• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.357-366
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• 1993

연구배경 : $^{99m}Tc$-DTPA의 폐청소율은 폐포상피세포의 손상도를 반영하고 일부 질환에서는 기존의 폐기능검사보다 더 예민한 것으로 알려져 있다. 흡입된 $^{99m}Tc$-DTPA의 폐청소율은 $^{99m}Tc$-DTPA가 침착되는 부위에 의해 많은 영향을 받아 체외에서 감마카메라로 폐의 방사능 소실속도를 측정하는 방법으로는 섬모운동에 의한 청소속도와 폐포상피를 통한 흡수속도를 구분 할 수 없어 전체 폐의 방사능 소실속도가 폐포상피세포의 투과성만을 반영한다고 할 수 없고 또 장시간동안 감마카메라로 촬영을 해야하는 등 방법이 복잡하다. 흡입된 $^{99m}Tc$-DTPA는 체내에서 24시간 이내에 모두 소변으로 배설되고, 첫 2시간동안 소변으로 배설되는 $^{99m}Tc$-DTPA량은 폐포상피세포를 통한 흡수속도에 의해 결정된다고 알려져 있어, 본 연구자들은 2시간과 24시간 소변내의 방사능배설량의 비를 이용하여 간편하게 폐청소율을 구하는 방법의 유용성 여부를 관찰하기 위해 본 연구를 시행하였다. 방법 : 비흡연 정상인과 미만성 간질성 폐질환환자들을 대상으로 폐기능 검사를 시행하였고 $^{99m}Tc$-DTPA를 vaporizer를 통하여 5분간 흡입후 앙와위에서 폐의 후부상을 감마카메라로 1분단위영상방식으로 30분간 컴퓨터에 수록하여 폐방사능 반감기($T_{1/2}$)를 구하였으며, 또 흡입후 2시간과 24시간 소변을 모아 2시간대 24시간 소변내 방사능배설량비를 구하여 다음과 같은 결과를 얻었다. 결과: 1) 비흡연 정상인에서 $T_{1/2}$와 2시간대 24시간 소변내 방사능배설량비간에는 통계적으로 의미있는 역상관관계가 관찰되었다(r=-0.77, p<0.05). 미만성 폐질환 환자에서 폐방사능 반감기와 2시간대 24시간 소변내 방사능배설량비간에도 역시 의미있는 역상관관계가 관찰되었다 (r=-0.63, p<0.05). 2) 미만성 간질성 폐질환 환자에서 $T_{1/2}$는 $38.65{\pm}11.63$분으로 비흡연 정상인의 $55.53{\pm}11.15$분에 비하여 통계적으로 유의하게 짧았으며, 2시간대 24시간 소변내 방사능배설량비 역시 미만성 간질성 폐질환 환자에서 $52.15{\pm}10.07%$로 비흡연 정상인의 $40.43{\pm}5.53%$에 비해 유의하게 증가되어 있었다(p<0.05). 3) $T_{1/2}$나 2시간대 24시간 소변내 방사능배설량비는 환자군에서 폐확산능과 유의한 상관관계가 없었다(p>0.05). 결론 : 이상의 결과로 $^{99m}Tc$-DTPA의 2시간대 24시간 소변내 방사능배설량비는 폐포상피세포의 투과성을 잘 반영하여 폐포상피세포의 손상정도를 반영하는 간편한 bedside 검사로 생각되며 특히, 폐포상피세포 투과성이 증가되어 있는 미만성 간질성 폐질환 환자에서 예민한 추적경사로 폐확산능과 상호보완적으호 유용하게 사용될 수 있을 것으로 생각된다.

• 대한핵의학회지
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• 제28권3호
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• pp.338-342
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• 1994

이상의 성적을 종합하여 보면, 강남성모병원 방사선과에 근무하는 정상성인 17인을 대상으로 앙와위에서 Tc-99m-DTPA 연무를 흡입시킨 후 측정한 Tc-99m -DTPA 폐제거율은 그 반감기가 평균 5$51{\pm}11.2$분이었고, 좌위에서 흡연시킨 후 측정한 다른 보고들과는 달리 폐하부에서 더 빨랐다.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.374-380
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• 2021

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.775-780
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• 2012

8-isoprostane (8-$isoPGF_{2{\alpha}}$) is a reliable marker and considered a gold standard for lipid peroxidation. There are very few reports of 8-isoprostane levels in cancer patients, and in patients undergoing chemotherapy. Oxidative stress is however expected and has been observed in patients with cancer. This study measured 8-isoprostane levels in urine by ELISA of 25 patients undergoing chemotherapy for advanced non-small cell lung cancer, at cycles 1, 2, and 3 of treatment. It considers the creatinine clearance of the patients, and correction of 8-isoprostane levels by creatinine clearance, and overnight urine volume methods. The average 8-isoprostane levels in urine increased more than 6 to 12 fold on chemotherapy treatment, from $532{\pm}587$ pg/mL at cycle $1,6181{\pm}4334$ at cycle 2, and $5511{\pm}2055$ at cycle 3. Similar results were obtained if 8-isoprostane levels were corrected for overnight urine volume, giving averages of $285{\pm}244{\mu}g$ at cycle $1,4122{\pm}3349$ at cycle 2, and $3266{\pm}1200$ at cycle 3. No significant difference was seen in average total overnight urine volume or number of urinations between chemotherapy cycles except for a large variation in urine volume between cycle 2 and 3. Creatinine levels were significantly different only between cycles 1 and 2 (p=0.016). In conclusion, cisplatin therapy has been shown to induce high levels of lipid peroxidation in lung cancer patients and can be assessed from the 8-isoprostane marker in overnight urine, with or without urine volume correction.

• Archives of Pharmacal Research
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• 제25권6호
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• pp.770-780
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• 2002

The airway surface liquid (ASL), often referred to as mucus, is a thin layer of fluid covering the luminal surface of the airway. The major function of mucus is to protect the lung through mucociliary clearance against foreign particles and chemicals entering the lung. The mucus is comprised of water, ions, and various kinds of macromolecules some of which possess the protective functions such as anti-microbial, anti-protease, and anti-oxidant activity. Mucus glycoproteins or mucins are mainly responsible for the viscoelastic property of mucus, which is crucial for the effective mucociliary clearance. There are at least eight mucin genes identified in the human airways, which will potentially generate various kinds of mucin molecules. At present, neither the exact structures of mucin proteins nor their regulation are understood although it seems likely that different types of mucins are involved in different functions and might also be associated with certain airway diseases. The fact that mucins are tightly associated with various macromolecules present in ASL seems to suggest that the defensive role of ASL is determined not only by these individual components but rather by a combination of these components. Collectively, mucins in ASL may be compared to aircraft carriers carrying various types of weapons in defense of airborne enemies.

• Journal of Microbiology and Biotechnology
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• 제22권7호
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• pp.907-916
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• 2012

Burkholderia cepacia is an important pathogen that often causes pneumonia in immunocompromised individuals. Here, it was demonstrated that the TLR5 agonist flagellin could locally activate innate immunity. This was characterized by rapid expressions of IL-$1{\beta}$, TNF-${\alpha}$, and iNOS mRNA and a delay in the expression of IL-10 mRNA. A significant elevation in the IL-$1{\beta}$, TNF-${\alpha}$, and nitric oxide levels was also noted. In the respiratory tract, flagellin induced neutrophil infiltration into the airways, which was observed by histopathological examination and confirmed by the neutrophil count and level of myeloperoxidase activity. This was concomitant with a high activity of alveolar macrophages that engulfed and killed B. cepacia in vitro. The flagellin mucosal treatment improved the B. cepacia clearance in the mouse lung. Thus, the present findings illustrate the profound stimulatory effect of flagellin on the lung mucosal innate immunity, a response that needs to be exploited therapeutically to prevent the development of respiratory tract infection by B. cepacia.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.416-423
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• 1993

경북대학교 의과대학 호흡기내과에서 운동시 호흡곤란을 호소하며 입원하여 개흉폐생검, 경기관지 폐생검 및 기관폐포세척을 하여 광학현미경 및 전자현미경소견상 특징적인 lamellar body가 보이는 폐포단백증으로 진단된 3예를 경험하였기에 문헌고찰과 함께 보고하였다.

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.360-368
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• 1998

배 경: Endothelin(ET)은 혈관내피세포, 기도상피세포등에서 분비되고, 혈판 및 기도를 수축시키는 작용외에도 섬유아세포를 증식시키는 기능을 가지고 있다. 한편 미만성간질성폐질환은 염증세포의 침윤과 섬유화를 특정으로 하는 질환이며 이러한 질환을 가전 환자에서 혈장 및 기관지폐포세척액내의 ET 농도가 증가한다는 보고가 있었다. 또 폐혈관손상이 있는 경우 폐순환을 통한 ET의 제거율이 감소하기 때문에 ET의 동정맥비가 증가한다는 보고가 있었다. 이에 저자등은 미만성간질성폐질환 환자에서 혈장 ET 농도가 증가하는지, 또 증가한다면 어떠한 기전에 의하여 증가하는 지를 알고자 본 연구를 시행하였다. 방 법: 도플러심초음파상 폐동맥고혈압이 없는 미만성간질성폐질환 환자 17명과 정상대조군 11명을 대상으로 혈장, 요 중 및 기관지폐포세척액내의 ET 농도를 측정하였고, 또 이들의 ET 동-정맥 비와 요배설율을 구하였다. 성 적: 동맥혈, 정맥혈, 요 중 및 기관지폐포세척액내의 ET 농도는 미만성간질성폐질환군에서 대조군보다 유의하게 증가하였고 (P<0.05), ET의 동-정맥 비와 요배설율에는 유의한 차이가 없었다 (P>0.05). 결 론: 이상의 결과, 미만성간질성폐질환 환자의 혈장, 요 중 및 기관지폐포세척액내의 Endothelin농도는 대조군에 비해 유의하게 증가되어 있었고, 혈장 ET농도 증가의 기전은 폐실질에서의 분비증가로 사료되었다.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.136-140
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• 2014

Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient's condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

• Tuberculosis and Respiratory Diseases
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• 제38권4호
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• pp.372-378
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• 1991

Some kinds of newer fluoroquinolone antibiotics are known to interact with theophylline, which is widely used as a potent bronchodilator in asthma or chronic obstructive lung disease. To evaluate the effect of enoxacin and ciprofloxacin on the metabolism of theophylline, aminophylline was administered intravenously in bolus (6 mg/kg) over 30 minutes to 6 healthy volunteers (age: $23.3{\pm}4.2$ year, body weight: $63.2{\pm}9.0\;kg$, height: $169.0{\pm}6.5\;cm$, female 3, male 3) before and after per oral 5-day medication of enoxacin and ciprofloxacin, respectively and we measured the level of theophylline in serum. The results were as follows: 1) Enoxacin and ciprofloxacin did not influence the volume of distribution significantly. 2) Enoxacin decreased the clearance of theophylline significantly (from $42.9{\pm}14.6\;ml/min$ to $30.1{\pm}6.3\;ml/min$: p<0.05), but ciprofloxacin did not cause significant decrease (to $32.8{\pm}6.2\;ml/min$: p>0.005). 3) Enoxacin increased the elimination half life of theophylline significantly (from $496{\pm}83\;min$ to $693{\pm}32\;min$: p<0.001), but ciprofloxacin did not cause significant increase (to $687{\pm}222\;min$: p>0.05). These results suggested that enoxacin influenced clearance and elimination half life significantly and thorough monitoring of the level of theophylline in patients with coadminstration of enoxacin and theophylline was necessary. In case of ciprofloxacin, the influence on the metabolism of theophylline was not statistically significant, but one exceptionally large decrease of the clearance and increase of the elimination halflife of theophylline suggested the necessity of monitoring of theophylline level during coadministration of ciprofloxacin and theophylline.