에게서 소량의 객혈이 관찰되었다. 결론: 말초폐결절 조직검사를 위한 기관지초음파내시경 검사에서 CT workstation을 사용하는 것은 시술자가 시술 전 해당 병변 부위의 해부학적 위치 및 구조를 이해하는데는 도움을 줄 수 있으나 진단률 개선이나 검사시간을 단축하는데는 한계가 있었다.
정화식,안종준,제갈양진,서광원,나승원,이태훈,강병주,전재범,정지원,정윤성 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-
After respiratory viral infection, post-viral bacterial pneumonia often develops.Except influenza virus,predominant bacteria are not known in post-viral bacterial pneumonia.We studied to know whether there is a difference in the cause of post-viral bacterial pneumonia according to the type of respiratory virus.From 2013 to 2016,at Ulsan,multiplex PCR(for simultaneous detection 7 respiratory viruses)had been done in patients with respiratory symptoms.The radiologic evidence of pneumonia was evaluated through CXR/CT.The patients`medical records including results of sputum and blood culture(done in 48hours after hospital visit) were reviewed. Respiratory viruses were detected in 3327/5297 patients and 706/3327 patients had infiltrations in CXR/CT.Clinically significant bacteria were identified in 252/706 patients.Under 16years[136/252,(54.0%)],Mycoplasma was the most frequent bacterium,regardless of the preceding virus type. In 16 and over 16years[116/252,(46.0%)],Influenza A(n=21) preceded post-viral bacterial pneumonia of S.aureus(6/21),Klebsiella(4/21),S.pneumoniae(3/21),Acinetobacter spp. (3/21), Human rhinovirus(n=24) preceded that of S.aureus(7/24),Klebsiella(3/24),Chlamydia(3/24),Pseudomonas spp.(3/24), Human metapneumovirus(n=20) preceded that of S.aureus(4/20),Klebsiella(4/20),Acinetobacter spp.(4/20),Coronavirus(n=13) preceded that of Klebsiella(3/13),Acinetobacter spp.(3/13),RSV(n=13) preceded that of E.coli(3/13),Acinetobacter spp.(3/13) (P<0.001). The causing pathogens of post-viral bacterial pneumonia are different according to type of culprit respiratory viruses.
P-8 Improving In-hospital Cardiac Arrest ; a Pilot Study for a Nationwide Survey
박연희,안종준,강병주,문재영 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-
Purpose: In-hospital cardiac arrest (IHCA) is one of major factors which represent patient safety and quality of health care. Rapid response system (RRS) is one of ways to diminish avoidable IHCA. We designed this study to ascertain prevalence of IHCA in Korea and estimate efficacy of RRS on IHCA. Methods: This was retrospective multi-center study, which included 14 hospitals. Two hospitals stated to operate RRS June 2014 and other twelve hospitals did not have RRS. We collected data about IHCA rates and the characteristics of each hospital. Results: In terms of the number of yearly adult admission, 20,000-29,999/year group was most common in hospitals without RRS and in hospitals with RRS were 30,000-39,999/year group was most common. In 2013, before starting RRS, CPR rate was higher in hospitals with RRS group than those without RRS group (2.38 per 1000 adult admission vs 2.15 per 1000 adult admission). Hospitals with RRS showed statistically significant reduction of CPR rate between 2013 and 2015 [odd ratio (OR) 0.731, 95% confident interval (CI) (0.577-0.927), p = 0.009]. However, in hospitals without RRS, CPR rates were not decreased significantly. [OR 0.960, 95% CI (0.838~1.100), p = 0.555] Conclusions: RRS can help to reduce IHCA rate by preventing avoidable IHCA events. Therefore, it will improve patient safety and quality of health care system.