• Journal of Korean Medical classics
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• v.18 no.2 s.29
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• pp.20-44
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• 2005

통과한의학화서양의학적원리연구심신적상호관계(通過韓醫學和西洋醫學的原理硏究心腎的相互關係), 득도료여하결론(得到了如下結論) 경연구심신지간재한의학상구유(經硏究心腎之間在韓醫學上具有): 심양여신음유'심신상교'적'수화기제'관계(心陽與腎陰有'心腎相交'的'水火旣濟'關係). 차외환유신양(명문화)여심양(심화)적상호의존관계(此外還有腎陽(命門火)與心陽(心火)的相互依存關係). 우유심장신여신장정적상호의존관계이지유신정충족시(又有心藏神與腎藏精的相互依存關係而只有腎精充足時), 재가이사심주신지적공능유지정상(才可以使心主神志的功能維持正常). 경연구심신지간재서양의학상구유(經硏究心腎之間在西洋醫學上具有): 제일(第一), 심장여신장재해부학상밀절연계(心臟與腎臟在解剖學上密切聯係), 즉종심장좌심실분지출신동맥(卽從心臟左心室分枝出腎動脈), 진이형성신소구등신장적혈관구화모세혈관강(進而形成腎小球等腎臟的血管球和毛細血管綱). 제이(第二), 심장향신장공응혈액(心臟向腎臟供應血液), 신장시인체중접수혈공최다적장기(腎臟是人體中接受血供最多的臟器). 제삼(第三), 심장통과심납소(ANP)적분비(的分泌), 증가신혈류양급신소체여과율(增加腎血流量及腎小體濾過率). 제사(第四), 신장통과신소(腎臟通過腎素)(renin)적분비조절혈압(的分泌調節血壓). 제오(第五), 신공능부전대심장구성부면영향(腎功能不全對心臟構成負面影響). 제육(第六), 심장여신장지간종서양의학적각도고려(心臟與腎臟之間從西洋醫學的角度考慮), 야존재착상생화상극관계(也存在着相生和相克關係). 경연구심신적상호관계재수행중적작용(經硏究心腎的相互關係在修行中的作用), 득출여하결론(得出如下結論): 제일(第一), 수행영인안정심지(修行令人安定心志), 사심화하강(使心火下降). 제이(第二), 수행시적호흡조절조폐금생신수(修行時的呼吸調節助肺金生腎水), 저시소유적수행법도재중시호흡조절적근본이유(這是所有的修行法都在重視呼吸調節的根本理由). 제삼(第三), 수행시발생수승화강(修行時發生水昇火降). 저실제상시의뢰심화중적일음효여신수중적일양효적발동내완성(這實際上是依賴心火中的一陰爻與腎水中的一陽爻的發動來完成). 제사(第四), 통과수행(通過修行), 가이달도보정적목적(可以達到保精的目的), 유차보장생명적지보(由此保藏生命的至寶). 제오(第五), 통과수행(通過修行), 가이달도연정화기(可以達到煉精化氣), 약능주도연정화기(若能做到煉精化氣), 가사인체불누설정액(可使人體不漏泄精液), 반이화기이증강인체기능(反而化氣以增强人體機能), 시보정적유효수단(是保精的有效手段). 수행적관건시'남자수성불누정(修行的關鍵是'男子修成不漏精), 여자수성온불누경(女子修成不漏經)'.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.201-209
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• 2004

Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.

• The Korean Journal of Physiology
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• v.18 no.1
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• pp.67-79
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• 1984

In an effort to elucidate the physiological characteristics in cardiopulmonary function, electromyogram(EMG), and blood chemistry in athletic high school students, an analysis of electrocardiogram(ECG) and EMG, pulmonary function test, venous blood gas analysis($Pvo_2$ and$Pvco_2$), and measurement of heart rate, blood pressure, respiratory rate, blood glucose and blood lactate were made for 16 to 19 year-old high school students who were divided into athletic (n=19) and non-athletic (n=20) group. The results obtained are summarized as follows. 1) ECG intervals in athletes were longer than in non-athletes, and the difference was significant in R-R, Q-T and T-P intervals. Resting heart rate in athletes was 56.3/min showing a bradycardia compared with 79.8/min in non-athletes. Amplitudes of R and T waves in lead $V_5$ were significantly higher than in non-athletes. 2) Pulmonary function parameters in athletes showed higher values than in non-athletes. Parameters which showed significant differences were FEV 0.5, PEF, FEF 25%, PIF and FEF $200{\sim}1.200\;ml. 3) Heart rate, blood pressure, and respiratory rate after exercise were significantly elevated from resting values. Heart rate and respiratory rate showed greater increase in non-athletes, while blood pressure showed greater increase in athletes. 4) $Pvo_2$ was lowered ana $Pvco_2$ was elevated after exercise, and there was no significant difference between two groups. 5) Blood glucose and lactate levels were elevated after exercise. The difference was significant in blood lactate, and was greater in non-athletes. 6) EMG amplitude was steadily increased with increasing load of exercise, and the increase was greater in athletes than in non-athletes.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.181-187
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• 2008

Purpose: In order to establish efficient palliative treatment plans. It is important to estimate the survival time of a terminally ill cancer patient as accurate as possible. Proper estimation of life expectancy aids not only in improving the quality of life of the patient, it also promotes productive communication between the medical staff and the patient. The aim of this study is to determine the efficacy of neutrophil-lymphocyte ratio as a predictor of survival time in terminally ill cancer patients. Methods: Between January 2004 and June 2007, 67 terminally ill cancer patients who were admitted or transferred for palliative care, were included. Patients were categorized into three groups by Neutrophil-Lymphocyte Ratio. Demographic characteristics, clinical characteristics and blood samples were analyzed. Results: In univariate analysis, survival time of the highest Neutrophil-Lymphocyte Ratio group (${\geq}12.5$) was significantly shorter than that of the others (hazard ratio (HR)=3.270, P=0.001). After adjustment for low performance status (ECOG score 4) and dyspnea, high Neutrophil-Lymphocyte Ratio (${\geq}12.5$) was significantly and independently associated with short survival time (HR=2.907, P=0.007). Neutrophil-Lymphocyte Ratio was also significantly increased before death (P=0.001). Conclusion: Neutrophil-Lymphocyte Ratio can be useful in predicting life expectancy in terminally ill cancer patients.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.99-111
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• 2019

Purpose: Respiratory syncytial virus (RSV) and human rhinovirus (hRV) are the most common causes of child respiratory viral infections. We aimed to investigate epidemiological and clinical characteristics of RSV and hRV single infections and coinfections. Methods: Nasopharyngeal aspirates of hospitalized children aged <5 years were tested using multiplex reverse transcription polymerase chain reaction (RT-PCR) from October 2014 to April 2017. Their medical records were retrospectively reviewed. Results: RSV or hRV was detected in 384 patients who divided into 3 groups: patients with RSV (R group, n=258); patients with hRV (H group, n=99); and patients with both (RH group, n=27). The R group (median age, 6 months) consisted of 248 (96.1%) patients with lower respiratory tract infection (LRTI), and 14 (5.4%) needed oxygen inhalation. Infants aged <12 months (63.2%) had respiratory difficulty and were supplied oxygen more often. The H group (median age, 16 months) consisted of 56 (56.6%) patients with LRTI, 4 (4%) required oxygen inhalation, and 1 (1.0%) required mechanical ventilation. Infants (40.4%) showed longer hospitalization compared to patients aged ${\geq}12$ months (5 vs. 4 days, P<0.05). The RH group consisted of 24 (88.9%) patients with LRTI, and 2 (7.4%) needed oxygen inhalation. Hospitalization days and oxygen inhalation and mechanical ventilation rates did not differ between single infections (R and H groups) and coinfections (RH group). Conclusions: RSV was detected more often in younger patients and showed higher LRTI rates compared to hRV. Single infections and coinfections of RSV and hRV showed no difference in severity.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.67-75
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• 1995

Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.107-115
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• 1998

Background: Chronic eosinophilic pneumonia(CEP) presents with profound systemic symptoms, including fever, malaise, night sweats, weight loss, and anorexia together with localized pulmonary manifestations such as cough, wheeze, and sputum. It is an illness occurring predominantly in women. The chest radiogragh shows fluffy opacities that often have a characteristic peripheral configuration. The hallmark of CEP is the peripheral blood eosinophilia and a prompt response to oral corticosteroid therapy. We investigated characteristics of eleven patients of chronic eosinophilic pneumonia, reported in Korea. Method: There were eleven reports of CEP from 1980 to 1996, including three cases experienced in our hospital. The journals were analysed in respects of clinical history, laboratory, and radiographic findings. Results: 1) Male vs. female ratio is 3 : 8. The peak incidence occurred in forty and fifty decades. The atopic diseases were present in 6 cases. Asthma was the commonest manifestation 2) The presenting symptoms were as follows: cough, dyspnea, sputum, weight loss, fever, general weakness, night sweats, urticaria with the descending incidence. 3) Peripheral blood eosinophilia was present in all patients(mean ; 38.4%) and serum IgE level was elevated in nine patients(mean ; 880IU/ml). Conclusion: The diagnosis of chronic eosinophilic pneumonia is based on classic symptoms, including fever, night sweats, weight loss with a typical roentgenogram of peripheral pulmonary infiltrates and peripheral blood eosinophilia, and that is confimed by lung biopsy and/or bronchoalveolar lavage. Chronic eosinophilic pneumonia is responsive to corticosteroid promptly and recommended at least 6 months of therapy to prevent relapse.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.409-419
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• 2002

Background : The therapeutic effects of surfactant on acute lung injury derive not only from its recruiting action on collapsed alveoli but also from its anti-inflammatory effects. Pro-apoptotic action on alveolar neutrophils represents one of the important anti-inflammatory mechanisms of surfactant. In the present study, we evaluated the effects of sufactant on the apoptosis of human peripheral and rat alveolar neutrophils. Methods : In the (Ed- the article is not definitely needed but it helps to separate the two prepositions 'in') in vitro study, human neutrophils were collected from healthy volunteers. An equal number of neutrophils ($1{\times}10^6$) (Ed-confirm) was treated with LPS (10, 100, 1000ng/ml), surfactant (10, 100, $1000{\mu}g/ml$), or a combination of LPS (1000ng/ml) and surfactant (10, 100, $1000{\mu}g/ml$). After incubation for 24 hours, the apoptosis of neutrophils was evaluated by Annexin V method. In the in vivo study, induction of acute lung injury in SD rats by intra-tracheal instillation of LPS (5mg/kg) was followed by intra-tracheal administration of either surfactant (30mg/kg) or normal saline (5ml/kg). Tenty-four hours after LPS instillation, alveolar neutrophils were collected and the apoptotic rate was evaluated by Annexin V method. In addition, changes of the respiratory mechanics of rats (respiratory rate, tidal volume, and airway resistance) were evaluated with one chamber body plethysmography before, and 23 hours after, LPS instillation. Results : in the in vitro study, LPS treatment decreased the apoptosis of human peripheral blood neutrophils (control: $47.4{\pm}5.0%$, LPS 10ng/ml; $30.6{\pm}10.8%$, LPS 100ng/ml; $27.5{\pm}9.5%$, LPS 1000ng/ml; $24.4{\pm}7.7%$). The combination of low to moderate doses of surfactant with LPS promoted apoptosis (LPS 1000ng/ml + Surf $10{\mu}g/ml$; $36.6{\pm}11.3%$, LPS 1000ng/ml +Surf $100{\mu}g/ml$; $41.3{\pm}11.2%$). The high dose of surfactant ($1000{\mu}g/ml$) decreased apoptosis ($24.4{\pm}7.7%$) and augmented the anti-apoptotic effect of LPS (LPS 1000ng/ml + Surf $1000P{\mu}g/ml$; $19.8{\pm}5.4%$). In the in vivo study, the apoptotic rate of alveolar neutrophils of surfactant-treated rats was higher than that of normal saline-treated rats ($6.03{\pm}3.36%$ vs. $2.95{\pm}0.58%$). The airway resistance (represented by Penh) of surfactant-treated rats was lower than that of normal saline-treated rats at 23 hours after LPS injury ($2.64{\pm}0.69$ vs. $4.51{\pm}2.24$, p<0.05). Conclusion : Surfactant promotes the apoptosis of human peripheral blood and rat alveolar neutrophils. Pro-apoptotic action on neutrophils represents one of the important anti-inflammatory mechanisms of surfactant.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.494-499
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• 2006

Purpose : Acinetobacter baumannii is increasingly recognized as an important cause of nosocomial infection, especially in neonatal intensive care units. But little is known about the clinical significance and hospital epidemiology of Acinetobacter species other than A. baumannii. The objective of this study is to describe the clinical characteristics and epidemiology of septicemia due to Acinetobacter species other than A. baumannii. Methods : We retrospectively reviewed 11 cases of blood culture proven nosocomial infection which occured in our neonatal intensive care unit from $4^{th}$ to $24^{th}$, February, 2004. To establish epidemiological analysis, we performed environmental cultures and an antibiogram was obtained from susceptability tests of isolated Acinetobacter species. Results : Clinical manifestations including fever, poor feeding, abdominal distension, diarrhea, bloody stool passage, vomiting, tachypnea and apnea were similar to other infectious diseases. Benign clinical courses were compared with poor prognose, including a high mortality rate in septicemia due to A. baumannii. The major predisposing factor among our patients was the presence of a peripheral intravascular catheter. Antibiogram was similar, but surveillance cultures of environmental specimens failed to identify the source of infection. Conclusion : Acinetobacter species other than A. baumannii were often considered relatively avirulent bacteria, but could be pathologic organisms if cultured in patients with clinical symptoms.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.482-485
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• 2013

This case report describes the increment of regulatory T cells in thyroid carcinoma of a mixed breed dog compared with normal dogs. A mixed breed dog was referred for a submandibular mass and hyperthermia. Right cervical mass was detected during the physical examination and radiography identified right cervical mass suspected thyroid gland. Accurate location and size of mass was confirmed using computed tomography and 3D reconstructed images. After confirmation of mass, surgical resection was performed and evaluation of regulatory T cells in blood of this patient was performed using flow cytometric assay. The percentage of regulatory T cells was 38.28% of all CD4 (+)/CD25 (+) T cells. This result was higher than median percentage of regulatory T cells of healthy 8 beagles ($7.66{\pm}1.65%$ (p<0.01) of all CD4 (+)/CD25 (+) T cells). And masses were confirmed as giant cell thyroid carcinoma based on histopathologic examination. After surgical resection of cervical mass was performed, the owner didn't want chemotherapy. Seven days later, cervical mass came out again. And CBC showed severe leukocytosis (WBC $47.6{\times}10^3/{\mu}L$) and non-regenerative anemia (PCV 21%). Suspected pulmonic metastasis regions became more severe. Finally the dog died of severe anemia and respiratory disorder.