간 부분절제술 후 간 조직 재생과정에서의 성장호르몬의 효과

이중의(Joong-Eui Rhee),서길준(Gil-Joon Suh),김영덕(Young-Deok Kim),정성은(Sung-Eun Jung),윤여규(Yeo-Kyu Youn) 대한외과학회 1999 Annals of Surgical Treatment and Research Vol.57 No.5

Zymosan-A에 의한 다장기 부전증시 성장호르몬이 혈중 TNF-α의 변화에 미치는 영향

김정택(Jung-Taik Kim),이중의(Joong-Eui Rhee),정성은(Sung-Eun Chung),윤여규(Yeo-Kyu Youn),오승근(Seung-Keun Oh) 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.53 No.4

소아 횡경막탈장 및 횡경막이완증

박귀원(Kwi-Won Park),이중의(Joong-Eui Rhee),목우균(Woo-Kyun Mok),조마해(Ma-Hae Cho),정성은(Sung-Eun Jung),이성철(Seong-Cheol Lee),김우기(Woo-Ki Kim) 대한외과학회 1993 Annals of Surgical Treatment and Research(ASRT) Vol.45 No.6

랫드의 출혈성 쇼크 모델에서 치료적 고탄산혈증이 전신적 염증 반응에 미치는 영향

강경원 ( Kyeong Won Kang ),조유환 ( You Hwan Jo ),김규석 ( Kyu Seok Kim ),이재혁 ( Jae Hyuk Lee ),이중의 ( Joong Eui Rhee ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.1

Purpose: This study was performed to investigate whether therapeutic hypercapnia could attenuate systemic inflammatory responses in hemorrhagic shock in rats. Methods: Male Sprague-Dawley rats were mechanically ventilated and underwent pressure-controlled (mean arterial pressure: 38±1 mmHg) hemorrhagic shock. At 10 minutes after the induction of hemorrhagic shock, the rats were divided into the normocapnia (PaCO_2=35-45mmHg, n=10) and the hypercapnia (PaCO_2=60-70mmHg) groups. The PaCO_2 concentration was adjusted by using the concentration of inhaled CO_2 gas. After 90 minutes of hemorrhagic shock, rats were resuscitated with shed blood for 10 minutes and were observed for 2 hours. The mean arterial pressure(MAP) and the heart rate were monitored continuously, and the results of arterial blood gas analyses, as well as the plasma concentrations of interleukin (IL)-6, IL-10, and nitrite/nitrate were compared between the normocapnia and the hypercapnia groups. Results: The MAP and the heart rate were not different between the two groups. The plasma concentration of IL-6 was significantly lower in the hypercapnia group than in the normocapnia group (p<0.05). The IL-10 concentration was not different and the IL-6 to IL-10 ratio was significantly lower in the hypercapnia group compared to the normocapnia group. The plasma nitrite/nitrate concentration of the hypercapnia group was lower than that of the normocapnia group. Conclusion: Therapeutic hypercapnia attenuates systemic inflammatory responses in hemorrhagic shock. (J Korean Soc Traumatol 2012;25:17-24)

쥐의 파라쿼트 중독 모델에서 설포라판의 영향

장귀상 ( Gui Sang Jang ),이재혁 ( Jae Hyuk Lee ),김규석 ( Kyu Seok Kim ),조유환 ( You Hwan Jo ),이중의 ( Joong Eui Rhee ),이경분 ( Kyoung Bun Lee ),박찬종 ( Chan Jong Park ),강창우 ( Chang Woo Kang ),이수훈 ( Soo Hoon Lee ),김중희 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.1

Purpose: Sulforaphane is a naturally-occurring isothiocyanate abundant in broccoli. It has been suggested as a promising antioxidant. In this study, the therapeutic effect of sulforaphane in paraquat intoxication was investigated. Methods: Paraquat was administered via the tail vein, after which sulforaphane or a vehicle (4% DMSO) was administered intraperitoneally 15 minutes after paraquat administration. Histological injury, lipid peroxidation, plasma cytokine (IL-6, IL-10), and nitric oxide were measured. In addition, the effect of sulforaphane on survival in paraquat-intoxication was observed. Results: Regarding histological injury, lipid peroxidation, and plasma cytokine and nitric-oxide response, sulforaphane administration showed no protective effects in paraquat-intoxicated rats. Rather, it increased mortality (log rank p=0.03) and caused lipid peroxidation, as well as plasma cytokine and nitric-oxide production, to be increased. Conclusion: Sulforaphane had no therapeutic effect on paraquat-intoxicated rats; rather, it increased mortality.

패혈증 백서 모델에서 비타민-C의 효과

이중의,신상도,표창해,서길준,정성은,윤여규 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : Multi-organ failure from sepsis is very lethal disease entity, which is suspected to be caused by activated inflammatory cells. Inflammatory cells activated by endotoxins generate oxidants and cytokines such as TNF-α and IL-6, which in turn stimulate macrophages and neutrophils. Augmented inflammation makes an organ-injury deteriorate into an organ-failure, which may progress to multi-organ failure. This study is designed to evaluate the therapeutic effects of vitamin-C, a scavenger of oxidants, in sepsis. Methods : Male Sprague-Dawley rats were divided into 3 groups : a control group, a group injected intrapetoneally with LPS(lipopolysaccharide), and a group injected intraperitoneally with LPS and vitamin-C. Each eight rats were sacrified 24 hours and 48 hours after injection, and samples of the blood, the liver and the lung were obtained. Biochemical assays of TNF-α level in the blood and malondialdehyde(MDA)level, catalase activity and nitric oxide synthase(NOS)activity in the liver and the lung tissues were performed. Results : Serum TNF-α level, tissue lipid peroxidation and tissue i-NOS activity were dramatically increased, and tissue catalase activity was exhausted rapidly in sepsis. High dose vitamin-C administration decreased serum TNF-α level, tissue lipid peroxidation and tissue i-NOS induction, and protected against catalase exhaustion. Conclusion : high dose vitamin-C therapy was proved to have definite antioxidant effect in septic condition.

백서의 패혈증 증후군 모델에서 고용량 비타민-C 투여의 효과에 관한 실험적 연구

이중의,정연권,정성은 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.4

1. Background : In sepsis syndrome, peroxidation reaction of polyunsaturated cell-membrane lipids by reactive oxygen free radicals is known as the main mechanism of cell injury. Recent explosive rush of studies on the biologic functions of NO has made it clear that NO is essential to the vessel function and microcirculation and increased production of NO in sepsis has important pathophysiologic actions. 2. Purpose : This study is designed to evaluate the therapeutic effects of vitamin-C, a famous antioxidant, on the liver tissue protection in severe intraperitoneal infection. 3. Methods : Female rats of Sprague- Dawley as experiment animal were divided into a control group(group-A) and two experimental groups of a peritonitis group (group-B) and a peritonitis-and-vitamin-C group(group-C). Peritonitis had been induced by cecal ligation and perforation under ketamine anesthesia. Vitamin-C (600 mg/kg) was injected intramuscularly. As a index of peroxidation reaction, malondialdehyde (MDA)level and catalase activity of the liver tissue were examined. And NOS activity in liver tissue was measured. In blood, the concentration of TNF- α was measured with ELISA method. 4. Results : On microscopic examination. liver tissue of group-B showed lymphocyte and neutrophil infiltration. fatty degeneration of hepatocyte, and destruction of liver lobular structure. In group-C, there were lesser lymphocyte and neutrophil infiltration and lesser structural injury in the liver tissue in comparison with in group-B. MDA levels of liver tissue were remarkably increased in group-B. Catalase activity of group-B was used up in very early phase of peritonitis. In comparison with group-B, group-C had significantly lower MDA levels and significantly higher catalase activity. Plasma TNF- α levels of group-B were markedly increased compared with group-A. Group-C showed markedly suppressed plasma TNF-α levels, compared to group-B. NOS activity in liver tissue of group-B was significantly increased. Vitamin-C suppressed increment of NOS activity. 5. Conclusion : Cell injury by reactive oxygen free radicals was thought to play a key role in sepsis. High dosage of vitamin-C had therapeutic cell-protective effect against lipid peroxidation, suppressive action on the TNF- α production, and inhibitory effect on NOS activation. The therapeutic effect of vitamin-C in sepsis was supposed to be mediated mainly by their antioxidant function. But the exact interaction between peroxidation reaction and NO or TNF- α could not elucidated clearly. Further well-designed experiment is necessary.

복부외상 환자의 진단법 : 진단적 복강 세척술 , 초음파 , 전산화 단층촬영 그리고 진단적 복강경술

이중의 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.2

To determine the roles of diagnostic peritoneal lavage (DPL), ultrasonography (US), computed tomography (CT) and diagnostic laparoscopy (DL) in the evaluation of abdominal trauma, the author reviewed and compared the data of recently published 26 reports about the diagnostic values of the diagnostic tools. Comparative analysis of sensitivity, specificity, positive predictive value, accuracy, indications & contraindications, advantages & disadvantages, non-therapeutic laparotomy rate of the diagnostic tools was performed. DPL has been the golden standard of abdominal trauma diagnosis, but DPL is too sensitive with very high non-therapeutic laparotomy rate. In detecting hollow viscus injury, DPL is superior to all others. Many users of US belive that US can serve bestly as a first-line of diagnostic adjunct in detecting free peritoneal and thoracic fluid in truncal blunt trauma. But US has some false negative rate in the diagnosis of solid organ injury itself, and frequently misses bowel and mesenteric injury. CT gains more popularity than DPL in blunt abdominal trauma recently. It is very sensitive and specific, but due to the requirement of coorperation from the patient, long performance time, and transportation to the CT room, it is not suitable as a first-line of diagnosis in blunt abdominal trauma. CT also has a limited diagnostic value in detecting bowel and mesenteric injury. DL, can be used on 3 purposes in abdominal trauma firstly, as a first-line of diagnostic tool, secondly, as a second-line of diagnostic tool, and finally, as a therapeutic tool. The first-line diagnosis should not miss a severe injury that requires prompt surgical treatment. And the second line of diagnosis should be able to differentiate a patient who belongs to the non-operative therapy from others accurately. Conclusively, in blunt abdominal trauma, US and DL are suitable as a first- and a second-line tool, respectively, In penetrating abdominal trauma, DPL and DL are suitable as a first- and a second-line diagnostic tool. Further prospective studies about this issue are expected.

강산 및 강알칼리 음독에서 냉각 용액을 사용한 희석 요법과 중화 요법의 가능성

이중의,송형곤,김동훈,권운용,곽영호,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: There is no effective treatment modality for caustic agent ingestion. Dilution and neutralization are prohibited because of the risk of secondary thermal injury. This experiment is designed to evaluate the amount of dilution and neutralization heat and to gauge the applicability of dilution and neutralization therapy using cold solutions to suppress the peak temperature. Methods: This is an in-vitro chemical experiment. HCl, CH3COOH, NaOH, and NH4OH are selected as representatives of strong and weak acids and strong and weak alkali, respectively. 20℃, 11.6M, 5.8M, and 2.9M solutions of each acid and alkali are made and mixed using a magnetic stirrer at a room air temperature of 28℃. The peak temperature, the duration above 40℃, and the heat amount are measured or calculated. Results: When a 11.6M HCl or NaOH solution is diluted with same amount of water, 32 or 18cal. per mL of HCl or NaOH is produced, respectively. HCl produces a significant peak temperature, but NaOH does not. The lower the concentration, the lower the amount of heat production. 11.6M CH3COOH and NH4OH solutions don't produce dilution heat.11.6M and 5.8M solutions of all acids and alkali produce destructive neutralization heat. However, 2.9M solutions produce neutralization heat which might be controllable. When a 11.6M HCl or NaOH solution is neutralized with a -10℃ 2.9 M NaOH or HCl solution, respectively, the peak temperature produced is below 40℃ and seems to add little thermal damage to viable tissue. Conclusion: Dilution and neutralization with a cold solution in cases of strong acid or alkali ingestion is a promising method to avoid thermal injury.

New Injury Severity Score(NISS)에 기초한 교통사고 손상 피라미드 연구

신상도,이중의,서길준,김재용,성주현,황은희,황승식 대한응급의학회 2003 대한응급의학회지 Vol.14 No.2

Purpose: This study was conducted to construct traffic accident-related injury pyramid based on the New Injury Severity Score (NISS). Methods: We constructed injury episodes to use the Traffic Accident Insurance database (1997~2001) and calculated the NISS by Abbreviated Injury Scale (AIS). All episodes were classified into three groups by using the NISS: minor group (1~10), moderate group (11~25), and severe group (25~75). Seventy-five points were assigned to all death episodes. We constructed a traffic-accident-related injury pyramid by using an NISS criterion. We compared frequencies and percentiles of episodes in the NISS-based injury pyramid. Resufts: The number of episodes was 2,012,135. Of these, 1,331,599 episodes involved males, and the other 680,536 episodes involved females. The number of death episodes was 2,091 in 1997, 1,971 in 1998, 2,430 in 1999, 2,546 in 2000 and 141 in 2002. The mean NISS was 6.89±6.31, and the percents for the minor group, the moderate group, and the severe group were 85.58%, 13.39%, and 1.03%, respectively. The percent of males in the severe group was higher than that of females by 2.43 times. The percent of older persons (>46 yrs) in the severe and moderate groups was higher than that of young adults (16-45 yrs) The percents of belt-unattached episodes, pedestrian episodes, and separated-car accident episodes in the severe group were higher than those of bet-attached episodes, passenger or driver episode, and car-to-car accident episodes. The mean out-patient-department follow-up period and the mean loss rate of labor ability increased from the minor group through the moderate group to the severe group. Conclusion: We confirmed the characteristics of the traffic-accident-related injury pyramid.