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Clinical Analysis of Bronchogenic Cyst (기관지성 낭종의 임상적 고찰)

  • 안재범;정성철;김우식;신용철;유환국;이정호;김병열;김인섭
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.585-590
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    • 2004
  • Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

The Role of Blind Protected Specimen Brushing (PSB) in Intubated Patients (기관 삽관 중인 환자에서 Blind Protected Specimen Brushing의 역할)

  • Yoo, Hee Seung;Hong, Ji Hyun;Yoon, Jang Uk;Eom, Kwang-Seok;Lee, Jae Myung;Kim, Chul Hong;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.1
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    • pp.59-68
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    • 2003
  • Background : In intubated patients, cultures of endotracheal aspirates (EA) are apt to contamination throughout the endotracheal tube. Therefore, the identification of etiologic agents via conventional EA cultures is not always reliable. In order to differentiate a pulmonary infection from a non-infectious disease, and to identify the true etiologic agent of acute pulmonary infection, blinded protected specimen brushing (PSB) was used, and its efficacy evaluated. Methods : In 51 intubated patients, with suspected pneumonia, blind PSB were performed, and the results compared with blood and EA cultures. A protected specimen brush was introduced through the endotracheal tube, and settled at the affected large bronchus. A specimen brush was introduced to the expected region using the blind method. The tip of the brush was introduced with an aseptic technique after vigorously mixed for 1 minute in $1cm^3$ of Ringer's lactate solution. The specimens were submitted for quantitative culture within 15 minutes, with a culture being regarded as positive if the colony forming units were above $10^3/ml$. Results : Of the 51 patients, 15 (29.4%) had community-acquired pneumonia (CAP), 27 (52.9%) hospital-acquired pneumonia (HAP) and 9 (17.6%) non-infectious diseases. The sensitivity and specificity of the quantitative PSB culture for the diagnosis of pneumonia were 52.4 and 88.9%, respectively. The sensitivity and specificity of EA were 78.6 and 77.8%, respectively. The blind PSB was superior to the EA for the identification of true etiologic agents. Of 53 episodes of 27 HAP patients, MRSA (Methicillin-resistant staphylococcus aureus) (41.5%) was the most common causative agent followed by Pseudomonas aeruginosa (15.1%), Klebsiella sp. (7.5%) and Acinetobacter sp. (7.5%). Conclusions : As a simple, non-invasive diagnostic modality, the blind PSB is a useful method for the differentiation of a pulmonary infection from non-infectious diseases and to identify the etiologic agents in intubated patients. A blind PSB can be performed without bronchoscopy, so is safer, more convenient and cost-effectiveness for patients where bronchoscopy can not be performed.

Usefulness of a Alvarado Scoring System for the Diagnosis of Acute Appendicitis in Children (소아 충수돌기염 진단에서 Alvarado Scoring System의 유용성)

  • Yang, Eun Seok;Yoon, Sung Kwan;Kim, Eun Young;Rho, Young Il;Park, Sang Kee;Park, Yeong Bong;Mun, Gyeong-Rae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.1-7
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    • 2004
  • Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.

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Absorbance as Simple Indicator for Polyphenol Content and Antioxidant Activity of Honey (벌꿀 폴리페놀 함량 및 항산화 활성의 간단지표로서의 400 nm 흡광도)

  • Pyo, Su-Jin;Kim, Jong-Sik;Lee, Dong Hee;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.30 no.6
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    • pp.555-562
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    • 2020
  • This study analyzed the total polyphenol (TP), total flavonoid (TF), and protein content, the Absorbance at 400 nm (A400), and the antioxidant and hemolytic activities of 150 Korean honey products, including 41 chestnut (CH), 42 acacia (AH), 62 multi-floral (MH), and five Styrax japonica (TH) varieties. Our results showed that the components and antioxidant activities of honey are dependent on botanical origin rather than farming area or farmer. CH showed the highest levels of TP (88.6±29.8 mg/100 g) and TF (1.20±0.82 mg/100 g), whereas TH had the highest protein (21.5±5.1 mg/100 g). A400 was the highest in CH (0.161±0.044). All of the honey products exhibited negligible hemolytic activity against human red blood cells up to 1 mg/ml. Potent radical scavenging activities for 1,1-diphenyl-2-picryl hydrazyl (DPPH), 2,2-azobis(3-ethylbenzothiazoline-6- sulfonate) (ABTS), nitrite and reducing power were also observed in CH. Correlation coefficients (CCs) between analysis parameters were calculated and the highest was identified between TP and ABTS scavenging activity (0.726). The CCs between A400 and TP and A400 and ABTS scavenging activity were 0.644 and 0.661, respectively, suggesting that A400 could be used as a quality indicator for the polyphenol content and antioxidant activity of particular honeys. Future research on polyphenol by flower origin and the identification of compounds for A400 is necessary.

Comparison of rCBF between Patients with Medial Temporal Lobe Epilepsy and Normal Controls using ${H_2}^{15}O\;PET$ (내측 측두엽 간질환자와 정상인의 ${H_2}^{15}O\;PET$을 이용한 뇌 혈류량 비교)

  • Kang, Eun-Joo;Lee, Jae-Sung;Nam, Hyun-Woo;Lee, Sang-Kun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.155-165
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    • 2002
  • Purpose: The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using ${H_2}^{15}O-PET$. Materials and Methods: 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was peformed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Results: During the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal legions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal legions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Conclusion: Epilepsy induced changes were found not only in relative increase/decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period.

An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly (노인의 건강증진을 위한 율동적 운동프로그램의 적용효과)

  • 이숙자
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism (뇌하수체저하증 소아에서 발생한 비알코올성 지방간질환)

  • Yoon, Jung-Min;Ko, Jae-Sung;Seo, Jeong-Kee;Shin, Choong-Ho;Yang, Sei-Won;Moon, Jin-Soo;Yang, Hye-Ran;Chang, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.51-57
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    • 2010
  • Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism. Results: The mean age at the time of diagnosis of hypopituitarism was 10.4${\pm}$3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1${\pm}$2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis. Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.

The Effects of Aprotinin Addition and Plastic Tube Usage for Glucagon Test Results (Glucagon 검사시 Aprotinin 첨가와 Plastic tube 사용이 미치는 영향)

  • Cho, Youn-Kyo;Choi, Sam-Kyu;Seo, So-Yeon;Shin, Yong-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.117-120
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    • 2011
  • Purpose: There are 3 warnings for Glucagon tests. First, EDTA tubes that already contain Aprotinin must be used for plasma collection. Second, for freezer storage of centrifuged plasma, glass tubes must be used. Last, glass tubes must be used for testing procedure. So we compared the glucagon results of next 3 situation to those of control group. First, We compared to results by tubes without Aprotinin and with aprotinin. Second, we compared to results by tubes(plastic vs glass) for plasma storage. Third, we compared to results by tubes(plastic vs glass) for testing. We tried to evaluate the results of the 3 different condition. Materials and Methods: 40 healthy adults were studied with normal results on the general medical check up and laboratory tests. We compared the results of 3 different condition belows: Blood were collected in EDTA tube containing aprotinin and plasma was stored in the glass tube for 3 days in a freezer and results were obtained by tests in the glass tubes. Results from EDTA plasma without aprotinin, results from platic tubes for freezer stroage, results from plastic tube when testing. Simple linear regression analysis and paired t-test using SPSS were done for statistical analysis. Commercial glucagon kit(RIA-method)which made by Siemens company were used. Results: Correlation coefficient between results of EDTA tubes with Aprotinin vs without Aprotinin was r=0.783 (p=0.064). Result of specimen in plastic tubes stored 3 days in a freezer showed lower value compared to those in glass tube(r=0.979, p=0.005). Also, results of testing in plastic tubes showed lower values than those testing in glass tubes. (r=0.754, p<0.001). Conclusion: It is recommended for glucagon determination to use EDTA tube with Aprotinin which is a inhibitor of protein breakdown enzyme. Results of plastic tube when storage and testing showed lower value than those of glass tubes, so it is recommended to store and test in glass tubes.

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$^{99m}Tc$ Labeling Kit Preparation and Characteristics of Anti-NCA-95 Monoclonal Antibody (항 NCA-95 단일클론항체의 $^{99m}Tc$표지 키트 제조 및 특성 연구)

  • Hong, Mee-Kyoung;Jeong, Jae-Min;Chung, June-Key;Choi, Seok-Rye;Kim, Chae-Kyun;Lee, Yong-Jin;Lee, Dong-Soo;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.541-547
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    • 1996
  • The previous monoclonal antibody labeling method for bone marrow immunoscintigrapy was complicated and laborious for clinical application. Also it showed a relatively low labeling efficiency. To improve this procedure, we compared several direct labeling methods of $^{99m}Tc$. 1) The labeling efficiency in the method using gluconate as a transchelator was low (40-70%), but immunoscintigraphy using this radiotracer produced a clear image. 2) To improve labeling efficiency, ${\beta}$-mercaptoethanol was removed after reduction. The labeling efficiency was improved up to 70-80%, but the radioactivity of the blood pool was high. 3) The higest labeling efficiency (>90%) and best quality images could be obtained by using MDP as a transchelating agent. It did not require additional procedures for separation of labeled antibodies. The immunoreactivity of this antibody was 60%. Residual MDP which can be taken up by the bone could be removed by PD-10 column. The reduced antibodies were stable with a high labeling efficiency (>90%) for up to 47 days by deep freezing. We concluded that the improved procedure for $^{99m}Tc$ labeling of anti-NCA-95 monoclonal antibody using MDP as a transchelating agent will be a simple and useful method for clinical application.

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Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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