Kim, Young-Whan;Park, Gye-Young;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
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제41권2호
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pp.127-134
/
1994
Background : Diffuse panbronchiolitis(DPB) is a chronic inflammatory lung disease of unknown etiology which has characteristic clinical, radiological and pathological features, and is distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. Clinically, patients with DPB have chronic cough, purulent sputum, exertional dyspnea, and finally respiratory failure. Until a few years ago, the prognosis of DPB had been thought to be very grave, because there had been no effective treatment for the disease. But recent1y, low-dose long-term erythromycin was found to be very effective on DPB. Even though DPB is prevalent in Japan, and is known to be rare outside of Japan, we have a1ready reported the clinical features of 16 DPB cases in Korea. We tried low-dose long-term erythromycin on DPB patients and analyzed the clinical effect of erythromycin. Methods : We analyzed the changes of subjective symptoms, physical signs, pulmonary function tests and chest X-rays on 14 DPB patients with more than 6 months erythromycin treatment during the period from September 1989 to August 1992 in Seoul National University Hospital. Results : 1) Subjective symptoms improved in all patients within 2-3 months, and 54.5% of the patients showed no symptom after one year of treatment. 2) Crackles and wheezing decreased in 92.9% of the patients after 3 months and completely disapppeared in 63.5% of the patients after one year of treatment. 3) FVC and FEV1 increased remarkably during the first 3 months, and slowly increased thereafter, reaching normal level after one year of treatment. 4) Small nodular lesions on chest X-ray decreased in all patients, and chest PA was normal in 36.4% of the patients after one year of treatment. 5) There was side effect in one patient, stopping medication because of dyspepsia. One patient stopped medication because of no symptom after 16 months of treatment, but her symptom recurring after one month, improving again after retreatment. Conclusion: Low-dose long-term erythromycin showed ramarkable effectiveness on DPB. Further studies are needed on the mechanism of the drug and the duration of the treatment.
Background : There have been several studies showing that angiotensin II and the angiotensin converting enzyme (ACE) contribute to the activation of fibroblast including the pulmonary fibrosis, and apoptosis of the alveolar epithelium in idiopathic intersititial pneumonia. This study was performed to identify the relationship between the serum angiotensin II, ACE and the pulmonary function test (PFT), the dyspnea score, and the cell fraction of the bronchoalveolar lavage fluid(BALF). Materials and Methods : Twenty three patients with idiopathic interstitial pneumonia from March, 1999 to October, 2001 at Gachon medical school were enrolled in this study. They were divided into IPF(UIP) (16) and NSIP (7) groups. Twelve of the idiopathic interstitial pneumonia patients (UIP : 5, NSIP : 7) were diagnosed by an open lung biopsy, 11 of IPF patients were diagnosed by the American Thoracic Society (ATS) diagnostic criteria. The PFT values, dyspnea score, serum ACE and angiotensin II were measured, and a bronchoscopy was performed to obtain the BALF. Results : Of all the patients, 7 were in the normal range and 14 showed an increase in the serum level of angiotensin II. In terms of the serum ACE level, 14 patients had an increased level. The DLCO% of the angiotensin II in increased group was significantly lower than the not-increased group (p=0.021). Other factors did not correlate with the serum ACE or the angiotensin II increased group and not-increased group. Conclusion : These results suggest that an increased angiotensin II serum level may be associated with increase in the of alveolar capillary block in the progression of pulmonary fibrosis in idiopathic interstitial pneumonia.
Background: There are various etiologies causing bronchiectasis, but the cases without definite causes account for a quite high proportion. It is also uncertain that immunoglobulin G subclass deficiency (IgGSD) is associated with bronchiectasis. Therefore, we tried to measure the frequency of IgGSD in patients with bronchiectasis of unclear etiology, and to observe the clinical features of those patients with bronchiectasis and IgGSD. Methods: For the outpatients of a university hospital who were diagnosed as bronchiectasis by chest CT, we produced comprehensive history taking and physical examinations, and finally selected 31 patients with bronchiectasis of unclear etiology. Results: Two patients had total immunoglobulin G deficiency. The frequency of IgGSD was comparatively high (n=14). When we compared IgGSD group to normal immunoglobulin G subclass group, there were no significant differences in sex, age, and the frequency of sinusitis, bronchial asthma, and the abnormal lung function. Conclusion: In cases of bronchiectasis without definite causes, it can be considered to measure the level of immunoglobulin G subclass. It is also probably worthwhile to further evaluate the relationship between IgGSD and bronchiectasis.
Purpose: Recently many studies show early exposure during childhood growth to endotoxin (lipopolysaccharides, LPS) and/or early exposure to allergens exhibit important role in development of allergy including bronchial asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life via the airways in the pathogenesis of allergic airways inflammation and airway hyperresposiveness (AHR) in mouse model of asthma. Methods: Less than one week-old Balb/c mice was used. Groups of mice were received either a single intranasal instillation of sterile physiologic saline, 1% ovalbumin (OVA), LPS or $1.0{\mu}g$ LPS in 1% OVA. On 35th day, these animals were sensitized with 1% OVA for 10 consecutive days via the airways. Animals were challenged with ovalbumin for 3 days on 55th days, and airway inflammation, hyperresponsiveness, and cytokine expression were assessed. Measurements of airway function were obtained in unrestrained animals, using whole-body plethysmography. Airway responsiveness was expressed in terms of % enhanced pause (Penh) increase from baseline to aerosolized methacholine. Lung eosinophilia, serum OVA-IgE and bronchoalveolar lavage (BAL) fluid cytokine levels were also assessed. ANOVA was used to determine the levels of difference between all groups. Comparisons for all pairs were performed by Tukey-Kramer honest significant difference test; $P$ values for significance were set to 0.05. Results: Sensitized and challenged mice with OVA showed significant airway eosinophilia and heightened responsiveness to methacholine. Early life exposure of OVA and/or LPS via the airway prevented both development of AHR as well as bronchoalveolar lavage fluid eosinophilia. Exposure with OVA or LPS also resulted in suppression of interleukin (IL)-4, 5 production in BAL fluid and OVA specific IgE in blood. Conclusion: These results indicate that antigen and/or LPS exposure in the early life results in inhibition of allergic responses to OVA in this mouse model of astham. Our data show that early life exposure with OVA and/or LPS may have a protective role in the development of allergic airway inflammation and development of allergen-induced airway responses in mouse model of asthma.
Recent studios have shown that narcotic drags produce an unusually intense, prolonged and segmental analgesic action in man whoa injected into the spinal subarachnoid or epidural space (Wang et al, 1979; Behar et al, 1979; Cousins et al, 1979; Magora et a., 1980, Johnston and McCaughey, 1980). Since 1960, many investigators claimed that low molecular weight(LMW) dextran increased the clinical duration of lidocaine(Loder, 1960; Loder, 1962), tetracaine (Chinn and Wirjoatmadja, 1967) and bupivacaine(Kaplan et al, 1975) in man but the mechanism of the action of dextran was unclear. But Curtiss and Scurlock(1979), and Buckled and Fink(1979) claimed that LMW dextran has no effect on the duration of action of bupivacaine in animal studies. The present study was performed to evaluate the clinical efficacy of analgesia by the thoracic epidural injection of morphine and bupivacaine mixture for the relief of pain due to fractured or contused ribs, to evaluate the duration of analgesic effect by the use of the above mixture in a hypertonic solution(dextran 70 or 50% dextrose in water) and to observe the possibility of improvement in the lung function after the pain block. The complications following the pain block were also observed. The 50 single thoracic epidural injections of the mixture were divided into three groups : Group 1(n=15) served as a control group and drags used for the relief of pain were as follows(Mean$\pm$S.D.): morphine($2.13{\pm}1.64\;mg$), 0.5% bupivacaine($3.10{\pm}1.04\;ml$) and 0.9% saline($3.64{\pm}1.11\;ml$). Group 2(n=16) serves as an experimental group and drugs were as follows(Mean$\pm$S.D.): morphine($2.13{\pm}0.72\;mg$), 0.5% bupivacaine($3.06{\pm}0.77\;ml$) and dextran 70($3.75{\pm}1.29\;ml$). Group 3 (n=19) served as an experimental group and drags were as follows(Mean$\pm$S.D.) : morphine($2.42{\pm}0.51\;mg$), 0.5% bupivacaine($3.21{\pm}0.71\;ml$) and 50% dextrose in water($3.58{\pm}1.11\;ml$). The results are were follows: 1) The Dumber of patients who obtained excellent and good analgesic effects following the block were greater in the experimental Croup 2(94%) and Group 3 (90%) than theme of the control Group 1 (80%). 2) The duration of pain relief which lasted more than 3 days after the epidural block was longer in the experimental Group 2 (81%) and Group 3 (75%) than those of the control Croup 1(67%). 3) The pulmonary reserve(FVC%+FEV 1.0%) of 27 cases who were treated by the pain block between 1 and 31 drys following the chest injury was increased to about 13% than those before the block, and that of 13 cases between 32 and 82 days following the chest injury was decreased to about 4% than those before the block. 4) Of the complications following the pain block, there were 5 cased(10%) of nausea within 2 hours following the block, 4 cases(8%) of vomiting after 2 hours following the block, 10 cases(20%) of pruritus after 3~4 hours following the block, 17 cases(34%) of transient urinary retention which tasted 8 to 19 hours, 3 cases(6%) of headache within 2 hoers following the block and 2 cases(4%) of dural puncture. In conclusion, it is suggested that the clinical duration of analgesic effect produced by morphine and bupivacaine mixture can be prolonged by addition of the hypertonic solution to the mixture.
The new medical device technologies for bio-signal information and medical information which developed in various forms have been increasing. Information gathering techniques and the increasing of the bio-signal information device are being used as the main information of the medical service in everyday life. Hence, there is increasing in utilization of the various bio-signals, but it has a problem that does not account for security reasons. Furthermore, the medical image information and bio-signal of the patient in medical field is generated by the individual device, that make the situation cannot be managed and integrated. In order to solve that problem, in this paper we integrated the QR code signal associated with the medial image information including the finding of the doctor and the bio-signal information. bio-signal. System implementation environment for medical imaging devices and bio-signal acquisition was configured through bio-signal measurement, smart device and PC. For the ROI extraction of bio-signal and the receiving of image information that transfer from the medical equipment or bio-signal measurement, .NET Framework was used to operate the QR server module on Window Server 2008 operating system. The main function of the QR server module is to parse the DICOM file generated from the medical imaging device and extract the identified ROI information to store and manage in the database. Additionally, EMR, patient health information such as OCS, extracted ROI information needed for basic information and emergency situation is managed by QR code. QR code and ROI management and the bio-signal information file also store and manage depending on the size of receiving the bio-singnal information case with a PID (patient identification) to be used by the bio-signal device. If the receiving of information is not less than the maximum size to be converted into a QR code, the QR code and the URL information can access the bio-signal information through the server. Likewise, .Net Framework is installed to provide the information in the form of the QR code, so the client can check and find the relevant information through PC and android-based smart device. Finally, the existing medical imaging information, bio-signal information and the health information of the patient are integrated over the result of executing the application service in order to provide a medical information service which is suitable in medical field.
Back ground : Arm span measurements provide a practical substitute for standing height to predict normal spirometric values in subjects unable to stand or those with a skeletal deformity such as kyphoscoliosis. The relationship between arm span and height has previously been reported as either a fixed ratio unaffected by age or as a regression equation in which the ratio varies as a function of age. The fixed ratio or regression equation is known to be specific for sex and race. Methods : We studied the relationship between standing height, arm span, and age in 381 Korean adult female subjects (ages 20 to 69 yrs) sampled in a general population. Results : The mean ratio for arm span to height is 1.004. Multiple linear analysis found arm span and age to be predictive of standing height (p=0.0001, $r^2$=0.76). We performed the analysis of the difference between the predicted height using either fixed ratio or regression equation and actual height. At the extremes of arm span and age, the ratio method either underestimated(at smaller arm span or younger age) or overestimated(at larger arm span or older age) as compared with actual height (p=0.0001). Conclusion : This results indicate that the estimated height using the fixed ratio method provides a less acceptable method of estimating height for the prediction of lung volumes in the Korean adult women when compared with the regression equations, especially at the extremes of stature or age.
Woo, Duck Soo;Seol, Won Jong;Kyung, Sun Young;Lim, Young Hee;An, Chang Hyeok;Park, Jeong Woong;Jeong, Sung Hwan;Lee, Jae Woong
Tuberculosis and Respiratory Diseases
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제55권5호
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pp.478-487
/
2003
Background : There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). Method : Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF. Results : The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients(M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups($202.5{\pm}58.5$ vs $163.7{\pm}47.3pg/ml$, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group. Conclusion : These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.
Hwang, Kyung Hee;Chang, Su Chan;Park, Jong Seok;Wahid, Fazli;Kim, You Young
Journal of Life Science
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제23권4호
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pp.501-509
/
2013
Formaldehyde (FA) is widely used in industries, and it is an indoor and outdoor pollutant. Exposure to FA may cause inflammation and respiratory oxidative stress. Studies have demonstrated that FA can cause cancer in animal models. During the regeneration process of injured starfish (Asterina pectinifera), several changes have been observed in the expression of cytokines. In particular, higher TGF-${\beta}1$ expression has been detected in arm cut starfish extract after eight days. The current study was designed to elucidate the in-vitro and the in-vivo pharmacological effects of starfish extract on FA exposure. We investigated the protective effects of intact starfish extract and arm cut starfish extract on an IMR-90 cell line and on mouse lung injury in response to FA exposure. In the presence of FA, inhalation of the arm cut starfish extract was associated with more promising cell proliferation, TNF-${\alpha}$, NF-${\kappa}B$ decrement, and $I{\kappa}-B{\alpha}$ increment. In the experimental group, the pulmonary structure of the arm cut starfish extract-treated group in the presence of FA exposure was similar to the control group, whereas the FA exposure group showed damage to the pulmonary structure. Moreover, the arm cut starfish extracts was more effective than the intact starfish extracts in terms of the expression of TNF-${\alpha}$, NF-${\kappa}B$, $I{\kappa}-B{\alpha}$, and surfactant protein A. The results obtained in this study demonstrate that arm cut starfish extracts are more effective in protecting pulmonary structure and function against FA exposure than intact starfish extracts.
Objective : The purpose of this study is to establish a category for acupuncture therapy by appropriate etiological analysis and differenciation of edema. Methods : We arrange Huang Di Nei Jing and thirty four kinds of literature about edema. Results : 1. The cause of Edema is functional disorder of lung, spleen, kidney, bladder and tri-energizer by six kinds of natural factors, internal injury and loss of nutritions. 2. Edema compartmentalize into the water of five zang organs, several kinds of edema(e,g. 5, 10, 12, 24) and yang & yin edema. 3. An ultimate cause of edema pathogenesis is the disturbance of Qi function in kidney. 4. In view of the results so far achived,'GV26(水淸)' is a vitally important acupoint in acupuncture treatment of edema.'GV26(水淸)' and 'CV9(水分)' are very useful acupoints in moxibustion. 5. In the acupuncture and moxibustion treatment of yang edema, we can use acupoints as like 'GV26(水溝)', 'S36(足三里)', 'B20(脾兪)' and 'SP9(陰陵泉)' by purgation and reduction for expelling wind, reducing fever and eliminating dampness. In an instance of yin edema, we can use acupoints as like 'CV9(水分)' 'S36(足三里)', 'CV6(氣海)', 'B20(脾兪)', 'B23(腎兪)' and 'K3(太谿)' by reinforcement for tonifying spleen yang-middle energizer-, qi-transmission and water promoting.
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