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Clinical Observation of Pleural Effusion (늑막염의 임상적 고찰)

  • Kim, Choon-Sup;Ju, Kee-Joong;Lee, Chang-Hwan;Park, Sung-Min;Shim, Young-Woong;Song, Kap-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.584-594
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    • 1993
  • Background: Among the respiratory diseases, there are a lot of cases of pleural effusion. The most common cause is tuberculosis. But the other cause such as lung malignancy is in an increasing tendency because of the development of diagnostic procedure, the decrease of the prevalence of the tuberculosis and the increase of the longevity. We need to know the accurate diagnosis as soon as possible for the correct therapy. Method: A clinical observation was made on 315 cases of pleural effusion seen at Pusan Adventist Hospital, from Jan, 1989 to Dec, 1992. For diagnostic procedure, thoracentesis, lymph node biopsy, bronchoscopy and percutaneous biopsy of the parietal pleura with Cope needle were performed. The following are parameters used in seperating the exudate from the transudate: pleural protein 3.0 g/dl, pleural protein/serum protein ratio 0.5, pleural LDH 200 IU, pleural LDH/serum LDH ratio 0.6, pleural cholesterol 60 mg/dl and pleural cholesterol/serum cholesterol ratio 0.3. Each parameters were compared, and misclassified rate and diagnostic efficiency were calculated. Results: The most common cause of exudate pleurisy was tuberculosis (82.3%) and malignancy was next (12.2%). The chief complaints of pleural effusion were noted as dyspnea (58.7%), chest pain (54.9%), coughing (50.2%) and fever (36.2%). Location of pleural effusion was noted as right side (51.4%), left side (41.3%) and both sides (7.3%). Amount of pleural effusion of the chest X-ray was minimum (46.8%), moderate (40.5%) and maximum (12.7%). Misclassified rates for each parameters in seperating the exudates from the transudates were as follows; protein: 5.2%, pleural protein/serum protein:7.6%, LDH: 13.9%, pleural LDH/serum LDH: 6.9%, cholesterol: 8.0%, pleural cholesterol/serum cholesterol: 5.6%. On the pleural biopsy, the tuberculosis granuloma was 60.8%, malignancy was 13.6%, infection was 2.3% and nonspecific inflammatory reaction was 23.3%. Conclusion: on the basis of the above results, the most common cause of exudative pleurisy was tuberculosis. We think that the plerual cholesterol/serum cholesterol ratio is the most useful supportive parameter in separating the exudates from the transudates. For accurate diagnosis, the pleural biopsy is the first procedure and repeated pleural biopsy of nonspedcific inflammatory reaction is required.

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Clinical Analysis of Pulmonary Hamartoma ; 29 Cases (폐과오종 29예에 대한 임상적 고찰)

  • Lee, Sang-Haak;Yoon, Hyung-Kyu;Song, So-Hyang;Lee, Sook-Young;Kim, Seok-Chan;Ahn, Joong-Hyun;Choi, Young-Mi;Kim, Chi-Hong;Kwon, Soon-Seong;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Lee, Kyo-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.644-649
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    • 2002
  • Background : Pulmonary hamartomas are the most common form of benign tumors, occurring in approximately 0.2% of routine autopsies. However, only a few reports on the clinical characteristics of pulmonary hamartoma in Korea have been published. Materials and Methods : The charts, X-rays and pathological specimens of 29 pulmonary hamartoma patients who were diagnosed by a pathological examination from 1990 to 1999 at the Catholic Medical Center were retrospectively reviewed. Results : The peak incidence of the tumor occurred in the sixth decade of life (37.5%). Seventeen patients (58.6%) were asymptomatic and 12 patients (41.4%) had symptoms. Chest discomfort was the most common symptom (31.0%). A total of 25 tumors (86.2%) were parenchymal, and 4 (13.8%) were endobronchial. Twenty cases were in the right lung and 9 cases were in the left lung (approximately 1:2.2). The RLL was the most commonly involved lobe (31.0%). Calcification was noted in 5 cases(19.2%) on a plain X-ray and in 5 cases (29.4%) on chest CT. Accompanied neoplasms were observed in 2 cases. Twenty-four hamartomas (82.8%) were diagnosed by a surgical resection and 4 cases(13.8%) were diagnosed by a fine needle aspiration biopsy. Twenty-six hamartomas (89.7%) were managed by a surgical resection. The follow up ranged from 4 to 55 months (mean, 19.6 months) and no recurrent pulmonary hamartomas were noted. Conclusion : Pulmonary hamartoma is more common in females and more commonly in the right lung. Calcification was noted only in 19.2% on a plain chest X-ray and 29.4% on a chest CT. No recurrent hamartomas had developed during the follow up period.

A Comparison of Conventional Cytology and ThinPrep Cytology of Bronchial Washing Fluid in the Diagnosis of Lung Cancer (폐암의 진단 검사 중 기관지 세척액에서 ThinPrep검사법과 기존의 세포검사법의 유용성에 대한 비교)

  • Kim, Sang-Hoon;Kim, Eun Kyung;Shi, Kyeh-Dong;Kim, Jung-Hyun;Kim, Kyung Soo;Yoo, Jeong-Hwan;Kim, Joo-Young;Kim, Gwang-Il;Ahn, Hee-Jung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.523-530
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    • 2007
  • Background: A ThinPrep$^{(R)}$ Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep$^{(R)}$ cytology using the bronchial washing fluid. Methods: The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep$^{(R)}$ and conventional cytology were performed for all specimens. Result: Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep$^{(R)}$ cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep$^{(R)}$ were 70.1% and 82.8%, respectively. Conclusion: ThinPrep$^{(R)}$ cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep$^{(R)}$ cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.

A Study on the Effect of Environmental Pollution on the Biomass Productivity of Paulownia coreana (환경오염(環境汚染)이 오동나무인공림(人工林)의 물질생산(物質生産)에 미치는 영향(影響)에 관한 연구(硏究))

  • Kim, Tae Wook;Lee, Kyong Jae;Park, In Hyeop
    • Journal of Korean Society of Forest Science
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    • v.58 no.1
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    • pp.8-16
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    • 1982
  • To study the comparison of aboveground biomass of paulownia coreana Uyeki of 6-year-old, located in Seongju of non-attacked forest and Ulsan of damaged forest by the air pollution were selected. Ten sample trees in Seongju district and seven trees in Ulsan selected taking account of DBH were measured for 16 trees in total within a $10{\times}10m$ experimental plot. The diagram of oven-dry weight distribution of stem, branch and needle for each 1m segment was constructed. The logarithmic regression equations between dry weight of each component and the two-variables, DBH and tree height, combined term were presented. IF the estimations are extended to a hectare area stand, it contains 47.49 tons of aboveground biomass in Seongju district and 19.05 tons of it in Ulsan. The annual net productions were 11.64 tons of above 2.29 kg/kg/yr in Ulsan and the efficiency of leaf to produce stem was 2.99kg/kg/yr in Seongju and 0.83kg/kg/yr in Ulsan.

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Changes in Aboveground Biomass and Nutrient Accumulation of the Korean-pine (Pinus koraiensis) Plantation by Stand Age at kangwondo Province (강원도(江原道) 지방(地方) 잣나무 인공림(人工林)의 임령변화(林齡變化)에 따른 지상부(地上部) 현존량(現存量)과 양분축적(養分蓄積))

  • Yi, Myong-Jong
    • Journal of Korean Society of Forest Science
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    • v.87 no.2
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    • pp.276-285
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    • 1998
  • The aboveground biomass and nutrient content (N, P, K, Ca and Mg) of Pinus koraiensis S. et Z., aged 9, 22, 34, 46, 66 years, were measured in the Experiment Forest of Kangwon National University of Kangwondo province. The site index of the stands ranged from 13.5 to 14.2. Allometric equations (logY=alogX+b, where Y, X is ovendry mass and DBH, respectively) relating dry weights of stem, branches and needles to diameter at breast height (DBH) were developed to estimate aboveground tree biomass. Total above ground tree biomass increased with stand age from $21.8t\;ha^{-1}$ in the 9-year-old stand to $130t\;ha^{-1}$ in the 66-Year-old stand. Aboveground biomass was allocated as follows : stem> branch > foliage, except for the 9-year-old stand which had a greater proportion of foliage biomass than branch biomass. As stand age increased, an increasing proportion of annual biomass increment was allocated to stems. The aboveground biomass of shrubs and herbs ranged from 0.4 to $3.9t\;ha^{-1}$ and from 0.05 to $0.6t\;ha^{-1}$, respectively. No relationship was found between aboveground understory biomass and stand age. The mass of woody debris and forest floor varied between 0.59 to $1.54t\;ha^{-1}$ and 6.0 to $21.63t\;ha^{-1}$, respectively. Nutrient accumulation in aboveground tree biomass increased with stand age and was in the order of N > Ca > K > P > Mg. Average rates of nutrients accumulation in biomass were greatest in the early stages of stand development, and less marked as stand aged. The nutrient concentrations in different tree components decreased in the order of needle > branch > stem. There were no detectable trends in nutrient content of the forest floor and mineral soils with stand age. Understory vegetation contributed little to the nutrient pool of these Korean pine ecosystems. Mineral soil contained the Breast proportion of nutrient capital of the various ecosystem compartments.

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Effects of Artificial Acid Rain on Seed Germination, Radicle Growth and Seedling Growth of Several Woody Species (인공산성우(人工酸性雨)가 몇 수종(樹種)의 종자발아(種子發芽), 유근생장(幼根生長) 및 묘목생장(苗木生長)에 미치는 영향(影響))

  • Kim, Gab-Tae
    • Journal of Korean Society of Forest Science
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    • v.81 no.1
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    • pp.30-39
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    • 1992
  • Artificial acid rain(pH2.0, 3.0, 4.0 and 5.0) was treated on the seeded pots of 4 species to examine its effects on germination, leaf injury and seedling growth. Aluminum ammonium sulfate solution (0.5, 1.0 and 2.5mM) and artificial acid rain (pH3.0, 4.0 and 5.0) were treated on the seeded germinators of 3 species to examine its effects on germination and radicle growth. Artificial acid rain was prepared by diluting sulfuric acid with ground water and ground water(pH6.5) was used as control. Artificial acid rain was sprayed to seeded pots three times per week. About 5mm of artificial acid rain was treated each time from early April to early October, 1991. Germination, seedling establishment, radicle growth, leaf injury and seedling growth were measured and compared among the treatments. The results were summarized as follows 1. Germination, seedling establishment rate of Pinus densiflora were highest on the pH5.0 pot whereas those of Ailanthus altissima was highest on the control pot, and those of Magnolia sieboldii showed the highest value on the pH3.0 pot. 2. The differences in seedling height of Pinus densiflora and Pinus rigida were significant among the treatment levels of acid rain, whereas those of Magnolia sieboldii and Ailanthus altissima were not significant. Seedling heights of Pinus densiflora and Pinus rigida were highest on the pH3.0 pot, and that of Magnolia sieboldii was highest on the pH4.0 pot, and that of Ailanthus altissima was highest on the control pot. 3. Seedling dry weights of Pinus densiflora. Pinus rigida, and Ailanthus altissima differed significantly among the treatments, but that of Magnolia sieboldii did not differ. Highest seedling dry weights of Magnolia sieboldii and Ailanthus altissima were observed on the pH4.0 pot, and that of Pinus densiflora was observed on the pH3.0 pot, and that of Pinus rigida was observed on the pH5.0 pot. 4. With decrease of pH value of artificial acid rain, the number of injured needle and injured individual tended to be increased. 5. The differences in effects of soil acidity were highly significant among the treatments for all species. 6. Radicle growth of Pinus densiflora differed significantly among pH levels and aluminum concentrations.

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Variation in Photosynthesis and Leaf Pigments of Susceptible Pinus densiflora and Resistant Pinus rigida Following Pine Gall Midge Attack (솔잎혹파리 침해(侵害)에 따른 감수성수종(感受性樹種)인 소나무와 저항성수종(抵抗性樹種)인 리기다소나무에 있어서 광합성(光合成) 및 엽(葉)의 색소변이(色素變異)에 관한 연구(硏究))

  • Lee, Don Koo;Sung, Joo Han
    • Journal of Korean Society of Forest Science
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    • v.65 no.1
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    • pp.1-11
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    • 1984
  • Susceptible trees of Pinus densiflora and resistant trees of Pinus rigida following pine gall midge (Tnecodiplosis japonensis Uchida et Inouye) attack were seasonally compared to examine the variation in needle growth and photosynthetic ability, respiration rate, chlorophyll contents, carotenoid and anthocyanin contents. Also, carotenoid and anthocyanin contents of larvae both from soil and from galled tissue were compared during March and September, respectively. The plantation damaged severely by this insect consisted mostly of 10-to 15-year old P. rigida and P. densiflora. The results obtained in this study were as follows: 1) The length of the infested needles of P. densiflora decreased by 48.1 percent compared with the normal needles, while that of P. rigida did 37.4 percent. 2) All of P. densiflora and P. rigida showed higher photosynthetic ability in normal needles than in infested needles. The maximum photosynthetic ability of P. densiflora was shown in mid-August, while that of P. rigida in mid-October. In contrast to that, respiration rate of infested needles was higher than that of normal needles in both species. The respiration rate of P. rigida was higher than that of P. densiflora. 3) P. rigida had higher total chlorophyll contents than P. densiflora. The total carotenoid contents tents in infested needles were higher than those in normal needles of both species. 4) Total carotenoid contents were generally higher in P. rigida than in P. densiflora during the growing season. The total carotenoid content (0.094mg/g) in larvae from soil was similar to that (0.092mg/g) in larvae from galled tissues. 5) Infested needles of both species showed higher anthocyanin contents than normal needles. Higher anthocyanin contents in galled needles were due primarily to its active formation stimulated by larval attack. Thus, reddish-brown coloration occurred only in galled needles of P. densiflora.

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The Satisfaction Survey of Users and Patients on the Developed Disposable Tourniquet (개발한 일회용 지혈대의 사용자 및 환자 만족도 조사)

  • Kim, Sang-Hyun
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.615-622
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    • 2016
  • The 18~20G needle is used to computer tomography (CT) contrast examination. Therefore, a patient has to apply a self-administering hemostasis (conventional method: CM) and often experience bleeding in the course. Thus, we developed the new disposable transparent tourniquet (TT) for reducing. This study was to compare the usefulness between the proposed transparent tourniquet and the existing hemostatic methods. A Satisfaction survey was conducted by 50 patients and 25nurses. The survey contained the satisfaction of the convenience, safety, sanitation, and wearing sensation of transparent tourniquet. We employed face-to-face interview on 5 points likert scales. And Chi-square, paired T-test were used for the statistics verification. As for the patients, the satisfaction levels were measured for each category with the gender, age. Patients evaluation, overall satisfaction high average sore used TT and there were statistical significance by paired T-test(p<0.05). The following is the average satisfaction level for each category: $4.4{\pm}0.53$ in; $4.28{\pm}0.57$ in safety; $4.52{\pm}0.54$ in sanitation; $4.16{\pm}0.54$ in wearing sensation. So the overall satisfaction level is measured at $4.34{\pm}0.51$. As for the nurses, CT work experience and the current satisfaction with tourniquet were counted as variables. The satisfaction level for each category is: $3.8{\pm}0.7$ in; $3.6{\pm}0.68$ in safety; $3.4{\pm}0.5$ in sanitation; $3.9{\pm}0.49$ in hemostasis. The overall satisfaction level is $3.8{\pm}0.3$. Patients' satisfaction levels were very high with little difference among variables. Nurses' satisfaction levels were different with the TT depending on their work experience but their overall satisfaction was high. This TT will be a starting point to minimizing patient's inconvenience and more studies are necessary to enhance their satisfaction.

The Change of Tumor Interstitial Fluid Pressure by Radiation Therapy in Patients with Metastatic Lymph Node in Head and Neck Area (방사선치료시 두경부 림파절 종양내 간질액 압력의 변화 양상)

  • Cho Moon-June;Kim Jae-Sung;Lee Intae;Kim Jun-Sang;Kim Ki-Hwan;Jang Ji-Young
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.127-132
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    • 2000
  • Purpose : To determine if the tumor intersitial fluid pressure (TIFP) and/or its change in patients with metastatic Iymph node in head and neck area can predict radiotherapy outcome. Materials and Methods : In 26 biopsy Proven metastatic Iymph node Patients in head and neck area with accessible by direct inspection and palpation, and of sufficient thickness (>1 cm) to permit accurate needle placement, we measured TIFP at cervical Iymph node before and during radiotherapy. Tumor size was measured clinically and radiologically. Results : The mean preradiotherapy TIFP was 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). Preradiotherapy TIFP significantly decreased when tumor size decreased (p=0.009). Preradiotherapy TIFP was not different between complete response group and group with partial or less response (p=0.75). Radiotherapy outcome was not different between group with above and group with below than average TIFP (p=0.229). TIFP decreased 36mmHg in complete response group and 29.7 mmHg in group with partial or less response. Conclusion :The mean TIFP was elevated with 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). TIFP decreased 36 mmHg in complete response group and 29.7 mmHg in group with partial or less respone but there was no statistically significant relationship in two groups.

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Radiotherapy of Neck Node Metastases from an Unknown Primary Cancer (원발병소 불명암의 경부림프절 전이에서 방사선치료의 역할)

  • Lee, Jeong-Eun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.219-226
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    • 2007
  • Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.