• Tuberculosis and Respiratory Diseases
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• 제66권1호
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• pp.47-51
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• 2009

간폐증후군은 간질환이 있는 환자에서 저산소증이 유발되는 상태로 폐내 혈관 확장으로 인해 폐내 동맥혈 산소공급에 결함이 발생하는 질환이다. 현재까지 간이식 외에 간폐증후군에 대한 다른 효과적인 치료법은 없는 것으로 알려져 있다. 국내에서는 간폐증후군의 증례 보고가 드물고, 특히 Child-Pugh 분류 A군에서의 발생 빈도는 낮은 것으로 보인다. 이에 저자들은 Child-Pugh 분류 A군인 대상성 간경화 환자에서 발생한 간폐증후군 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.271-277
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• 2011

Background: A chronic obstructive pulmonary disease (COPD) assessment test (CAT) has recently been developed as a short and simple method for assessing the quality of life in COPD patients. The object of this study was to assess the usefulness of the Korean version of the CAT for assessing COPD patients in an outpatient clinic. Methods: The study included 60 COPD patients in a stable state from an outpatient clinic. The authors investigated the frequency of acute exacerbation during aprevious year through reviewing medical records. We evaluated the spirometry test, a 6-min walk distance test, and obtained the MMRC dyspnea scale, the Korean version of the CAT, and the BODE index at the time of visit. To assess the usefulness of the CAT, correlations between the CAT and other methods were evaluated. Results: The mean age of patients was $68.3{\pm}8.6$ years and 95% of patients were male. There was a significant correlation between the CAT score and $FEV_1%$ (r=-0.323, p=0.012), the frequency of acute exacerbation (r=0.292, p=0.024), the MMRC dyspnea scale (r=0.554, p<0.001), the BODE index (r=0.380, p=0.003), and 6 MWD (r=-0.372, p=0.004). The mean CAT score increased according to the GOLD stage (stage 1, $10.7{\pm}4.5$; stage 2, $13.1{\pm}7.9$; stage 3, $16.3{\pm}6.2$; stage 4, $16.5{\pm}14.8$; p=0.746). Conclusion: The CAT was shown to be useful for the assessment of COPD severity. Therefore, the CAT is an easily applied and simple method for assessing COPD severity in an outpatient clinic.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.24-30
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• 2010

Background: A novel 2009 influenza A (H1N1) virus emerged and disseminated to all over the world. There are few reports on the clinical characteristics of patients with complications. We describe the clinical features of pneumonia in adult patients hospitalized, who have novel influenza infection. Methods: There were 43 adult patients enrolled into the study with pneumonia of 528 hospitalized patients confirmed influenza A (H1N1) virus infection by real-time reverse transcriptase polymerase chain reaction testing, between 24 August 2009 and 31 January 2010. The clinical data of patients with pneumonia were collected retrospectively. Results: There were 22 of 43 (51.2%) influenza patients with pneumonia that had higher risk factors for complications. Compared to 28 patients with influenza A (H1N1) viral pneumonia and 15 patients, who had isolated bacteria from cultures, those with mixed viral and bacterial pneumonia were significantly more likely to have unilobar consolidations on chest radiographs (53.3 vs. 10.7%, p<0.01) and higher scores of pneumonia severity index (PSI; 90 [66~100] vs. 53 [28~90], p=0.04). Six patients required mechanical ventilation support in an Intensive Care Unit and were more likely to have dyspnea (83.3 vs. 29.3%, p=0.02) and low levels of $PaO_2$ (48.3 [37.0~70.5] vs 64.0 [60.0~74.5] mm Hg, p=0.02) and high levels of pneumonia severity index (PSI) score (108.0 [74.5~142.8] vs. 56.0 [40.5~91.0], p=0.03). Conclusion: The majority of pneumonia patients infected with novel influenza improved. Chest radiographic findings of unilobar consolidations suggest that mixed pneumonia is more likely. Initial dyspnea, hypoxemia, and high levels of PSI score are associated with undergoing mechanical ventilation support.

• Journal of Chest Surgery
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• 제21권3호
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• pp.454-461
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• 1988

Myasthenia gravis is a functional neuromuscular disorder with characteristic voluntary muscle weakness. The role of thymus in pathogenesis of this disorder has become apparent that thymectomy in treatment has gained acceptance. Between January 1976 and June 1987, twenty patients underwent thymectomy for myasthenia gravis at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. A clinical study that is focused on the factors affecting the operative results was analyzed and the following results were obtained. Among the 20 patients, male to female ratio was 8:12 and the age of onset was ranged from 3 years to 67 years. The chief complaints in order of frequency were as follows; ocular symptoms such as ptosis and diplopia[7 cases], general weakness[4 cases], swallowing difficulty[3 cases], dyspnea[3 cases], dysphasia[1 case], headache[1 case] and dizziness[1 case]. The severity of disease was classified by modified Osserman`s method that Group IIa was 8 cases, Group IIb; 7 cases, Group IIc; 3 cases and Group I; 2 cases. In histopathology of thymus, the most frequent finding was hyperplasia[11 cases] followed by thymoma[4 cases], normal tissue[3 cases] and malignant` thymoma[2 cases]. There were two cases of postoperative complications; one case was wound infection and the other was mediastinitis. One case of malignant thymoma died due to respiratory failure with pulmonary metastasis. There was 16 cases[80%] of improvement after thymectomy as follows; complete remission was 4 cases[20%], marked improvement was 9 cases[45%] and subjective improvement only was 3 cases[15%]. The effect of severity and duration of disease on operative result has statistically significant. The effect of thymus histopathology on operative result was not statistically significant. But there were comparable results between thymoma cases and non-thymoma cases.

• 사상체질의학회지
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• 제27권1호
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• pp.42-56
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• 2015

Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Taeeumin Disease of Sasang Constitutional Medicine(SCM): Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, collection and organization of literature related to SCM such as Donguisusebowon, Text book of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine was performed. Secondly, journals related to clinical trial or Human complementary medicine of SCM were searched. Finally, 7 articles were selected and included in CPG for Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease. Results & Conclusions The CPG of Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease in Taeeumin Disease include classification, definition and standard symptoms of each pattern. Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease consists of two aspects : Esophagus-Cold (Wiwanhan) and Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology. Esophagus-Cold (Wiwanhan) symptomatology is classified into mild and moderate pattern by severity. Mild pattern of Esophagus-Cold (Wiwanhan) symptomatology is classified into Supraspinal Exterior (Baechu-pyo) initial and Wheezing-Dyspnea (Hyocheon) pattern. Moderate pattern of Esophagus-Cold (Wiwanhan) symptomatology is classified into Cold-reversal (Hanguel) and Cold-reversal (Hanguel) advanced pattern. And Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology is classified into severe and critical pattern by severity. Severe pattern of Esophagus-Cold Lung-Dry (Wiwanhan-paejo) is classified into Dry-Cold (Johan) pattern and Dry-Cold (Johan) advanced pattern. Critical pattern of Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology consists of Dry-Cold (Johan) intense pattern (Eumhyeol-mogal handa pattern).

• 한국산업보건학회지
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• 제34권1호
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• pp.57-66
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• 2024

Objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects. This study aimed to investigate the association between low peripheral oxygen saturation levels (SpO₂), and composite indices predicting death in male patients with (COPD). Method: A total of 140 participants with post-bronchodilator FEV₁/FVC ratio less than 0.7 were included. Three composite indices (ADO, DOSE, BODEx) were calculated using six variables such as age (A), airflow obstruction (O), body mass index (B), dyspnea (D), exacerbation history (E or Ex), and smoking status (S). Severity of airflow limitation was classified according to Global Initiative for Obstructive Lung Disease (GOLD) guidelines. SpO₂ was measured by pulse oximetry, and anemia and iron deficiency were assessed based on blood hemoglobin levels and serum markers such as ferritin, transferrin saturation, or soluble transferrin receptor. Results: Participants with low SpO₂ (<95%) showed significantly lower levels of %FEV₁ predicted (p=0.020) and %FEV₁/FVC ratio (p=0.002) compared to those with normal SpO₂ levels. The mMRC dyspnea scale (p<0.001) and GOLD grade (p=0.002) showed a significant increase in the low SpO₂ group. Receiver Operating Characteristic analysis revealed higher area under the curve for %FEV₁ (p=0.020), %FEV₁/FVC(p=0.002), mMRC dyspnea scale (p=0.001), GOLD grade (p=0.010), ADO (p=0.004), DOSE (p=0.002), and BODEx (p=0.011) in the low SpO₂ group. Conclusion: These results suggest that low SpO₂ levels are related to increased airflow limitation and the composite indices of COPD.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.101-103
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• 2016

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

• Journal of Nutrition and Health
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• 제41권4호
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• pp.307-316
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• 2008

The purpose of the study was to investigate nutritional status of chronic obstructive pulmonary disease (COPD) patients and to find out the differences according to the stages of disease. From March to October, 2006, 41 stable male patients of mild to severe COPD patients were recruited from Seoul National University hospital. The patients' of body weight and fat free mass were assessed by bioelectrical impedance analysis. The nutritional status of the patients was also assessed by 3-day recall, index of nutritional quality (INQ), dietary diversity score (DDS), dietary variety score (DVS), food group index pattern and dietary quality index (DQI). The total of 41 patients were classified into three groups, stage I, stage II and stage III groups according to the classification of Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard. The mean age of the patients in each stage were 67.2-66.9 years showing no significant difference. The ratio of $FEV_1$/FVC were $57.5{\pm}7.3$, $46.9{\pm}7.6$ and $38.2{\pm}6.8%$, respectively showing significant differences according to the stages of disease. The fat free mass of the stage II ($48.2{\pm}4.7kg$) and III ($47.3{\pm}4.5kg$) was significantly lower than that of stage I ($53.1{\pm}6.9kg$) patients. There were significant correlation of fat free mass with $FEV_{1}$, and BMI (body mass index) with $FEV_{1}$/FVC ratio (p < 0.05). COPD patients showed the diet-related clinical symptoms of anorexia, dyspnea, dyspepsia, and chewing difficulty. Daily intakes of calorie, K, vitamin $B_2$ and folate of the patients were very low ($83.8{\pm}20.7%$, $58.9{\pm}14.4%$, $70.7{\pm}19.6%$ and $74.4{\pm}10.2%$, respectively) however, they did not significantly different according to the stages of disease. Daily intake of calcium was significantly lower in the stage III patients (p < 0.05). The mean scores of dietary variety score was significantly lower in the stage III patients (p < 0.001). Dietary quality index of the patients were not different among the stages of disease and the scores indicated poor quality of diet. As a summary, we found that body fat free mass, regularity of exercise, frequency of having snacks and dietary variety score were significantly associated with the severity of chronic obstructive pulmonary disease.

• Journal of Chest Surgery
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• 제30권4호
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• pp.402-407
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• 1997

1986년 3월부터 1995년 3월까지 본 마산삼성 병원 흉부외과에서 경험한 총 28례의 외상성 횡 경 막 손상 환자를 분석 하였다. 들상에 의한 경우가 20례, 자상인 경우가 8례로서 둔상인 경우 1)례가 좌측, 자상인 경우 5례가 좌측으로 전반적으로 좌측이 우측보다 많았다. 대부분 다발성 손상을 동반하였으며 모든 예에서 흉통, 호흡곤란, 복통 등의 소견을 관찰할 수 있었고 내원당시 응급실에서 횡경막 파열을 의심할 수 있었던 경우는총25례로서 흉부X선 20례 UGI 3례, 폐쇄식 흉관 삽관식 손가락으로 파열공의 직접 확인이 2례 였다. 수술적 접근은둔상의 경우개흉술이 16례,개흉복술이 1례,개복술이 I례며,관통상의 경우는개흉술 3례, 개복술이 5례로서 수상후부 터 수술까지의 경과시간은 5시간 이내가 19례였다. 좌측 손상시 12례에서 위장이 늑막강내로 올라가 있었으며, 모든 결손은 비홉수성 봉합사를 사용하여 직접 단순 봉합을 하였으며, 술후 5례에서 패혈증, 저혈성 쇽크, 두부손상, 신부전 으로 술후 3일이내 사 망하였다.

• 혜화의학회지
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• 제5권2호
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• pp.473-484
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• 1997

This study was performed to survey the specific information about the time of onset, frequency, duration, and severity of the side effect of radiation therapy following breast cancer surgery, and identify the difference of these data according to the type of breast cancer surgery : modified radical mastectomy(MRM) vs. breast consevative operation(BCO). 38 breast cancer patients were interviewed with side effect profile about radiation therapy. Interview was done weekley from the start of radiation therapy through 6 weeks and 3 month follow-up interview was done at 3 month after completion of the treatment. The results are as follow : 1. Total score of side effect experienced by the breast cancer patients was rapidly increased at 2-3 week after intiating treatement and continousely raised maintaing high score until completion of the treatement. Some problems like cough, dyspnea and pain were more experienced after treatment. 2. Patients with modified radical mastectomy showed more total score of side effects than patients with breast conservative operation. And both patients with MRM and BCO experienced similar pattern of side effect to radiation therapy. Through these data we concluded that side effect to radiation therapy was not ended at completion of treatement. Patents will continously experiend various problems and suffer from not only acute side effects like skin problem, sore throat and swollowing difficulty but also late effect of the radiation therapy. Clinically these data can be used for oncologic nurse to provide informational interventions to prepare breast cancer patients for the radiation therapy.