Time Course Change of Phagocytes and Proinflammatory Activities in BALF in Endotoxin-induced Acute Lung Injury (시간별 내독소 정맥주입으로 유발된 급성폐손상의 변화양상에 대한 고찰)
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- Tuberculosis and Respiratory Diseases
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- v.44 no.2
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- pp.360-378
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- 1997
Background : Severe acute lung injury(ALI), also known as the adult respiratory distress syndrome(ARDS), is a heterogenous nature of dynamic and explosive clinical synrome that exacts a mortality of approximately 50%. Endotoxin(ETX) is an abundant component of the outer membrane of gram-negative bacteria capable of inducing severe lung injury in gram-negative sepsis and gram-negative bacterial pneumonia, which are among the most common predisposing causes of ARDS. The influx of PMNs into airway tissue is a pathological hallmark of LPS-induced lung injury. And there is a substantial evidence suggesting that cytokines are important mediators of lung injury in gram-negative sepsis. However, the kinetics of phagocytes and cytokines by an exact time sequence and their respective pathogenic importance remain to be elucidated. This study was performed to investigate the role of phagocytes and proinflammatory cytokines in ETX-induced ALI through a time course of changes in the concentration of protein,
Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
This paper studies the time-space and appreciation of the performance culture of Gwanseo region, which is considered to have formed a characteristic culture in late Joseon period. For this purpose, 4 gasa written in hangeul (Korean alphabet), as well as 4 yeonhaeng gasa, 108 articles of Gwanseoakbu were examined. Plus, among the 9 types of yeonhaengrok (Documents of Performance culture) written in Chinese character, those parts which describe the performance traits have been analyzed. Then, 'main list of terminology' has been deduced based on the categorization according to the following points : 1) subjects of performance and appreciation 2) time and period of performance 3) space of performance 4) contents of performance 5) background and motive for performance and 6) method of performance. Through this process, various 'nouns' and 'predicate verbs' in relation to performance culture emerged, which were systemized according to types of performance elements and categories. Major terminology includes predicate verbs and symbolic verbs such as nokuihongsang,' 'baekdaehongjang,' 'jeolsaekgeumga,' 'cheonga,' 'hwaryu,' 'gamuja,' and 'tongsoja,' as well as the terms already known such as gisaeng, iwon, yangbang, akgong, and jeonak, which refer to musicians and dancers. Subjects of performance were divided into performers and listeners, categorized into concert, music, and dance, according to performance form. In the case for music, it was divided into instrumental or vocal, solo or accompanied (byeongju, self-accompaniment). In the case for vocal music, noteworthy was the inclusion of profesional artist's singing (called gwangdae or uchang). The record of 23 names of popular artists from Gwanseo region, with mention of special talents for each person, reflects the degree of activeness and artistic level of the province. Depending on the appreciating patrons, the audience were indicated as the terms including 'yugaek (party guest),' jwasang,' 'on jwaseok,' and 'sonnim (guests).' It seems that appraisal for a certain performance was very much affected by the tastes, views, and disposition of the appreciating patrons. Therefore it is interesting to observe different comparative reviews of concerts of different regions given by literary figures, offering various criticism on identical performance. In terms of performance space, it has been divided into natural or architectural space, doing justice to special performance sites such as a famous pavilion or an on-the-boat performance. Specific terms related to the scale and brightness of stage, as well as stage props and cast, based on descriptions of performance space were found. The performance space, including famous pavilions; Yeongwangjeong, Bubyeokru, Baeksangru, Wolparu, and Uigeomjeong, which are all well-known tourist sites of Gwanseo province, have been often visited by viceroys. governors, and envoys during a tour or trip. This, and the fact that full-scale performances were regularly held here, and that more than 15 different kinds of boats which were used for boat concert are mentioned, all confirm the general popularity of boat concerts at the time. Performance time, categorized by season or time of day (am/pm/night) and analyzed in terms of time of occurrence and duration, there were no special limitation as to when to have a performance. Most morning concerts were held as part of official duties for the envoys, after their meeting session, whereas evening concerts were more lengthy in duration, with a greater number of people in the audience. In the case of boat concert, samples include day-time concert and performances that began during the day and which lasted till later in the evening. Major terminology related to performance time and season includes descriptions of time of day (morning, evening, night) and mention of sunset, twilight, moonlight, stars, candles, and lamps. Such terms which reflect the flow of time contributed in making a concert more lively. Terminology for the contents of performance was mostly words like 'instrumental,' 'pungak,' or 'pungnyu.' Besides, contextual expressions gave hints as to whether there were dance, singing, ensemble, solo, and duets. Words for dance and singing used in Gwanseo province were almost identical to those used for gasa and jeongjae in the capital, Hanyang. However, many sentences reveal that performances of 'hangjangmu' of hongmunyeon, sword dance, and baettaragi were on a top-quality level. Moreover, chants in hanmun Chinese character and folk songs, which are characteristic for this region, show unique features of local musical performance. It is judged that understanding the purpose and background of a performance is important in grasping the foundation and continuity of local culture. Concerts were usually either related to official protocol for 'greeting,' 'sending-off,' 'reports,' and 'patrols' or for private enjoyment. The rituals for Gwanseo province characteristically features river crossing ceremony on the Daedong river, which has been closely documented by many. What is more, the Gwanseo region featured continued coming and goings of Pyeongan envoys and local officers, as well as ambassadors to and fro China, which required an organized and full-scale performance of music and dance. The method of performance varied from a large-scale, official ones, for which female entertainers and a great banquet in addition to musicians were required, to private gatherings that are more intimate. A performance may take the form of 'taking turns' or 'a competition,' reflecting the dynamic nature of the musical culture at the time. This study, which is deduction of terminology in relation to the time-space and appreciation culture of musical performances of Gwanseo region in late Joseon period, should be expanded in the future into research on 'the performance culture unique to Gwanseo region,' in relation to the financial and administrative aspects of the province, as well as everyday lifestyle. Furthermore, it could proceed to a more intensive research by a comparative study with related literary documents and pictorial data, which could serve as the foundation for understanding the use of space and stage, as well as the performance format characteristic to Korean traditional performing arts.