• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• 대한핵의학회지
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• 제29권1호
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• pp.125-132
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• 1995

The purpose of this study was to establish mononuclear cell cultures such as lymphocytes or buffy coat for the biological dosimetry of in vitro Irradiation of the radionuclide Tc-99m in order to exclude the effect of residual doses seen in the cultures of whole blood. Biological do simetry of Tc-99m on cultured mononuclear cells at doses ranging from 0.05 to 6.00 Gy, by scoring unstable chromosomal aberrations(Ydr) observed in cultured lymphocytes, were performed using peripheral venous blood of healthy normal person. The results showed that; (1) In vitro irradiation of radioisotope in separated lymphocyte or buffy coat showed trace amount of residual doses of isotope after washing. Residual doses of isotopes are increased in proportion to exposed time and irradiated dose without difference between I-131 and Tc-99m. (2) We obtained these linear-quadratic dose response equations in lymphocyte and buffy coat culture after in vitro irradiation of Tc-99m, respectively (Ydr = 0.001949 $D^2$ +0.006279D + 0.000185; Ydr= 0.002531 $D^2$-0.003274 D+0.003488). In conclusion, the linear quadratic dose-response equation from in vitro irradiation of Tc-99m with lymphocyte and buffy coat culture was thought to be useful for assessing Tc-99m induced biological effects. And mono-nuclear cell cultures seem to be the most appropriate experimental model for the assessment of biological dosimetry of internal irradiation of radionuclides.

• 대한예방한의학회지
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• 제14권3호
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• pp.1-12
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• 2010

Objective : Samulatang (herbal description) is much used for women's disease in Korean Traditional Medicine. The aim of this study is to evaluate reproductive toxic effect by Samultang in pregnant rats and fetuses, and ascertain a dose-response relationship Method : Pregnant Sprague-Dawley rats were administered with the Samultang at single, double and quadruple dose for 20 days, orally. Pregnant rats were sacrificed at 20th day of gestation, and observed internal and reproductive organs. Live fetuses of gestation were randomly selected and fixed in 95% ethanol. Fetuses were stained with alcian blue and alizarin red S. We observe maternal body weight,, index associated pregnancy, and skeletal malformations in fetus Result : Maternal body weight of Samultang treated group has increased, side effect was not found in maternal body compared to that of control group. There were no significant difference in internal and reproductive organs. Double concentration administered group had lowest value in number of implantation, live fetuses, implantation rate and delivery rate, Also double concentration administered group showed higher early and late resorption rate than the other group. But, these are not significant. In the sex ratio, number of females, bigger than number of males in all Samultang administered groups. The fetuses of dams treated with Samultang didn't showed external and skeletal malformation. Vertebral and sternal variations were observed in single, double and quadruple concentration administered group but, compared to the control, those variations were insignificant. There were no significant changes in number of ribs, cervical, thoracic, lumber, sacral and caudal vertebrae Conclusion : Samultang is not expected to affect on pregnant rats and fetus about maternal body weight and number of live fetuses. There were no significant changes in organ weight, reproductive organs. Although skeletal variations were showed in vertebrae and sternum, treated groups were shown insignificant changes in skeletal variation

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.377-384
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• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• Journal of Radiation Protection and Research
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• 제40권4호
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• pp.216-222
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• 2015

천연방사성물질을 취급하는 산업시설의 종사자들은 공정에서 발생하는 공기 중 입자의 흡입에 의해 만성적인 내부피폭을 받을 수 있다. 방사성 물질을 함유한 공기 중 입자 흡입에 의한 내부피폭은 입자의 크기, 모양, 밀도, 흡수형태에 따라 달라진다. 본 연구에서는 공기 중 부유 입자의 물리화학적 특성에 따른 피폭방사선량 민감도를 평가하였다. 흡입에 의한 내부피폭선량 평가는 국제방사선방호위원회 66 인체호흡기모델을 이용하였다. 일반적으로 입자의 크기가 감소할수록 예탁유효선량은 증가하는 경향을 보였으며, 입자 크기 $0.01{\mu}m$와 $100{\mu}m$ 에서의 피폭방사선량은 $^{238}U$ 의 경우 약 100 배, $^{230}Th$ 의 경우 약 50 배 차이를 보였다. 모양인자가 작을수록 피폭방사선량은 높게 나타났으며, 모양인자가 1 일 때 피폭방사선량은 모양인자가 2 일 때 보다 18% 높았다. 입자의 밀도가 증가할수록 피폭방사선량은 높게 나타났으며, 입자 밀도가 $11g{\cdot}cm^{-3}$ 인 경우 피폭방사선량은 밀도가 $0.7g{\cdot}cm^{-3}$ 인 경우에 비해 60% 높게 나타났다. $^{238}U$ 의 경우 피폭방사선량은 흡수형태 S, M, F 순으로 높게 나타났으며, 흡수형태 S 의 경우 F 에 비해 피폭방사선량이 약 9 배 높게 나타났다. $^{230}Th$ 의 경우 피폭방사선량은 흡수형태 F, M, S 순으로 높게 나타났으며, 흡수형태 F 의 경우 S 에 비해 피폭방사선량이 약 16 배 높게 나타났다. 민감도 평가에서 나타난 것처럼 입자의 물리화학적 특성을 고려하지 않고 피폭방사선량을 평가하는 경우 평가값은 실제값에 비해 수십 혹은 수백 배 이상 왜곡 될 수 있다. 천연방사성물질을 취급하는 작업장에서 종사자의 정확한 피폭방사선량 평가를 위해서는 취급하는 물질, 작업환경 등을 고려하고 입자의 물리화학적 특성값을 실측하여 실시하는 것이 바람직하다.

• Tuberculosis and Respiratory Diseases
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• 제57권1호
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• pp.72-77
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• 2004

연구배경 : 폐암의 말기에 관찰되는 기도 폐쇄는 호흡곤란, 기침, 객혈 및 발열 등을 일으키고 반복적인 호흡기계 감염의 원인이 되기도 한다. 그러나 대부분의 경우 방사선 치료, 항암화학요법 또는 수술적 치료를 받았기 때문에 더 이상 치료를 할 수 없는 어려움이 있다. 따라서 기도 폐쇄를 호전시키기 위한 보조적인 방법으로 광역동 치료가 한 방법임이 알려져 있다. 방 법 : 기도 폐쇄가 관찰되는 폐암 환자에게 기관지 내시경 시행 48시간 전에 광감작물질인 porfimer sodium (Photofrin$^{(R)}$)을 kg당 2mg으로 정맥주사 후 일광화상 및 광과민반응을 방지하기 위해 직사광선을 차단시켰다. Light source는 diode laser를 이용하였고, light dose는 180-200 $joul/cm^2$, 방사하는 빛의 강도는 400 $mW/cm^2$ 으로 하였으며 interstitial irradiation 및 cylindrical diffuser 를 이용하여 630nm의 레이져를 조사하였다. 시행 48시간 후 기관지내시경을 시행하여 괴사된 조직을 제거하고 남아있는 종양 부위에 대해 재조사를 시행하였다. 결 과 : 폐암 수술 후 수술부위의 국소적인 재발을 보인 경우가 1예, 기도 폐쇄로 인한 호흡곤란을 호전시키기 위해 시행한 경우가 4예였다. 광역동 치료를 통해 종양조직의 선택적인 괴사를 관찰할 수 있었고 괴사조직을 제거한 후에는 기도 폐쇄가 4예에서 호전되었다. 광역동 치료 종결 후 호흡곤란 및 활동도가 호전된 경우가 3예에서 관찰되었고 폐쇄성 폐렴으로 인한 객담 및 발열의 소견 및 기관지암에 의한 객혈의 경우에도 광역동 치료 후 호전되었다. 결 론 : 기도 폐쇄가 관찰되는 폐암 환자에서 보존적인 치료 방법으로 기관지내시경을 이용한 광역동 치료는 호흡곤란, 반복적인 호흡기계 감염 및 객혈 등을 호전시키기 위한 효과적인 방법 중의 하나이다.

• Journal of Radiation Protection and Research
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• 제13권2호
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• pp.41-51
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• 1988

우리나라의 환경특성에 적합한 섭식경로 내부피폭 해석코드를 확립하기 위한 준비과정으로서 FOOD III 코드를 부분적으로 보완하여 한국 성인 남자에 대한 선량평가 결과를 보완전의 결과와 비교하고 앞으로의 개선방안을 논의 하였다. 평가예제로는 1984년도 고리 원전 1호기에서의 Mn-54, Co-58, Co-60, I-131, I-132의 방출량 자료와 부지경계선상 대기확산인자(X/Q)의 최대값을 사용하였다. 보완된 코드로 계산한 결과, 장기별 선량은 보완 전에 비해 $20{\sim}70%$ 정도 낮아졌으며 예탁실효선량당량은 ICRP 제한치의 0.16%인 $7.935{\times}10^{-6}Sv/y$로 계산되어 보완전의 $1.32{\times}10^{-5}Sv/y$에 비해 40% 정도 낮게 평가되었다.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.200-208
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• 2021

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion: The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

• Tuberculosis and Respiratory Diseases
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• 제86권1호
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• pp.33-46
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• 2023

Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period. Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 ㎍/25 ㎍) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician's evaluation (effective, ineffective/no change, worsening, indeterminable) and lung function improvement. Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment. Conclusion: This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.

• Journal of Radiation Protection and Research
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• 제18권1호
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• pp.37-51
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• 1993

본 연구에서는 환기장치로 제어하는 환경인 라돈 표준실 및 라돈 발생기로부터 이론적으로는 Jacobi모델 이론을 사용하여 라돈 자핵종의 농도를 계산하였으며, 실험적으로는 두 발생 조건으로부터 채취된 시료를 알파스펙트럼 분석법에 의해 측정 분석하여 그 농도를 결정하였다. 이론적인 계산치와 실험적인 측정결과를 비교해 본 결과 매우 잘 일치되는 좋은 결과를 얻게 되었다. 따라서 이러한 연구는 실내 라돈환경에서 라돈 자핵종의 알파방출체에 의한 내부피폭선량을 보다 정확히 평가하고, 라돈 자핵종의 개별 농도를 신속히 결정하는 데 크게 기여할 것이라 사료된다.