• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.123-131
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. Methods: We enrolled 85 patients with COPD (76 males, 9 females; mean age, $70.6{\pm}7.1years$) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. Results: The average AP diameter was significantly greater in patients with COPD compared with normal controls ($13.1{\pm}2.8cm$ vs. $12.2{\pm}1.13cm$, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls ($0.66{\pm}0.061$ vs. $0.61{\pm}0.86$; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=-0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). Conclusion: Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.

• The Journal of Dong Guk Oriental Medicine
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• v.4
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• pp.53-66
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• 1995

After 394 inpatients examined as to the result of combined treatment of Oriental and Western medicine on Dongguk Incheon oriental medicine hospital and Dongincheon Gil hospital from july/21/1994 to june/21/1995 for 11 months, the results were obtained as follows : 1. Distribution of sex ; male 187(47.5%), female 207(52.5%) 2. Distribution of age ; 60-69 years 110(28%), 50-59 years 88(22.3%), 70-79 years 84(21.3%), 40-49 years 39(9.9%), 30-39 years 34(8.6%) and the others 39(9.9%) 3. Distribution of disease ; cardiovascular disease 234(59.5%), musculoskeletal disease 62(15.7%) and the others 98(24.3%) 4. Distribution of consult from Oriental medicine to Western medicine ; internal medicine 373(87.4%), Orthopedic 32(7.5%) and the others 22(5.1%) 5. Distribution of test ; routine laboratory test 364(31.7%), chest X-ray 189(16.5%), LFT 177(15.4%), brain CT 129(11.2%) and the others 290(25.2%) 6. Distribution of Western medicine treatment ; fluid therapy 163(35.5%), antihypertensiv 100(21.8%), antibiotics 53(11.6%), oral hypoglycemic agents and insulin preperations 46(10.1%) and the others 95(20.8%) 7. Distribution of disease of consult from Western medicine to Oriental medicine ; obesity 14(34.2%), liver disease 13(31.7%), lumbago 8(19.5%) and the others 6(14.6%) Distribution of Oriental medicine treatment ; Acupuncture and Moxibustion 25(38.5%), astarvation cure 22(33.8%), Oriental herbs 18(27.7%) 8. Distribution of the admission period ; 1-10 days 148(37.6%), 11-20 days 105(26.6%), 21-30 days 69(17.5%) and the others 72(18.3%).

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.68-71
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• 2012

Untreated massive hemoptysis, especially in patients with tuberculous-destroyed lung, is a serious complication resulting in considerable morbidity and mortality. We report a case of a patient who had active tuberculosis and a destroyed left lung with massive bleeding. He was transferred to our clinic with intubation of a right-sided Robertshaw double lumen tube and right upper lobe collapse likely due to tube malposition that was presented on chest X-ray. Because hemoptysis had persisted after bronchial arterial embolizaton, we replaced the double lumen tube with a conventional endotracheal tube and inserted an endobronchial blocker into the left main bronchus through an endotracheal tube guided by bronchoscopy to prevent aspiration of blood into the right lung. Left pneumonectomy was performed and hemotpysis was ceased. We suggest that the use of an endobronchial blocker followed by surgery may be a safe and effective modality of treatment in patients with persistent bleeding after bronchial arterial embolization.

• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.224-229
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• 2008

Erdheim-Chester disease (ECD) is a rare disease that is characterized by multi-organ involvement of foamy histiocytes. It causes systemic inflammation, and also demonstrates various clinical manifestations and has a poor prognosis. We encountered a case of ECD in a patient that had been treated for underlying polycythemia vera. As far as we know, this is the first reported case worldwide where ECD developed in association with polycythemia vera. A 59-year-old man visited our hospital due to pleuric pain at the right side of the chest. Pleural tissue that was obtained following a thoracoscopic biopsy showed non-Langerhan's cell histiocytosis, suggesting the presence of ECD. The histiocytes stained positively for CD68, but were negative for S-100 and CD1a. The patient also complained of pain at both hips and the right shoulder area. An X-ray and magnetic resonance image demonstrated that the lesion showed sclerosis and osteolysis in both the proximal femur and right humerus. Treatment was started with predinisolone, and subsequently cyclophosphamide was added. ECD is a very rare multi-systemic disease, and its cause and therapeutic options have not yet been defined. ECD has a poor prognosis. Therefore, we believe that additional case studies are needed prior to the determination of a novel therapy for ECD.

• Journal of Digital Convergence
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• v.13 no.9
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• pp.351-359
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• 2015

This convergence study analyzed the effectiveness of digital radiography system of copper(Cu) filter in the added filtration for the removal of lower energy radiation through dose and image evaluation. We were analyzed from April to June 2015 result of the examination. Cu filter was applied to each non, 0.1, 0.2, 0.3 mm according to change of kV and mAs and doses were evaluated. Image quality was evaluated by PSNR, MAE, MSE, CNR, SNR and qualitative analysis was performed by seven items for resolution and contrast from chest x-ray criteria of national cancer checkup. The absorbed doses with Cu were lowered by 16-88 % than non-filter but the gaps decreased as kV increased. PSNR were over 30 dB and all significant and CNR and SNR were superior with non-filter but in the qualitative analysis, there were different statistical significant according to each item. The score of 0.1 mm filter was high at pulmonary blood vessel observation and in the 0.3 mm Cu, there were no statistical signigicant except high density and full of air portion. Cu filter can improve image quality with lower radiation dose using better radiation quality and correction power at digital radiography system.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.618-623
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• 1995

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to $6{\mu}m$ in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other environmental areas, especially those contaminated by pigeon droppings. Humans and animals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum KOH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.197-202
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• 1993

Polymyositis (PM) is a inflammatory connective tissue disease involving predominantly skeletal muscles, characterized by symmetrical, proximal muscle weakness, inflammation, and frequently, degeneration. Interstitial lung disease in association with PM occurs in 5~10% of cases and carries an especially grave prognosis. Although the cause of lung involvement in PM is not known, the underlying pathologic process in the lung is an immune mediated inflammation of alveolar structures, alveolitis. It is of interest, therefore, that cyclophosphamide, an immune modulating agent, has been reported to be effective in the treatment of PM. We report a case of corticosteroid resistant PM associated with interstitial lung disease, successfully treated with cyclophosphamide. A 37-year-old female was presented with 8 months duration of cough, exertional dyspnea, and muscle weakness. She had typical symptoms, physical findings, and elevated muscle enzyme levels in serum with characteristic findings of muscle biopsy. She also had typical interstitial lung disease pattern on chest X-ray and high resolution CT with restrictive pattern on pulmonary function test. The findings of transbronchial lung biopsy was compatible with interstitial lung disease. She failed to respond to corticosteroid initially. Subsequently steroids and cyclophosphamide were given with excellent clinical improvement.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.303-310
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• 2003

Background : Lymphangioma of the mediastinum is an uncommon benign tumor of lymphatic origin that is most often seen in children, is very rare in adults and is frequently discovered incidentally on chest x-ray exams. While radiology (CT and MRI) may suggest the diagnosis and allow an assessment of the operative difficulties, the histology of the surgical specimen is required for precise diagnosis. Complete resection is the only treatment; however, in some patients resection was incomplete because of the infiltrating character of these tumors, leading to recurrence. We report three cases of mediastinal lymphangioma with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.342-346
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• 2011

Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.507-519
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• 2003

Purpose: The purpose of this study was to identify the prevalence, health behaviors, and control of hypertension in rural areas in Korea. Method: A total of 927 subjects above age 20 were selected from the areas which fell under the jurisdiction of the 24 Community Health Center located in Chungcheongbuk-do. The employees in the Community Health Center visited and interviewed patients. Data were collected using a questionnaire from July to October 2002. Result: The result showed that women had higher hypertension prevalence rates than men and the increment of its rate leveled up according to age. The hypertension prevalence rate was significantly high when the monthly income was less than 1 million won, their type of the Medical Insurance was the Guardian, they were only able to read Korean characters, and they were bereaved of spouses. In the Health behavior related to hypertension, the hypertension group showed a significantly lower level than the non- hypertension group in terms of drinking rate, smoking rate, intake of salt and intake of meat. There was no significant difference in the exercise rate and coffee intake rate between these groups. In the degree of the obesity the hypertension group was significantly higher than the non-hypertension group. The factors related to hypertension were that the duration for the incidence of hypertension was 12 to 60 months and took up 41.2%. The places where the medical check-ups occurred were the Community Health Center at 46.6%, the medical institution was mostly hospitals recording 46.5%. There were 66.1% of the targets who knew well about their blood pressure and there were 64.7% people who received education about it. As for the education place, the rate of Community Health Center was mostly high and it stood at 77.0%. In the aspect of the management of hypertension, the targets who took medicine on a regular basis were up to 76.1% and the targets who measured blood pressure once a month happened to be about 46.1 %. The targets who always recorded their blood pressure were 3.8%, chest X-ray as a related examination of hypertension reached 32.6%, electrocardiogram examination was 36.2%, cholesterol and serum lipid examination took up 33.6%, and the eye ground examination took 7.3%, which showed the lowest level of all.