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

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.429-436
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• 1998

Approximately 100 drugs have been reported to affect the lungs adversely. Among these, pulmonary toxicity caused by antieneoplastic agent. is being recognized more frequently. Cyclophosphamide is an immunosuppressive alkylating agent used for the treatment of a wide variety of malignant and nonmalignant diseases. The incidence of pulmonary toxicity is probably less than 1 percent The first case was reported in 1967. Since then, more than 20 well-documented cases of pulmonary toxicity associated with cyclophosphamide have been reported in the literature. In Korea, three patients were identified with cyclophosphamide-induced lung disease. The typical features of toxicity include dyspnea, fever, cough, new parenchymal infiltrates, gas exchangs abnormalities on pulmonary function tests, and pleural thickening on chest roentgenogram. The best approach to management is early diagnosis, discontinuation of the offending drug and administration of corticosteroid therapy. Recently, we experienced a case of diffuse alveolar damage induced by cyclophosphamide. The patient presented with early-onset pulmonary toxicity and died of repiratory failure despite early use of corticosteroid.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.143-154
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• 1991

Pneumconiosis is a sort of pulmonary fibrosis consequent to the inhalation of the respirable dusts. Thus, the pathogenesis of silicosis have concentrated largely on the early response of alveolar macrophage and the later fibroblastic stimulation. But the role of the other cells and continuing cell injury in the pathogenesis has not been fully studied. And the chemical factors such as prostaglandin, fibroblast stimulating factor and inhibiting factor and chemotaxin are also participated in the mechanism of pulmonary fibrosis in silicosis. In order to clarify the role of alveolar cells and prostaglandin, we investigated the changes of the cellularities in bronchoalveolar lavage fluid and tissue pathology in the experimental silicosis with the time sequence. The experimental animals were divided into 3 groups; control group received only intratracheal injection of 0.5 ml saline, silica group received the intratracheal instillation of 40 mg silica with the same amount saline, and aspirin group received 450 mg/kg of aspirin after silica instillation. The results were as follows: 1) The total cells of bronchoalveolar lavage fluid in the silica group markedly increased in comparison with the control group, but there was no significant difference between the silica and aspirin groups. 2) The percentages of alveolar macrophages to the total number of cells in the silica group tended to be lower than those in the control group and also lower than those in the aspirin group at the 1st week after silica instillation. 3) The percentages of neutrophils to the total number of cells in the silica group were significantly higher than those in the control group during the entire period and also higher than those in the aspirin group at the 3rd day after silica instillation. 4) In the silica group, the percentages of lymphocytes to the total number of cells were increased 143 progressively with the time course and those were significantly higher than those in the control group from the 3rd week after silica administration. There were marked differences of lymphocyte percentages between the silica and aspirin groups at the 1st week after silica instillation. 5) The inflammatory change was observed in the rat lung at the 1st day after silica instillation. Also the silicotic nodule appeared in the silica group at the 1st week but we could not find out that nodule in the aspirin group at that time. The fibrotic changes in the rat lung tended to be increased progressively with the time course, therefore, the diffuse fibrotic pattern appeared in the whole field at the 20th week after silica instillation. 6) By the electron microscopy, there were gradual increases of phagosomes and vacuoles in the alveolar macrophage in the silica group as compared with the control group. These results suggest that the neutrophils and the lymphocytes have also participated in the pulmonary fibrosis even though the alveolar macrophage has a major role, and prostaglandin mediate the inflammation and pulmanary fibrosis in the experimental silicosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.508-513
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• 2018

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.97-100
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• 2010

A 73-year-old man was admitted with a sudden onset of dyspnea. He had never smoked. The chest radiograph and computed tomography revealed bilateral ground glass opacity and an enlarging perihilar consolidation with lymphadenopathies. There was a higher percentage of eosinophils (72%) in the bronchoalveolar lavage fluid (BALF) than normal. The patient was diagnosed with acute eosinophilic pneumonia and managed with steroid. Pneumocystis pneumonia (PCP) was diagnosed by an examination of the BALF, and the patient was treated with trimethoprim-sulphamethoxazole. The patient tested positive to the HIV antibody and the peripheral blood CD-4 positive lymphocyte count was only $33/{\mu}L$. The percentage of eosinophils in the BALF can increase in some cases of PCP that is complicated with AIDS. Only a few cases of eosinophilic pneumonia associated with PCP pneumonia have been reported in patients with AIDS but there are no case reports in Korea. This case highlights the need to consider PCP when the percentage of eosinophils in the BALF is elevated.

• The Korean Journal of Physiology
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• v.2 no.2
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• pp.63-73
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• 1968

It is well known that mammalian alveolar membrane is covered with a very thin layer of surfactant film which characteristically reduces surface tension of alveolar membrane, and maintains alveolar stability. Since Clements in 1957 demonstrated that the surfactant is extractable by mincing the lung tissue in saline, various studies on the subject have been succeeded by many workers. However, the effect of radiation on the surfactant is not well clarified. Present study was attempted to observe the effect of x-irradiation on the activity of surfactant in rabbits. X-ray in dose of 300 r, 600 r or 900 r was irradiated to the chest of rabbits. The lung was removed from normal or irradiated rabbits sacrificed by arterial blood shedding, and lung-saline extract, adding 3 grams of lung tissue to 50 mili-liters of saline, was prepared by means of Vertis homogenizer. Tension-area diagram of lung extract was recorded automatically by a modified Langmuir-Wilhelmy balance with a synchronized recording system designed in this department. The surface tension of lung extract was measured at 1st, 2 nd, 3 rd, 7 th and 15 th post-radiation day in 300 r irradiated group, at 3 rd, 7 th and 15 th post-radiation day in 600 r irradiated group, 3 rd and 7 th post-radiation day in 900 r irradiated group respectively. For the histo-pathological study, lung tissue preparations were made in all irradiatiated groups on the day of experiment and in normal group. The results obtained are summarized as follows: 1. The minimal surface tension, maximal surface tension and stability index of normal rabbits lung extracts were 7.68 dynes/cm, 38.84 dynes/cm, and 1.39 respectively. 2. The activity of surfactant was depressed prominently by x-irradiation. However, increase in the dose of x-irradiation did not show any significant change in the degree of surfactant activity suppression. The most marked depression in surfactant was observed at the third post-radiation day in all irradiated groups. 3. Activity of surfactant depressed by x-irradiation showed a tendency of recovering to normal on 15 th post-radiation day. 4. The tendency of change in activity of surfactant following x-irradiation was somewhat correlative with histo-pathological changes. But the degree of depression of surfactant by x-irradiation did not correspond to the degree of histo-pathological changes, and recovery of lung tissue from radiation damage, tissue edema and congestion, seemed to be followed by restoration of surfactant activity. 5. The width of the tension-area diagram was measured at the surface area of 40% in lung extract of normal and x-irradiated rabbits. And it was found that the changes of the width corresponded well with that of minimum surface tension and of stability index in all normal and x-irradiated groups.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1241-1247
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• 1996

From January 1989 to March 1996, we have operated on 102 cases of non-small cell lung cancer at the department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine. They were clinically evaluated. The results are as follows; 1. The peak incidence of age of primary lung cancer was 5th decade(34.3%) and 6th decade(38.2%). Male to female ratio was 2.5:1. 2. Most of symptoms were respiratory, which were cough(61.8%), sputum(43.l%), chest discomfort and pain(30.4%), dyspnea(27.5%), and hemoptysis(9.8%). Asymptomatic cases were 1.9% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy(59.8%), sputum cytology(17.6%), percutaneous needle aspiration(11.8%) and open biopsy(10.8%). 4. Histopathologic classifications were squamous cell carcinoma(55.9%), adenocarcinoma(30.5%), adenosquamous cell carcinoma(6.9%), large cell carcinoma(4.9%), bronchioalveolar cell carcinoma(0.9%), and mixed cell carcinoma(0.9%). 5. Methods of operation were pneumonectony(47.1%), lobectomy(38.2%), bilobectomy(5.9%), wedge resection(1.9%), exploration(6.9%), and overall resectability was 93.1%. 6. Postoperative staging classifications were Stage I (13.7%), Stage II(31.4%), Stage IIIa(38.3%), Stage IIIb(14.7%), and Stage IV(1.9%). 7. The postoperative complications developed in 9.8%, and operative mortality was 1.9 %. 8. One year survival rate was 81.7%, 3 year 49.7% and 5 year 21.8%. According to stage, 5 year survival rate was 39% in stage I, 24.3% in stage II, 23.9% in stage IIIa.

• Proceedings of the Membrane Society of Korea Conference
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• 1998.10a
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• pp.96-98
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• 1998

1. 서론 : 팔라듐이나 이의 합금막들은 높은 선택적 투과특성으로 인해 수소 정제나 분리막 반응기와 같은 산업응용 분야에서 매우 높은 관심을 갖고 있다. 상업적으로 이용되고 있는 이러한 막들은 통상적인 metallugical process에 의해 제조괸 self-supported type으로 수소 투과 속도가 낮을 뿐만 아니라 팔라듐 등은 고가의 귀금속이므로 비경제적이다. 따라서 현재 대부분의 연구자들은 기계적 강도를 유지하기 의한 다공성 지지체 위에 얇은 금속 박막을 코팅함으로서 투과성을 높이는 동시에 경제적인 복합막 형태의 막을 만드는데 연구의 촛점을 맞추고 있다. 이러한 형태의 막을 제조하기 위한 금속 박막 제조법은 무전해 도금법(electroless deposition), 화학증착법(CVD), 스퍼터링(sputtering), 전해도금법(electrodeposition) 등이 시도되었다. 그러나 수소에 대한 우수한 선택적 투과 특성을 갖기 의해서는 대부분 5$\mu$m 이상의 두꺼운 막을 제조하였으며 이보다 얇은 막의 제조에 한계가 있기 때문에 이들 막에 대한 기체 투과 특성에 대한 연구결과는 많지 않다. 본 연구에서는 기존의 전기도금법을 응용한 소위 'vacuum electrodeposition' 이란 새로운 기술을 도입함으로써 우수한 선택적 투과성을 갖는 2$\mu$m 이하의 팔라듐 합금 박막 제조를 가능하게 하였다. 지지체 표면의 거칠음 정도, 평균 기공 크기 등의 지지체 성질의 조절에 의한 금속 박막의 핀홀을 최소화함으로써 질소와 같은 inert gas의 투과도는 거의 없게 유지하는 동시에 금속 박막 두께, 결정 구조(e.g. grain size), 합금 조성 등을 조절함으로써 수소의 투과도를 높이고자 하였다. 있다. 후자의 경우, 미량의 과산화수소수 (1~10,000 ppm)를 이용해 처리 해주는 방법의 경우 경제적으로 큰 장점이 있고, 처리가 단순하다는 장점이 있으나 과산화수소수 자체에 포함하고 있는 높은 impurit level, 그리고 처리후 장시간의 flushing time을 가져야 한다는 단점등이 존재 하고 있다.요구된다. 몰입이 가능하여 임계치가 저하된 것으로 여겨진다. 또한 광학적 이득의 존재는 이 구조에 의한 극단파장 반도체 레이저다이오드의 실현 가능성을 나타내는 것이다.548 mL에 비해 통계학적으로 의의 있게 적었다(p<0.05). 결론: 관상동맥우회로 조성수술에서 전방온혈심정지액을 사용할 때 희석되지 많은 고농도 포타슘은 fliud overload와 수혈을 피하고 delivery kit를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.를 보였다.4주까지에서는 비교적 폐포는 정상적 구조를 유지하면서 부분적으로 소폐동맥 중막의 비후와 간질에 호산구 침윤의 소견이 특징적으로 관찰되었다. 결론: 분리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술

• Proceedings of the Mineralogical Society of Korea Conference
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• 2003.05a
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• pp.51-51
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• 2003

임진강대의 변성이질암은 전형적인 바로비안형 변성분대를 보이며, 남쪽으로 갈수록 변성도가 증가하여 석류석$\longrightarrow$십자석$\longrightarrow$남정석 대를 정의한다. 우리는 반상변정의 성장과 여러번에 걸친 광역변형작용의 연관성을 밝히기 위해 광물의 반응관계와 성장순서 그리고 미구조(microstructure)를 -특히 석류석에 대해서- 연구하였다. 임진강대는 크게 세 번에 걸쳐 변형작용을 받은 것으로 해석된다: (1) 지각 두께의 증가에 수반된 압축변형작용 (D$_{n-1}$), (2) 주 엽리(Sn)를 만든 변형작용(Dn), 그리고 (3) 연성전단작용에 수반된 신장변형작용(D$_{n+1}$ ). 석류석대의 석류석 반상변정에서는 약간 휘어진 포유물 궤적(inclusion trail)이 주 엽리면에 대해 연속적이며, 이는 Dn과 동시기에 반상변정이 생성되었음을 지시한다. 이러한 석류석은 녹니석과 백운모로 구성된 주 엽리를 치환하면서 자라기 때문에, 녹니석+백운모+석영=석류석+흑운모+$H_2O$의 반응에 의해 만들어진 것으로 해석된다. 석류석 자형변정(idioblast)이 주 엽리를 자르면서 성장하기도 하는데, 이는 Dn 이후에도 석류석이 후구조(post-tectonic) 광물로 성장했음을 지시한다. 또한, 이러한 석류석은 흑운모를 치환하기 때문에, 동구조(syn-tectonic) 석류석의 생성반응에서와는 달리 흑운모가 반응물임을 알 수 있다. 한편, 십자석대의 석류석은 포유물 궤적에 의해 정의되는 S$_{n-1}$면이 주 엽리면과 사각을 이루며 단속적이기 때문에, D$_{n-1}$과 Dn 사이에 자란 것으로 해석된다. 이와는 대조적으로 십자석은 주 엽리를 치환하면서 자라고 있어서 Dn과 동시기 혹은 Dn 이후에 자랐을 것으로 해석된다..의 환경문제를 발생하지 않으며, 공정액에 첨가제를 투입하지 않으므로 순환형 친환경공정으로 각광받을 수 있다. 본 연구에서는 고온, 고농도의 NaOH 수용액의 처리에 적합한 막소재와 발생될 수 있는 제반 문제점 등을 파악하였고, 장기간의 실험을 거쳐 최적 투과 압력(Trans membrane pressue), 세정 조건 및 주기, 막재질에 있어서 보강하여야 할 Point, 최적 운전 조건들을 토출해 내었고, 향후 실제 Plant에 적용할 계획이다.는 양적으로 다른 두 가지의 유사한 마그마가 수반된 것으로 추정된다. 것으로 추정된다.를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.를 보였다.4주까지에서는 비교적 폐포는 정상적 구조를 유지하면서 부분적으로 소폐동맥 중막의 비후와 간질에 호산구 침윤의 소견이 특징적으로 관찰되었다. 결론: 분리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된다.전 도부타민 심초음파는 관상동맥우회로술 후

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.60-64
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• 2019

Swyer-James syndrome (SJS), also known as Swyer-James-MacLeod syndrome and unilateral hyperlucent lung syndrome, is rare acquired pulmonary disorder develops secondary to infectious etiologies in early childhood. Viral respiratory infection such as adenoviruses or Mycoplasma pneumoniae in infancy or early childhood rarely cause Swyer-James syndrome. It is generally characterized on radiographs by a unilateral small lung with hyperlucency and air trapping on expiration. In many cases unaffected lung tissue functions normally, compensating for affected lung portion. Preoperative assessment is needed to determinate individual's pulmonary function. A 4-year-old boy with Swyer-James syndrome visited Seoul National University Dental Hospital Department of pediatric dentistry for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions on deciduous teeth. Considering patient's underling disease, age, and level of cooperation, dental treatment under general anesthesia was scheduled. Dental treatment was done with composite resin and stainless-steel crown. Since ventilation of Swyer-James syndrome patients was diminished because of airway obstruction, close monitoring of ventilation is necessary during dental treatment. Considering pulmonary pathology, general anesthesia rather than sedation is recommended when special behavior management is required for dental treatment. Swyer-James syndrome patients can tolerate general anesthesia and surgery well, according to several reports.