Bronchial Brushing and Bronchial Washing for Diagnosis of Central Lung Cancer (중심형 폐암 진단을 위한 기관지찰과술과 기관지세척술)
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- Tuberculosis and Respiratory Diseases
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- v.46 no.6
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- pp.817-825
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- 1999
Background : Forceps biopsy, bronchial brushing, and bronchial washing are used in conjunction with bronchoscopy to provide specimens for histologic and cytologic analysis in patients with suspected lung cancer. This study was performed to evaluate how many times brushing should be done and how much fluid should be used during bronchial washing for increasing diagnostic yield, and to evaluate which combination of these procedures gives the highest diagnostic yield. Methods : Forty patients, with suspected lung cancer, who had bronchoscopically visible lesions were enrolled in this prospective study. During one bronchoscopic examination four forceps biopsies, four bronchial brushings, and bronchial washing were done in all patients. The patients were divided into four groups by the amount of normal saline used for bronchial washing; group I, 10 ml ; group II, 20ml ; group III 30ml, and group IV, 40ml. We analyzed the results in 36 patients confirmed as lung cancer. Results : The diagnostic sensitivity of bronchial washing before and after forceps biopsy and bronchial brushing were 36% and 28%, respectively. The cumulative diagnostic sensitivity of bronchial washing was 47% and significantly higher than that of bronchial washing before or after forceps biopsy and bronchial brushing (p<0.05). The diagnostic sensitivity of bronchial washing with saline of 30ml was significantly higher than that of bronchial washing with saline of 10ml or 20ml (p<0.05). The diagnostic sensitivity of the first brushing was 75%, the second brushing 78%, the third brushing 83%, and the fourth brushing 67%. With repeated brushing up to three times, the diagnostic sensitivity increased to 92% (p<0.05). However, inclusion of the fourth brushing did not give a further increase of the diagnostic sensitivity. The diagnostic sensitivity of forceps biopsy was 86%. The diagnostic sensitivities of forceps biopsy by the type of bronchial lesion were as follows: tumor, 88%; infiltration, 67%; infiltration with nodularity, 80%; and collapse, 100%. The combination of forceps biopsy and bronchial washing gave a diagnostic sensitivity of 89%. The diagnostic sensitivity of combining forceps biopsy with bronchial brushing was 97%. Addition of bronchial washing did not increase the diagnostic yield over forceps biopsy and bronchial brushing. Conclusion : In patients with central lung cancer, forceps biopsies and repeated brushings up to three times should be done for maximal diagnostic yield.
Background: Cell mediated immune response mediated by interaction between CD4+ T lymphocytes and macrophagies is thought to play an important role in tuberculous pleurisy. This interaction is dependent on the interplay of various cytokines. The immunologic response of tuberculous pleurisy is thought to depend on the balance between helper T cell(Th1) cytokine Interleukin-12, Interferon gamma and Th2 cytokine IL-4, IL-10. To understand immunologic mechanism in tuberculous pleurisy and evaluate diagnostic value of these cytokines, the concentrations of Th1 cytokine IL-12, IFN -
This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.
The Samgwang Au-Ag deposit has been one of the largest deposits in Korea. The deposit consists of eight lens-shaped quartz veins which filled fractures along fault zones in Precambrian metasedimentary rock, which feature suggest that it is an orogenic-type deposit. The Ti-bearing minerals occur in wallrock (titanite, ilmenite and rutile) and laminated quartz vein (rutile). They occur minerals including biotite, muscovite, chlorite, white mica, monazite, zircon, apatite in wallrock and white mica, chlorite, arsenopyrite in laminated quartz vein. Chemical composition of titanite has maximum vaules of 3.94 wt.% (Al2O3), 0.49 wt.% (FeO), 0.52 wt.% (Nb2O5), 0.46 wt.% (Y2O3) and 0.43 wt.% (V2O5). Titanite with 0.06~0.14 (Fe/Al ratio) and 0.06~0.15 (XAl (=Al/Al+Fe3++Ti)) corresponds with metamorphic origin and low-Al variety. Chemical composition of ilmenite has maximum values of 0.07 wt.% (ZrO2), 0.12 wt.% (HfO2), 0.26 wt.% (Nb2O5), 0.04 wt.% (Sb2O5), 0.13 wt.% (Ta2O5), 2.62 wt.% (As2O5), 0.29 wt.% (V2O5), 0.12 wt.% (Al2O3) and 1.59 wt.% (ZnO). Chemical composition of rutile in wallrock and laminated quartz vein has maximum values of 0.35 wt.%, 0.65 wt.% (HfO2), 2.52 wt.%, 0.19 wt.% (WO3), 1.28 wt.%, 1.71 wt.% (Nb2O3), 0.03 wt.%, 0.07 wt.% (Sb2O3), 0.28 wt.%, 0.21 wt.% (As2O5), 0.68 wt.%, 0.70 wt.% (V2O3), 0.48 wt.%, 0.59 wt.% (Cr2O3), 0.70 wt.%, 1.90 wt.% (Al2O3) and 4.76 wt.%, 3.17 wt.% (FeO), respectively. Rutile in laminated quartz vein is higher contents (HfO2, Nb2O3, As2O5, Cr2O3, Al2O3 and FeO) and lower content (WO3) than rutile in wallrock. The substitutions of rutile in wallrock and laminated quatz vein are as followed : rutile in wallrock [(Fe3+, Al3+, Cr3+) + Hf4+ + (W5+, As5+, Nb5+) ⟵⟶ 2Ti4+ + V4+, 2Fe2+ + (Al3+, Cr3+) + Hf4+ + (W5+, As5+, Nb5+) ⟵⟶ 2Ti4+ + 2V4+], rutile in laminated quartz vein [(Fe3+, Al3+) + As5+ ⟵⟶ Ti4+ + V4+, (Fe3+, Al3+) + As5+ ⟵⟶ Ti4+ + Hf4+, 4(Fe3+, Al3+) ⟵⟶ Ti4+ + (W5+, Nb5+) + Cr3+], respectively. Based on these data, titanite, ilmenite and rutile in wallrock were formed by resolution and reconcentration of cations (W5+, Nb5+, As5+, Hf4+, V4+, Cr3+, Al3+, Fe3+, Fe2+) in minerals of wallrock during regional metamorphism. And then rutile in laminated quartz vein was formed by reconcentration of cations (Nb5+, As5+, Hf4+, Cr3+, Al3+, Fe3+, Fe2+) in alteration minerals (white mica, chlorite) and Ti-bearing minerals reaction between hydrothermal fluid originated during ductile shear and Ti-bearing minerals (titanite, ilmenite and rutile) in wallrock.
Background : Matrix metalioproteinase(MMP)-2 and MMP-9 have been known to play an important role in cell migration and the tissue remodeling process by type IV collagen lysis, a major component of the basement membrane. Intra-alveolar fibrosis, secondary to an injury to the basement membrane of the alveolar epithelial lining, is a major process in the pathogenesis of idiopathic pulmonary fibrosis(IPF). Therefore, MMP-2 and MMP-9 was hypothesized to play an important role in IPF pathogenesis. As a result, their level may reflect the activity or prognosis. Method : Forty one progressive IPF patients(age
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70