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Rebound Inflammation Associated with Rewarming from Hypothermia in an Endotoxin-Injured Lung
임채만 대한중환자의학회 2013 Acute and Critical Care Vol.28 No.2
Background: Hypothermia is known to suppress inflammation in various experimental and clinical settings. We wanted to investigate how the suppressed inflammation by hypothermia is affected during rewarming. Methods: Mice were being assigned to normothermia (37oC) or hypothermia (32oC). After 30 minutes at the assigned temperature, lipopolysaccharide was administered intratracheally. The mice were then randomly grouped and subjected to 4 hours of normothermia (N), 24 hours of normothermia (NN), 4 hours of hypothermia (H), or 4 hours of hypothermia followed by normothermia for the next 20 hours (HN). In another experiment, other HN mice were treated with varying doses of anti-TNF-α or anti-IL-1β antibodies (0, 6.25, 12.5, 25, and 50 μg/250 μl) immediately prior to rewarming. Results: The neutrophil counts of BAL fluid (×104/ml) were 23.0 ± 13.1 in the N, 6.4 ± 3.1 in the H (p = 0.002 vs N), 20.4 ± 10.2 in the NN, and 49.7 ± 21.0 in the HN (p = 0.005 vs H; p < 0.001 vs NN). Myeloperoxidase activity of the lung (unit/μg) was 6.7 ± 2.9, 7.9 ± 1.9, 17.8 ± 4.0 (p < 0.001 vs N), and 12.9 ± 5.9 (p = 0.034 vs H, p = 0.028 vs NN), respectively. Compared with control HN, total WBC and neutrophil counts of mice treated with anti-TNF-α antibody or anti-IL-1β antibody prior to rewarming were lower at all tested doses. The combination of both anti-TNF-α or anti-IL-1β antibodies was not increasingly reducing the neutrophilic sequestration. Conclusions: Rewarming from induced hypothermia resulted in augmentation of neutrophilic sequestration of endotoxin-injured lung. Treatment with antibodies against TNF-α or IL-1β prevented this rebound of neutrophilic infiltration.
패혈증환자에서 APACHE III Scoring System의 예후적 가치
임채만,이재균,이성순,고윤석,김우성,김동순,김원동,박평환,최종무,Lim, Chae-Man,Lee, Jae-Kyun,Lee, Sung-Soon,Koh, Youn-Suck,Kim, Woo-Sung,Kim, Dong-Soon,Kim, Won-Dong,Park, Pyung-Hwan,Choi, Jong-Moo 대한결핵및호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.6
연구배경: 중환자의 예후를 정량화하는 체점체계 중 APACHE III system은 중환자실 제 1병일 점수는 물론 일갱신 점수도 환자의 위험도를 갱신하는 것이 알려진 바 있어 패혈증 환자들에서 APACHE III score의 예후 지표로서의 가치를 알아 보고자 하였다. 방법: 48명의 패혈증 환자들에서 후향적으로 중환자실 제 1병일, 2병일 및 3병일의 APACHE III score를 조사하여 패혈증 생존자와 비생존자 간의 차이를 분석하였다. 결과: 패혈증 생존자는 비생존자에 비해 APACHE III system에 따른 중환자실 제 1병일 정수가 유의하게 낮았으며, 제 2일 및 제 3일의 점수도 각각의 전날 점수에 비해 유의하게 감소하였다. 폐혈증 비생존자의 경우 제 1병일 점수가 생존자에 비해 높았고, 제 2병일 및 제 3병일 점수 역시 각각의 전날 점수에 비해 증가하는 경향을 보였다. 결론: APACHE III system에 따른 제 1병일 점수 및 제 3병일까지의 점수의 일변동은 패혈증 환자의 예후를 반영하는 것으로 사려된다. Background: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. Methods: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1(D1), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the D1 score, and also in respect to the changes of the updated D2 and D3 scores. Results: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older($62.7{\pm}12.6$ vs $51.1{\pm}18.1$ yrs), presented with lower mean arterial pressure($56.9{\pm}26.2$ vs $67.7{\pm}14.2\;mmHg$) and showed greater number of multisystem organ failure($1.2{\pm}0.8$ vs $0.2{\pm}0.4$) than the survivors(p<0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The D1 score was lower in the survivors (n=21) than in the nonsurvivors ($44.1{\pm}14.6$, $78.5{\pm}18.6$, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (D1 vs D2, $44.1{\pm}14.6$ : $37.9{\pm}15.0$, p=0.035; D2 vs D3, $37.9{\pm}15.0$ : $30.1{\pm}9.3$, p=0.0001) but showed a tendency to increase in the nonsurvivors (D1 vs D2 (n=21), $78.5{\pm}18.6$ : $81.3{\pm}23.0$, p=0.1337; D2 vs D3 (n=11), $68.2{\pm}19.3$ : $75.3{\pm}18.8$, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, $53.8{\pm}10.0$ in the survivors, $55.3{\pm}10.3$ in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(D1 vs D2, $53.3{\pm}10.0$ : $43.6{\pm}16.4$, p=0.0278; D2 vs D3, $43.6{\pm}16.4$ : $31.2{\pm}10.3$, p=0.0005), but showed a tendency to increase in the nonsurvivors(D1 vs D2 (n=6), $55.3{\pm}10.3:66.7{\pm}13.9$, p=0.1562; D2 vs D3 (n=4), $64.0{\pm}16.4:74.3{\pm}18.6$, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors ($5.5{\pm}2.9$ vs $1.9{\pm}3.7$, p=0.046) in this group. Conclusion: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.
초고압처리 시간과 pH 변화에 의한 마늘의 이취성분 저감화
임채란(Chae-Lan Lim),홍은정(Eun-Jeung Hong),노봉수(Bong-Soo Noh),최원석(Won-Seok Choi) 한국식품과학회 2010 한국식품과학회지 Vol.42 No.5
마늘의 사용 확대와 고부가가치의 새로운 기능성 소재 및 제품을 개발하고자 마늘의 독특한 향을 제거하기 위하여 침지액의 pH와 초고압처리시간을 달리하여 실험하였으며, 마늘향의 변화를 GC와 전자코를 이용하여 측정하였다. 시료를 90분간 완충용액(pH 1.8-10.2)에 침지 시킨 뒤 500 MPa의 압력으로 56초-15분 4초 초고압처리를 하였다. GC 분석 결과 19개의 함황화합물이 분리 동정되었고 알데하이드, 알콜, 퓨란, 탄화수소, 케톤류 역시 검출되었다. 전자코 분석으로 얻은 데이터로 주성분 분석을 실시한 결과 초고압처리한 시료 모두 대조구에 비하여 이취가 많이 감소하였고, 초고압처리시간이 증가할수록 마늘의 향이 급격히 감소하였다. 강산성 및 강알카리 조건에서도 마늘의 향은 감소하였다. pH는 마늘 향의 형성에 영향을 주었으며 특히 강산의 경우 마늘향의 저감화에 더 효과적이었다. 초고압처리시간이 증가함에 따라 총 sulfide 화합물의 양이 감소하였고 pH 6의 용액에 침지 후 15분 4초간 초고압처리한 시료의 경우 생마늘에 비하여 향이 약 70% 감소하였다. 전자코와 GC-MS 결과의 상관성 분석 결과 R<SUP>2</SUP> 값이 0.9620로 나타나 두 실험결과가 유사함을 입증해 주었다. 이상의 결과를 토대로 침지액의 pH와 초고압처리시간의 조절로 마늘 이취의 저감화가 가능함을 확인할 수 있었다. Effects of pH (1.8-10.2) and time (56 sec-15 min 4 sec) at high hydrostatic pressure (500 MPa) on the reduction of volatile compounds in garlic were studied. Volatile components of garlic were obtained from the headspace, analyzed, and identified by gas chromatography (GC)-mass spectrometry and an electronic nose. Nineteen sulfur compounds were identified as major compounds in garlic, and furan, aldehydes, alcohols, and ketones were also detected. Off-flavor compounds were more effectively reduced under strong acidic conditions. As the residence time at 500 MPa increased from 56 sec to 15 min 4 sec, the total amount of volatile compounds decreased significantly. The total amount of sulfur compounds decreased about 70% compared to those of raw garlic when the garlic was soaked in buffer (pH 6.0) and treated at 500 MPa for 15 min 4 sec. A principal component analysis showed that the off-flavors of garlic were reduced by the operating time of high hydrostatic pressure as well as pH treatment. The correlation coefficient of the results between GC and the electronic nose analysis was 0.9620. Therefore, pH and high hydrostatic pressure treatment could be used as an efficient method for reducing of garlic off-flavor.