• Journal of Haehwa Medicine
• /
• v.5 no.2
• /
• pp.497-497
• /
• 1997

간질성폐질변(間質性肺疾變)은 결체조직질병(結締組織疾病)의 상견(常見)되는 병발증(倂發證)이지만, 지금까지는 이상적(理想的)인 치료법(治療法)이 없었다. 본(本) 연구(硏究)는 본병(本病)의 병리기전(病理機轉)이 중의(中醫)에서의 "어혈(瘀血)"증(證) 상호(相互) 유사(類似)한 것으로부터 시작(始作)하여, 중의(中醫)의 "활혈화어법(活血化瘀法)"과 결합(結合)하여 치료(治療)하면서 환자(患者)의 폐기능(肺氣能) 검사결과(檢査結果)의 변화(變化)를 추적(追跡)해, 그 치료효과(治療效果)에 대(對)한 평가(評價)를 내리는 작업(作業)으로 이루어졌다. 먼저 풍습과(風濕科)에 의뢰(依賴)하여 결체조직질병(結締組織疾病)에 간질성폐병(間質性肺病)이 병발(倂發)한 환자(患者)를 선별(選別)한 후(後)에, 서의치료(西醫治療) 통(通)해서 그 원발성(原發性) 질병(疾病)이 은정(隱靜)한 상태(狀態)에까지 이르도록 한 후(後), 필요(必要)한 최저량(最低量)의 서의약(西醫藥)만을 유지(維持)케 하였다. 환자(患者)의 의사(意舍)에 따라서 두 개의 조(組)로 나누어, 실험군(實驗群)은 중의(中醫)에서 회진(會診)하고, Raynaud 증후군(症候群)의 유무(有無)에 따라서, 당귀사역탕(當歸四逆湯) 혹(或)은 혈부축어탕(血府逐瘀湯)을 농축분제(濃縮粉劑)로 투여(投與)하며 연속(連續)하여 6개월간(個月間) 치료(治療)하였다. 대조군(對照群)의 경우(境遇)에는 중의(中醫)가 회진(會診)하지 않았다. 14개월(個月)동안 모두 실험군(實驗群) 23례(例)와 대조군(對照群) 16례(例)를 대상(對象)으로 연구(硏究)를 하였는데, 모두 여성환자(女性患者)였다. 압축성폐용량(壓軸性肺用量)(FVC), 폐총용량(肺總用量)(TCL), carbon monoxide에 대(對)한 폐(肺)의 확산능력(擴散能力)(DLCO), 그리고 폐포공기량(肺泡空氣量)(VA)에 대(對) DCLO의 비(比)를 지표(指標)로 삼아, 폐기능(肺氣能)의 손상정도(損傷程度)에 따라서 box plot으로 분석(分析)하고, 폐기능(肺氣能)의 손상(損傷)을 측정(測定)하는 시스템을 만들었다. 실험결과(實驗結果), 실험군(實驗群)이 대조군(對照群)에 비(比)해서 치료(治療) 전(前)보다 명현(明顯)한 개선(改善)이 있었다. 폐기능(肺氣能)을 검사(檢査)한 수치(數値)들을 일반적(一般的)으로 통계처리(統計處理)한 것을 응용(應用)하고, TCL과 FVC의 모형식(模型式)을 만든 결과(結果), 실험군(實驗群)에서 FVC가 치료과정(治療過程)의 기간(其間)과 정비례(正比例)하여 향상(向上)되고, 또한 치료효과(治療效果)가 명현(明顯)하게 나타나기 시작(始作)하는 시기(時期)가 중의(中醫) 치료과정(治療過程)을 거친 실험군(實驗群)의 제(第)12개(個)에서 DLCO와 DLCO/VA의 향상(向上)이 나타나는 시기(時期)와 거의 일치(一致)하는 것을 발견(發見)하였다.

• Journal of Preventive Medicine and Public Health
• /
• v.16 no.1
• /
• pp.153-156
• /
• 1983

1950년(年) 이후(以後) 무연탄(無煙炭)으로 만든 연탄(煉炭)을 취사(炊事), 난방용(煖房用)으로 가정(家庭)에서 광범위(廣範圍)하게 사용(使用)하게 되면서 연탄(煉炭)가스내(內)의 일산화탄소(一酸化炭素)로 인(因)한 중독사고(中毒事故)가 빈발(頻發)하여 심각(深刻)한 국민보건(國民保健)의 문제(問題)가 되어왔다. 저자(著者)들의 실태조사(實態調査)(1975년도(年度))에 의(依)하면 서울특별시일원(特別市一圓)에 있어 일산화탄소중독(一酸化炭素中毒)의 년간발생(年間發生)은 인구(人口), 10만당(萬當) 경증(輕症) 260명(名), 혼수상태(昏睡狀態)의 중증중독(重症中毒) 45명(名), 사망(死亡) 1명(名)으로 위험인구(危險人口)를 3,000만명(萬名)으로 하였을 때 전국적(全國的)으로 일산화탄소중독(一酸化炭素中毒)의 추정발생수(推定發生數)는 년간(年間) 경증(輕症) 78만명(萬名), 중증(重症) 13만(萬) 5천명(千名), 사망(死亡) 3,000명(名)으로 그 피해(被害)의 규모(規模)가 100만을 육박(肉薄)하는 가공(可恐)할 수자(數字)를 보여주고 있다. 저자(著者)들은 이러한 심각(深刻)한 국민보건(國民保健)의 문제(問題)를 우선(于先) 실천가능(實踐可能)한 제이차예방(第二次豫防)에 역점(力點)을 두어 고압산소요법(高壓酸素療法)을 보급(普及)할 목적(目的)으로 일인용고압산소장치(一人用高壓酸素裝置)를 개발(開發)하고 1969년(年) 1월(月)에 서울대학교병원(大學校病院)에 고압산소치료실(高壓酸素治療室)을 개설(開設)하여 급성일산화탄소(急性一酸化炭素) 중독환자(中毒患者)에 대(對)한 응급치료(應急治療)를 실시(實施)하여 1978년(年)까지 10년간(年間)의 치료결과(治療結果)를 요약(要約)한바 다음과 같다. 1. 총치료환자수(總治療患者數)는 2,242명(名)이고 회복(回復)된 수(數)는 2,202명(名)으로 98.2%의 회복률(回復率)을 보였다. 2. 계절적(季節的)으로 10월(月)에서 4월(月)까지가 연중최성기(年中最盛期)이나 5월(月)에서 9월(月)까지도 적지않은 환자(患者)의 발생(發生)을 볼 수 있었다. 3. 연령별분포(年齡別分布)를 보면 15세(歲)${\sim}29$세군(歲群)이 전체환자(全體患者)의 반이상(半以上)인 52.7%를 차지하고 있고 $0{\sim}14$세군(歲群)은 인구비(人口比)에 대해 발생(發生)이 훨씬 적은 결과(結果)를 보이고 있다. 4. 도착시간별(到着時間別) 입원율(入院率)은 오전(午前) 10시이후(時以後) 도착군(到着群)서부터는 입원율(入院率)이 급증(急增)하는데 이는 병원도착(病院到着)이 늦일수록 당일회복(當日回復)이 되지못하고 입원가료(入院加療)하게 됨을 나타내주는 결과(結果)라 할 수 있다. 5. 병발증(倂發症)으로는 급성욕창, 폐렴(肺炎) 및 신경학적(神經學的) 이상등(異常等)의 소견(所見)을 많이 볼 수 있었다.

• Radiation Oncology Journal
• /
• v.14 no.2
• /
• pp.123-128
• /
• 1996

Purpose : This is a retrospective study to compare the Palliation rates, survival rates and complications of low dose rate and high dose rate endobronchial brachytherapy in the management of malignant airway obstruction. Materials and methods : Forty three consecutive patients with malignant airway compromise from primary or metastatic lung tumors were treated with low dose rate(LDR) endobronchial Iridium-192 insertion(21 patients) between October 1988 and June 1992, and high dose rate(HDR) endobronchial brachytherapy(22 patients) between August 1992 and April 1994 with palliative aim Flexible fiberoptic bronchoscopy under fluoroscopic control was utilized in all 91 procedures. Twenty seven LDR Procedures delivered a dose of 5-7.5 Gy to a 1.0 cm radius respectively. Results : Subjective and objective responses to treatments were evaluated on follow-up examinations by clinical examination, chest x-rays and CT scan of the chest on some patients. Fifteen of 21 LDR patients and 19 of 22 HDR Patients showed subjective improvement in terms of better breathing and less Productive cough as well as complete disappearance of hemoptysis. Objective improvement on chest x-rays and CT scan of the chest had been demonstrated on 8 LDR Patients and 10 HDR patients. Conclusion : The technique of LDR and HDR endobronchial brachytherapy is simple and well tolerated procedure with minimal morbidity It Provides excellent palliation by keeping airway Patent in these short life-spanned patients.

• Journal of Oral Medicine and Pain
• /
• v.36 no.1
• /
• pp.21-24
• /
• 2011

Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

• Journal of Chest Surgery
• /
• v.42 no.6
• /
• pp.725-731
• /
• 2009

Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.