• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.548-553
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• 2006

Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.218-226
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• 2006

Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.

• Tuberculosis and Respiratory Diseases
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• v.62 no.5
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• pp.398-405
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• 2007

Background: There is little data on the 3 year prognosis and quality of life of patients on long-term (>72 hour) mechanical ventilation in a medical intensive care unit (MICU). Methods: Patients with long-term mechanical ventilation from May 2003 through July 2003 in MICU of Asan Medical Center, Seoul were enrolled in this studay. The survival rates were observed prospectively at 1, 3, 6, 12, 24, 36 months, and the quality of life of survivor was measured at 12 months by using Short Form 36 (SF-36). Results: The survival rate at 1, 3, 6, 12, 24 and 36 months was 54.8% (40/73), 39.7% (29/73), 30.1% (22/73), 20.5% (15/73), 18.3% (13/71) and 16.9% (12/71), respectively. There was a similar survival rate regardless of the diseases that required mechanical ventilation. A neoplasm or chronic liver disease had a worse survival rate than chronic lung or kidney disease (p<0.05). Each SF-36 domain except for the Role-emotional was inferior to the general population. Conclusions: The survival rate of patients with mechanical ventilation more than 72 hours is decreases continuously until 12 months but is relatively constant from 12 to 36 months. In these patients quality of life is also decrased.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.331-336
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• 2007

Background: Although pulmonary tuberculosis (TB) is a respiratory disease, the presence of Mycobacterium tuberculosis (Mtb) DNA or Mtb itself has been reported in the peripheral blood (PB) of several patients with pulmonary TB. Additionally, it was recently announced that active pulmonary TB patients donated PB, and that this blood was then transfused to other individuals in Korea. Methods: Sixty-nine patients with bacteriologically-confirmed pulmonary TB (35), non-tuberculous mycobacterial (NTM) lung disease (6), and other lung diseases (28) were enrolled in this study, which was conducted to determine if Mtb DNA could be detected in the PB by PCR. In addition, 10 pulmonary TB patients with high-burden bacilli were also enrolled in this study for the culture of Mtb in PB. Results: PCR detected the presence of Mtb in 22.8% (8/35) of the pulmonary TB patients, in 16.7% (1/6) of the patients with NTM lung disease, and in none of the patients with other diseases (0%). In addition, no Mtb was cultured from the PB of the 10 pulmonary TB patients. Conclusion: Although Mtb DNA was detected in the PB of some patients with pulmonary TB, viable Mtb was not isolated from the PB of those patients, which indicates that patients that viable Mth may not be transmitted via trasfusion of blood of pulmonary TB patients.

• Applied Microscopy
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• v.18 no.2
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• pp.1-20
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• 1988

The species of the slug used in the experiment is Limax flavus L. For identifying the chemical characteristics of the epidermis, granules and mucus-producing cell of this animal is examined with methylene blue-basic fuchsin double stain and PAS-alcian blue reagent. For the ultrastructural research of the epidermal free surface, the epitheial cell and the parenchymal cell are used with scanning electron microscope and transmission elec-tron microscope respectively. I . Epidermal tissue The epidermal tissue of the slug is observed being divided into the dorsal and the ventral side(toot pad) respectively. 1) Dorsal epidermal tissue The dorsal epidermis of the slug is constituted with the simple columnar epithelium and the microvilli are compacted on the epidermal free surface. Two different types of the secretory granules of the neutral and the acid mucus are observed between the epithelial cells, and the neutral mucous granules are highest electron-dense but the acid mucous granules are observed to be electron-lucent. 2) Foot epidermal tissue The Foot epidermis is formed with the taller simple columnar epithelium than the dorsal epidermis and these cells have both a large number of the microvilli and a few number of the large villi. The secretory granules of three different types, which are acid, neutral and mixed mucous granule of two different types are observed between the epithelial cells. The neutral mucous granules are highest electron dense but the acid mucous granules are observed to be electron-lucent. II . Mucous granule-producing cell and mucus-producing cells Seven different types of the granules-producing cell and the mucus-producing cells are observed between the parenchyma. 1) A-type of acid mucous granule-producing cell The electron-lucent granules are largely occupied in the cytoplasm of these cells and then the granules are surrounded by irregular membrane. These electron-lucent granules exhibit alcianophilia with PAS-alcian blue reaction, so these granules are certified to be acid mucopolysaccharide. 2) B-type of acid mucus-producing cell The nucleus and the cytoplasm of these cells are pushed by the acid mucus of the electron-lucent toward the cell membrane. This mucus has been confirmed to be the acid mucopolysaccharide with PAS-alcian blue reagent. 3) A-type of neutral mucous granule-producing cell These cells contain the electron-dense round granules with approximately $1{\mu}m$ in diameter, which exhibit strongly PAS-positive reaction. These granules are confirmed to be the neutral mucoplysaccharide. 4) B-type of neutral mucous granule-producing cell These cells contain two different types of electron dense granules and electron-lucent granules; The former exhibits to be strongly PAS-positive and the latter to have alcianophilia reaction respectively. 5) C-type of neutral mucus-producing cell These cells are similar to the shape and the size of the B-type of mucus-producing cell but these two different types of cells are stained with reversing properties to each other. The mucus of the C-type cell that electron-lucent is largely occupied in the cytoplasm that exhibits strongly PAS-positive reaction. 6) D-type of neutral mucous granule-producing cell These cells contain round granules about $1{\mu}m$ in size which are observed to be medium electron-dense granules and those granules are stained brightly red with PAS-weak positive reaction. The granules are certified to be neutral mucopolysaccharide. 7) E-type of neutral mucous granule-producing cell These cells are similar to the shape and the size of the D-type of neutral mucous granule-producing cell. These cells contain a large number of granules with about $1{\mu}m$ in diameter showing electron-lucent and then granules are seen to be PAS-weak positive reaction. III. Parenchyma The clear cell and dark cell are found in the parenchyma of the Limax flavus L. 1) Clear cell These cells are round formed and the nucleus of the cells are larger than cytoplasm. These cells which have the electron-lucent cytosol possess poorly developed organelles. 2) Dark cell These cells are found to be dark cells due to high electron-density, which exhibit strongly methylene-blue reaction from double stain of methylene blue-basic fuchsin.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.219-237
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• 1994

The ultimate goal of clinical periodontal therapy is to achieve regeneration of a healthy connective tissue reattachment. Conventional therapy including scaling, root planing, gingival curettage, gingivectomy and flap procedures of various types results primarily in repair rather than regeneration of the periodontium. In order for periodontal regeneration to occur, progenitor periodontal ligament cells must migrate to the denuded root surface, attach to it, proliferate and mature into an organized and functional fibrous attachment apparatus. Polypeptide growth factors belong to a class of potent biologic mediators which regulate cell differentiation, proliferation, migration and metabolism. Insulin-like growth factor-I (IGF- I ) of these factors appear to have an important role in periodontal wound healing and bone formation. The purpose of this study is to evaluate the effects of IGF- I on the periodontal ligament cells to use as a regeneration promoting agent of periodontal tissue. Human periodontal ligament cells were obtained from periodontal tissue explants culture of the first premolar tooth extracted for the orthodontic treatment. Cells were cultured in Dulbecco's modified Eagle medium(DMEM) with 10% fetal bovine serum. Fourth to seventh passage cells were plated in 24 well tissue culture plates and medium changed to serum-free medium prior to addition of growth factors. Cell proliferation was measured by the incorporation of $[^3H]-thymidine$ into DNA, Protein synthesis was determined by measurement of $[^3H]-proline$ incorporation into collagenase-digestible protein(CDP) and noncollagenous protein(NCP) according to the method of Peterkofsky and Diegelmann (1971), And alkaline phosphatase activity was measured as one parameter of osteoblastic differentiation. The results were as follows : The DNA synthetic activity was increased in a dose-dependent manner with IGF- I except for 0.1ng/ml concentration of IGF- I At the concentration of 10, 100ng/ml, IGF- I significantly increased the DNA synthetic activity(P<0.05) The total protein, collagen and noncollagen synthesis was increased in a dose-dependent manner with IGF- I except for 0.1ng/ml concentration of IGF- I. At the concentration of 1, 10, 100ng/ml, IGF- I significantly increased the total protein, collagen and noncollagen synthesis activity(P<0.95, P<0.001). The % of collagen was not effected according to the concentration of IGF- I. The alkaline phosphatase activity was increased in a dose-, time-dependent manner with IGF- I (10, 100ng/ml). In conclusions, the present study shows that IGF- I has a potentiality to enhance the DNA synthesis of periodontal ligament cells with including the increase of the total protein and collagen synthetic activity. The use of IGF- I to mediate biological stimulation of periodontal ligament cells shows promise for future therapeutic applications.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.303-320
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• 1994

Current acceptable methods For promotin gperiodontal regeneration are base on removal of diseased soft tissue, root treatment, guided tissue regeneration, inteoduction of new graft materials and biological mediators. Platelet-derived growth factor(PDGF) is one of polypeptide growth factor. PDGF has been reported as a biological mediator which regulates activities of wound healing process including the cell proliferation, migration and metabolism. The purposes of this study is to evaluate the effects of PDGF-AA, BB on the periodontal ligament cells to use as a regeneration promoting agent of periodontal tissue. Human periodontal ligament cells were prepared from the first premolar tooth extracted for the orthodontic treatment and were cultured in DMEM/10% FBS at the $37^{\circ}C$, 5% $CO_2$ incubator. Author measured the DNA synthesis, total protein, collagen and noncollagenous protein synthesis and alkaline phosphatase activity according to the concentration of PDGF-AA and BB(0, 0.1, 1, 10, 100ng/ml). The results were as follows : The DNA synthetic activity was increased dose dependently by PDGF-AA and BB. The maximum mitogenic effect was at the 100ng/ml of PDGF-AA and 10ng/ml of PDGF-BB. The total protein, collagen and noncollagen systhesis was increased dose dependently by PDGF-AA and BB. The % of collagen was slightly decresed according to the concentration of PDGF-AA and BB. The effect of PDGF-AA and BB were not specific for collagen synthesis since it also increased noncollagenous protein synthesis. The effect of PDGF-AA and BB on alkaline phosphatase activity did not show any significant, meanwhile the alkaline phosphatase activity of 14 days group showed significnat increase. In conclusion, PDGF-AA and BB may have important roles in stimulation of DNA synthesis in human periodontal ligament cells, which means an increase in collagen-synthesizing cells, and may be useful for clinical application in periodontal regenerative procedures.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.536-546
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• 1996

Background : The survival benefit of combination chemotherapy comparing supportive care to patients with advanced non-small cell lung cancel, especially stage IV non-small cell lung cancer patients with metastatic disease, is controversial. The main goal of this study was to evaluate the difference in survival between patients treated with chemotherapy and those who were not and to identify prognostic factors in the patients with stage IV non-small cell lung cancer. Methods : From January 1989 to December 1994, total 67 patients including 20 patients treated with combination chemotherapy and 47 patients treated with only supportive care in stage IV non-small cell lung cancer patients with metastatic disease were enrolled in this study. Combination chemotherapy consisted of etoposide $120mg/m^2$ iv for 3 days and cis-platin iv day 1 every 4 weeks. The treatment groups were retrospectively analyzed by age, sex, histologic cell type, weight loss, serum LDH level, ECOG performance status and major organ metastasis. Results : The significant prognostic factors influencing survival on this study were ECOG performance status and histologic subtype. Overall response rate by combination chemotherapy was 30%(complete response 0%, partial response 30%). Median survival of overall patients was 13.6 weeks and median survival of Chemotherapy group, 20 weeks, was significantly longer than that of supportive care group, 11.7 week(p<0.01). Median survival of responded in patients receiving chemotherapy, 45.5 weeks, was significantly longer than that of non-responder, 17.3 weeks(p<0.05). 1 year-survival rate of chemotherapy group and supportive care group was 15N and 8%, respectively. Nausea or vomiting, alopecia and anemia were seen in nearly most cases after this combination chemotherapy. Toxicities above grade 3 included neutropenia, anemia, thrombocytopenia, infection, fever, nausea, vomiting and alopecia. But this combination chemotherapy was relatively well tolerated except one treatment-related death from sepsis associated with severe granulocytopenia. Conclusion : These results suggest that systemic chemotherapy might be helpful to the stage IV non-small cell lung cancer patients with good performance status and large scale randomized prospective trials should be performed.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.419-424
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• 2004

Background : Although bronchodilator reversibility testing is widely performed to diagnose asthma or COPD, there is debate upon its usefulness and methods to differentiate asthma from COPD. The purpose of this study is to elucidate the role of bronchodilator reversibility testing in differentiating asthma from COPD and to confirm which method is better at evaluating bronchodilator reversibility. Methods : 26 asthma patients and 31 COPD patients were reviewed retrospectively. Spirometry was performed before and after bronchodilator inhalation to get $FEV_1$, FVC. To evaluate bronchodilator reversibility, the increase in $FEV_1$ or FVC was expressed as three methods, 'percentage of the baseline value', 'percentage of the predicted value', or 'absolute value'. Area under the ROC curve was measured to compare the three methods. In addition, the criteria of American Thoracic Society (ATS) for bronchodilator reversibility were compared to those of European Respiratory Society (ERS). Results : 1. In differentiating asthma from COPD, 'percentage of the predicted value', or 'absolute value' method was useful but 'percentage of the baseline value' was not. However, the ability to differentiate was weak because areas under the ROC curves by all methods were less than 0.75. 2. The criteria of ERS were superior to those of ATS for bronchodilator reversibility to differentiate asthma from COPD because likelihood ratio (LR) of a positive test by ERS criteria was greater than ATS criteria and because LR of a negative test by ERS criteria was less than ATS criteria. Conclusion : In differentiating asthma from COPD, bronchodilator reversibility testing has a weak role and should be considered as an adjunctive test.

• Tuberculosis and Respiratory Diseases
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• v.65 no.1
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• pp.23-28
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• 2008

Background: Thymic epithelial tumors are the most common tumors affecting the anterior mediastinum. The aim of this study is to investigate clinical features of the patients who were diagnosed with thymic epithelial tumors at Pusan National University Hospital. Methods: We retrospectively reviewed the records of thirty-seven patients who were diagnosed with thymic epithelial tumors from Jan. 1997 to Jan. 2007. The pathological classification and clinical stage of the thymic epithelial tumors were based on the WHO classification and Masaoka's staging system. A total 37 patients were enrolled: 23 were males and 14 were females, and their mean age was 51.3 years. Results: Thirty patients presented symptoms at the time of diagnosis and their symptoms were as follows: chest pain (53%), dyspnea (23%), and cough (17%). Myasthenia gravis was diagnosed in five patients. With respect to the tumor staging, three cases (8%) were stage I, 10 cases (28%) were stage II, 12 cases (32%) were stage III, 6 cases (16%) were stage IVA and 6 cases (16%) were stage IVB. Twenty-four cases (67%) displayed stage III or IV disease. The pathological types according to the WHO classification were as follows: B1 (32%), C (23%), B3 (20%), B2 (16%), AB (6%) and A (3%). Twenty-four patients underwent thymothymectomy and four of these patients relapsed. Stage III or type B3 was common in the relapsed patients. Five patientsexpired. Stage IV or type B3 and C were common in the expired patients. Conclusion: In this study, stage III or IV disease and type B3 or C were common at the time of diagnosis and these findings might contribute to postoperative recurrence and a poor outcome.