• Title/Summary/Keyword: 호흡수

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Clinical Characteristics of Miliary Tuberculosis (속립성 폐결핵의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.144-151
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    • 1994
  • Background: Miliary tuberculosis almost always results from the discharge of infected caseous material into the blood stream, usually from a well hidden lymph node in the presentation of this disease in the past four decades, and although it is seen less frequent1y today than previously, its presentation and manifestation may require greater suspicion and diligence by the physician. We investigated the clinical characteristics, predisposing factors and accompanying diseases of miliary tuberculosis and tried to acquire the early diagnosis and treatment of this disease. Methods: A retrospective clinical study was done on 40 cases of miliary tuberculosis admitted to Hanyang University Hospital from Mar. 1989 to Dec.1992. The study investigated age and sex distribution, seasonal distribution, duration of symptoms before admission, pre-disposing factors, clinical symptoms, biochemical findings, chest X-ray findings, extrapulmonary tuberculosis associated with miliary tuberculosis, prognosis and mortality rate. Results: 1) The patients were most common in the age group between 20 and 29(23%) and the ratio of male to female was 1.4:1(male 23 : female 17). 2) Sputum smears for tubercle bacilli were positive in 5 cases(13%). 3) The most common clinical symptoms were fever with chilling(47.5%), coughing(47.5%), second most common symptom was dyspnea(32.5%), and the physical findings on admission were tachycardia(30%), weight loss(27.5%), meningeal signs(17.5%) in order. 4) The predisposing factors were heavy alcohol drinking(6 cases), steroid use(3 cases), pregnancy(2 cases) etc. 5) The chest X-ray findings on admission were miliary shadow only(40%), in addition pneumonic infiltration, pleurisy, and calcification in order. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis(30%), bone and joint tuberculosis(17.5%), intestinal tuberculosis(15%) in order. 7) Biochemical findings were increased SGOT/SGPT(32.5%), increased alkaline phosphatase(32.5%), hypoalbuminemia(15%), hyponatremia(15%) etc. 8) About 4-6 weeks later after treatment(INH, RFP, PZA, EMB), 26 cases(65%) were improved on clinical symptoms or chest X-ray, 12 cases(30%) were stationary or aggravated, and 2 cases(5%) were died. Conclusion: For the early diagnosis and treatment of miliary tuberculosis, we must see its presentation and manifestation with greater interest and suspicion and investigate its predisposing factors and accompanying diseases.

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The Effect of Midazolam As Sedative Agent in Bronchoscopy (기관지내시경 검사시 전처치로서 Midazolam의 효과)

  • Lee, Sang-Haak;Hyun, Dae-Sing;Lee, Sook-Young;Kim, Seok-Chan;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.612-618
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    • 2002
  • Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.

Characterization of Nitric Oxide (NO)-Induced Cell Death in Lung Epithelial Cells (폐상피세포에서 Nitric Oxide (NO)에 의한 세포사에 관한 연구)

  • Yong, Wha Shim;Kim, Youn Seup;Park, Jae Seuk;Jee, Young Koo;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.187-197
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    • 2004
  • Background : Nitric Oxide (NO) is a multi-faceted molecule with dichotomous regulatory roles in many areas of biology. NO can promote apoptosis in some cells, whereas it inhibits apoptosis in other cell types. This study was performed to characterize NO-induced cell death in lung epithelial cells and to investigate the roles of cell death regulators including iron, bcl-2 and p53. Methods : A549 cells were used for lung epithelial cells. SNP (sodium nitroprusside) and SNAP (S-nitroso-N-acetyl- penicillamine) were used for NO donor. Cytoxicity assay was done by MTT assay and crystal violet assay. Apoptotic assay was done by fluorescent microscopy after double staining with propidium iodide and hoecst 33342. Iron inhibition study was done with RBCs and FeSO4. For bcl-2 study, bcl-2 overexpressing cells (A549-bcl-2) were used and for p53 study, Western blot analysis and p53 functionally knock-out cells (A549-E6) were used. Results : SNP and SNAP induced dose-dependent cell death in A549 cells and fluorescent microscopy revealed that SNAP induced apoptosis in low doses but necrosis in high doses while SNP induced exclusively necrotic cell death. Iron inhibition study using RBCs and FeSO4 significantly blocked SNAP-induced cell death. And also SNAP-induced cell death was blocked by bcl-2 overexpression. Finally, we found that SNAP activate p53 by Western blot analysis and that SNAP-induced cell death was decreased in the abscence of p53. Conclusion : In lung epithelial cells, NO can induce cell death, more precisely apoptosis in low doses and necrosis in high doses. And iron, bcl-2, and p53 play important roles in NO-induced cell death.

The Diagnostic Value of Interferon-γ Assay in Patients with Active Tuberculosis (활동성 결핵의 진단에서 혈청 인터페론 감마 측정법의 유용성)

  • Park, So Young;Park, Yong Bum;Choi, Jeong Hee;Lee, Jae Young;Kim, Jae-Seok;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.13-19
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    • 2009
  • Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

Particulate Matter 10 from Asian Dust Storms Induces the Expression of Reactive Oxygen Species, NF-κ, TGF-β and Fibronectin in WI-26 VA4 Epithelial Cells (황사의 PM10이 WI-26 VA4 Cells에서 Reactive Oxygen Species, NFκB, TGF-β, Fibronectin의 발현에 미치는 영향)

  • Park, Kyeong Seon;Kim, Yu Jin;Yoon, Jin Young;Kyung, Sun Young;An, Chang Hyeok;Lee, Sang Pyo;Park, Jeong Woong;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.504-511
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    • 2008
  • Background: Particulate matter may be toxic to human tissue. Ambient air particulate matter ${\leq}10{\mu}m$ in aerodynamic size ($PM_{10}$), which changes under different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also spread unique particulate matter in affected areas. We evaluated production of ROS, $TGF-{\beta}$, fibronectin, and $NF{\kappa}B$ by exposing normal epithelial cells to Asian dust particulate matter. Methods: Bronchial epithelial cells were exposed to 0, 50, ${\leq}100{\mu}g/ml$ of a suspension of $PM_{10}$ for 24 h. ROS were detected by measurement of DCF release from DCF-DA by FACScan. $TGF-{\beta}$, fibronectin, and $NF{\kappa}B$ were detected by western blotting. Results: $PM_{10}$ exposure increased the expression of $TGF-{\beta}$, fibronectin, and $NF{\kappa}B$. ROS production and $TGF-{\beta}$ levels were significantly higher with 50 or ${\leq}100{\mu}g/ml$ $PM_{10}$. Fibronectin and $NF{\kappa}B$ production were significantly higher after ${\leq}100{\mu}g/ml$ of $PM_{10}$. Conclusion: $PM_{10}$ from Asian dust particles might have fibrotic potential in bronchial epithelial cells via ROS induction after $PM_{10}$ exposure.

A Clinical Study on Multiple Myeloma (다발성 골수종의 임상적 고찰)

  • Hwang, Hyeong-Ki;Lee, Choong-Ki;Hyun, Myung-Soo;Shim, Bong-Sup;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.106-113
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    • 1991
  • A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings : 1. The peak incidence was in 7th decade and male to female ratio was 1.8 : 1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group(SWOG) : plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III(84%) 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%. Kappa to Lambda ratio of 1.1 : 1. 6. Hematologic & biochemical fingins revealed anemia with <8.5% of hemoglobulin in 42%, hypercalcemia with < 10.6mg% of serum calcium in 22%, azotemia >2.0mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull(65%), rib(42%), L-spine(35%), pelvis(23%), T-spine(19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeoloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.

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Changes of Blood Gases, Plasma Catecholamine Concentrations and Hemodynamic Data in Anesthetized Dogs during Graded Hypoxia Induced by Nitrous Oxide (아산화질소에 의한 점진적 저산소가스 흡입이 혈중 가스치와 Catecholamine치 및 혈역학에 미치는 영향)

  • Kim, Sae-Yeon;Song, Sun-Ok;Bae, Jung-In;Cheun, Jae-Kyu;Bae, Jae-Hoon
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.97-113
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    • 1998
  • The sympathoadrenal system plays an important role in homeostasis in widely varing external environments. Conflicting findings, however, have been reported on its response to hypoxia. We investigated the effect of hypoxia on the sympathoadrenal system in dogs under halothane anesthesia by measuring levels of circulating catecholamines in response to graded hypoxia. Ten healthy mongreal dogs were mechanically ventilated with different hypoxic gas mixtures. Graded hypoxia and reoxygenation were induced by progressively decreasing the oxygen fraction in the inhalation gas mixture from 21%(control) to 15%, 10% and 5% at every 5 minutes, and then reoxygenated with 60% oxygen. Mean arterial pressure, central venous pressure and mean pulmonary arterial pressure were measured directly using pressure transducers. Cardiac output was measured by the thermodilutional method. For analysis of blood gas, saturation and content, arterial and mixed venous blood were sampled via the femoral and pulmonary artery at the end of each hypoxic condition. The concentration of plasma catecholamines was determined by radioenzymatic assay. According to the exposure of graded hypoxia, not only did arterial and mixed venous oxygen tension decreased markedly at 10% and 5% oxygen, but also arterial and mixed venous oxygen saturation decreased significantly. An increased trend of the oxygen extraction ratio was seen during graded hypoxia. Cardiac output, mean arterial pressure and systemic vascular resistance were unchanged or increased slightly. Pulmonary arterial pressure(PAP) and pulmonary vascular resistance(PVR) were increased by 55%, 76% in 10% oxygen and by 82%, 95% in 5% oxygen, respectively(p<0.01). The concentrations of plasma norepinephrine, epinephrine and dopamine increased by 75%, 29%, 24% in 15% oxygen and by 382%, 350%, 49% in 5% oxygen. These data suggest that the sympathetic nervous system was activated to maintain homeostasis by modifying blood flow distribution to improve oxygen delivery to tissues by hypoxia, but hemodynamic changes might be blunted by high concentration of nitrous oxide except PAP and PVR. It would be suggested that hemodynamic changes might not be sensitive index during hypoxia induced by high concentration of nitrous oxide exposure.

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Perception on food allergy labelling and management of nutritional education among higher grade elementary school students in Jeju area (제주지역 초등학교 고학년 학생들의 식품알레르기 유발표시제에 대한 인식도 및 영양교육 운영 실태 조사)

  • Lee, Yunkyoung;Kim, Hyun-Hee;Ko, Yang-Sook
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.530-541
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    • 2015
  • Purpose: This study was conducted to examine the prevalence of food allergy, food allergy knowledge, and perception on food allergen labelling along with management of substitute meals in school foodservice in elementary school students in Jeju, South Korea. Methods: Six elementary schools in Jeju-si were randomly selected, and the higher grade elementary school students (n=1,500), from fourth graders to sixth graders, were surveyed using a questionnaire in July 2014. A total of 1,000 responses were used for data analysis. Results: The percentage of students who had experienced food allergy was 16.7%; 26.4% had been diagnosed as having a food allergy by doctors. Milk, crabs, and shrimps were the most frequent allergenic foods with common symptoms including urticaria followed by itching, and vomiting. As the student's grade went up, the knowledge scores on food allergy showed a significant increase. Although students with and without food allergy experience had a similar level of knowledge on food allergy and perception on food allergen labelling, students with food allergy experience had a significantly lower level of healthy dietary practices. Last, only 20.4% of students with food allergies were offered substitute meals by school foodservices, and 30.8% of students received food allergy education. Conclusion: For prevention and management of food allergies in school foodservice, schools should provide an individualized substitute meal plan and food allergy education to students, parents, and teachers.

Changes of Bacterial Population during the Decomposition Process of Red Tide Dinoflagellate, Cochiodinium polykrikoides in the Marine Sediment Addition of Yellow Loess (황토첨가 해양퇴적물에서 적조생물 Cochiodinium polykrikoides 분해중 세균군집의 변동)

  • PARK Young-Tae;LEE Won-Jae
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.31 no.6
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    • pp.920-926
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    • 1998
  • To investigate the effects of yellow loess on the microbial community after applying into C. polykrikoides as a red tide centrol method during decomposition process, we conducted this study using microcosm experiments, which consisted of sediment collected from Jinhae and Masan bay. The composition, number of bacteria and respiratory electron transport system activity (ETSA) were analyzed. The number of heterotrophic bacteria examined in the samples of both stations reached maximum value within 12 hrs with $10^7$ cells/dry g, independent with the yellow loess applied. In addition, a differenee in the variation of heterotrophic bacterial composition was not observed by adding the yellow loess, and Vibrio spp. always appeared during the culture periods, However, in day 8 culture, the sulfate reducing bacteria was $3.8\times10^7$ cells/dry g in Masan bay and $5.5\times10^6$ cells/dry g in Jinhae bay samples without yellow loess, and these were 120, 350 fold-and 160, 420 fold-increased when yellow loess was added (1 : 1, 1 : 2). The average ETSA was 6.8$\~$7.6 $\mu$g formazan $h^{-1}$ dry $g^{-1}$ independently with yellow loess in aerobic condition for both samples, but activity was decreased by addition of yellow loess in anaerobic. Thus the addition of yellow loess to marine sediment seems to have an effect to inhibit the anaerobic decomposition process and growth of sulfate reducing bacteria which lead to the bad condition of marine environments.

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Effect of Grain Sources on the Ruminal Methane Production in Hanwoo Steers (한우 거세우의 반추위메탄가스 생성량에 대한 곡류사료원의 영향)

  • Seol, Yong-Joo;Kim, Kyoung-Hoon;Baek, Youl-Chang;Lee, Sang-Cheol;Ok, Ji-Woun;Lee, Kang-Yeon;Choi, Chang-Weon;Lee, Sung-Sil;Oh, Young-Kyoon
    • Journal of Animal Science and Technology
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    • v.54 no.1
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    • pp.15-22
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    • 2012
  • This study was conducted to investigate the effects of grain sources on the ruminal methane production in Hanwoo steers. Six Hanwoo steers (BW = 614.4 ${\pm}$ 8.3 kg) were fed, on a DM basis (TDN 6.91 kg), 10% rice straw and 90% barley or corn based concentrate, respectively, according to Korean Feeding Standards (Hanwoo). Each period lasted 18 days including a 14-day adaptation and a 4-day measuring period. The steers were in the ventilated hood-type respiration chamber system (one cattle per chamber) during each measuring period to measure heat and methane production for 1 day. Nutrient intake and digestibility were not affected by steer fed grain sources. Methane concentration was not affected by steer fed either barley or corn-based concentrate, respectively (0.022% vs. 0.025%). Methane production was greater by steers fed corn than those fed barley (119.3 g/day vs. 139.4 g/day). This result indicated that methane emission factor by maintenance energy requirement for the late fattening Hanwoo fed corn was higher than the steers fed barley (43.6 kg/head/year) vs. corn (50.9 kg/head/year). Methane conversion rate (Ym) was 0.04 Ym and 0.05 Ym for barley and corn, respectively.