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Physiologic Changes Induced with Lipopolysaccharide in Rats.

Kyoung Min LEE ; Kwang Ho LEE ; Kong Been IM ; Jong Taek PARK ; Young Bok LEE

The Korean Journal of Critical Care Medicine.1999;14(2):137-142.

BACKGOUND: Bacterial endotoxin or lipopolysaccharide (LPS) is believed to mediate the tissue damage and shock observed in Gram-negative sepsis (GNS) by initiating a cascade of events, including activation of the coagulation, fibrinolytic and complement systems, and release of proinflammatory cytokines. However, the clinical pictures that result from GNS and endotoxin are quite different. The physiologic changes induced with LPS were investigated in this study. METHODS: Fifty two male Sprague-Dawley rats were injected intraperitoneally with Escherichia coli LPS. Blood samples and bronchoalveolar lavage (BAL) fluid were obtained at baseline and at 2, 4, 8, 16, 24, and 48 hours after injection. Nitrate/nitrite levels were measured from plasma and BAL samples. Lipid peroxide (LPO) levels were measured from plasma. We measured also protein concentration and number of polymorphonuclear leukocytes (PMNL) and macrophages from BAL samples. RESULTS: Administration of LPS caused significant increase in nitrate/nitrite concentrations of plasma and BAL fluid (p<0.01). ED50 of LPS was 1.76 mg/kg in plasma nitrate/nitrite assay. Plasma LPO levels were increased slightly after administration of LPS, but no statistical significance. Protein concentration was increased significantly (p<0.01) 4 hours after the administration of LPS. LPS induced increase of the number of PMNLs and macrophages of BAL samples significantly (p<0.05). CONCLUSIONS: LPS increased NO production and alveolar permeability in rats. Also, LPS increased the number of inflammatory cells in the lung.
Animals ; Bronchoalveolar Lavage ; Complement System Proteins ; Cytokines ; Escherichia coli ; Humans ; Lung ; Macrophages ; Male ; Neutrophils ; Nitric Oxide ; Permeability ; Pharmacology ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Sepsis ; Shock

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Procalcitonin as a Prognosis Marker for the Severe Sepsis and Septic Shock Patients in Emergency Department.

Seung Woon CHOI ; Hoon KIM ; Kyung Hwan KIM ; Dong Wun SHIN ; Jun Seok PARK ; Jun Young ROH ; Jun Min PARK

The Korean Journal of Critical Care Medicine.2011;26(4):250-255. doi:10.4266/kjccm.2011.26.4.250

BACKGROUND: Advance in sepsis management has increased the survival of patients with sepsis. However, severe sepsis and septic shock patients still have high mortality. We intend to verify the use of the procalcitonin (PCT) level as a prognosis marker in patients with severe sepsis or septic shock in the emergency department (ED). METHODS: ED Patients with severe sepsis or septic shock were enrolled in our study. We used mortality and Intensive Care Unit (ICU) days as a prognosis index, and compared the PCT level in survivors and non-survivors. We introduced the simplified acute physiology score 3(SAPS3) to assess the severity of the patients and analyzed whether or not the PCT level correlated with the severity index. RESULTS: The PCT level in septic shock patients [7.36 (0.92-33.69, IQR)] was higher than that in severe sepsis patients [3.24 (0.36-10.53, IQR)] (p = 0.04). However, there was no significant PCT level difference between survivors [median (IQR), 6.59 (0.60-29.25)] and non-survivors [median (IQR), 3.49 (0.40-20.41)] (p = 0.293). The SAPS3 score was higher in the non-survivor group [median (IQR), 64 (59.0-71.5)] than in the survivor group [median (IQR), 77 (68.5-82.0)] (p = 0.001). The PCT level did not correlate with either ICU days or hospital days. CONCLUSIONS: Using the PCT level as a prognosis factor in severe sepsis and septic shock patients in ED has little value.
Calcitonin ; Emergencies ; Humans ; Intensive Care Units ; Prognosis ; Protein Precursors ; Sepsis ; Shock ; Shock, Septic ; Survivors

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A report of peripheral circulatory insufficiency following frequent percutaneous puncture of the radial artery and the bracheal artery cannulation.

Kam Jin SHIN ; Sang Kwi LEE ; Hee Sun SONG

The Korean Journal of Critical Care Medicine.1993;8(2):97-100.

No abstract available.
Arteries* ; Catheterization* ; Punctures* ; Radial Artery*

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Obstructive Fibrinous Tracheal Pseudomembrane: An Update.

Alberto MANASSERO ; Matteo BOSSOLASCO

The Korean Journal of Critical Care Medicine.2014;29(3):241-242. doi:10.4266/kjccm.2014.29.3.241

No abstract available.
Fibrin*

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Successful Bridging Hemostasis Using a Sengstaken-Blakemore Tube in Massive Rectal Variceal Bleeding.

Kyung Su KIM ; Gil Joon SUH ; Woon Yong KWON

The Korean Journal of Critical Care Medicine.2014;29(3):237-240. doi:10.4266/kjccm.2014.29.3.237

Life-threatening rectal variceal bleeding is a rare complication of liver cirrhosis. Various therapeutic interventions including endoscopic variceal ligation and percutaneous transvenous obliteration have been proposed to control significant rectal variceal bleeding. However, these definite hemostasis modalities are not readily available and require an experienced endoscopist or interventional radiologist. Therefore, bridging therapy to control active bleeding is necessary especially in patients with massive bleeding. We report a case of massive rectal variceal bleeding in which a Sengstaken-Blakemore tube was effective at stopping the bleeding until percutaneous transvenous obliteration could be performed.
Esophageal and Gastric Varices* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis* ; Humans ; Hypertension, Portal ; Ligation ; Liver Cirrhosis

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An Anthropometric Measurements of the Upper Airway Using Fiberoptic Laryngoscope in Korean Adults.

Sang Kyi LEE ; Chun Won YOO

The Korean Journal of Critical Care Medicine.1997;12(2):143-150.

Introduction: An anthropometric distance is crucial for an easy endotracheal intubation and correct placement of endotracheal tube in the trachea. There may be a racial difference of the anthropometric measurement. So we measured the anthropometric distances of the upper airway in Korean adult patients. METHODS: A standard anesthetic induction and maintenance was performed in 100 adult patients following endotracheal intubation. Various anthropometric measurements were determined while the patients head were in a neutral position. Thyromental and sternomental distance were measured. A distance from upper central incisor to carina or cricoid cartilage was directly measured using fiberoptic laryngoscope. However, the length from upper central incisor to midtrachea & the cricoid cartilage-carina distance were indirectly calculated from the above measured distances. Correlation analyses were also performed between age, height, or weight and the above measured anthropometric distances. RESULTS: The mean distances from upper central incisor to carina, cricoid cartilage or midtrachea were 25.5+/-1.8, 13.9+/-1.9, or 19.8+/-1.8cm respectively. The mean distance from cricoid cartilage to carina was 11.6+/-1.4cm. Thyromental and thyrosternal distance were 6.6+/-0.9 and 15.7+/-1.5cm respectively. All mean anthropometric distances of male were longer than those of female patients. Thirty-eight patients (38%) had the thyromental distance < or = 6cm while one patient (1%) had thyrosternal distance < or = 12.5cm. A good correlation (r< or =0.6) was observed between height and upper central incisor-carina distance. CONCLUSIONS: This study suggests that these measured anthropometric data are useful for an easy endotracheal intubation and accurate endotracheal placement in the trachea.
Adult* ; Cricoid Cartilage ; Female ; Head ; Humans ; Incisor ; Intubation, Intratracheal ; Laryngoscopes* ; Male ; Trachea

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Lipid Emulsion in the Successful Resuscitation of Local Anesthetic Toxicity after Ankle Block.

Sang Hee PARK ; Sang Hyun KWAK ; Kyung Yeon YOO ; Hyun Jung LEE ; Keun Bae YOOK ; Seok Jai KIM

The Korean Journal of Critical Care Medicine.2014;29(3):234-236. doi:10.4266/kjccm.2014.29.3.234

Unexpected occurrence of local anesthetic toxicity is not rare and can cause fatal complications that do not respond to any known drug of intervention. Recently, the successful use of lipid emulsion for local anesthetic toxicity has been reported and recommended as a rescue method for cardiac or neurologic complications. We report a case of seizure attack and respiratory arrest successfully recovered with the use of intravenous lipid emulsion. Clinicians must be aware of the beneficial role of lipid emulsion in cases of local anesthetic toxicity.
Anesthetics, Local ; Ankle* ; Antidotes ; Fat Emulsions, Intravenous ; Neurotoxicity Syndromes ; Resuscitation* ; Seizures

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Mycotic Aneurysm of the Aortic Arch.

Ji Hye SEO ; Dae Won PARK ; Won Suk CHOI

The Korean Journal of Critical Care Medicine.2014;29(3):231-233. doi:10.4266/kjccm.2014.29.3.231

A mycotic aneurysm of the thoracic aorta is rare. We report a case of mycotic aneurysm that developed in the aortic arch. An 86-year-old man was admitted with fever and general weakness. Blood culture yielded methicillin-resistant Staphylococcus aureus. Chest X-ray showed an enlarged aortic arch, and computed tomography scan revealed an aneurysm in the aortic arch. The patient was treated only with antibiotics and not surgically. The size of the aneurysm increased rapidly, resulting in bronchial obstruction and superimposed pneumonia. The patient died of respiratory failure.
Aged, 80 and over ; Aneurysm ; Aneurysm, Infected* ; Anti-Bacterial Agents ; Aorta, Thoracic* ; Fever ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Respiratory Insufficiency ; Staphylococcus aureus ; Thorax

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Acute Adrenal Insufficiency Associated with Acute Coronary Syndrome.

Youngji KIM ; Woojin JUNG ; Inkuk CHO ; Seyeol YANG ; Ho HAN ; Jung Hwan PARK

The Korean Journal of Critical Care Medicine.2014;29(3):226-230. doi:10.4266/kjccm.2014.29.3.226

Acute adrenal insufficiency (AAI) in acute coronary syndrome (ACS) patients is rare and may be frequently underestimated as simple ACS, since symptoms of AAI are nonspecific. Physicians should be fully aware of the possibility of occult AAI combined with ACS, if clinical suspicion is high. Herein, we report a rare case of a 67-year-old female patient with concomitant AAI and drug eluting stent fracture-induced ACS. To our knowledge, there have been no case reports of AAI associated with ACS in Korea.
Acute Coronary Syndrome* ; Adrenal Insufficiency* ; Aged ; Female ; Humans ; Korea ; Stents

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Cardiogenic Shock in a Patient with Intermediate Coronary Artery Disease due to Preoperative Spasm.

Donghun SHIN ; Min Jin LEE ; Chul Hong PARK ; Joongkeun KIM ; Dae Sung LEE ; Jun Hyok OH

The Korean Journal of Critical Care Medicine.2014;29(3):222-225. doi:10.4266/kjccm.2014.29.3.222

The best management strategy for angiographically intermediated coronary artery diseases remains controversial. Lesions, when coupled with spasm, can lead to catastrophic results and cardiogenic shock. We report a case of a 62-year-old man who had an intermediate coronary artery disease presenting with cardiogenic shock due to coronary spasm during a preoperative period.
Coronary Artery Disease* ; Coronary Vasospasm ; Humans ; Middle Aged ; Perioperative Period ; Preoperative Period ; Shock, Cardiogenic* ; Spasm*

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