• Title/Summary/Keyword: F/M 비

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Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma (악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가)

  • Lee, Eunsol;Chae, Eun Jin;Kang, Sunji;Yeom, Yoo Kyeong;Lee, Hyun Joo;Park, Jong Chun;Shin, So Youn;Choi, Yoon Young;Choi, Joon Ho;Do, Kyung-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.232-238
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    • 2013
  • Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.

Nasal Continuous Airway Pressure Titration Unmasks Periodic Limb Movements in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증에서 지속적 상기도 양압술에 따른 주기성 사지운동증의 표출)

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.103-110
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    • 1998
  • Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.

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Studies on the Induction of Sprouting of Dormant Seed Potato in Fall Crop Production (추작감자의 최아법에 관한 연구)

  • Jae-Young Cho
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.21 no.1
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    • pp.97-124
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    • 1976
  • To find out the most effective method of treatments for the induction of sprouting of dormant seed potato pieces for the fall crop production of Irish cobbler, this experiment was carried out with sprout inducing bed and field performance trial. In GA treatments, about 10 days were required to sprout and resulted uniform and thin 3-4 sprouts per tuber piece, but sprouts were slender and rooting was not observed. In Ethrel treatments, 20-25 days were required, and sprouts were inferior than that of GA treatment in uniformity of sprouting, and percentage of rotten pieces and of healthy sprouted tuber pieces, but number of sprouts per tuber pieces was low, being 1-2, and sprouts were short, thick, and healthy, and showed good rooting. In GA and Ethrel mixture treatments, 1-2 more days were required to sprout than GA treatments, but sprouts were relatively healthy, and other sprouting pattern were like that of GA treatments. In Ethylene chlorohydrin and 6-Benzyl-adenine treatments, sprouting was like that of Ethrel treatments, but much more days were required than Ethrel treatments and tendency of severe rotting was observed. Optimum treating methods of promising chemicals found to be 1-2 and 2-5 ppm GA solution, 500 and 1000-2000 ppm Ethrel solution, and 1-2+250-500 and 5+250-500 ppm GA and Ethrel mixture solution for 60 min. treatment of tuber piece and whole-tuber, respectively. Induction of sprouting in dry and hot time resulted severer rotting of tuber pieces during the induction of sprouting and with the advancement of dormancy, being delayed in date of treatment, tendency of promotion of sprouting and rooting was observed. When sprouted tuber piece was transplanted at the same date, yields were in order of Ethrel, GA and Ethrel mixture, and GA treatment, indicating the correlation between yield and healthiness of sprout and rooting status of sprouted tuber piece. In all treatments, earlier transplanting resulted higher yields.

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Environmental Damage to Nearby Crops by Hydrogen Fluoride Accident (불화수소 누출사고 사례를 통한 주변 농작물의 환경피해)

  • Kim, Jae-Young;Lee, Eunbyul;Lee, Myeong Ji
    • Korean Journal of Environmental Agriculture
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    • v.38 no.1
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    • pp.54-60
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    • 2019
  • BACKGROUND: Hydrogen fluoride is one of the 97 accident preparedness substances regulated by the Ministry of Environment (Republic of Korea) and chemical accidents should be managed centrally due to continual occurrence. Especially, hydrogen fluoride has a characteristic of rapid diffusion and very toxic when leaking into the environment. Therefore, it is important to predict the impact range quickly and to evaluate the residual contamination immediately to minimize the human and environmental damages. METHODS AND RESULTS: In order to estimate the accident impact range, the off-site consequence analysis (OCA) was performed to the worst and alternative scenarios. Also, in order to evaluate the residual contamination of hydrogen fluoride in crop, the samples in accident site were collected from 15-divided regions (East direction from accident sites based on the main wind direction), and the concentration was measured by fluoride ($F^-$) ion-selective electrode potentiometer (ISE). As a result of the OCA, the affected distance by the worst scenario was estimated to be >10 km from the accident site and the range by the alternative scenario was estimated to be about 1.9 km. The residual contamination of hydrogen fluoride was highest in the samples near the site of the accident (E-1, 276.82 mg/kg) and tended to decrease as it moved eastward. Meanwhile, the concentrations from SE and NE (4.96~28.98 mg/kg) tended to be lower than the samples near the accident site. As a result, the concentration of hydrogen fluoride was reduced to a low concentration within 2 km from the accident site (<5 mg/kg), and the actual damage range was estimated to be around 2.2 km. Therefore, it is suggested that the results are similar to those of alternative accident scenarios calculated by OCA (about 1.9 km). CONCLUSION: It is difficult to estimate the chemical accident-affecting range/region by the OCA evaluation, because it is not possible to input all physicochemical parameters. However simultaneous measurement of the residual contamination in the environment will be very helpful in determining the diffusion range of actual chemical accident.

To Assess Whether Lee's Grading System for Central Lumbar Spinal Stenosis Can Be Used as a Decision-Making Tool for Surgical Treatment (요추 중심 신경관 협착에 있어서 Lee's Grade를 통한 MRI 평가방법이 수술적 치료 결정에 유용한가에 대한 연구)

  • Do Yeon Ahn;Hee Jin Park;Jung Woo Yi;Ji Na Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.102-111
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    • 2022
  • Purpose To evaluate the correlation between Lee's grades and surgical intervention for central lumbar spinal stenosis (CLSS) and to assess whether this grading system can be used as a decision-making tool for the surgical treatment of this condition. Materials and Methods This retrospective study included 290 patients (M:F = 156:134; mean age, 46 ± 16 years). Radiologists assessed the presence and grade of CLSS at the stenosis point according to Lee's grading system, in which CLSS is classified into four grades according to the shape of the cauda equina. Correlation coefficients (rs) between Lee's grades and the operation were calculated with Spearman rank correlation. Results Among the operated patients, grade 2 was the most commonly assigned grade (50%-58%), grade 3 was less common (35%), and grade 0 was the least common (2%-3%). Among the non-operated patients, grade 1 was the most common (63%-65%), grade 0 was less common (15%-16%), and grade 3 was the least common (8%). The distribution of grades differed between the operated and non-operated groups (p < 0.001). Less than 25% of patients who underwent surgery were assigned grades 0 and 1, and more than 88% were assigned grades 2 and 3. A moderate correlation was found between the grade and surgical intervention (rs = 0.632 and rs = 0.583). Conclusion Lee's grade was moderately correlated with surgical intervention. Lee's grading system can be a decision-making tool for the surgical treatment of CLSS.

A Comparative Study of the Standard Uptake Values of the PET Reconstruction Methods; Using Contrast Enhanced CT and Non Contrast Enhanced CT (PET/CT 영상에서 조영제를 사용하지 않은 CT와 조영제를 사용한 CT를 이용한 감쇠보정에 따른 표준화섭취계수의 비교)

  • Lee, Seung-Jae;Park, Hoon-Hee;Ahn, Sha-Ron;Oh, Shin-Hyun;NamKoong, Heuk;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.235-240
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    • 2008
  • Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.

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Analysis of Greenhouse Thermal Environment by Model Simulation (시뮬레이션 모형에 의한 온실의 열환경 분석)

  • 서원명;윤용철
    • Journal of Bio-Environment Control
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    • v.5 no.2
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    • pp.215-235
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    • 1996
  • The thermal analysis by mathematical model simulation makes it possible to reasonably predict heating and/or cooling requirements of certain greenhouses located under various geographical and climatic environment. It is another advantages of model simulation technique to be able to make it possible to select appropriate heating system, to set up energy utilization strategy, to schedule seasonal crop pattern, as well as to determine new greenhouse ranges. In this study, the control pattern for greenhouse microclimate is categorized as cooling and heating. Dynamic model was adopted to simulate heating requirements and/or energy conservation effectiveness such as energy saving by night-time thermal curtain, estimation of Heating Degree-Hours(HDH), long time prediction of greenhouse thermal behavior, etc. On the other hand, the cooling effects of ventilation, shading, and pad ||||&|||| fan system were partly analyzed by static model. By the experimental work with small size model greenhouse of 1.2m$\times$2.4m, it was found that cooling the greenhouse by spraying cold water directly on greenhouse cover surface or by recirculating cold water through heat exchangers would be effective in greenhouse summer cooling. The mathematical model developed for greenhouse model simulation is highly applicable because it can reflects various climatic factors like temperature, humidity, beam and diffuse solar radiation, wind velocity, etc. This model was closely verified by various weather data obtained through long period greenhouse experiment. Most of the materials relating with greenhouse heating or cooling components were obtained from model greenhouse simulated mathematically by using typical year(1987) data of Jinju Gyeongnam. But some of the materials relating with greenhouse cooling was obtained by performing model experiments which include analyzing cooling effect of water sprayed directly on greenhouse roof surface. The results are summarized as follows : 1. The heating requirements of model greenhouse were highly related with the minimum temperature set for given greenhouse. The setting temperature at night-time is much more influential on heating energy requirement than that at day-time. Therefore It is highly recommended that night- time setting temperature should be carefully determined and controlled. 2. The HDH data obtained by conventional method were estimated on the basis of considerably long term average weather temperature together with the standard base temperature(usually 18.3$^{\circ}C$). This kind of data can merely be used as a relative comparison criteria about heating load, but is not applicable in the calculation of greenhouse heating requirements because of the limited consideration of climatic factors and inappropriate base temperature. By comparing the HDM data with the results of simulation, it is found that the heating system design by HDH data will probably overshoot the actual heating requirement. 3. The energy saving effect of night-time thermal curtain as well as estimated heating requirement is found to be sensitively related with weather condition: Thermal curtain adopted for simulation showed high effectiveness in energy saving which amounts to more than 50% of annual heating requirement. 4. The ventilation performances doting warm seasons are mainly influenced by air exchange rate even though there are some variations depending on greenhouse structural difference, weather and cropping conditions. For air exchanges above 1 volume per minute, the reduction rate of temperature rise on both types of considered greenhouse becomes modest with the additional increase of ventilation capacity. Therefore the desirable ventilation capacity is assumed to be 1 air change per minute, which is the recommended ventilation rate in common greenhouse. 5. In glass covered greenhouse with full production, under clear weather of 50% RH, and continuous 1 air change per minute, the temperature drop in 50% shaded greenhouse and pad & fan systemed greenhouse is 2.6$^{\circ}C$ and.6.1$^{\circ}C$ respectively. The temperature in control greenhouse under continuous air change at this time was 36.6$^{\circ}C$ which was 5.3$^{\circ}C$ above ambient temperature. As a result the greenhouse temperature can be maintained 3$^{\circ}C$ below ambient temperature. But when RH is 80%, it was impossible to drop greenhouse temperature below ambient temperature because possible temperature reduction by pad ||||&|||| fan system at this time is not more than 2.4$^{\circ}C$. 6. During 3 months of hot summer season if the greenhouse is assumed to be cooled only when greenhouse temperature rise above 27$^{\circ}C$, the relationship between RH of ambient air and greenhouse temperature drop($\Delta$T) was formulated as follows : $\Delta$T= -0.077RH+7.7 7. Time dependent cooling effects performed by operation of each or combination of ventilation, 50% shading, pad & fan of 80% efficiency, were continuously predicted for one typical summer day long. When the greenhouse was cooled only by 1 air change per minute, greenhouse air temperature was 5$^{\circ}C$ above outdoor temperature. Either method alone can not drop greenhouse air temperature below outdoor temperature even under the fully cropped situations. But when both systems were operated together, greenhouse air temperature can be controlled to about 2.0-2.3$^{\circ}C$ below ambient temperature. 8. When the cool water of 6.5-8.5$^{\circ}C$ was sprayed on greenhouse roof surface with the water flow rate of 1.3 liter/min per unit greenhouse floor area, greenhouse air temperature could be dropped down to 16.5-18.$0^{\circ}C$, whlch is about 1$0^{\circ}C$ below the ambient temperature of 26.5-28.$0^{\circ}C$ at that time. The most important thing in cooling greenhouse air effectively with water spray may be obtaining plenty of cool water source like ground water itself or cold water produced by heat-pump. Future work is focused on not only analyzing the feasibility of heat pump operation but also finding the relationships between greenhouse air temperature(T$_{g}$ ), spraying water temperature(T$_{w}$ ), water flow rate(Q), and ambient temperature(T$_{o}$).

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A Study on the Effect of Water Soluble Extractive upon Physical Properties of Wood (수용성(水溶性) 추출물(抽出物)이 목재(木材)의 물리적(物理的) 성질(性質)에 미치는 영향(影響))

  • Shim, Chong-Supp
    • Journal of the Korean Wood Science and Technology
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    • v.10 no.3
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    • pp.13-44
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    • 1982
  • 1. Since long time ago, it has been talked about that soaking wood into water for a long time would be profitable for the decreasing of defects such as checking, cupping and bow due to the undue-shrinking and swelling. There are, however, no any actual data providing this fact definitly, although there are some guesses that water soluble extractives might effect on this problem. On the other hand, this is a few work which has been done about the effect of water soluble extractives upon the some physical properties of wood and that it might be related to the above mentioned problem. If man does account for that whether soaking wood into water for a long time would be profitable for the decreasing of defects due to the undue-shrinking and swelling in comparison with unsoaking wood or not, it may bring a great contribution on the reasonable uses of wood. To account for the effect of water soluble extractives upon physical properties of wood, this study has been made at the wood technology laboratory, School of Forestry, Yale university, under competent guidance of Dr. F. F. Wangaard, with the following three different species which had been provided at the same laboratory. 1. Pinus strobus 2. Quercus borealis 3. Hymenaea courbaril 2. The physical properties investigated in this study are as follows. a. Equilibrium moisture content at different relative humidity conditions. b. Shrinkage value from gre condition to different relative humidity conditions and oven dry condition. c. Swelling value from oven dry condition to different relative humidity conditions. d. Specific gravity 3. In order to investigate the effect of water soluble extractives upon physical properties of wood, the experiment has been carried out with two differently treated specimens, that is, one has been treated into water and the other into sugar solution, and with controlled specimens. 4. The quantity of water soluble extractives of each species and the group of chemical compounds in the extracted liquid from each species have shown in Table 36. Between species, there is some difference in quantity of extractives and group of chemical compounds. 5. In the case of equilibrium moisture contents at different relative humidity condition, (a) Except the desorption case at 80% R. H. C. (Relative Humidity Condition), there is a definite line between untreated specimens and treated specimens that is, untreated specimens hold water more than treated specimens at the same R.H.C. (b) The specimens treated into sugar solution have shown almost the same tendency in results compared with the untreated specimens. (c) Between species, there is no any definite relation in equilibrium moisture content each other, however E. M. C. in heartwood of pine is lesser than in sapwood. This might cause from the difference of wood anatomical structure. 6. In the case of shrinkage, (a) The shrinkage value of the treated specimen into water is more than that of the untreated specimens, except anyone case of heartwood of pine at 80% R. H. C. (b) The shrinkage value of treated specimens in the sugar solution is less than that of the others and has almost the same tendency to the untreated specimens. It would mean that the penetration of some sugar into the wood can decrease the shrinkage value of wood. (c) Between species, the shrinkage value of heartwood of pine is less than sapwood of the same, shrinkage value of oak is the largest, Hymenaea is lesser than oak and more than pine. (d) Directional difference of shrinkage value through all species can also see as other all kind of species previously tested. (e) There is a definite relation in between the difference of shrinkage value of treated and untreated specimens and amount of extractives, that is, increasing extractives gives increasing the difference of shrinkage value between treated and untreated specimens. 7. In the case of swelling, (a) The swelling value of treated specimens is greater than that of the untreated specimens through all cases. (b) In comparison with the tangential direction and radial direction, the swelling value of tangential direction is larger than that of radial direction in the same species. (c) Between species, the largest one in swelling values is oak and the smallest pine heartwood, there are also a tendency that species which shrink more swell also more and, on the contrary, species which shrink lesser swell also lesser than the others. 8. In the case of specific gravity, (a) The specific gravity of the treated specimens is larger than that of untreated specimens. This reversed value between treated and untreated specimens has been resulted from the volume of specimen of oven dry condition. (b) Between species, there are differences, that is, the specific gravity of Hymenaea is the largest one and the sapwood of pine is the smallest. 9. Through this investigation, it has been concluded that soaking wood into plain water before use without any special consideration may bring more hastful results than unsoaking for use of wood. However soaking wood into the some specially provided solutions such as salt water or inorganic matter may be dissolved in it, can be profitable for the decreasing shrinkage and swelling, checking, shaking and bow etc. if soaking wood into plain water might bring the decreasing defects, it might come from even shrinking and swelling through all dimension.

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The Effect of Recombinant Human Epidermal Growth Factor on Cisplatin and Radiotherapy Induced Oral Mucositis in Mice (마우스에서 Cisplatin과 방사선조사로 유발된 구내염에 대한 재조합 표피성장인자의 효과)

  • Na, Jae-Boem;Kim, Hye-Jung;Chai, Gyu-Young;Lee, Sang-Wook;Lee, Kang-Kyoo;Chang, Ki-Churl;Choi, Byung-Ock;Jang, Hong-Seok;Jeong, Bea-Keon;Kang, Ki-Mun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.242-248
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    • 2007
  • Purpose: To study the effect of recombinant human epidermal growth factor (rhEGF) on oral mucositis induced by cisplatin and radiotherapy in a mouse model. Materials and Methods: Twenty-four ICR mice were divided into three groups-the normal control group, the no rhEGF group (treatment with cisplatin and radiation) and the rhEGF group (treatment with cisplatin, radiation and rhEGF). A model of mucositis induced by cisplatin and radiotherapy was established by injecting mice with cisplatin (10 mg/kg) on day 1 and with radiation exposure (5 Gy/day) to the head and neck on days $1{\sim}5$. rhEGF was administered subcutaneously on days -1 to 0 (1 mg/kg/day) and on days 3 to 5 (1 mg/kg/day). Evaluation included body weight, oral intake, and histology. Results: For the comparison of the change of body weight between the rhEGF group and the no rhEGF group, a statistically significant difference was observed in the rhEGF group for the 5 days after day 3 of. the experiment. The rhEGF group and no rhEGF group had reduced food intake until day 5 of the experiment, and then the mice demonstrated increased food intake after day 13 of the of experiment. When the histological examination was conducted on day 7 after treatment with cisplatin and radiation, the rhEGF group showed a focal cellular reaction in the epidermal layer of the mucosa, while the no rhEGF group did not show inflammation of the oral mucosa. Conclusion: These findings suggest that rhEGF has a potential to reduce the oral mucositis burden in mice after treatment with cisplatin and radiation. The optimal dose, number and timing of the administration of rhEGF require further investigation.

The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.