• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.656-663
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• 2005

배 경 : 급성호흡곤란으로 응급실에 내원한 환자에서 그 원인질환을 감별하는 것은 효율적인 치료에 매우 중요하나 임상양상만으로 감별진단하기는 어려운 경우가 많다. 최근에 쉽게 측정하고 확인이 가능한 생화학적 표지자인 B-type natriuretic peptide에 대해 연구가 이루어지고 있다. 방 법 : 2004년 3월부터 7월까지 한양대학교병원 응급실로 급성호흡곤란을 주소로 내원한 261명의 환자를 대상으로 혈청 BNP를 측정하였고 임상적 소견을 후향적으로 분석하였다. 결 과 : 대상환자를 증상의 원인에 따라 크게 심부전군(n=119, 382, 113-1230 pg/ml)과 비심부전군(n=142, 29, 7-81 pg/ml)으로 나누었고(사람수, 중위수, 백분위수 25-백분위수 75), 하위집단으로 심부전군은 COPD와 좌심부전이 동반된 군(n=5, 820, 354-1620 pg/ml), 폐성심군(n=3, 1650, 239-1990 pg/ml), 좌심부전군(n=111, 378, 106-1120 pg/ml)으로, 비심부전군은 COPD군(n=20, 39, 21-101 pg/ml), 기타 호흡기질환군(n=56, 59, 10-129 pg/ml), 기타 다른 원인군(n=66, 15, 6-47 pg/ml)으로 분류하였다. 혈장 BNP는 원인 질환에 따라 유의한 차이를 보였으며(p<0.001), COPD군과 좌심부전이 동반된 COPD군을 비교했을 때 심부전이 동반될 때 혈장 BNP가 의미있게 높았다(p=0.002). 당뇨병, 고혈압, 흡연 및 신부전 등 심질환의 위험인자가 없는 환자들에서 심부전의 동반 유무와 BNP값을 비교해 보았을 때, 심부전이 동반된 경우 의미있게 BNP값이 증가되어 있었다(p<0.001). 또한, BNP가 133 pg/ml이상일 경우 예민도 0.73, 특이도 0.87로 심부전에 대한 치료에 반응할 수 있는 환자군을 감별할 수 있었다. 결 론 : 혈장 BNP는 급성호흡곤란의 감별진단에서 심부전의 유무를 알아내고 효율적인 치료를 앞당기는데 유용한 검사이다. 특히, 기존의 호흡기 질환을 가지고 있거나 심장질환의 위험요인이 없더라도 BNP가 높은 수치를 보일 경우에는 심부전의 가능성을 고려해서 환자에게 접근해야 한다.

• 대한간호
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• 제5권3호통권23호
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• pp.107-113
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• 1966

Fourty cases. of dyspneic patients Chiefly from cardiac origin, were studied for the purpose of tests of relieability from the distress by positional changes of the patient using hospital bed. Followings were the results. 1)Respiration and pulse rate were

• Tuberculosis and Respiratory Diseases
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• 제78권1호
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• pp.36-40
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• 2015

Malignant pleural mesothelioma (MPM) is an aggressive, treatment-resistant, and generally fatal disease. A 68-year-old male who was diagnosed with MPM at another hospital came to our hospital with dyspnea. We advised him to take combination chemotherapy but he refused to take the treatment. That was because he had already received chemotherapy with supportive care at another hospital but his condition worsened. Thus, we recommended photodynamic therapy (PDT) to deal with the dyspnea and MPM. After PDT, the dyspnea improved and the patient then decided to take the combination chemotherapy. Our patient received chemotherapy using pemetrexed/cisplatin. Afterwards, he received a single PDT treatment and then later took chemotherapy using gemcitabine/cisplatin. The patient showed a survival time of 27 months, which is longer than median survival time in advanced MPM patients. Further research and clinical trials are needed to demonstrate any synergistic effect between the combination chemotherapy and PDT.

• 대한기관식도과학회지
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• 제15권1호
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• pp.64-67
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• 2009

Paratracheal air cysts are rare lesions and detected incidentally during CT scan or autopsy. Histopathologic diagnoses of paratracheal air cysts include trachocele, tracheal diverticulum and lymphoepithelial cyst. The cysts are lined by ciliated columnar epithelium and have communication with trachea. Previous reports suggested an association with obstructive lung disease because of increased expiratory pressures in these patients. Most of these cysts are asymptomatic but rarely cause productive cough, wheezing, recurrent laryngeal nerve paralysis and difficult intubation. We report a case of paratracheal air cyst causing dyspnea with a review of literature.

• 성인간호학회지
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• 제20권4호
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• pp.652-663
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• 2008

Purpose: This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. Methods: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. Results: The overall fitness indices of modified model were good($x^2$ = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, $x^2$/df = 1.194). Functional capacity was influenced directly by age(${\beta}$ = -.304, p = .000), dyspnea(${\beta}$ = -.278, p = .000), self-efficacy(${\beta}$ = .240, p = .000), social support(${\beta}$ = .175, p = .004), pulmonary function(${\beta}$ = .169, p = .008), and oxygen saturation(${\beta}$ = .099, p = .048). These variables explained 39.3% in functional capacity. Conclusion: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

• The Korean Journal of Pain
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• 제21권1호
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• pp.62-65
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• 2008

A 73-year-old man with sudden sensory neural hearing loss received a stellate ganglion block. Two hours after the block, the patient complained of newly developed neck discomfort. After an additional two hours, the neck swelled up gradually and neck pain and dyspnea developed. A plain radiograph of neck revealed narrowing of the upper airway; a tracheostomy was performed and the dyspnea was improved. On the next day, the pain site extended to the right scapula and a CT image revealed a huge retropharyngeal hematoma. Hematoma evacuation and bleeder ligation were then performed and the patient was discharged on the fourth day after admission without any complications. A practitioner should always remember to educate the patients about possible complications and undertake intensive observation when performing procedures, even in patients who do not initially present with a compromised airway.

• 대한기관식도과학회지
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• 제6권2호
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• pp.204-208
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• 2000

Endobronchial metastases from extrathoracic primary malignancies are uncommon. Breast, renal, and colonic carcinomas are primary sites most likely to give rise to endobronchial metastases. A number of other tumours have been reported as being complicated by endobronchial metastasis, including ovarian, thyroid, uterine, adrenal, testicular and prostatic carcinomas. The incidence of endobronchial metastasis has been estimated at 2% in patients who died of metastatic disease. Lung parenchymal metastases are common manifestations in patients with rectal cancer, however spread to the major airway is extremely rare. We herein report a case of endobronchial metastasis from rectal adenocarcinoma. A 69-year-old male patient who had been previously treated with surgical resection with rectal cancer presented with a 8-month history of gradually increasing dyspnea and non-productive cough. Clinical and radiological investigations revealed endobronchial metastasis involving, and penetrating, the lower carina and the left main bronchus. We confirmed endobronchial metastasis from the rectal carcinoma by bronchoscopic biopsy.

• 한국인공지능학회지
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• 제6권2호
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• pp.17-22
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• 2018

According to the World Health Organization, the top 10 causes of death worldwide include heart disease. Heart diseases include coronary disease, which induces acute myocardial infarction. Ticagrelor drugs are being used to treat acute alliances, but it has become difficult to breathe due to the drugs. In a related study, Tobias predicted that uric acid causes acute respiratory distress independently of other factors, including BNP. And in the Ahmad study, serum uric acid numbers were related to the left ventricle depending on the level of uric acid. Experimental data are data used after 155 patients who received coronary intervention took ticagrelor. The research methods were leveraged by gradient decent algorithm and linear regression. In order to avoid overfitting in the experiment, training data and test data were separated into 70 and 30 percent respectively. The experimental results lacked the predictability of other attributes except DT in the correlation coefficient and crystal coefficient. However, all attributes related to dyspnea other than DT are determined to be related to causing relaxation of the heart in the left ventricle. Therefore, the attribute causing dyspnea is determined to be an attribute causing relaxation of the heart of the DT and left ventricle.

• Journal of Chest Surgery
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• 제10권2호
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• pp.343-348
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• 1977

The author reviewed 10 patients of chest wall tumors which were operated during 7 years, from 1970 to 1976, in Department of Thoracic and Cardiovascular Surgery in Chonnam University Hospital. Benign tumors were 6 patients, malignant tumors were 2 patients and metastatic tumors were 2 patients. Benign tumors were more than malignant tumors, but total cases were small, so, statistical analysis was not enough. Specific symptoms of chest wall tumor were swelling due to mass and pain. All cases had swelling due to mass and 4 cases [40%] had pain. Dyspnea was noted in metastatic tumors. The review of the literatures was also done.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3129-3133
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• 2012

Diagnosis and treatment procedures in cancers and resulting anxiety negatively affect the individual and the family. Particularly treatment methods may generate psychological symptoms. The aim of this study was to determine the level of such symptoms in Turkish gynecologic cancer patients receiving chemotherapy. A total of 41 patients who were referred to our gynecologic oncology research clinic between January-March 2012, receiving 3 months or more chemotherapy and who agreed to participate were enrolled in study. All the data were collected using a personal information form, Edmonton Symptom Assesment System and State-Trait Anxiety Inventory. Patients received highest point average from fatigue symptom ($6.53{\pm}2.67$) and lowest point average from dyspnea ($1.53{\pm}3.03$) according to Edmonton Symptom Assesment System. The mean State Anxiety score of patients was $43.1{\pm}9.77$ and mean Trait Anxiety score was $46.7{\pm}7.01$. Comparing symptoms of patients and mean State Anxiety score it was found that there was a statistically significant corelation with symptoms like pain (p<0.05), sadness (p<0.001), insomnia (p<0.05), state of well being (p<0.001) and dyspnea (p<0.05). Similarly comparing symptoms of patients and mean Trait Anxiety score demonstrated significant correlations for fatigue (p<0.05), sadness (p<0.01), insomnia (p<0.01) and state of well-being (p<0.01). As a result, patients with gynecological cancers experienced symptoms related to chemotherapy and a moderate level of anxiety. In accordance, appropriate interventions should recommended for the evaluation and improvement of anxiety and symptoms related to treatment in cancer patients.