• Tuberculosis and Respiratory Diseases
• /
• v.41 no.1
• /
• pp.20-25
• /
• 1994

Background: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug 1992. Methods: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. Results: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis, 18.2%(22) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. Conclusion : Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.

• Journal of Preventive Medicine and Public Health
• /
• v.17 no.1
• /
• pp.127-135
• /
• 1984

Personal and social characteristics, disease status, reason of delay of receiving drug from City Health Center and knowledge and attitude on the pulmonary tuberculosis were compared between the faithful group in treatment and the unfaithful group among the patients for pulmonary tuberculosis registered in a City Health Center in order to analyze the factors which influenced the faithfulness to treatment. Record as well as interview survey was done toward all patients of 247 who were registered and being cared during over 6 months in a City Health Center from April 1, 1982 to March 31, 1983, and results were as follows; 1. There was no statistically significant difference in sex and age distribution between the faithful group in treatment and the unfaithful group. 2. There was no statistically significant difference in marital status distribution between the faithful group and unfaithful group in treatment. 3. The lower education group comprised higher proportion than the higher education group among the faithful group in treatment. 4. The proportion of the emlployed was higher than unemlpoyed among the unfaithful group in treatment. 5. The proportion of mild case was higher than severe case among the unfaithful group in treatment. 6. As for the onset of delay of receiving drug, 'less than 3 month after starting treatment' was 59.5% among the unfaithful group in treatment. 7. The reasons of delay of receiving drug were 'no time' (42.2%). 'being away from home' (25.0%), 'being sick' (13.8%), and 'forgot the appointed date' (12.0%). 8. There was no statistically significant difference in the knowledge on the communicability of the tuberculosis between the faithful groups in treatment and the unfaithful group. 9. There was no statistically significant difference in the knowlege on B.C.G. as vaccination drug of tuberculosis between the faithful group and the unfaithful group in treatment. 10. There was no statistically significant difference in the satisfaction on the treatment of health center between the group of faithful and unfaithful in treatment. 11. There was no statistically significant difference in the belief on the complete recovery of tuberculosis between the faithful group and the unfaithful group in treatment. 12. The rate of consulting on tuberculosis treatment with life partner was higher among the faithful group in treatment than the unfaithful group.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.1
• /
• pp.83-91
• /
• 2006

Background : For unknown reasons, the serum ferritin concentrations are higher in patients with acute lung injury. A pretreatment with aspirin reduces the acute lung injury in rats subjected severe hemorrhage, and increases the rate of ferritin synthesis in vitro. This study investigated the effect of aspirin on the serum ferritin changes in rats subjected to severe hemorrhage. Methods : Hemorrhagic shock was induced by withdrawing blood (20 ml/kg of B.W.) through the femoral artery for 5 min. The rats were pretreated with aspirin (10 mg/kg, i.v.) 30 min before hemorrhage. Results : The protein content and leukocyte count in the bronchoalveolar lavage fluid, lung tissue myeloperoxidase activities were significantly higher after hemorrhage. The aspirin pretreatment prevented these changes. The serum and lavage fluid ferritin concentrations were elevated higher after hemorrhage. These were also attenuated by the aspirin pretreatment. Conclusion : The changes in the serum and lung lavage ferritin level might be closely related to the severity of hemorrhage-induced acute lung injury. Therefore, the serum and lavage ferritin concentrations can be a useful biomarker for patients with precipitating conditions.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.1
• /
• pp.204-212
• /
• 1998

Bronchiolitis obliterans organizing pneumonia(BOOP) is a type of diffuse interstitial lung disease that has emerged in the past decade as an important cause of acute respiratory illness in adult. Clinically, the entity usually starts with a subacute influenza-like illness, followed by cough, progressive dyspnea, and weight loss. Organized inflammatory polypoid materials predominantly affecting distal bronchioles, alveolar ducts, and peribronchial alveolar spaces are a key pathologic findings. BOOP is characterized by a good response to glucocorticoid and an excellent prognosis. However, there is a subset of BOOP who presents with a fulminant course leading to death or chronic severe fibrosis with marked impairment of lung function. Recently, we have experienced a case of rapidly progressive BOOP, diagnosed by open lung biopsy and showed a reluctant response to corticosteroid.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.6
• /
• pp.590-596
• /
• 2001

The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.4
• /
• pp.381-392
• /
• 2004

Arsenic trioxide($As_2O_3$) was introduced into the treatment of refractory or relapsed acute promyelocytic Ieukemia. Some investigators have reported that arsenic trioxide had induced apoptosis in a variety of solid human tumor cell lines, including non-small cell lung cancer. Non-steroidal anti-inflammatory drugs(NSAIDs) are powerful chemopreventive agents for gastrointestinal cancers and the growth of established tumors are reduced by inducing apoptosis. It's also reported that NSAIDs enhanced tumor response to chemotherapeutic drugs or radiation. In this study, we aimed to determine whether combination of arsenic trioxide with sulindac augmented its apoptotic potential in NCI-H157 human lung cancer cells. The human lung cancer cell line NCI-H157 was treated with arsenic trioxide and sulindac. Cell viability was measured by the MTT assay. Apoptosis was measured by nuclear staining and flow cytometric analysis. The catalytic activity of the caspase families were measured by the fluorogenic cleavage of biosubstrates. The western blotting were also performed to define the mechanical basis of apoptosis. Combination treatment of arsenic trioxide and sulindac decreased the viability of NCI-H157 human lung cancer cells in a dose-dependent manner. The catalytic activity of caspase-3, 8 and 9 proteases were increased after combination treatment. Consistently PARP was cleaved from 116kDa to 85kDa fragments, and the expression of ICAD was decreased by time-dependent manner. Also combination treatment increased the expression of Fas and Fas/L. Combination therapy of arsenic trioxide with sulindac augments cell death and induces apoptosis via the activation of caspase cascade in NCI-H157 human lung carcinoma cells.

• Tuberculosis and Respiratory Diseases
• /
• v.63 no.5
• /
• pp.449-453
• /
• 2007

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.5
• /
• pp.522-531
• /
• 2003

Background : Hemorrhagic shock and trauma are two of the most common causes of acute lung injury. The activation of cyclooxygenase is one of the important causes of acute lung injury. This study investigated the effect of aspirin, a well-known cyclooxygenase inhibitor, on severe hemorrhage-induced acute lung injury in rats. Methods : The hemorrhagic shock was induced by withdrawing blood; 20ml/kg of B.W., through the femoral artery in 5 min. The mean arterial pressure was recorded through the femoral artery on a polygraph. Results : In the present investigation, the lung tissue myeloperoxidase activity, protein contents and leukocyte counts, in bronchoalveolar lavage fluid, increased significantly 2 and 24 h after the hemorrhage induction. Although the decreased mean arterial pressure spontaneously recovered, acute lung injury occurred after severe hemorrhage. These changes were effectively prevented by a single intravenous injection of aspirin (10 mg/kg of B.W.) 30 min before the hemorrhage. Conclusion : These results suggest that severe hemorrhage-induced acute lung injury is mediated, in part, by the activation of cyclooxygenase. Furthermore, pretreatment of aspirin in acute lung injury-prone patients, or prophylactic treatment of aspirin to the patients with precipitating conditions, could be helpful in the prevention of acute lung injury.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.5
• /
• pp.485-496
• /
• 2002

Background : Nonsteroidal anti-inflammatory drugs (NSAIDs) are useful in the chemoprevention of colon cancers. Continuous NSAID use results in a 40% to 50% reduction in the relative risk of colorectal cancer. The precise mechanism by which NSAIDs prevent and/or cause the regression of colorectal tumors is not known. Some investigators have reported that certain NSAIDs induce apoptosis and alter the expression of the cell cycle regulatory genes in some carcinoma cells when administered at a relatively high concentration. However, the possibility of NSAIDs application as chemopreventive agents in lung cancers remains to be elucidated. To address this question, the human lung cancer cell line NCI-H1299 was used to investigate whether or not NSAIDs might induce the apoptotic death of NCI-H1299 cells. Methods : A viability test was carried out using a MTT assay. Apoptosis was measured by flow cytometric analysis and unclear staining(DAPI). The talytic activity of the caspase family was measured by the fluirigenic cleavage of biosubstrates. To define the mechanical basis of apoptosis, western blot was performed to analyze the expression of the death substrates(PARP and ICAD). Results : NaSaL significantly decreased the viability of the NCI-H1299 cells, which was revealed as apoptosis characterized by an increase in the $subG_0/G_1$ population and unclear fragmentation. The catalytic activity of caspase-3 protease began to increase after 24 Hr and reached a peak 30 Hr after treatment with 10 mM NaSaL. In contrast, caspase-6, 8, and 9 proteases did not have a significantly altered enzymatic activity. Consistent with activation of caspase-3 protease, NaSaL induced the cleavage of the protease biosubstrate. Conclusion : NaSaL induces the apoptotic death of NCI-H1299 human lung cancer cells via the activation of caspase-3 protease.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.3
• /
• pp.250-258
• /
• 1993

Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.