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- 저자 : 천일영 ( Yil Young Chen ) (검색결과 3 건)
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천일영 ( Yil Young Chen ),홍훈표 ( Hoon Pyo Hong ),김명천 ( Myung Chun Kim ),고영관 ( Young Gwan Ko ),김동필 ( Dong Pil Kim ) 대한외상학회 2003 大韓外傷學會誌 Vol.16 No.2
Portal venous gas is a severe and life-threatening sign since it is associated with an overall mortality rate ranging from 75% to more than 90% in instances due to noniatrogenic causes, but its mechanism is still not fully understood. However, after blunt abdominal trauma, portal venous gas is found even if only rarely. Because of developments and improvements in diagnostic procedures, especially computed tomography and ultrasonography, portal venous gas and intestinal pnuematosis can detected, and treated early, and a recent study reported mortality rates as low as 29%. Therefore, in the emergency department, the emergency physician must pay attention to portal venous gas in patients with blunt abdominal trauma. Delay in diagnosis and treatment may lead to intra-abdominal catastrophe, sepsis, and increased mortality. We report a case of portal venous gas and intestinal pnematosis after blunt abdominal trauma.
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소장의 허혈 - 재관류 후 조직 손상에 미치는 멜라토닌의 회복 효과
천일영,김명천,고영관,백형환,조용호 대한응급의학회 2003 대한응급의학회지 Vol.14 No.3
Purpose: It is now well recognized that reperfusion of ischemic tissues initiates a complex series of reactions that can paradoxically injure tissues. Apoptosis occurs in select cell populations during morphologic development and during cellular injury, including oxygen radical exposure, ischemia-reperfusion, and sepsis. Thus, in this study, we examined relation of the melatonin effect to the injection time and the dose, and role of melatonin in apoptosis. Methods: Intestinal ischemia-reperfusion injury was induced in rats by clamping the superior mesenteric artery for 30 minutes. After reperfusion injury for 30 minutes, the experimental group was administered melatonin (10 mg/kg) intraperitoneally and the control group received saline and ethanol. At 30 minutes, 60 minutes, and 90 minutes, 1) pulmonary histological assessments (interstitial PMNs/10HPFs and lung (alveolar) injury score), 2) alveolar microvascular permeability assessments (wet-weignt to dry-weight ratio and lipid peroxidation activity, malondialdehyde, MDA), and 3) western blotting assessments (p53, p2l, Bax, and bcl-2) were made. For comparison, long- time (60-minute) reperfusion and double- dosage melatonin (20 mg/kg) were also studied. Results: The lung injury score was 1.00±0 in the melatonin group at 90 minutes and 3.28±0.30 in the saline group (p<0.01). The number of sequestered neutrophils was significantly higher in the control group at 90 minutes (34.38±16.76/10 HPFs) than in the melatonin-treated group (5.63±2.73/10 HPFs; p<0.01). In the melatonin group at 90 minutes, the wet-weight to dry-weight ratio was 4.69±0.16, and in the saline group, the ratio was 4.78±0.17 (p>0.05). A marked difference was found between the ischemia-reperfusion control group and the experimental group at 90 minutes regarding lipid peroxidation activity (Malondialdehyde, 16.45±0.19,μM vs 10.93±0.11 μM, p<0.01). In the melatonin group, p2l expressions were found to be much more than in the control group. But, p53, bcl-2, and Bax expressions were found to be in the control group. Conclusion: Melatonin injection within 60 min after reperfusion may promote recovery of repefusion injury, but double-dose melatonin injection was inefficacious. Also, melatonin inhibit apoptosis by p2l expression.
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급성 허혈성 뇌졸중에 있어서 혈전 용해제 적용 기준의 위반에 따른 예후 및 합병증에 대한 평가
김신철,천일영,김명천,고영관 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3
Purpose: In many other countries, based on research, recombinant tissue plasminogen activator (r-tPA) has been approved for the treatment of acute ischemic strokes. However, in Korea, little research has been done till now, in spite of using r-tPA widely. We sought to assess the feasibility and the efficacy of treatment and to evaluate the prognosis and complications at the violation of using r-tPA. Our study was compared with other previous studies. Methods: A retrospective review is presented of 25 the cases of patients with acute ischemic stroke treated with r-tPA according to the National Institutes of Neurological Disorders and Strokes (NINDS) protocol. We classified the groups by protocol violation (time, blood pressure, and computed tomography). We then analyzed neurologic outcomes by using the National Institutes of Health Strokes Scale (NIHSS) and complications based on whether or not intracerebral hemorrhage (ICH) had occurred. Results: Of the 25 patients (mean age: 57 males: 19), 6 had time violation (onset time>180 min), 4 had blood-pressure violation (systolic BP> 185 mmHg), 5 had CT violation (low density at initial CT). The NIHSS score improved in 64% of all patients after 24 hours. However, improvement was lower in the case of deviation present than it was in the case of deviation absent (time, blood pressure, and CT, respectively, 20%, 50%, and 40%; p-value respectively 0.0274, 0.8350, and 0.4125). ICH occurred in 6 cases, but in cases of deviation present, ICH occurred at a greater frequency. Conclusion: Our safety and feasibility of outcome compared favorably with NINDS and other previous studies. In addition, we confirmed that the presence of protocol deviation was associated a poor outcome.
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