• Title/Summary/Keyword: 악화환자

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Changes of Sputum Matrix Metalloproteinases and Tissue Inhibitor of Matrix Metalloproteinase-1 by Antibiotic Treatment in Acute Exacerbation of Chronic Bronchitis (만성 기관지염의 급성 악화에서 항생제 투여에 의한 유도객담 내 Matrix metalloproteinase와 Tissue inhibitor of matrix metalloproteinase의 변화)

  • Yoon, Hyoung-Kyu;Ahn, Joong-Hyun;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.420-430
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    • 2002
  • Background : Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. Objectives ; The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods : We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results : There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusion : The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.

A Study on Life Changes of Oral Lichen Planus Patients by SRRS (SRRS를 이용한 구강 편평태선 환자의 생활변화에 관한 연구)

  • Ko, Myung-Yun;Park, Su-Hyeon;Ok, Su-Min;Huh, Joon-Young;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.9-17
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    • 2012
  • Lichen planus is a chronic inflammatory mucocutaneous disease that affects multiple sites of the body. Often it involves the oral mucosa, but also involve other sites such as skin, genitals, scalp and nails. There is no clear cause of oral lichen planus (OLP), current data suggest that OLP is a T-cell mediated autoimmune disorder which may have an altered self-peptide triggering apoptosis of oral epithelial cells. Usually OLP appears in middle-aged women which tends to be chronic with periods of exacerbation and remission. There are many theories those causes the OLP such as psychological and environmental factors, genetic tendency, drugs and more. 60-70% of lichen planus is accompanied by oral lesions, and more than half of its cases are not able to defined by their skin. In this study, among all the possibility(possible) theories, we tried to evaluate the influence of emotional stress in exacerbating OLP. There were thirty patients with a clinical or histological diagnosis of OLP and other thirty subjects who did not show any signs of systemic disorders include OLP. They were evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the OLP patients than the control group. Therefore it could be concluded that psychological stressors play an important role in the exacerbating OLP.

Preoperative Risk Factors for the Prognosis of Mitral Regurgitation in Patients with Coronary Artery Stenosis and Mitral Regurgitation Who Underwent Coronary Artery Bypass Surgery Alone (승모판폐쇄부전증을 동반한 관상동맥협착증 환자에서 시행한 단독 관상동맥우회술 후 승모판폐쇄부전증의 예후에 영향을 미치는 수술 전 요인)

  • Jin, Ung;Park, Chan-Beom;Choi, Si-Young;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.410-415
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    • 2004
  • Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.

계절건강 지킴이 - 콜록콜록~ 또 감기앓이? 감기의 릴레이를 끊어라!

  • Son, Ji-Hye
    • 건강소식
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    • v.38 no.11
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    • pp.24-25
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    • 2014
  • 초가을까지 기승을 부리던 더위가 물러가자 감기가 몰려온다. 확연하게 커진 밤낮의 일교차와 건조해진 날씨에 병원을 찾는 호흡기 환자들의 발길이 잦아지고, 면역력이 약한 어린이가 있는 가정은 아이들 병간호에 여념이 없다. 겨우 다 나았나 싶었는데 재발하기가 더 악화되어 가을 겨울 내내 우리를 괴롭히는 감기. 대체 그 연속성의 원인은 무엇일까.

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박태균의 건강칼럼

  • Park, Tae-Gyun
    • 건강소식
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    • v.32 no.8
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    • pp.32-33
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    • 2008
  • 식생활이 서구화되면서 몸속에 돌이 생기는 담석증 환자가 크게 늘고 있다. 우리나라 성인 10명 가운데 1명이 담석증을 앓고 있으며, 최근 증가 추세에 있다고 한다. 위장병이 없는데도 오른쪽 윗배에 통증이 심하고 기름진 음식을 먹을 때 소화가 안 되면 담석증을 의심해야 한다. 그대로 방치했을 경우 담염이나 췌장염, 암으로 악화될 수 있어 그 심각성이 우려되는 담석증의 치료법과 예방법을 알아본다.

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공기청정기의 필요성과 원리

  • 서국섭
    • The Magazine of the Society of Air-Conditioning and Refrigerating Engineers of Korea
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    • v.33 no.4
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    • pp.8-11
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    • 2004
  • 최근 황사, 새집증후군(SHS), 조류독감 등과 같은 인간의 건강을 위협하는 요인들의 증가 및 대기오염에 의한 실내공기질의 악화는 비염, 천식과 같은 호흡기 질환과 아토피 같은 각종 알레르기 질환 관련 환자들의 증가로 실내의 공기를 건강한 공기로 전환시켜 이러한 질환들을 예방 또는 완화시키는 방법으로서 공기청정기에 대해 설명하고자 한다.(중략)

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최신 의학정보 - 회전근개손상? 오십견? 복잡한 어깨질환 구분법

  • Sin, Beom-Su
    • 건강소식
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    • v.36 no.10
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    • pp.44-45
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    • 2012
  • 어깨통증은 매우 흔한 질병이지만 원인과 증상이 다양해 잘못된 진단과 처치로 적당한 치료시기를 놓치기 쉽다. 파스를 붙이는 것에서부터 물리치료, 운동요법 등 병원을 찾기 전 환자 스스로 해볼 만한 여러 대안이 많다는 점도 이런 이유 중 하나다. 어깨통증은 간단한 방법으로 치료되거나 자연스레 낫기도 한다. 하지만 통증이 너무 오래 동안 지속되거나 악화되면 반드시 어깨를 전문으로 보는 병원을 찾아 진단을 받는 게 중요하다.

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A Survey of Deaths in Hospitalized Patients for Pulmonary Tuberculosis (폐결핵으로 사망한 환자들의 치료경력)

  • Oh, Seung-Joon;Yoon, Ki-Heon;Yoo, Jee-Hong;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.694-699
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    • 1993
  • Background: After the introduction of more potent antituberculous drugs and the nation-wide tuberculosis management the prevalence rate and mortality rate of pulmonary tuberculosis has been reduced continuously. But we still experienced many patients who succumbed to this disease. So we investigated the causes of treatment failure and death of patients with pulmonary tuberculosis to delineate the problems in the management of these patients. Methods: Retrospective analysis of medical records of 55 patients who died of pulmonary tuberculosis in Kyung-Hee University Hospital during the period of Mar. 1979-Feb. 1990. Results: 1) Average duration of illness was $11.9{\pm}10.1$ years. 2) The mortality rate of in-patients with pulmonary tuberculosis was 2.09%. 3) 47.3% of patients had been treated more than twice and the sputum positive rate was 52.7%. 4) Causes of death were acute respiratory failure(56.4%), asphyxia by hemoptysis(14.6%), cor pulmonale(9.1%), tension pneumothotax(7.3%), vital organ involvement(9.1%) and coexisting diseases(3.5%). Conclusion: Many of these patients had long duration of illness, persistant sputum AFB and high incidence of acute respiratory failure as a fatal complication. It seemed that patient's neglect of their disease and inadequate treatment had caused aggravation of tuberculosis.

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Development of Guidelines for Raid Response to Acute Deteriorating of Hospitalized Patients (입원환자의 급성 악화 신속대응 가이드라인 개발)

  • Lee, Ha-Nui;Park, Jeong-Sook
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.359-373
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    • 2022
  • The purpose of this study was to develop evidence-based practice guideline for rapid response to acute deterioration of hospitalized patients. The guideline was developed according to the Clinical Practice Guideline Adaptation Manual. and evaluated using AGREE II tool. The guidelines were checked content validation by an expert group, final 130 recommendations in 5 sections including management, recognition, activation, response, and evaluation. The average of the overall practical application to the guidelines was 4.41±0.78 out of 5, which showed high applicability in clinical work.

A Case of Spontaneous Pneumomediastinum and Pneumopericardium in a Patient with Acute Exacerbation of Idiopathic Pulmonary Fibrosis (자발성 종격동기흉과 심낭기종을 동반한 특발성 폐섬유증의 급성 악화 1예)

  • Yun, Se-Young;Kim, Yong-Ho;Choi, Eun-Kyoung;Hong, Seuk-Kyun;Ji, Young-Ku;Lee, Kye-Young;Choi, Young-Hi;Myong, Na-Hye;Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.704-709
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    • 2001
  • Background : Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.

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